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Comparison of Physical Therapy with Energy Healing for Improving Range of Motion in Subjects with Restricted Shoulder Mobility

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Two forms of energy healing, Reconnective Healing (RH) and Reiki, which involve light or no touch, were tested for efficacy against physical therapy (PT) for increasing limited range of motion (ROM) of arm elevation in the scapular plane. Participants were assigned to one of 5 groups: PT, Reiki, RH, Sham Healing, or no treatment. Except for no treatment, participants were blinded as to grouping. Range of Motion, self-reported pain, and heart rate variability (HRV) were assessed before and after a 10-minute session. On average, for PT, Reiki, RH, Sham Healing, and no treatment, respectively, ROM increased by 12°, 20°, 26°, 0.6°, and 3° and pain score decreased by 11.5%, 10.1%, 23.9%, 15.4%, and 0%. Physical therapy, Reiki, and RH were more effective than Sham Healing for increasing ROM (PT: , ; Reiki: , ; RH: , ). It is possible that this improvement was not mediated by myofascial release because the subjects’ HRV did not change, suggesting no significant increase in vagal activity. Sham treatment significantly reduced pain compared to no treatment (, ) and was just as effective as PT, Reiki, and RH. It is the authors’ opinion that the accompanying pain relief is a placebo effect.
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Evidence-Based Complementary and Alternative Medicine
Volume , Article ID , pages
http://dx.doi.org/.//
Research Article
Comparison of Physical Therapy with Energy
Healing for Improving Range of Motion in Subjects
with Restricted Shoulder Mobility
Ann Linda Baldwin,1,2 Kirstin Fullmer,2and Gary E. Schwartz1
1Laboratory for the Advances in Consciousness and Health, Department of Psychology, University of Arizona,
Tucson, AZ 85721-0068, USA
2Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ 85724-5051, USA
Correspondence should be addressed to Ann Linda Baldwin; abaldwin@u.arizona.edu
Received  June ; Accepted  October 
Academic Editor: Kevin Chen
Copyright ©  Ann Linda Baldwin et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Two forms of energy healing, Reconnective Healing (RH) and Reiki, which involve light or no touch, were tested for ecacy
against physical therapy (PT) for increasing limited range of motion (ROM) of arm elevation in the scapular plane. Participants
wereassignedtooneofgroups:PT,Reiki,RH,ShamHealing,ornotreatment.Exceptfornotreatment,participantswereblinded
as to grouping. Range of Motion, self-reported pain, and heart rate variability (HRV) were assessed before and aer a -minute
session. On average, for PT, Reiki, RH, Sham Healing, and no treatment, respectively, ROM increased by ,
,
, .,and
and pain score decreased by .%, .%, .%, .%, and %. Physical therapy, Reiki, and RH were more eective than Sham
Healing for increasing ROM (PT: 𝐹 = 8.05,𝑃 = 0.008;Reiki:𝐹 = 10.48,𝑃 = 0.003 ;RH:𝐹 = 30.19,𝑃 < 0.001). It is possible
that this improvement was not mediated by myofascial release because the subjects’ HRV did not change, suggesting no signicant
increase in vagal activity. Sham treatment signicantly reduced pain compared to no treatment (𝐹 = 8.4,𝑃 = 0.007)andwasjust
as eective as PT, Reiki, and RH. It is the authors’ opinion that the accompanying pain relief is a placebo eect.
1. Introduction
Shoulder pain is a common musculoskeletal symptom,
accounting for % of all musculoskeletal complaints [].
Lifetime prevalence of shoulder pain has been reported to
range from % to % of the population []. e precise
causes of shoulder pain within the joint are unknown, but
the nongenetic variants are thought to result from joint intra-
articular degeneration (osteoarthritis), structural damage
(torn rotator cu and/or ligaments), infection or inamma-
tion (bursitis and tendinitis), or arthritis []. Rotator cu
pathology and subacromial impingement are among the most
common diagnoses pertaining to shoulders [,].
