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44 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 9 education SOMATIC RESEARCH Massage Therapy for ADHD A Systematic Review of Its Impact on Pediatric Treatment By Niki Munk, PhD A recent systematic review focusing on the use of massage therapy for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and young people examined the question: What is the impact of massage therapy on ADHD treatment for children and adolescents? This systematic review and meta-analysis is important because it does not include language criteria (which expands the number of studies included); it provides an updated overview of the evidence with reflection on the evidence strength; it demonstrates excellent reporting and information synthesis; and it highlights the need for more research in this area. ADHD: A BRIEF OVERVIEW ADHD is a neurodevelopmental disorder with three types of presentation: predominately inattentive, predominately hyperactive-impulsive, or a combination presentation in which both types are equally present. 1 ADHD is not exclusively a childhood disorder, although most of the ADHD-related attention does tend to be on young people. While often beginning in a person's early age, the condition and impactful symptomology can span an individual's life course. 2 ADHD-focused consideration and research tends to focus on children and adolescents; however, the continuation or exacerbation of symptoms carried over into adulthood accompany an increased risk for other comorbid conditions, including anxiety, substance dependency/abuse, bipolar disorder, and high under-attainment rates for education and occupational security. 3 Due to the magnified negative outcomes of ineffectively treated or managed ADHD symptomology for emerging or established adults, the impact of ADHD treatment in youth should be considered across the life-course trajectory. The cause of ADHD is not currently known; however, research suggests that a combination of and/or interaction between genetic, environmental, and non-genetic factors may be influential, including substance use during pregnancy, environmental toxin exposure, brain injuries, and low birth weights. 4 Over 6 million (9.4 percent) young people from age 2–17 have had a diagnosis for ADHD within their lifetimes in the United States. 5 Treatment approaches for ADHD include pharmacological interventions (e.g., stimulants or antidepressants) in addition to behavioral therapy and social skills training. 6 Integrative approaches, such as diet modification, exercise, or therapeutic massage, seek to provide assistance with troublesome ADHD symptomology without pharmacological burden. SYSTEMATIC REVIEW AND META-ANALYSIS: THE PROCESS AND WHAT'S INVOLVED A systematic review is a summation and reflection on the available research that meets a specific inclusion criteria. Systematic reviews are conducted in an effort to synthesize what is known about a specified topic and consider the findings of similar studies on said topic in relation to each other. Systematic reviews also allow for the consideration of research merit and quality in relation to outcomes for a given cohort of research studies addressing a particular research question. The systematic approach and analysis methodology that examines the combined and similar data extracted from published studies included in a systematic review

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