Massage therapy for people with HIV/AIDS
ABSTRACT Infection with human immunodeficency virus (HIV) and acquired immunodeficency syndrome (AIDS) is a pandemic that has affected millions of people globally. Although major research and clinical initiatives are addressing prevention and cure strategies, issues of quality of life for survivors have received less attention. Massage therapy is proposed to have a positive effect on quality of life and may also have a positive effect on immune function through stress mediation.
The objective of this systematic review was to examine the safety and effectiveness of massage therapy on quality of life, pain and immune system parameters in people living with HIV/AIDS.
A comprehensive search strategy was devised incorporating appropriate terms for HIV/AIDS, randomised controlled trials (RCTs), massage therapy and the pertinent measures of benefit. All electronic databases identified were searched in November 2008, including Cochrane Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, SCIENCE CITATION INDEX, AIDSLINE, AIDSearch, CINAHL, HEALTHSTAR, PsycLIT, AMED, Current Contents, AMI, NLM GATEWAY, LILACS, IndMed, SOCIOFILE, SCI, SSCI, ERIC and DAI. We also reviewed relevant published and unpublished conference abstracts and proceedings and scrutinised reference lists from pertinent journals. There were no language or date restrictions.
Studies were identified by two reviewers based on trial design (RCTs) and participants (ie, people of any age with HIV/AIDS, at any stage of the disease) who had undergone an intervention that included massage therapy for the identified aims of improving quality of life and activity and participation levels, improving immune function, reducing pain and improving other physiological or psychological impairments.
Two reviewers independently identified included studies and extracted relevant data. Two other reviewers independently reviewed the included studies for risk of bias. All data and risk of bias judgements were entered into Revman (v5) and meta-analyses were conducted where appropriate.
Twelve papers were identified, from which four were included. The remaining eight papers were excluded predominantly due to inappropriate methodology. The four included studies were highly clinically heterogenous, investigating a range of age groups (ie, children, adolescents and adults) across the disease spectrum from early HIV through late-stage AIDS. The settings were either community or palliative care, and the outcome measures were a combination of quality of life and immunological function. The trials were judged to be at moderate risk of bias mostly because of incomplete reporting. For quality of life measures, the studies reported that massage therapy in combination with other modalities, such as meditation and stress reduction, are superior to massage therapy alone or to the other modalities alone. The quality of life domains with significant effect sizes included self-reported reduced use of health care resources, improvement in self-perceived spiritual quality of life and improvement in total quality of life scores. One study also reported positive changes in immune function, in particular CD4+ cell count and natural killer cell counts, due to massage therapy, and one study reported no difference between people given massage therapy and controls in immune parameters. Adverse or harmful effects were not well reported.
There is some evidence to support the use of massage therapy to improve quality of life for people living with HIV/AIDS (PLWHA), particularly in combination with other stress-management modalities, and that massage therapy may have a positive effect on immunological function. The trials are small, however, and at moderate risk of bias. Further studies are needed using larger sample sizes and rigorous design/reporting before massage therapy can be strongly recommended for PLWHA.
- SourceAvailable from: Ava Lorenc
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- "In fact, patients were likely to use conventional parameters such as CD4-counts to make their decisions . There is some evidence that CT can benefit PLWHA, namely exercise , stress-management   and massage . This case study provides a description of an NW London community multi-agency service and explores its impact, in particular the CT provision, for both staff and clients. "
ABSTRACT: To present a case study of complementary therapy (CT) provision within a community HIV multi-agency service in a Northwest London deprived area. Anonymised routine service data were provided for all clients (n = 1030) August 2010 to October 2012. Face-to-face meetings provided feedback from volunteers (9 CT-using clients and 9 staff). CT-users were demographically similar to other clients. Support for coping with HIV was commonly cited as a service benefit. Over 26 months 1416 CT sessions were provided; 875 aromatherapy and 471 shiatsu. CT-users' most common concerns were pain (48%), stress (15%) and insomnia (13%), few had heard of or used CT before. Perceived mental and emotional benefits included relaxation,stress relief, relieving musculoskeletal aches and pains. Service challenges included time and funding, though staff felt CT may be cost-effective. CT may provide important support and treatment options for HIV disease, but cost effectiveness requires further evaluation.Complementary therapies in clinical practice 02/2014; 20(1):65-9. DOI:10.1016/j.ctcp.2013.10.003