Apart from pain, shoulder damage or degeneration oen
leads to limited ROM of the shoulder. Chronic so tissue
disorders, such as tendinitis, bursitis, rotator cu tears, and
impingement syndrome, may result in secondary adhesive
capsulitis. It is the adhesions that limit ROM []. Physical
therapy is usually the rst choice of treatment for these
problems []. Physical therapy encompasses many types of
interventions including manual manipulation, therapeutic
exercise, functional training, and electrotherapeutic modal-
ities. However, it is the manual manipulation that requires
the most sustained physical eort by the therapist. In a
study addressing job strain in physical therapists [], % of
the  physical therapists interviewed experienced a work-
relatedacheorpainduringtheyearpriortothefollow-
upsurvey.emostcommonregionwasthelowback,
followed by the wrist and hand. In another investigation
[], % of  physical therapists who returned completed
questionnaires indicated that they were treating or handling
a patient when they rst experienced lower back pain on
thejob.Whenaskedtoselectthemechanismofinjury,%
of the respondents selected “liing with sudden maximal
Evidence-Based Complementary and Alternative Medicine
eort”and%chose“bendingandtwisting.”Overhalfof
these therapists reported recurrent episodes. Since manual
manipulation may cause recurrent pain for the therapists it
would be advantageous to limit its use to cases in which it is
strictly necessary in order to promote a patients recovery.
e purpose of this research was to determine whether
manual manipulation is necessary for success in short-term
treatment of limited ROM of arm elevation in the scapular
plane. Other therapies, such as Reiki and Reconnective
Healing, that do not involve physical eort were compared
with PT for eectiveness in improving ROM. e 
National Health Interview Survey, compiled by Barnes et al.,
[] indicated that . million adults and , children in
the United States received one or more sessions of energy
healing, such as Reiki, during the previous year. According
totheAmericanHospitalAssociation,[]%ofAmerican
hospitals (more than  facilities) oered Reiki as a hospital
service in . A joint publication by the American Holistic
Nurses Association and American Nurses Association []
lists Reiki as an accepted form of treatment.
Reikiisadministeredbythehands,placedlightlyonor
near the body of the recipient. e Reiki practitioner focuses
his attention on the recipient and then allows the energy
to ow passively through their body and hands where it is
passed to the recipient. ese procedures are described by
variousUsuiReikitrainingmanualsandReikiwebsites,such
as http://www.reiki.org/FAQ/Questions&Answers.html;
http://www.reiki.org/reikipractice/practicehomepage.html
Intention.
Practitioners who learn Usui Reiki receive similar train-
ing and specic objectives are laid out for each one of
the three levels (e.g., see http://www.reiki.org/Download/
FreeDownloads.html).
Peer-reviewed research demonstrates that recipients of
Reiki experience feelings of relaxation, mental clarity, pain
relief, decreased anxiety, and a sense of wellbeing. ese
studies are described in several reviews []. Physiolog-
ical signs of relaxation in recipients include increases in
their parasympathetic autonomic nervous system activity [,
]. ere are currently no studies published in peer-
reviewed journals addressing the eects of Reiki on ROM.
Reconnective healers work with their hands to sense and
manipulate what they term as bioelds, which are energy
elds that surround living beings []. Reconnective Healing
is said to involve tuning into the healing energy frequencies
needed by each recipient and receiving and sensing the
energy. Unlike Reiki, there is no specic “centering” or
grounding” process involved in which practitioners focus
on the present moment through concentrating on their
breathing. All Reconnective healers receive training from
instructors who have followed a prescribed syllabus which
isthesameworldwide,andsotheprocedureisrepro-
ducible among healers (see http://www.thereconnection
.com/programs/reconnective-healing-level -i-ii/).
People receiving Reconnective Healing anecdotally
report a range of sensations including warmth, tingling, cold,
and throbbing and physiological responses such as rapid
eye movements, deepening breath, stomach gurgling, and
muscle twitching. However, there are no published studies
addressing the eectiveness of RH in reducing pain. Overall,
none of the energy healing modalities have been tested for
ecacy on people with limited ROM.
In this study, manual manipulation (joint mobilization,
long axis distraction, and gentle rebounding) was tested
against RH and Reiki in patients with limited ROM. ese
energy healing therapies only involve light touch or no touch
and so if they are as eective as manual manipulation in
improving ROM, this would imply that manual manipula-
tion, per se, is not necessary for alleviating this particular
impairment.
Another objective was to assess self-reported pain and
heart rate variability (HRV) as secondary outcome variables,
before and aer each type of treatment; HRV is a measure
of sympathovagal balance which may provide some insight
into possible mechanisms of pain relief because it is known
that stimulation of the vagus nerve can reduce pain []. Such
stimulation can occur directly through myofascial release
[] and there is some evidence that it can be mediated
indirectly by application of Reiki [,].
2. Methods
2.1. Recruitment and Consenting of Participants. is investi-
gation was approved by the University Institutional Human
Subjects Protection Committee. People with limited range of
motion of one or both shoulders were recruited for the study
by providing iers to local chiropractors, physical therapists,
masseurs, and tness coaches, by posting the ier at various
locations of the university campus such as Campus Health
Service, Family and Community Medicine, Student Recre-
ation Center, Libraries, Arthritis Center, Athletics Depart-
ments, and Center for Integrative Medicine and by running
a radio advertisement on National Public Radio. e iers
were deliberately posted in a wide variety of locations in order
to attract potential participants who were representative of
the population at large rather than just individuals looking
for nontraditional therapies. Investigators’ conversations with
the potential participants during the enrollment process con-
rmed that most potential participants were fairly traditional
in their medical choices.
