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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.//
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;
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
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
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-
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
of the respondents selected “liing with sudden maximal
Evidence-Based Complementary and Alternative Medicine
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
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.
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
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
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
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
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
() 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
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-
() 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
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
in the second phase they were recruited for the RH, PT, and
control groups. In both cases participants were assigned to
90 subjects
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
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 
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
Number of Sham
Number of PT
Number of Reiki
Number of RH
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
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
2.6. Instructions to erapists. All practitioners were
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
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
close in front of a wall, without touching it, with their arms at
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,
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
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
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.
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)
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
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
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
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.
/. 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.
Mean ROM
Pre ±SD
Mean ROM
Post ±SD
(Post pre) 𝑁
Control . ±. . ±. . 
Sham . ±. . ±. .
PT . ±. . ±. . 
Reiki . ±. . ±. .
RH . ±. . ±. . 
T : Mean pre- and postpain scores.
Group Mean pain
Pre ±SD
Mean pain
Post ±SD
(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 ,.
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
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,
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
ROM (deg)
F : Average range of motion, in degrees above the horizontal,
for all  treatment groups.
Pain score
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
Heart rate (bpm)
F : Average heart rate (beats/minute) for all  treatment
4. Discussion
is study showed that a -minute session of RH or Reiki
signicantly more eective than PT when performed for this
short time period. ese results cannot be explained by a
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
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
opiates or activated the dopaminergic system [].
Previous experiments evaluating the immediate eective-
ness of PT (manual manipulation only) in improving ROM
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.
. Pressure pain
threshold, or the degree of pressure sucient to cause the
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,
current study may not have been mediated by this mechanism
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
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
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.
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.
[] M. Urwin, D. Symmons, T. Allison et al., “Estimating the
burden of musculoskeletal disorders in the community: the
comparative prevalence of symptoms at dierent anatomical
sites, and the relation to social deprivation,Annals of the
Rheumatic Diseases,vol.,no.,pp.,.
[] S. Green, R. Buchbinder, and S. Hetrick, “Physiotherapy inter-
ventions for shoulder pain,Cochrane Database of Systematic
Reviews, no. , Article ID CD, .
[] J. P. Iannotti, “Evaluation of the painful shoulder,” Journal of
Hand erapy,vol.,no.,pp.,.
[] P. J. McMahon and R. E. Sallis, “e painful shoulder: zeroing in
on the most common causes,” Postgraduate Medicine,vol.,
[] E. Naredo, P. Aguado, E. de Miguel et al., “Painful shoulder:
comparison of physical examination and ultrasonographic
ndings,Annals of the Rheumatic Diseases,vol.,no.,pp.
–, .
[] J.H.StevensonandT.Trojian,“Evaluationofshoulderpain,
Journal of Family Practice, vol. , no. , pp. –, .
[] K.M.Johansson,L.E.Adolfsson,andM.O.Foldevi,“Eectsof
acupuncture versus ultrasound in patients with impingement
syndrome: randomized clinical trial,Physical erapy,vol.,
no. , pp. –, .
[] J. R. Andrews, “Diagnosis and treatment of chronic painful
shoulder: review of nonsurgical interventions,Journal of
Arthroscopic and Related Surgery,vol.,no.,pp.,
eectiveness of a physiotherapy program for chronic rotator
cu pathology: a protocol for a randomised, double-blind,
placebo-controlled trial,BMC Musculoskeletal Disorders,vol.
, article , .
[] M. A. Campo,S. Weiser, andK. L. Koenig , “Job strain in physical
therapists,Physical erapy,vol.,no.,pp.,.
[] M. Molumphy, B. Unger, G. Jensen, and R. B. Lopopolo,
“Incidence of work-related low back pain in physical therapists,
Physical erapy,vol.,no.,pp.,.
[] P. M. Barnes, B. Bloom, and R. L. Nahin, Complementary and
Alternative Medicine Use among Adults and Children: United
States, 2007, National Health Statistics Reports, Hyattville, Md,
USA, .
