Massage & Bodywork

NOVEMBER | DECEMBER 2019

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Systematic Reviews & Meta-Analyses Randomized Controlled Trials Cohort Studies Case-Control Studies Case Series, Case Reports Editorials, Expert Opinion Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 47 the three Western-disciplined treatments outlined the body regions addressed. The acupoints and regions most commonly identifi ed for treatment among the TCM derived studies included Xinshu (BL 15), Ganshu (BL 18), Baihui (GV 20), Kangong, Shenshu (BL 23), Sishencong (EX-HN 1), Pishu (BL 20), Zusanil (ST 36), Abdomen, Tianmen (BL 2), Taiyang (EX-HN 5), and Quchi (LI 11). The oldest of the included studies (published in 1998) was from the Western massage approach and included a standardized protocol for smooth strokes using moderate pressure along the children's neck, shoulders, and back. 11 The other two Western-derived studies were the next oldest and were published in 2003; one used Swedish, manual lymph drainage, and craniosacral approaches in an individualized protocol, 12 while the other used stroking, rocking, and stretching to address the children's head, neck, arms, torso, back, and legs. 13 The systematic review points to each of the included studies indicating some, if not all, positive outcomes for their participants, but the overall quality of the evidence was graded low due to several limiting factors, including those related to study design, participants being very different from each other, small sample sizes, and the overall low number of studies on the topic. In some cases, study authors did not report enough information, did not conduct appropriate statistical analysis, and/or did not respond when contacted to provide additional, not-included pertinent data from the original article. The older, Western-disciplined studies used the Conners' Teacher and Patient Rating Scales in addition to other measures, such as a Happy Face Scale, a fi dget score, or observed time on tasks. Outcomes for these studies included better anxious-passive and asocial scores compared to waitlist control and improved teacher-observed time on tasks compared to relaxation therapy. All of the TCM-disciplined studies in the review used the effective rate, proportion of participants with improvement after treatment, as one of or the primary outcome measure. Due to differences in measures and comparison groups, meta- analysis was only conducted on four of the TCM-based trials, each of which compared the effective rate for ADHD symptoms for those treated with massage versus Ritalin. The meta-analysis results indicated that the effective rate for those receiving massage was better (p=0.0004) compared to those taking Ritalin. The systematic review also noted that one of the studies included in the meta-analysis found TCM massage improved hyperactivity and scores on an ADHD-specifi c scale (both p<0.00001) over Ritalin. 14 It is important to note that the systematic review did not actively compare the Western-originated and TCM- originated studies, although much of my summary makes those distinctions. I part and parceled out the highlighted comparisons because I believe it improves the systematic review's usefulness from a clinical standpoint. also included) examining massage for those 18 years or younger with ADHD diagnosis using validated outcome measures assessing improvements in ADHD core symptomology, including impulsivity, inattention, and hyperactivity. The search on several English and Chinese databases identifi ed 348 unique articles with the key search terms—a majority of which (93 percent) were excluded based on their titles and abstracts because they did not meet the criteria. Of the remaining 23 articles that received a full-text review, two independent reviewers ultimately extracted data from 11 studies—eight of which were included in meta-analysis. Included studies fell into two categories: those in which interventions were standardized (n=5) and those in which interventions were individualized (n=6). Included studies could be further categorized by those coming from a Western approach (n=3) and those administered from a traditional Chinese medicine (TCM) approach (n=8). The three studies encompassing a Western approach to massage therapy came from the United States (n=2) and Canada (n=1). It is interesting to note that while Sweden is considered a Western country, one of the TCM studies originated in Sweden and was published in Chinese. Treatment applications ranged from one per day to two per week, and most sessions were 20–30 minutes long. Treatments applied from the TCM discipline described particular acupoints used during their treatment (listed in the review's intervention details table), but only two of SOMATIC RESE ARCH

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