Potential participants were rst screened by telephone
to determine whether they met the following inclusion and
exclusion criteria:
() at least  years of age;
() self-ambulatory (no assistive devices);
() having had a nongenetic ROM limitation for at
least one year and having some form of medical
documentation of the problem;
() ROM limitation being the result of injury (sports
related or otherwise), surgery, arthritis, or adhesive
capsulitis;
() having had no experience of energy healing (Reiki or
Reconnective Healing), including sessions, seminars,
or reading “e Reconnection” by Dr. Pearl [];
() if female, must not be pregnant.
Evidence-Based Complementary and Alternative Medicine
T : Medical diagnoses of experimental participants.
Number of patients SLAP tear Torn RC Arthritis Impingement Bone spur Injury Capsulitis Bursitis Unknown X-ray/MRI
    ∗∗  
One case was in combination with torn rotator cu.
∗∗Both cases were in combination with torn rotator cu.
SLAP: superior labrum, anterior to posterior.
ose who met all the criteria were interviewed at the
university and tested to determine whether the ROM of at
least one of their arms was limited to somewhere between
below the horizontal plane and above the horizontal
plane.Peoplewhowerequaliedwereconsentedforthestudy
aer the experimental protocols; risks and benets had been
explained. During the consenting process, participants lled
out a demographics questionnaire, consisting of birthplace,
ethnicity, age, height, and weight. ey also provided the
following information regarding their specic shoulder prob-
lem:
() reason for ROM limitation and whether diagnosed by
a physician;
() length of time they have had limited ROM;
() whether le, right, or both arms are aected;
() types of health-based practitioners the person had
previously visited for this problem, such as medical
doctor (MD), chiropractor (DC), osteopath (DO),
physical therapist (PT), naturopath (ND), acupunc-
turist (LAc), and massage therapist;
() whether or not the problem was diagnosed as a result
of MRI scanning or radiographs;
() whether the subject had surgery to attempt to alleviate
theproblem,andifso,thetypeofsurgery.Was
internal xation inserted? Did surgery make the
problem better/worse/or cause no change?
() Whether a prior surgery caused the problem.
2.2. Group Assignment. Apoweranalysisat%power
was performed to nd the number of subjects necessary
to detect a signicant dierence between groups of for
arm elevation in the scapular plane, based on the previously
observed variance. From this test, a group size of  was
chosen for the study. e value of was chosen because
the focus of this study was to determine whether energy
healing produced large improvements in ROM. e study was
conducted in the following way: six experimental sessions,
involving – participants, were held at a local hotel, easily
accessible by participants and therapists. e six sessions
were carried out in the following order: (i) Reconnective
Healing, (ii) Reiki, (iii) Sham Healing, (iv) physical therapy,
(v) control, and (vi) RH plus PT. Due to logistics, recruitment
was performed in two phases. In the rst phase subjects were
recruitedfortheRH,Reiki,andShamHealinggroups,and
in the second phase they were recruited for the RH, PT, and
control groups. In both cases participants were assigned to
90 subjects
were
consented
81 subjects
were available
on study day
78 subjects
still fullled ROM
inclusion criteria on
study day
F : Flow chart of subject participation.
one of three groups on a rotating basis according to order of
recruitment.
2.3. Demographics of Experimental Participants. Aowchart
of the retention of  recruited subjects is shown in Figure .
Of the  participating subjects,  were males and 
were females. All subjects were Caucasian, except for seven
Hispanic, two Asian, and one “other.” e participants’ ages
ranged from  to  and the mean age for each group was
61.3 ± 53.2 (SD) (control), 58.5 ± 59.4 (Sham), 64.4 ± 56.6
(PT), 66.4 ±58.3 (Reiki), and 59.8 ±52.2 (RH). e dierence
in mean age between groups was not statistically signicant
(ANOVA analysis of variance). e corresponding gender
ratios for each group (male to female) were ., ., .,
., and ..
2.4. Medical History and Diagnosis of Experimental Partici-
pants. e diagnoses of the participants relevant to restricted
shoulder mobility are shown in Table . In most cases (/)
the diagnoses were made using radiographs and/or magnetic
resonance imaging. e frequency of the dierent diagnoses
was fairly uniform between groups (see Table ). Nineteen
of the participants had experienced their condition for less
than two years,  for between two and ve years, and 
formorethanveyears.Sixteenoftheparticipantshad
experienced shoulder surgery, between one and  years
previously, in an attempt to improve their range of motion
and/or reduce pain. e surgery had been partially successful
for a short time in ve cases and unsuccessful in the others.