[] L. Gill, “More hospitals oer alternative therapies for mind,
body, spirit,USA Today, September , http://www.usatoday
.com/news/health/---alternative-therapies N.htm.
[] American Holistic Nurses Association and American Nurses
Association, Holistic Nursing: Scope and Standards of Practice,, Silver Spring, Md, USA, .
history, theory, practice, and research,Alternative erapies in
Health and Medicine, vol. , no. , pp. –, .
[] S. Jain and P. J. Mills, “Bioeld therapies: helpful or full of hype?
Abestevidencesynthesis,International Journal of Behavioral
[] A. L. Baldwin, A. Vitale, E. Brownell, J. Scicinski, M. Kearns,
and W. Rand, “e touchstone process: an ongoing critical
evaluation of Reiki in the scientic literature,Holistic Nursing
Practice, vol. , no. , pp. –, .
[] N. Mackay, S. Hansen, and MA. McFarlane, “Autonomic ner-
vous system changes during Reiki treatment: a preliminary
study,Journal of Alternative and Complementary Medicine,vol.
, no. , pp. –, .
[] A. Vitale, “An integrative review of Reiki touch therapy
research,” Holistic Nursing Practice,vol.,no.,pp.,
[] R. S. C. Friedman, M. M. Burg, P. Miles, F. Lee, and R. Lampert,
“Eects of Reiki on autonomic activity e arlyae r acute coronary
syndrome,Journal of the American College of Cardiology,vol.
, no. , pp. –, .
[] B. Rubik, “e bioeld hypothesis: its biophysical basis and
role in medicine,Journal of Alternative and Complementary
[] A. Kirchner, H. Stefan, K. Bastian, and F. Birklein, “Vagus
nerve stimulation suppresses pain but has limited eects on
neurogenic inammation in humans,European Journal of Pain,
jamin, “Osteopathic manipulative treatment and its relationship
to autonomic nervous system activity as demonstrated by
heart rate variability: a repeated measures study,Osteopathic
Medicine and Primary Care, vol. , article , .
[] L. D´
ıguez, M. Arroyo-Morales, C. Fern´
nas, F. Garc´
ıa-Lafuente, C. Garc´
ıa-Royo, and I. Tom´
“Immediate eects of reiki on heart rate variability, cortisol
levels, and body temperature in health care professionals with
burnout,” Biological Research for Nursing,vol.,no.,pp.
, .
[] E. Pearl, e Reconnection: Heal Others Heal Yourself,Hay
House, Carlsbad, Calif, USA, st edition, .
[] R.Z.Tashjian,J.Deloach,C.A.Porucznik,andA.P.Powell,
“Minimal clinically important dierences (MCID) and patient
acceptable symptomatic state (PASS) for visual analog scales
(VAS) measuring pain in patients treated for rotator cu
pp. –, .
[] H.WalachandW.B.Jonas,“Placeboresearch:theevidencebase
for harnessing self-healing capacities,Jour nal of Alter native and
Complementary Medicine, vol. , supplement , pp. S–S,
[] O.Surenkok,A.Aytar,andG.Baltaci,“Acuteeectsofscapular
mobilization in shoulder dysfunction: a double-blind random-
ized placebo-controlled trial,Journal of Sport Rehabilitation,
Evidence-Based Complementary and Alternative Medicine
[] P. Teys, L. Bisset, and B. Vicenzino, “e initial eects of a
Mulligan’s mobilization with movement technique on range
of movement and pressure pain threshold in pain-limited
shoulders,Manual erapy,vol.,no.,pp.,.
[] H. Vermeulen, P. Rozing, W. Obermann, S. Le Cessie, and
T. P. M. V. Vlieland, “Comparison of high-grade and low-
grade mobilization techniques in the management of adhesive
capsulitis of the shoulder: randomized controlled trial,Physical
[] A. Johnson, J. Godges, G. Zimmerman, and L. Ounanian, “e
eect of anterior versus posterior glide joint mobilization on
external rotation range of motion in patients with shoulder
adhesive capsulitis,Journal of Orthopaedic and Sports Physical
[] J. Yang, C. Chang, S. Chen, S.-F. Wang, and J.-J. Lin, “Mobi-
lization techniques in subjects with frozen shoulder syndrome:
randomized multiple-treatment trial,Physical erapy,vol.,
no. , pp. –, .
