Massage & Bodywork

SEPTEMBER | OCTOBER 2015

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F r e e S O A P n o t e s w i t h M a s s a g e B o o k f o r A B M P m e m b e r s : a b m p . u s / M a s s a g e b o o k 51 Limitations of this study include not having a consistent massage treatment protocol completed by a trained massage therapist. Even though the family members were trained in massage, it was minimal compared to that of a licensed massage therapist. Findings might have been even more improved if a trained therapist was utilized. Second, reduction in pain may have been overestimated because of the positive attention shown by the family member to the patient. Third, there was no mention of pain medication used by the patients in either group, which may have affected the pain outcomes. Finally, it is unknown if the pain reduction lasted beyond 2 hours. CONCLUSIONS Overall, the following conclusions can be made: 1. Patients in the ICU and cardiac ward who underwent cardiac surgery appeared to have a reduction in pain with massage therapy. 2. The duration and type of care that demonstrated benefits included three 15-minute hand massages by a trained research nurse, and a single 30-minute full-body massage by a trained family member. 3. Massage type, duration, and frequency will most likely affect the outcomes. Currently, the best protocol for surgical cardiac patients is not known. More research is needed. 4. Even though no adverse events were disclosed in these articles, each patient is different. Be sure you discuss any massage protocol with your client's cardiologist and health- care team prior to providing a postsurgical massage. Notes 1. US Centers for Disease Control and Prevention, "Inpatient Surgery," accessed July 2015, www.cdc.gov/nchs/fastats/inpatient-surgery.htm. 2. M. Boitor et al., "Evaluation of the Preliminary Effectiveness of Hand Massage Therapy on Postoperative Pain of Adults in the Intensive Care Unit After Cardiac Surgery: A Pilot Randomized Controlled Trial," Pain Management Nursing 16, no. 3 (June 2015): 354–66. 3. S. S. Najafi et al., "The Effect of Massage Therapy by Patients' Companions on Severity of Pain in the Patients Undergoing Post Coronary Artery Bypass Graft Surgery: A Single-Blind Randomized Clinical Trial," International Journal of Community Based Nursing and Midwifery 2, no. 3 (July 2014): 128–35. Jerrilyn Cambron, DC, PhD, MPH, LMT, is an educator at the National University of Health Sciences and president of the Massage Therapy Foundation. Contact her at jcambron@nuhs.edu. In a similar Iranian clinical trial, 74 patients who received coronary artery bypass graft (CABG) surgery were randomized to a group that received massage by a trained relative versus standard care. 3 Subjects were screened the day before surgery. They were included if they were a candidate for CABG; willing to participate in the research; 18–70 years old; hospitalized for at least three days after the operation; oriented to person, place, and time; did not use narcotics or alcoholic drinks during the last two months; had no history of nervous, neurovascular, psychiatric, or respiratory disturbances; and did not have coagulation disorders. Exclusion criteria included severe pain after cardiac surgery, reduction of level of consciousness, instability in hemodynamic status, unwilling to continue cooperation, presence of coagulation problems, and suffering from chronic pain. On the third day after the surgery, subjects were randomized to either massage or standard care control. The massage was performed by a family member who was trained for 60–90 minutes and also received an educational CD for home viewing. The research nurse taught and approved each participating family member, most of which were the patient's children (68.6 percent). The massage intervention was the Thailand classic method performed with sweet almond oil under the nurse's supervision for 30 minutes. Massage was based on the patient's tolerance and could include the back, lumbar, shoulders, arms, forearms, palm and fingers of both hands, thighs, foreleg, soles, insteps and toes, abdomen, and neck. The single intervention was performed when the patient was transferred from ICU to the cardiac surgery unit on the third day after the operation. Pain was measured using McGill's Visual Analogue Scale (VAS) with a line numbered 0–10 and was collected before the massage, as well as 30 minutes, 60 minutes, and 2 hours after the intervention. The control group received routine care and their pain rating was collected on the third day after surgery at the same time intervals. The average initial pain levels were 6.6 out of 10 in the intervention group and 7.1 in the control group. Immediately after the intervention, the respective pain levels were 3.4 and 7.1. After 30 minutes, the pain levels were 3.0 and 7.1. After 60 minutes they were 2.8 and 7.1, and after 120 minutes they were 3.3 and 7.2. All results demonstrated significant differences between the groups, with the massage group having a higher level of improvement. All of the patients in the intervention group were satisfied with massage therapy. SOMATIC RESE ARCH

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