Each experimental group included some participants who
had had surgery (Table ).
2.5. Selection of erapists. ree therapists were selected for
each arm of the study, except for the no-treatment control
group. Each therapist would work on one-third of the par-
ticipants in their group. e Reconnective healers ( males, 
female) were experienced instructors from e Reconnection
LLC Teaching Team, who train students worldwide. e
Reiki practitioners ( male,  females) were local, had been
practicing Usui Reiki professionally for a minimum of 
years, were  generations removed from the founder, Mikao
Evidence-Based Complementary and Alternative Medicine
T : Group distributions of medical diagnoses and surgeries.
Diagnosis/surgery Number of C ont rol
groups
Number of Sham
groups
Number of PT
groups
Number of Reiki
groups
Number of RH
groups
SLAP 
Torn RC 
Arthritis 
Impingement 
Bone spur   
Injury 
Capsulitis 
Bursitis   
Unknown 
Shoulder surgery 
Usui, and had received the highest level of Reiki training.
e licensed physical therapists ( females) were local and
didnotincludeenergyworkintheirrepertoire.Allhad
practiced PT for over  years, had their own practices, and
were experienced in treating complex medical and physical
conditions in a range of traditional PT settings. ree people
( male,  females) who had absolutely no experience with any
formofenergyhealingwerechosentobeshamhealers.
2.6. Instructions to erapists. All practitioners were
instructednottodisclosewhattypeoftherapytheywould
provide because the participants did not know what kind of
treatment they were getting.
Reconnective healers used mainly hands-o treatment.
Reiki practitioners focused their healing intention on increas-
ing the participant’s ROM and used mainly hands-on treat-
ment for each participant. Physical therapists were asked to
give their normal basic manipulation of the shoulder joints
and surrounding deep tissue. e physical therapists chose
to provide gentle passive ROM and simple glenohumeral
joint mobilizations (inferior glides) in attempt to increase
shoulder abduction and exion. Long axis distraction was
applied to the glenohumeral joint, as was gentle rebounding.
Sham healers were asked to wave their hands slowly over
the participant’s shoulder area and upper body, – inches
away from their body, and to occasionally draw their hands
back away from them, similar to the actions of Reconnective
Healers.
All therapists were told that the participants had ROM
limitations resulting from shoulder injuries or arthritis but
were not told any details about the specic problems of
individual participants or which shoulder was most aected.
Each practitioner worked with  participants, one aer
the other, and then had a -minute rest before working
with the next  participants. During the practitioner rest
breaks, the participants went to another room for pre-or post
measurement of their ROM and HRV.
2.7. Experimental Procedure. On arrival, participants were
informed by a student that they would be receiving a
treatment, which may be energy healing, Sham Healing,
or PT, or no treatment at all, to assess how this aects
their range of motion. e student was blinded as to the
type of therapy each participant would receive except for
those in the no-treatment control group. e participants
were similarly blinded. Each participant lled out a visual
analog scale (VAS) expectancy survey, asking whether they
expected the treatment to work. ey were then shown a
video explaining how their ROM would be measured before
andaertreatment.Briey,theywouldbeaskedtostand
close in front of a wall, without touching it, with their arms at
theirsides.eywouldthenbevideo-recordedastheymoved
their arms out to the sides and then up towards their head,
in a scapular plane (i.e., not bringing their arms forward)
as far as they could go, while keeping their arms straight,
soasnottoinvolvetheelbowjointintheexercise,once
with palms facing up and once with palms facing down. One
reason ROM was measured by video analysis rather than
using a goniometer is that it is noninvasive. A goniometer is
positioned on the subjects, scapular spine as they hold their
full ROM, which can be painful. In addition, since we were
looking for large improvements in ROM, there was no need
for the .accuracy of the goniometer.
Aer watching the video, each participant performed the
exercise and then lled out a VAS pain assessment reecting
the maximum pain they felt when moving their arms. Next,
each participant was seated for measurement of HRV. It is
generally recognized that respiration has an important eect
on HRV and so respiration was also measured in this study.
A strap was snugly placed around their chest to measure
respiration rate, and a pulse sensor was connected to the mid-
dle nger of their le hand to measure pulse rate (interbeat
interval) for calculation of HRV. e strap and sensor were
connected to a computer via a BioGraph Inniti ProComp
module (ought Technology Ltd., Montreal, Canada) to
enable data recording. Each participant was asked to relax,
keep still, and not speak for ve minutes while data were
recorded.