[] D. Conroy and K. Hayes, “e eect of joint mobilization as a
component of comprehensive treatment for primary shoulder
impingement syndrome,Journal of Orthopaedic and Sports
Physical erapy,vol.,no.,pp.,.
[] A. F. Kachingwe, B. Phillips, E. Sletten, and S. W. Plunkett,
“Comparison of manual therapy techniques with therapeutic
exercise in the treatment of shoulder impingement: a ran-
domized controlled pilot clinical trial,JournalofManualand
Manipulative erapy,vol.,no.,pp.,.
... 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 ...
Full-text available
Background: Biofield therapies offer a novel, non-invasive approach to treating chronic diseases based on assessing and adjusting an individual's physiological and emotional responses through their bio-energetic field. Reconnective Healing(™) (RH) is defined as: "…not just energy healing, but instead a more comprehensive spectrum of healing composed of energy, light, and information." Objectives: Several biofield therapies, such as Reiki, Therapeutic Touch and Johrei, have already been reviewed in the literature but RH has received little attention even though it is taught and practiced worldwide. This review provides a critical assessment of RH as a healing modality. Methods: Scientific research articles published in peer-reviewed journals addressing RH were identified using relevant databases and archives. Information was extracted from each article that met selection criteria for evaluation of quality of reporting and design. This review summarizes and critically evaluates the five currently published peer-reviewed research papers involving RH and assesses whether RH provides consistent physiological outcomes between the studies. Results: These results, taken together, suggest: (i) exposure of a healer or healee to RH, either directly or indirectly, amplifies their degree of autonomic arousal and energy, (ii) RH can reduce pain and improve range of motion in people with shoulder limitations, and (iii) when individuals experience RH as a group, their autonomic nervous systems simultaneously show sudden similar responses consistent with the idea that RH is mitigated by entrainment of biofields. Conclusions: Since these studies are extremely varied in design it is not possible at this point to reach conclusions about the general effectiveness of RH. More clinical and physiological research performed on different populations under a range of conditions is needed in order to support this healthcare approach.
... 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. ...
Full-text available
Patients with intervertebral disc herniation (IVDH) seek complementary and conventional medical therapies to manage related problems. This study aimed to determine the effectiveness of Reiki compared with physiotherapy to relieve the lower back pain intensity and to improve the activities of daily living (ADL) in the IDVH patients. In this clinical trial study, 60 patients with IVDH were randomly assigned to one of the Reiki, physiotherapy, and drug therapy groups. The severity of pain and the ADL were measured using visual analog scale (VAS) pain and ADL–Instrumental ADL questionnaire before and after the intervention. A significant difference was found in pain intensity and ADL improvement between Reiki and the drug therapy. However, there was no significant difference between Reiki and physiotherapy groups in managing pain and improving ADL. Reiki and physiotherapy are effective methods in managing pain and improving ADL in patients with IVDH; however, Reiki is more cost-effective and faster treatment method than physiotherapy.
