Effect of Foot Reflexology Protocol on Premenstrual Syndrome Symptoms in Nursing Students: a Pre–Post Pilot Study

Background: Premenstrual syndrome is a highly prevalent cyclical disorder among women of childbearing age which interferes with daily activities, mood, and quality of life. Purpose: To evaluate the effects of a foot reflexology protocol on relieving pre-menstrual syndrome symptoms in nurs-ing students. Setting: Nursing School, São Paulo Uni-versity, Brazil. Participants: A convenience sample of 17 nursing students, diagnosed with moderate-to-severe premenstrual syn-drome as assessed by the Premenstrual Symptoms Screening Tool (PSST). Research design: A pre–post pilot inter-vention study. Intervention: The intervention consist-ed of eight reflexology sessions lasting 30 minutes for eight weeks. Main Outcome Measure: Evaluation of the participants by the PSST applied at the beginning and at the end of the study. Results: The participants had an average age of 21.7 (±2.6) years, ranging from 19 to 28 years; all were single, and most were in the third year of the course (58.8%); 75.6% lived with their family; 82.4% do not use contraceptives; 64.7% reported regular menstrual flow with an average duration of 5.1 (±1.1) days, and an average menstrual cycle interval of 29.3 (±4.9) days. The intervention significantly reduced the premenstrual symptoms assessed by the PSST (p<.017) with a pre–post difference of 10.2 points in the overall score, and the items score decreased between 1.2 to 3.4 for difficulty concentrating, insomnia, hy-persomnia, feeling overwhelmed, muscle/joint pain, bloating, weight gain; and be-tween 3.5 to 5.2 to anger/irritability, anxiety/tension, tearful, depressed mood, de-creased interest in daily activities, fatigue, overeating, and breast tenderness. There was a significant decrease regarding the functional impact of premenstrual symp-toms domain in the overall score with a pre–post difference of 10.7, and between 1.7 and 3.0 for all of the items (p<.04), except for the item “your home responsibilities”. Conclusion: Foot reflexology has shown promising results in reducing premen-strual syndrome symptoms.

The effectiveness of Chair Massage on Stress and Pain in Oncology

Background: There is a high prevalence of moderate-to-high levels of chronic stress among nurses, as well as an occurrence of musculoskeletal disorders. Purpose: To evaluate the effectiveness of chair massage to reduce chronic stress and musculoskeletal pain in the Oncology Nursing team. Setting: Two teaching cancer hospitals, one public and the other private, in São Paulo city, Brazil. Participants: A total of 60 women from the Oncology Nursing team. Research Design: A randomized controlled trial divided into two groups: chair massage and control without intervention. Intervention: The massage group received two chair massage sessions lasting 15 minutes, twice a week, for three weeks. Main Outcome Measure: Reduction of stress and pain measured by the List of Signs and Symptoms (LSS) and the Brief Pain Inventory (BPI), respectively. Results: The average age was 32 (± 5.3) years. There was a reduction of stress measured by the LSS with a statistical difference in the group-time interaction (p < .001), with a Cohen’s d value of 1.21 between groups. The BPI analysis showed a statistically significant difference in the group-time interaction for general activity (p < .008), mood (p < .03), work (p < .000), and sleep (p = .03), with reduced pain interference in these components. Conclusion: Chair massage reduced stress and pain interference in the team’s daily life activities, bringing a positive impact in the context of work stress and pain in Oncology nursing professionals.

Effect of Ice Massage to Head and Spine on Blood Pressure and Heart Rate Variability in Patients with Hypertension: a Pilot Study

Background: Ice massage is one of the common hydrotherapeutic procedures. The current study is first of its kind, conducted to evaluate the effect of ice massage to head and spine on blood pressure and heart rate variability in patients with hypertension. Materials and Methods: Fifteen hypertensive subjects with the mean ± standard deviation (SD) age of 48.87 ± 11.17 yrs were recruited and underwent only one session of ice massage to head and spine for 20 min. Blood pressure and heart rate variability were assessed before and immediately after the intervention. Results: Results of this study showed a significant reduction in systolic blood pressure (p = <.001), diastolic blood pressure (p < .001) and heart rate (p = .012), and a significant increase in R-R Interval (the intervals between adjacent R waves in the electro cardiogram) (p = .001) in the posttest assessments compared to its respective pre-test assessments. Conclusion: Results suggest that 20 min of ice massage to head and spine may reduce blood pressure and heart rate in patients with hypertension. However, there is no evidence that this provides any significant clinical impact for the patient.