Next, each participant was taken to the treatment room
to meet the therapist or to lie supine on a massage table for
 minutes if they were in the no-treatment control group.
In this case, since no therapist was present, a student sat
Evidence-Based Complementary and Alternative Medicine
quietly in the same room as the participant and then told
them when the  minutes was up and directed them back to
the measurement room. If a therapist was present, he asked
the participants to show how high they could raise their arms
in a scapular plane out to the sides and towards their head,
keeping their arms straight and palms down, and took a
photoofthemshowingtheirmaximalROMwithacamera
thatwasprovidedinthetreatmentroom.enheaskedthe
subjects to lie supine on the massage table for the treatment.
Aer the therapist had completed the treatment he asked
the participants to stand and demonstrate their ROM, palms
down as before, and took another photo. ese photos were
later compared with the videos taken in the measurement
room to check for reproducibility of pre-and postmeasures.
e participant was then guided to the measurement room
to reassess his ROM, pain evaluation, and HRV.
2.8. Outcome Measures. e primary outcome variable was
pre-and postmeasurement of ROM of arm elevation in the
scapular plane. e video measure of ROM was highly
reproducible. Corresponding measures for a given person
taken in the measurement and treatment rooms only diered
by an average of . Secondary outcome variables were (i)
expectancy, pretreatment, that the treatment would work,
(ii) self-reported pain level during elevation, and (iii) HRV.
PainandHRVwereevaluatedpre-andposttreatmentorno
treatment. All data were coded to conceal the identity of each
subject and their experimental group from the data analyzer,
thus minimizing, and hopefully preventing, eects of possible
researcher bias.
2.8.1. Range of Motion. e video recordings were used to
obtain an image of each participant’s maximal ROM pre- and
posttreatment. From each image the angle of elevation of each
arm (as depicted by the straight line connecting the wrist to
the mid-point of attachment of the shoulder to the trunk)
couldbemeasuredaboveorbelowthehorizontal(humeral
angle). A depiction of this measurement is shown in Figure .
Angles above the horizontal were positive from to ,
and those below the horizontal were negative. Four angles
were obtained for each pre- and postmeasure: le arm palms
up,learmpalmsdown,rightarmpalmsup,andrightarm
palms down.
2.8.2. Secondary Outcomes
(i) Expectancy that the treatment would work was
assessed with a  mm VAS before the subject
entered the treatment room. Each subject was asked
to mark a vertical line on the VAS to indicate
expectancy. No expectancy at all was represented by
 mm and denite expectancy by  mm.
(ii) Pain severity was assessed with a  mm VAS. Each
subject was asked to mark a vertical line on the
VAStoindicateperceivedlevelofpain.Nopainwas
represented by mm and extreme pain by  mm.
Apreviousstudy[] performed on patients treated
for rotator cu disease indicated that the minimal
F : Depiction of humeral angle as a measure of range of
motion. Angles above the horizontal are positive from to ,and
thosebelowarenegative.
clinically important dierence (MCID) for VAS mea-
suring pain is  mm.
(iii) Interbeat interval (heart rate) data, measured over
a period of  minutes pre- and posttreatment, were
exported as a text le from the BioGraph Inniti
Physiology Suite soware into a freeware HRV pro-
gram, http://kubios.uef./.isprogramanalyzesthe
data to quantify the variability in heart rate that
exists in a given recording in terms of established
measures. Time domain parameters include the stan-
dard deviation of the interbeat interval (IBI), SDRR,
which provides a gross measure of HRV, and the
root mean square of successive dierences in IBI
(RMSSD), which reects the parasympathetic activity
of the autonomic nervous system.
2.9. Statistics. Four-way Repeated Measures Analysis of Vari-
ance (ANOVA) was run for ROM to test for signicant
dierences among the  groups for the treatment eect, pre
versus post, palms down or up and le arm or right arm.
If the dierence was signicant, ANOVA was then repeated
pairwise. Similar tests were run for pain scores, HR, and HRV.
STATISTICA for Windows soware was used for the analysis.
3. Results
3.1. Expectation. ere was no signicant dierence between
the average self-reported expectation levels of the  groups
(𝐹 = 0.25, 𝑃 = 0.9). e mean expectation values were as
follows: control: .; Sham: .; PT: .; Reiki: .; and
RH: ..
3.2. Range of Motion. Most of the patients who received
PT, Reiki, or Reconnective Healing showed improved ROM.