... 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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Background Reiki is an energy healing technique or biofield therapy in which an attuned therapist places their hands on or near the client’s body and sends energy to the client to activate the body’s ability to heal itself and restore balance. It was developed in Japan at the end of the 19th century by Mikao Usui of Kyoto. Given the enormous international socioeconomic burden of mental health, inexpensive, safe, and evidenced-based treatments would be welcomed. Reiki is safe, inexpensive, and preliminary research suggests it may assist in treating a wide variety of illnesses. Given that Reiki is a biofield therapy, growing in use, and not yet accepted by the dominant biomedical paradigm, it is important to establish its effectiveness over placebo. This study aimed to examine Reiki’s effectiveness over placebo in treating symptoms of mental health and to explore parameters for its effectiveness. Method A systematic review of randomized placebo-controlled trials (RPCTs) examining Reiki’s effectiveness in treating symptoms of mental health in adults was conducted through a systematic search of PubMed, PsycINFO, MEDLINE, CINAHL, Web of Science, Scopus, Embase, and ProQuest. Fourteen studies met the inclusion criteria, and risk of bias was assessed using Cochrane’s Revised ROB 2 assessment tool. This was followed by a grading of recommendations, assessment, development and evaluations (GRADE) assessment. Results The evidence to date suggests that Reiki consistently demonstrates a greater therapeutic effect over placebo for some symptoms of mental health. The GRADE level of evidence is high for clinically relevant levels of stress and depression, moderate to high for clinically relevant levels of anxiety, low to moderate for normal levels of stress, and low to moderate for burnout, and low for normal levels of depression and anxiety. Conclusion The results suggest that, Reiki may be more effective in treating some areas of mental health, than placebo, particularly if symptoms are clinically relevant. To date, there are a small number of studies in each area, therefore findings are inconclusive and, more RCTs controlling for placebo in Reiki research are needed. Most included studies were also assessed as having a risk of bias of some concern. Incorporating Reiki as a complementary treatment to mainstream psychotherapy for depression, stress, and anxiety may be appropriate. Systematic Review Registration [ ], identifier [CRD42020194311].
... 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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Energy Healing techniques are considered as one of the age-old practices dating its origin back to the ancient scriptures, to be precise much earlier than those. Scientific technology has been incorporated on a small scale into these in recent decades, beginning in the twentieth century. Even in the twenty-first century, little progress has been made in this area. This literature review is an eye-opener for the world to get familiarized with various energy healing techniques and their basic functionality. The various technical devices used for the detection and treatment of the biofield are depicted in brief in this review. The modalities in which Artificial Intelligence is used in various energy healing techniques are introduced here. The review culminates with a note on the future scope of the Energy Healing techniques on a wider horizon incorporating Artificial Intelligence wherever necessary.
... 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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This blinded, controlled pilot study investigated the effects of Reiki on 46 patients undergoing knee replacement surgery. Of the 3 groups, Reiki, Sham Reiki, and Standard of Care, only the Reiki group showed significant reductions in pain, blood pressure, respiration rate, and state anxiety, which provides evidence for a full-scale clinical study.
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The term frozen shoulder was first introduced by Codman in 1934. He described a painful shoulder condition of insidious onset that was associated with stiffness and difficulty sleeping on the affected side. Codman also identified the marked reduction in forward elevation and external rotation that are the hallmarks of the disease. Long before Codman, in 1872, the same condition had already been labelled periarthritis by Duplay. In 1945, Naviesar coined the term adhesive capsulitis. [2] The pathophysiology of idiopathic adhesive capsulitis (frozen shoulder) is poorly understood. Most authors have reported various degrees of inflammatory changes in the synovial membrane. Adhesions between the shoulder capsule and the humeral head have been noted by some, but not all, authors. [4] The aetiology of periarthritis of the shoulder, however, is not clearly understood. Amongst the factors suggested are trauma myocardial infarction hemiplegia, pulmonary tuberculosis, thyrotoxicosis, cerebral tumour, and epilepsy. [7] Subjects with Frozen Shoulder Syndrome group A treated with ERM and MWM and group B treated with MRM. The duration of each treatment was 3 weeks. There was an improvement in mobility and functional ability at 12 weeks in subjects treated with the 3 mobilization techniques. Comparing the effectiveness of the 3 treatment strategies in subjects with unilateral Frozen Shoulder Syndrome, ERM and MWM were more effective than MRM in increasing mobility and functional ability. [22].
