Hematopoietic Cell Transplant and Use of Massage for Improved Symptom Management: Results from a Pilot Randomized Control Trial

Osher Center for Integrative Medicine, University of California, San Francisco, CA 94115, USA.
Evidence-based Complementary and Alternative Medicine (Impact Factor: 1.88). 02/2012; 2012(2):450150. DOI: 10.1155/2012/450150
Source: PubMed


Background. Pediatric hematopoietic cell transplant (HCT) is a lifesaving treatment that often results in physical and psychological discomfort. An acupressure-massage intervention may improve symptom management in this setting.
Methods. This randomized controlled pilot trial compared a combined massage-acupressure intervention to usual care. Children were offered three practitioner-provided sessions per week throughout hospitalization. Parents were trained to provide additional acupressure as needed. Symptoms were assessed using nurses' reports and two questionnaires, the behavioral affective and somatic experiences scale and the Peds quality of life cancer module.
Results. We enrolled 23 children, ages 5 to 18. Children receiving the intervention reported fewer days of mucositis (Hedges' g effect size ES = 0.63), lower overall symptom burden (ES = 0.26), feeling less tired and run-down (ES = 0.86), having fewer moderate/severe symptoms of pain, nausea, and fatigue (ES = 0.62), and less pain (ES = 0.42). The intervention group showed trends toward increasing contentness/serenity (ES = +0.50) and decreasing depression (ES = −0.45), but not decreased anxiety (ES = +0.42). Differences were not statistically significant.
Discussion. Feasibility of studying massage-acupressure was established in children undergoing HCT. Larger studies are needed to test the efficacy of such interventions in reducing HCT-associated symptoms in children.

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    • "But it is in contrast to the results of Wolf et al.[23] Billhult et al. also described that massage is useful for symptom management including nausea in children with cancer.[32] Wolf et al. found combined massage — acupressure to decrease the symptoms of children with cancer, such as nausea, but that was not significant.[33] It may be a result of the small sample size (massage = 16 and usual care = 7) in their study, and if the study had been done in a larger sample size, the effect of massage might have been significant. "
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    ABSTRACT: Nausea and vomiting are the most common and unpleasant side effects of chemotherapy, and they may prevent successful treatment completion. Antiemetics not only cannot control nausea and vomiting completely but also have numerous side effects. So it is necessary to find other methods for a better control. This study aimed to assess the effect of massage therapy on chemotherapy-induced nausea and vomiting in pediatric cancer. In this randomized controlled clinical trial study, 70 patients (4-18 years of age) under chemotherapy were divided into two (massage therapy and control) groups randomly. In the massage group at 0.5 h and 24 h before and 24 h after chemotherapy, the patients were massaged (Swedish massage) for 20 min, respectively. All indices of nausea and vomiting (incidence, severity, time, and length) were assessed by Visual Analogue Scale (VAS) and BARF scales and other questionnaires and documented. The results of Mann-Whitney and chi-squire tests indicated that in the massage group, the incidence of nausea was 25.7%, the severity, length, and times of nausea were 20%, 54 min, and 0.35 times, respectively, and the severity and times of vomiting were 0.24 scores and 0.31 times lower than those of the control group (P < 0.05), respectively. But vomiting incidence in the two groups showed no significant difference (P = 0.192). Massage therapy reduced chemotherapy-induced nausea and vomiting. So, nurses can use it and educate it to the patients' families. Nurses, besides using it clinically, can provide instructions to families for involving them in the treatment process and they feel they are more efficate in care of their suffering children.
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    • "Only four studies focused on longer-term changes in patients' outcomes after the intervention [25–27,30]. The follow-up periods ranged from one week after hospital discharge [26], two to four weeks following all sessions [27] up to 6 months post transplant [25] and 1, 2 and 6 months after diagnosis [30]. Table 3 Clinical Trials Interventions toward reducing anxiety in parents with a child with malignancy. "
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    ABSTRACT: Introduction This paper reports the findings of a systematic review which evaluates the evidence from RCTs regarding the effectiveness of complementary and alternative medical interventions (CAM) in reducing anxiety in parents whose children suffer from malignancies. Method CINAHL, COCHRANE, EMBASE, PUBMED, SCOPUS and PSYCINFO electronic databases were searched, based on the following search terms: parent*, child*, anxiety, complementary, psychological, cognitive, behavioral, interventions, cancer, leukemia, lymphoma, ‘brain tumors’. Results In total 9 studies met the eligibility criteria. Six RCT's were pilot studies. Five trials targeted parents of children undergoing bone marrow transplantation, two studies targeted parents of children with various cancer diagnoses and two others targeted parents of children with leukemia. A variety of stress reduction techniques were reported. Overall, 5/9 of the studies reported the use of massage therapy. In two out of the five studies which used massage therapy on children as an intervention, massage was accompanied with relaxation/imagery in the first and in the second, parents delivered acupressure to their children. Two other studies used breathing techniques/guided imagery, another one used relaxation training and the last one used inhalation aromatherapy. Conclusions The methodological quality of reviewed RCT's studies was low and many failed to provide sufficient information in order to assess their quality on many of the methodological indicators. Although, the review did not provide strong evidence in favor of CAM interventions, the results were encouraging. The studies showed promising results and some positive trends such as the feasibility and acceptability of CAM interventions in pediatric oncology/hematology unit.
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    ABSTRACT: Acupressure is a Chinese medical technique that involves application of pressure to acupuncture points on the body. This study aimed to examine whether a four-week self-administered acupressure course could reduce depressive mood. Sixteen male and nine female college students (33.2 ± 10.0 years) who majored in acupuncture and moxibustion medicine were randomly assigned to either a self-administered acupres-sure group or a control group. The participants in the self-administered acupressure group were instructed to conduct five acupressure sessions three times a day (morning, midday, and night). Each session in-cluded applying pressure on three points on the left and right side of the neck for five seconds. The con-trols were asked to continue their daily routine. Depressive mood levels were measured at baseline, two weeks later, and following intervention. Depressive mood levels were similar between both groups at baseline. It decreased two weeks later and remained constant until the end of the intervention. Depressive mood levels were significantly lower in the self-administered acupressure group than in the control group at two weeks from baseline and after intervention. These results provide initial evidence that self-admin-istered acupressure may improve depressive mood.
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