Relativenumbersofsubjectsineachgroupshowingimprove-
mentwereasfollows:PT:/;Reiki:/;andRH:
/. Although it appears that the Reiki group started the
study with a lower range of motion than the other groups,
this dierence was not statistically signicant. ere was
no signicant dierence between the pretreatment ROM
measures of the  groups (ANOVA analysis of variance, 𝐹=
Evidence-Based Complementary and Alternative Medicine
T : Mean pre- and post-ROM averaged over palms up and
down and le and right arms.
Group
Mean ROM
Pre ±SD
(degrees)
Mean ROM
Post ±SD
(degrees)
Dierence
(Post pre) 𝑁
Control . ±. . ±. . 
Sham . ±. . ±. .
PT . ±. . ±. . 
Reiki . ±. . ±. .
RH . ±. . ±. . 
T : Mean pre- and postpain scores.
Group Mean pain
Pre ±SD
Mean pain
Post ±SD
Dierence
(Post pre) 𝑁
Control . ±. . ±. . 
Sham . ±. . ±. . 
PT . ±. . ±. . 
Reiki . ±. . ±. . 
RH . ±. . ±. . 
1.4, 𝑃 = 0.24). e average pretreatment ROM values for all
 groups were positive, although some individuals showed
negative values. Comparing postmeasures to premeasures
there was a highly signicant dierence between the  groups
(averaged over palms up and down and le and right arms,
𝐹 = 10.3, 𝑃 < 0.001). ese results are shown in Figure
and Table .
On average ROM increased by ,.
,
,
,and
for control, sham, PT, Reiki, and RH groups, respectively.
Pairwise analysis showed that Sham treatment was no better
than the no-treatment control and that PT, Reiki, and RH
wereallsignicantlymoreeectivethanSham(PT:𝐹=
8.05, 𝑃 = 0.008;Reiki:𝐹 = 10.48, 𝑃 = 0.003;RH:𝐹=
30.19, 𝑃 < 0.001). Reconnective Healing was signicantly
more eective than PT (𝐹 = 9.61, 𝑃 = 0.004), but there
was no signicant dierence between Reiki and PT (𝐹=
1.73, 𝑃 = 0.20).
3.3. Self-Reported Pain. ere was no signicant dierence
between the pretreatment pain scores of the  groups
(ANOVA analysis of variance, 𝐹 = 0.73, 𝑃 = 0.57).
Comparing postmeasures to premeasures there was a highly
signicant dierence between the  groups, (𝐹 = 4.75, 𝑃 <
0.002). ese results are shown in Figure and Table .
On average the pain score decreased by %, .%, .%,
.%, and .% for control, sham, PT, Reiki, and RH groups,
respectively.However,theaveragepainreductioninthePT
and Reiki groups did not reach the MCID. Pairwise analysis
showed that unlike the ROM results, the sham treatment was
signicantly more eective in reducing pain than the no-
treatment control (𝐹 = 8.4, 𝑃 = 0.007); in fact, none of
the other treatments were anymore eective than the sham
treatment (PT: 𝐹 = 0.42, 𝑃 = 0.52;Reiki:𝐹 = 0.57, 𝑃 =
0.46;RH:𝐹 = 1.9, 𝑃 = 0.18). Although RH was no more
80
70
60
50
40
30
20
213
Groups
Pretreatment
Posttreatment
ROM (deg)
45
F : Average range of motion, in degrees above the horizontal,
for all  treatment groups.
5.5
5.0
4.5
4.0
3.5
3.0
2
2.5
2.0
13
Groups
Pretreatment
Posttreatment
Pain score
45
F : Average pain score (VAS) for all  treatment groups.
eective than the sham treatment in reducing pain, pairwise
comparisons indicated that RH was more eective than Reiki
(𝐹 = 4.77, 𝑃 = 0.037)orPT(𝐹 = 5.48, 𝑃 = 0.026).
3.4. Heart Rate. Although heart rate signicantly decreased
posttreatment when all  groups were considered (𝐹=
6.55, 𝑃 = 0.01), there was no dierence in this reduction in
HR between the groups, including the no-treatment control
group. e results are shown in Figure .
3.5. Heart Rate Variability. e mean respiration rate of
participants did not var y between groups. erefore, the HRV
results of the study were not inuenced by alterations in
respiration. Neither SDRR nor RMSSD signicantly changed
posttreatment compared to pretreatment when all  groups
were considered (SDRR: 𝐹 = 2.3, 𝑃 = 0.134;RMSSD:𝐹=
1.46, 𝑃 = 0.23).
Evidence-Based Complementary and Alternative Medicine
80
76
78
74
72
70
68
66
64
213
Groups
Pretreatment
Posttreatment
Heart rate (bpm)
45
F : Average heart rate (beats/minute) for all  treatment
groups.