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Aim: The aim of this article is to review the current literature on the therapeutic uses and efficacy of Triphala. Herbal remedies are among the most ancient medicines used in traditional systems of healthcare such as Ayurveda. Triphala, a well-recognized and highly efficacious polyherbal Ayurvedic medicine consisting of fruits of the plant species Emblica officinalis (Amalaki), Terminalia bellerica (Bibhitaki), and Terminalia chebula (Haritaki), is a cornerstone of gastrointestinal and rejuvenative treatment. Methods: A search of the PubMed database was conducted. Results: In addition, numerous additional therapeutic uses described both in the Ayurvedic medical literature and anecdotally are being validated scientifically. In addition to laxative action, Triphala research has found the formula to be potentially effective for several clinical uses such as appetite stimulation, reduction of hyperacidity, antioxidant, anti-inflammatory, immunomodulating, antibacterial, antimutagenic, adaptogenic, hypoglycemic, antineoplastic, chemoprotective, and radioprotective effects, and prevention of dental caries. Polyphenols in Triphala modulate the human gut microbiome and thereby promote the growth of beneficial Bifidobacteria and Lactobacillus while inhibiting the growth of undesirable gut microbes. The bioactivity of Triphala is elicited by gut microbiota to generate a variety of anti-inflammatory compounds. Conclusions: This review summarizes recent data on pharmacological properties and clinical effects of Triphala while highlighting areas in need of additional investigation and clinical development.
This blinded, controlled pilot study investigated the effects of Reiki on 46 patients undergoing knee replacement surgery. Of the 3 groups, Reiki, Sham Reiki, and Standard of Care, only the Reiki group showed significant reductions in pain, blood pressure, respiration rate, and state anxiety, which provides evidence for a full-scale clinical study.
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Energy medicine (EM) derives from the theory that a subtle biologic energy can be influenced for therapeutic effect. EM practitioners may be trained within a specific tradition or work solo. Few studies have investigated the feasibility of solo-practitioner EM in hospitals. This study investigated the feasibility of EM as provided by a solo practitioner in inpatient and emergent settings. Feasibility study, including a prospective case series. Inpatient units and emergency department. To investigate the feasibility of EM, acceptability, demand, implementation, and practicality were assessed. Short-term clinical changes were documented by treating physicians. Patients, employees, and family members were enrolled in the study only if study physicians expected no or slow improvement in specific symptoms. Those with secondary gains or who could not communicate perception of symptom change were excluded. EM was found to have acceptability and demand, and implementation was smooth because study procedures dovetailed with conventional clinical practice. Practicality was acceptable within the study but was low upon further application of EM because of cost of program administration. Twenty-four of 32 patients requested relief from pain. Of 50 reports of pain, 5 (10%) showed no improvement; 4 (8%), slight improvement; 3 (6%), moderate improvement; and 38 (76%), marked improvement. Twenty-one patients had issues other than pain. Of 29 non-pain-related problems, 3 (10%) showed no, 2 (7%) showed slight, 1 (4%) showed moderate, and 23 (79%) showed marked improvement. Changes during EM sessions were usually immediate. This study successfully implemented EM provided by a solo practitioner in inpatient and emergent hospital settings and found that acceptability and demand justified its presence. Most patients experienced marked, immediate improvement of symptoms associated with their chief complaint. Substantial practicality issues must be addressed to implement EM clinically in a hospital, however.
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Burnout is a work-related mental health impairment comprising three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Reiki aims to help replenish and rebalance the body's energetic system, thus stimulating the healing process. The objective of this placebo-controlled, repeated measures, crossover, single-blind, randomized trial was to analyze the immediate effects of Reiki on heart rate variability (HRV), body temperature, and salivary flow rate and cortisol level in health care professionals with burnout syndrome (BS). Participants included 21 health care professionals with BS, who were asked to complete two visits to the laboratory with a 1-week interval between sessions. They were randomly assigned the order in which they would receive a Reiki session applied by an experienced therapist and a placebo treatment applied by a therapist with no knowledge of Reiki, who mimicked the Reiki treatment. Temperature, Holter ECG recordings (standard deviation of the normal-to-normal interval [SDNN], square root of mean squared differences of successive NN intervals [RMSSD], HRV index, low frequency component [LF], and high frequency component [HF]), salivary flow rate and cortisol levels were measured at baseline and postintervention by an assessor blinded to allocation group. SDNN and body temperature were significantly higher after the Reiki treatment than after the placebo. LF was significantly lower after the Reiki treatment. The decrease in the LF domain was associated with the increase in body temperature. These results suggest that Reiki has an effect on the parasympathetic nervous system when applied to health care professionals with BS.