The The Effects of Massage Therapy on a Patient with Migraines and Cervical Spondylosis: a Case Report

Background: Migraines involve moderate- to-severe neck and face pain that lasts four to 72 hours, and are followed by fatigue and stiffness. Migraines are treated using medications, massage therapy (MT), and non-pharmacological alternatives. Cervical spondylosis (CS) is characterized by degeneration of the intervertebral discs, neck pain, and involvement of soft tissues in the cervical area. CS is treated using medications and manual therapy, including MT. Objective: To determine the effects of MT on cervical range of motion and daily function in a patient with migraines and CS. Case Presentation: The patient was an active 56-year-old female diagnosed with migraines and CS. Initial evaluation included cervical range of motion (ROM), goniometry, reflexes, myotomes, dermatomes, local sensation testing and orthopedic tests. Assessment was followed by five MT treatments. Swedish massage, myofascial trigger point release, and proprioceptive neuromuscular facilitation (PNF) stretching were applied to the back, neck, head, and face. The Headache Disability Index (HDI) was administered on the initial and final visits to evaluate patient function. Cervical ROM was measured pre- and posttreatment using a universal goniometer. Treatment was conducted by a second-year MT student at the MacEwan Massage Therapy Teaching Clinic in Edmonton, Alberta. Results: All cervical ranges of motion improved. The Headache Disability Index score decreased, but was not considered significant. The patient reported decreased stiffness in the upper back and shoulders, reduced migraines, and better sleeping patterns after the MT intervention. Conclusion: MT was effective in increasing cervical ROM, but had no significant effect on daily function. Further research is warranted on effects of MT on CS and migraines.

The Effect of Oketani Breast Massage on Successful Breastfeeding, Mothers’ Need for Breastfeeding Support, and Breastfeeding Self-Efficacy: an Experimental Study

Background: The negative effects of cesarean section on breastfeeding are a major global concern. Purpose: This study aimed to determine the effect of Oketani breast massage on the maternal need for support during breastfeeding, breastfeeding success, and breastfeeding self-efficacy. Setting: Three hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran, from April to July 2019. Study Design: The participants in this experimental study were 113 pregnant women who were candidates for cesarean section. The mothers were selected using convenience sampling and randomly assigned. In addition to routine care, the mothers in the intervention group received Oketani breast massages twice. However, the mothers in the control group received routine care. The data were collected using the Infant Breastfeeding Assessment Tool (IBFAT), LATCH Assessment Score, and the Breastfeeding Self-Efficacy Scale (BSES). The data were analyzed with SPSS 20 software via the independent samples t test, the Mann–Whitney U test, and the chi-square test. Results: The results of the study suggested that the breastfeeding success rate, which was evaluated with IBFAT in both the first two breastfeeding stages and the last pre-discharge breastfeeding, was significantly higher for the mothers in the intervention group (p < .001). In addition, the mother’s need for support, which was evaluated with LATCH in the first two breastfeeding stages (p = .044) and the last pre-discharge breastfeeding (p < .001) in the intervention group, was less. The total number of breastfeeding sessions from birth to discharge was higher in the intervention group (p = .002). Furthermore, the mothers in the intervention group breastfed their infants in a significantly shorter time interval (p = .002). Breastfeeding self-efficacy, according to the BSES, was significantly higher in the mothers of the intervention group (p < .001). Conclusion: Oketani massage can be used as a care intervention by nurses to improve breastfeeding in mothers who undergo cesarean sections.