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ABSTRACT: ENGLISH ABSTRACT: Background Albeit Virtual Reality (VR) has been shown to be a useful adjunct in the reduction of pain during burn care and therapy, the current VR systems are expensive and may not be economically feasible for developing countries such as South Africa, where health budgets are stringent. Objective The purpose of this study was to ascertain the effect of a lowcost VR system (eMagin Z800 3DVisor), used in conjunction with pharmacologic analgesics, on reducing pain and anxiety in adult burn injury patients undergoing physiotherapy treatment, compared to pharmacologic analgesics alone at a South African hospital. Study design Single-blinded, within-subject study design. Methods Pain and anxiety outcome measures were measured by a blinded assessor using the Numeric Pain Rating Scale and Burn Specific Pain and Anxiety Scale. Descriptive statistics, Chi-square tests as well as the Student’s paired t-test were used to analyze data. Main findings Eleven eligible adult burn injury patients consented to participate in this study (3 female, 8 male; median age 33 years: range 23-54 years). A marginal (p=0.06) to insignificant (p=0.13) difference between the two conditions (analgesics with VR and analgesics alone) in reducing pain was found. No significant difference (p=0.58) was found between the two conditions (analgesics with VR and analgesics alone) for anxiety. Interpretation There is a trend that a low-cost VR system, when added to routine pharmacologic analgesics, is an economically feasible and safe adjunct therapy and could be of considerable benefit if implemented into the current pain management regimen of burn injury patients at a South African Hospital. AFRIKAANSE OPSOMMING: Agtergrond Ofskoon dit al bewys is dat Virtuele Realiteit (VR) ’n nuttige hulpmiddel is om pyn tydens die versorging en behandeling van brandslagoffers te verlig, is die huidige VR stelsels duur en dalk nie uitvoerbaar in ontwikkelende lande soos Suid-Afrika waar die gesondheidsbegrotings beperk is nie. Doel Om die uitwerking te bepaal van ’n laekoste VR stelsel (eMagin Z800 3DVisor) op die vermindering van pyn en angs by volwasse pasiënte met brandwonde wat fisioterapeutiese behandeling in ’n Suid-Afrikaanse hospitaal ondergaan. Studieplan ’n Enkel-blinde, binnesubjek-ontwerp. Metodes Volwasse proefpersone is opeenvolgend gewerf by die brandeenheid van die Tygerberg-hospitaal. Die laekoste VR stelsel, tesame met pynstillers, is ewekansig aan een helfte van die pasiënte in’n fisioterapeutiese behandelingsessie toegewys en die proefpersone is slegs een keer getoets. Die pyn en angs se resultaatmetings is deur ’n blinde meting gedoen deur die numeriese pynskattingskaal en die brandspesifieke pyn- en angsskaal te gebruik. Beskrywende statistieke, Chi-kwadraat-toetse en studente se gepaarde t-toets is gebruik om die data te analiseer. Bevindings Elf geskikte volwasse pasiënte met brandwonde het ingestem om aan die studie deel te neem, drie was vroulik en agt was manlik (mediaan-ouderdom 33; reeks 23-54). ’n Marginale (p=0.06) tot onbeduidende verskil (p=0.13) is gevind tussen die twee kondisies om pyn te verlig (met of sonder die toediening van VR). Wat angs betref, is geen beduidende verskille (p=0.58) tussen die twee kondisies (met of sonder die toediening van VR) gevind nie. Interpretasie Daar is ’n neiging dat ’n laekoste VR-stelsel, wanneer dit saam met die gewone farmakologiese pynstillers gebruik word, ’n veilige en ekonomiese praktiese adjunk therapie is en beduidend voordelig kan wees wanneer dit geïmplementeer word as deel van die huidige pynbeheerregimen van brandslagofferpasiënte by ’n Suid-Afrikaanse hospitaal. A thesis presented in partial fulfillment of the requirements for the degree of M.Sc. in Physiotherapy at the Stellenbosch University MSc Physio Embargo lift date 2009-11-23 PLT 2010
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ABSTRACT: Physiotherapy is concerned with identifying and maximizing movement potential, within the spheres of promotion, prevention, treatment and rehabilitation. Physical therapists practice in a broad range of inpatient, outpatient, and community-based settings such as hospice and palliative care centers where as part of a multidisciplinary team of care, they address the physical and functional dimensions of the patients' suffering. Physiotherapy treatment methods like therapeutic exercise, electrical modalities, thermal modalities, actinotherapy, mechanical modalities, manual physical therapy and assistive devices are useful for a range of life-threatening and life-limiting conditions like cancer and cancer-associated conditions; HIV; neurodegenerative disorders like amyotrophic lateral sclerosis, multiple sclerosis; respiratory disorders like idiopathic pulmonary fibrosis; and altered mental states. The professional armamentarium is still expanding with inclusion of other miscellaneous techniques which were also proven to be effective in improving quality of life in these patients. Considering the scope of physiotherapy in India, and in palliative care, professionals in a multidisciplinary palliative care team need to understand and mutually involve toward policy changes to successfully implement physical therapeutic palliative care delivery.Indian Journal of Palliative Care 09/2010; 16(3):138-46. DOI:10.4103/0973-1075.73670