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Reiki is used by a growing number of people but little is known about the scientific basis for its use. The Touchstone Process was developed as an ongoing process to systematically analyze published, peer-reviewed studies of Reiki, the results being made accessible to the public online. Thirteen scientifically qualified experts in the field of Reiki were assembled into 3 teams to retrieve, evaluate, and summarize articles using standardized, piloted evaluation forms. Summaries of 26 Reiki articles, including strengths and weaknesses, were posted on a newly developed Web site (, together with an overall summary of the status of Reiki research and guidelines for future research: The Touchstone Process determined that only 12 articles were based on a robust experimental design and utilized well-established outcome parameters. Of these articles, 2 provided no support, 5 provided some support, and 5 demonstrated strong evidence for the use of Reiki as a healing modality. There is a need for further high-quality studies in this area.
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The aim of this study was to evaluate the initial effects of scapular mobilization (SM) on shoulder range of motion (ROM), scapular upward rotation, pain, and function. Pretest-posttest for 3 groups (SM, sham, and control). A double-blinded, randomized, placebo-controlled trial was conducted to evaluate the initial effect of the SM at a sports physiotherapy clinic. 39 subjects (22 women, 17 men; mean age 54.30 +/- 14.16 y, age range 20-77 y). A visual analog scale, ROM, scapular upward rotation, and function were assessed before and just after SM. SM (n = 13) consisted of the application of superoinferior gliding, rotations, and distraction to the scapula. The sham (n = 13) condition replicated the treatment condition except for the hand positioning. The control group (n = 13) did not undergo any physiotherapy and rehabilitation program. Pain severity was assessed with a visual analog scale. Scapular upward rotation was measured with a baseline digital inclinometer. Constant Shoulder Score (CSS) was used to measure shoulder function. After SM, we found significant improvements for shoulder ROM, scapular upward rotation, and CSS between pretreatment and posttreatment compared with the sham and control groups. In the sham group, shoulder-ROM values increased or decreased for the shoulder and scapular upward rotation was not changed. Pain, ROM, and physical function of the shoulder were not significantly different in the sham group than in controls (P > .05). SM may be a useful manual therapy technique to apply to participants with a painful limitation of the shoulder. SM increases ROM and decreases pain intensity.
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Biofield therapies (such as Reiki, therapeutic touch, and healing touch) are complementary medicine modalities that remain controversial and are utilized by a significant number of patients, with little information regarding their efficacy. This systematic review examines 66 clinical studies with a variety of biofield therapies in different patient populations. We conducted a quality assessment as well as a best evidence synthesis approach to examine evidence for biofield therapies in relevant outcomes for different clinical populations. Studies overall are of medium quality, and generally meet minimum standards for validity of inferences. Biofield therapies show strong evidence for reducing pain intensity in pain populations, and moderate evidence for reducing pain intensity hospitalized and cancer populations. There is moderate evidence for decreasing negative behavioral symptoms in dementia and moderate evidence for decreasing anxiety for hospitalized populations. There is equivocal evidence for biofield therapies' effects on fatigue and quality of life for cancer patients, as well as for comprehensive pain outcomes and affect in pain patients, and for decreasing anxiety in cardiovascular patients. There is a need for further high-quality studies in this area. Implications and future research directions are discussed.