4. Discussion
is study showed that a -minute session of RH or Reiki
wasaseectiveasPTinimprovingROMinpeoplewith
restrictedshouldermobility;infactRH,butnotReiki,was
signicantly more eective than PT when performed for this
short time period. ese results cannot be explained by a
placeboeectbecauseshamtreatmentdidnotsignicantly
improve ROM. On the other hand, although PT, RH, and
Reiki all signicantly reduced the pain scores reported by
participants compared to no treatment, the sham treatment
wasjustaseectiveasthehealingmodalities.ereduction
in pain experienced by participants apart from those in the
no-treatment group can be attributed to the placebo eect.
It is interesting that Sham Healing signicantly reduced
pain but did not improve ROM. ese results suggest that the
benecial eects of Reiki and RH (but not Sham) on ROM
may arise from alterations in local joint or muscle structures
rather than the pain system. e success of the Sham Healing
in reducing pain was probably triggered by the expectation of
healing arising from the appearance and actions of the sham
healerthatmayhavethenstimulatedareleaseofendogenous
opiates or activated the dopaminergic system [].
Previous experiments evaluating the immediate eective-
ness of PT (manual manipulation only) in improving ROM
andreducingpaininsubjectswithshoulderproblemsreport
mixed results and small sample sizes. Surenkok et al. []
showed that scapular mobilization of the aected shoulder
of  people with painful shoulder restriction signicantly
improved ROM by an average of . e mobilization
included superior and inferior gliding, rotations,and distrac-
tion to the scapular. A control group was included. However,
there was no signicant reduction of pain as measured by
a VAS when participants raised their arms before and aer
treatment. Teys et al. []testedaMulligansmobilization
with movement technique, in which the physical therapist
applies a sustained glide to the glenohumeral joint while the
patient concurrently actively moves the joint, on  patients
with painful shoulder constriction. Sets of  repetitions were
applied with a  s rest interval between sets. A control
group was included. is type of therapy had an immediate
positive eect on both ROM and pressure pain threshold.
Rangeofmotionincreasedonaverageby.
. Pressure pain
threshold, or the degree of pressure sucient to cause the
patientpainwhenappliedtothemostsensitivepointonthe
anterior aspect of the shoulder, was signicantly decreased
by %. However, the change in ROM was not related to
the reduction in pain pressure threshold, consistent with our
nding that Sham Healing signicantly reduced pain but did
not aect ROM.
Five other studies investigated the eects of PT manual
manipulation on patients with painful shoulder restriction,
but these experiments extended over weeks and no measure-
ments were reported aer the rst session. ree of the 
investigations showed improvement in average ROM aer
treatment []. Two studies did not show improvement
[,] but only mid-range rather than endrange manipula-
tions were applied to the shoulders.
e mechanisms by which PT, Reiki, and RH improved
ROM are not known. A theoretical basis for the action
of manual manipulation PT and its eect in the body
has been advanced based on autonomic activation causing
concomitant vasodilatation, smooth muscle relaxation, and
increased blood ow, resulting in improved ROM, decrease
in pain perception, and/or change in tissue. In support of
this theory it was shown that cervical myofascial release,
such as that used by physical therapists, shis sympathovagal
balance from sympathetic to parasympathetic []. However,
theimprovementinROMseeninthePTgroupinthe
current study may not have been mediated by this mechanism
becausenosignicantincreaseinHRVwasobservedaerPT.
For the same reason the benecial eects of RH and Reiki in
this case did not seem to operate through rebalancing of the
autonomic nervous system.
One limitation of this study is that inferences drawn
from the results should be conned to those seen in a single
-minute treatment session with no follow-up. Another
possible limitation is that the physical therapists chose to only
include manual therapy performed at the glenohumeral joint
rather than the entire shoulder complex and this may have
limited their eectiveness. Further studies to evaluate such
issuesasthetimecourseoftheeectofPT,Reiki,andRHand
the outcome on disability and function are warranted. ere
is a clear clinical need for nonsurgical treatments that are safe
and eective for chronic, painful shoulder.
5. Conclusion
ispilotstudyisaproofoftheconceptthattheuseof
RHorReikiisaseectiveasmanualmanipulationPTin
improving ROM in patients with painful shoulder limitation
when evaluated immediately aer a -minute treatment.
e results suggest that it would be benecial for physical
therapists to be trained in RH or Reiki as well as PT so that
they could reduce the need for manual work on patients,
Evidence-Based Complementary and Alternative Medicine
at least in cases of shoulder limitations. However, further
research is required in which patients are reevaluated over
longer time periods to determine whether the healing eect
of a -minute RH or Reiki session is sustained at least as
long as for a -minute PT session. e degree of increased
eectiveness of longer or repeated treatments of RH, Reiki,
or PT would also need to be compared.
