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Effects of Shiatsu on the Health-Related Quality of Life of a Person with Secondary Progressive Multiple Sclerosis: a Mixed Methods N-of-1 Trial within a Whole Systems Research Case Study

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Stergios Tsiormpatzis at Aalto University
Stergios Tsiormpatzis
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Abstract

Introduction: Multiple Sclerosis (MS) is a chronic neurological disorder with high prevalence in Finland. Most people with MS will develop Secondary-Progressive MS (SPMS) over the years. People with MS report lower than the average Health-Related Quality of Life (HRQoL) and use Complementary and Alternative Medicine (CAM) for their symptoms. Personalised interventions such as shiatsu have an insufficient evidence base. The n-of-1 trial is a promising study design for personalised interventions in chronic conditions but has not been used a lot in CAM research. The aim was to investigate if shiatsu affects the HRQoL of a person with SPMS. Methods: Six-periods counterbalanced mixed-methods n-of-1 trial within a Whole Systems Research (WSR) case study was used. The short version of the MSQLI, data collected from a semi-structured interview and case notes were used to assess the effect of the treatment. The collected data analysed quantitatively and qualitatively and synthesised as a descriptive case study. Results: The study was able to document improvements in spasticity, bowel function, fatigue, pain, sleep and relaxation. No adverse events occurred. Preliminary estimations of the onset and wash-out of shiatsu effects were inferred. Advantages and drawbacks of the design are discussed to improve future applicability. Conclusions: Shiatsu was able to improve some domains of the HRQoL of the specific person with SPMS. It was a safe treatment with no adverse events. Mixed methods n-of-1 trial within a WSR case study was an appropriate design for the study.
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European Journal of Integrative Medicine
journal homepage: www.elsevier.com/locate/eujim
Research paper
Effects of shiatsu on the health-related quality of life of a person with
secondary progressive multiple sclerosis: A mixed methods N-of-1 trial
within a whole systems research case study
Stergios Tsiormpatzis*
Northern College of Acupuncture/Middlesex University London, United Kingdom
ARTICLE INFO
Keywords:
Multiple sclerosis
Quality of life
Shiatsu
n-of-1
Mixed methods
Whole system research
ABSTRACT
Introduction: Multiple Sclerosis (MS) is a chronic neurological disorder with high prevalence in Finland. Most
people with MS will develop Secondary-Progressive MS (SPMS) over time. People with MS report lower than the
average Health-Related Quality of Life (HRQoL) and use Complementary and Alternative Medicine (CAM) for
their symptoms. Personalised interventions such as shiatsu have an insufficient evidence base. The n-of-1 trial is
a promising study design for personalised interventions in chronic conditions but has not little used in CAM
research. The aim was to investigate if shiatsu affects the HRQoL of a person with SPMS.
Methods: Six-periods counterbalanced mixed-methods n-of-1 trial within a Whole Systems Research (WSR) case
study was used. The short version of the MSQLI, data collected from a semi-structured interview and case notes
were used to assess the effect of the treatment. The collected data analysed quantitatively and qualitatively and
synthesised as a descriptive case study.
Results: The study was able to document improvements in spasticity, bowel function, fatigue, pain, sleep and
relaxation. No adverse events occurred. Preliminary estimations of the onset and wash-out of shiatsu effects were
inferred. Advantages and drawbacks of the design are discussed to improve future applicability.
Conclusions: Shiatsu was able to improve some domains of the HRQoL of the specific person with SPMS. It was a
safe treatment with no adverse events. Mixed methods n-of-1 trial within a WSR case study was an appropriate
design for the study.
https://doi.org/10.1016/j.eujim.2019.101006
Received 23 August 2019; Received in revised form 27 October 2019; Accepted 4 November 2019
⁎
Corresponding author at: Tuohilammentie 388, 03300, Otalampi, Finland.
E-mail address: stsio@orientalmedicine.eu.
European Journal of Integrative Medicine 32 (2019) 101006
1876-3820/ © 2019 Elsevier GmbH. All rights reserved.
T
For the accepted manuscript (authors version) of the article that is shared under the CC-BY-
NC-ND 4.0 license, according to the publishers article sharing policies, please refer to my
personal website in the address:
https://orientalmedicine.eu/index.php/publications
For the final version, please refer to the:
European Journal of Integrative Medicine, Volume 32, December 2019, 101006 or the address:
https://doi.org/10.1016/j.eujim.2019.101006
... Recently the author presented the results of a mixed method Nof-1 trial within a whole systems research case study, aiming to assess the effect of shiatsu on the health-related quality of life of a person with secondary progressive multiple sclerosis (SPMS) [1] (henceforth called ''our study"). In our study, one patient with no previous experience of shiatsu was recruited by a letter of invitation sent to former patients of the practitioner for sharing. ...
... In our study, one patient with no previous experience of shiatsu was recruited by a letter of invitation sent to former patients of the practitioner for sharing. The first responder was screened and satisfied our study's eligibility criteria [1]. ...
... After each shiatsu session, case notes were kept and used as evidence during the analysis and synthesis of the case. The results of the MSQLI questionnaires, as well as the verbatim transcript of the interview and the case notes, are available in the original publication of our study [1]. For ethical reasons, our study did not include enough data collection points that could permit statistical analysis of the questionnaires (a single administration at the end of each period). ...
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