Most shoulder problems seen by the primary care physician involve impingement syndrome or problems at the acromioclavicular joint. Despite the complexity of the structures involved, most of these conditions can be diagnosed and treated without difficulty. MRI or other imaging studies are seldom needed but can be used to confirm a questionable diagnosis. Referral to an orthopedic surgeon is appropriate if shoulder problems persist for 3 to 6 months or if there is evidence of a medium or large rotator cuff tear, severe shoulder stiffness, or a complicated fracture.
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
The purpose of this double-blind, randomized controlled pilot study was to compare the effectiveness of four physical therapy interventions in the treatment of primary shoulder impingement syndrome: 1) supervised exercise only, 2) supervised exercise with glenohumeral mobilizations, 3) supervised exercise with a mobilization-with-movement (MWM) technique, or 4) a control group receiving only physician advice. Thirty-three subjects diagnosed with primary shoulder impingement were randomly assigned to one of these four groups. Main outcome measures included 24-hour pain (VAS), pain with the Neer and Hawkins-Kennedy tests, shoulder active range of motion (AROM), and shoulder function (SPADI). Repeated-measures analyses indicated significant decreases in pain, improved function, and increases in AROM. Univariate analyses on the percentage of change from pre- to post-treatment for each dependent variable found no statistically significant differences (P<0.05) between the four groups. Although not significant, the MWM and mobilization groups had a higher percentage of change from pre- to post-treatment on all three pain measures (VAS, Neer, Hawkins-Kennedy). The three intervention groups had a higher percentage of change on the SPADI. The MWM group had the highest percentage of change in AROM, and the mobilization group had the lowest. This pilot study suggests that performing glenohumeral mobilizations and MWM in combination with a supervised exercise program may result in a greater decrease in pain and improved function although studies with larger samples and discriminant sampling methods are needed.
Job stress has been associated with poor outcomes. In focus groups and small-sample surveys, physical therapists have reported high levels of job stress. Studies of job stress in physical therapy with larger samples are needed. The purposes of this study were: (1) to determine the levels of psychological job demands and job control reported by physical therapists in a national sample, (2) to compare those levels with national norms, and (3) to determine whether high demands, low control, or a combination of both (job strain) increases the risk for turnover or work-related pain. This was a prospective cohort study with a 1-year follow-up period. Participants were randomly selected members of the American Physical Therapy Association (n=882). Exposure assessments included the Job Content Questionnaire (JCQ), a commonly used instrument for evaluation of the psychosocial work environment. Outcomes included job turnover and work-related musculoskeletal disorders. Compared with national averages, the physical therapists reported moderate job demands and high levels of job control. About 16% of the therapists reported changing jobs during follow-up. Risk factors for turnover included high job demands, low job control, job strain, female sex, and younger age. More than one half of the therapists reported work-related pain. Risk factors for work-related pain included low job control and job strain. The JCQ measures only limited dimensions of the psychosocial work environment. All data were self-reported and subject to associated bias. Physical therapists' views of their work environments were positive, including moderate levels of demands and high levels of control. Those therapists with high levels of demands and low levels of control, however, were at increased risk for both turnover and work-related pain. Physical therapists should consider the psychosocial work environment, along with other factors, when choosing a job.
The MCID is the smallest difference in an outcome score which a patient perceives as beneficial. The PASS is the score below which patients consider themselves well. The purpose of this study was to determine the MCID and PASS for a visual analog scale (VAS) measuring pain in patients treated for rotator cuff disease. 81 patients with rotator cuff disease were evaluated after 6 weeks of non-operative treatment with a VAS measuring pain and two transition questions utilized in determining the MCID and PASS. The MCID and PASS were estimated to be 1.4 cm (P = .0255) and 3 cm (95% CI - 22.69, 37.31) on a 10 cm VAS measuring pain, respectively. Age (P = .0492) and hand-dominance (P = .0325) affected the MCID while age (P = .0376) and duration of follow-up (P = .0131) affected the PASS. The MCID and PASS estimates provide the basis to determine if statistically significant changes in VAS pain scores after treatment are clinically important and if the treatment allowed patients to achieve a satisfactory state. Level 3; Nonconsecutive series of patients, diagnostic study.