Acknowledgments
e authors thank Nadia Silva and Maggie Nham for their
help in consenting participants and data recording. is
research was funded by e Reconnection and Canyon
Ranch, Tucson, AZ, USA. Neither funding source played any
part in the analysis of data for this study nor in the writing of
the paper.
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... Data were reported from a total of 197 individuals, plus a class of an unspecified number of participants across the five included studies. Two studies involved participants with health issues, 30,31 and three studies involved participants without any stated health problems, 25,32,33 one of which focused on the RH practitioners themselves. 25 Only two of the five studies incorporated independent control groups. ...
... 25 Only two of the five studies incorporated independent control groups. 25,31 ...
... Among the biomarkers of physiologic changes in healees and healers, the most frequently assessed were electrodermal activity (EDA 30,32,33 ) and heart rate/heart rate variability (HR/HRV). 25,31 Other measures, assessed in single studies, were peripheral blood flow, 25 range of motion (ROM), 31 and self-reported pain levels. 31 ...
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... 20 Studies show that Reiki reduces pain 21 and improves the quality of life. 11,13,[22][23][24] Although studies are varying in the effectiveness of distance Reiki, the present study showed a positive effect of distance Reiki on pain and ADL in patients with IVHD, which is consistent with the previous studies. 13,21,23,24 Although the present study compared 3 different interventions and showed a significant improvement in the pain relief and ADL in patients with IVDH, it had some limitations, which were beyond the control of the researchers. ...
... 11,13,[22][23][24] Although studies are varying in the effectiveness of distance Reiki, the present study showed a positive effect of distance Reiki on pain and ADL in patients with IVHD, which is consistent with the previous studies. 13,21,23,24 Although the present study compared 3 different interventions and showed a significant improvement in the pain relief and ADL in patients with IVDH, it had some limitations, which were beyond the control of the researchers. The pain perception may be affected by ambient factors such as environmental noise. ...
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... The search found 26 randomized placebo controlled trials (RPCTs) that examined hands-on Reiki's effectiveness over placebo in adults using valid outcome measures translated in English (Thornton, 1991;Dressen and Singg, 1998;Witte and Dundes, 2001;Shiflett et al., 2002;Mackay et al., 2004;Shore, 2004;Gillespie et al., 2007;Assefi et al., 2008;Bowden et al., 2010Bowden et al., , 2011Catlin and Taylor-Ford, 2011;Díaz-Rodríguez et al., 2011a,b;Ventura Carraca, 2012;Baldwin et al., 2013Baldwin et al., , 2017Fortes Salles et al., 2014;Novoa and Cain, 2014;Rosada et al., 2015;Alarcao and Fonseca, 2016;Erdogan and Cinar, 2016;Midilli and Gunduzoglu, 2016;Vasudev and Shastri, 2016;Bat, 2021;Yüce and Taşcı, 2021;Çinar et al., 2022). Fourteen of these met PICO for examining the effectiveness of Reiki over placebo in measuring symptoms of mental health (Thornton, 1991;Dressen and Singg, 1998;Shiflett et al., 2002;Shore, 2004;Bowden et al., 2010Bowden et al., , 2011Díaz-Rodríguez et al., 2011a,b;Rosada et al., 2015;Erdogan and Cinar, 2016;Vasudev and Shastri, 2016;Baldwin et al., 2017;Yüce and Taşcı, 2021;Çinar et al., 2022). ...
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... Observations were made on improved blood flow and enhanced mental focus among the practitioners of Reconnective Healing during the healing state [21]. Pain reduction and improved range of motion were observed in some people with shoulder limitations through this healing technique [22]. ...
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... For this calculation, effect sizes for self-reported pain, heart rate, and heart rate variability (HRV) were estimated using the means and standard deviations of an earlier experiment in which Reiki was tested versus other healing modalities or no treatment. 16 No pilot data were available to perform a power analysis for State-Trait Anxiety Inventory (STAI); although the group size (n = 15) is sufficient for the other evaluation outcomes, larger group sizes are generally used for STAI. The STAI was still included to determine data trends for the effects of Reiki on this important parameter. ...
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To the Editor: Autonomic dysfunction, as measured by heart rate variability (HRV), predicts outcome after myocardial infarction ([1][1]). Medications that enhance parasympathetic tone, such as beta-adrenergic blockers, improve outcomes ([2][2]). Although the detrimental effects of emotional stress
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