The Journey of a Massage Therapist’s Experience After Receiving a Formal Complaint

Discussions of professionalism and conflict within practice are an important area of enquiry as massage therapy practice continues to be recognized within the health care realm. The scientific literature has paid little attention to these massage therapy professional and ethical dilemmas. Herein, we explore one such area of conflict between a client and therapist in regard to communication and complaints. An interview was conducted to gain further insight to the situation and is structured based upon the following interview guide: description of the instance, how the therapist handled this situation, reflection on how the therapist’s actions contributed to the situation, brief discussion of how other professions handled these types of situations, and reflection on what could have been done differently.

Perceived Pain Responses to Foam Rolling Associate with Basal Heart Rate Variability

Background: Foam rolling (FR) is a self-myofascial release technique with unclear effects on autonomic functioning, indexed by heart rate variability (HRV). FR can be perceived as painful or relaxing, which may explain interindividual HRV responses. Purpose: To determine if acute FR alters resting HRV. A secondary aim was to determine if perceived pain during FR would predict HRV responses. Setting: Academic institution. Methods: In a randomized, crossover design, healthy adults (50% female) performed total body FR or control on separate days. Perceived pain ratings were obtained following FR of each muscle group and summed to generate an overall perceived pain rating. Seated measures of the mean RR interval and the natural logarithm of the root-mean square of successive RR interval differences (LnRMSSD, a parasympathetic HRV index) were obtained at 5-10 min pre-, 5-10 min post-, and 25-30 min post-FR. Results: No effects were observed for RR interval (p = .105–.561) or LnRMSSD (p = .110–.129). All effect sizes ranged from trivial–small (0.00–0.26). Changes in RR interval (r = 0.220–0.228, p = .433–.488) and LnRMSSD (r = 0.013–0.256, p = .376–.964) were not associated with pain scale sum. Baseline LnRMSSD was associated with pain scale sum (r = -0.663; p = .001). Conclusion: FR did not systematically alter HRV, nor did perceived pain ratings predict HRV responses. Those with lower pre-FR HRV reported higher perceived pain during FR. Basal cardiac autonomic activity may, therefore, influence pain sensitivity to FR in healthy adults.

Acute and Chronic Periocular Massage for Ocular Blood Flow and Vision: a Randomized Controlled Trial

Introduction: The ocular blood flow (OBF) is responsible for supplying nutrition to the retina, which plays a fundamental role in visual function. Massage is expected to improve the blood flow and, consequently, vascular function. The aim of this study was to determine the shortterm and long-term effects of periocular massage on OBF and visual acuity. Methods: The OBF and visual acuity were measured in 40 healthy adults aged 20–30 years before and after massage, and also in control subjects. Three massage methods were used: applying periocular acupressure (“Chinese eye exercise”: CE), using a facial massage roller (MR), and using an automated eye massager (AM). The OBF and visual acuity were first measured before and after applying each type of massage for 5 min. Eye massage was then applied for 5 min once daily over a 60-day period, while the control group received no massage. The same measurements were then performed again. Results: Performing short-term periocular massage showed significant interactions in time and massage effects on visual acuity in CE and AM groups, and on OBF in AM group, while 60-day massage period exerted no significant effects. No significant relationship was found between OBF and visual acuity changes. Conclusions: These results suggest that short-term periocular massage with Chinese eye exercise and automated eye massager can improve OBF and visual acuity, although no causal relationship was supported.

Effectiveness of Massage Including Proximal Trigger Point Release for Plantar Fasciitis: a Case Report

Background: Plantar fasciitis (PF) is a common degenerative condition of the plantar fascia. Symptoms include tenderness on the plantar surface of the foot, pain on walking after inactivity, and difficulty with daily activities. Rest, non-steroidal anti-inflammatories, and manual therapies are frequently used treatments for PF. Trigger point release (TrPR) for PF has been found as a viable treatment option. Objective: To determine the effects of massage, including proximal TrPR, for pain and functional limitations in a patient with PF. Method: A student massage therapist from MacEwan University administered five massages, one initial and one final assessment over five weeks to a 46-yearold female with diagnosed PF. She complained of unilateral plantar heel pain (PHP) and deep pulling from mid-glutes to the distal lower limb bilaterally. Evaluation involved active and passive range of motion, myotomes, dermatomes, reflexes, and orthopedic tests. The treatment aim was to decrease PHP by releasing active trigger points (TrPs) along the posterior lower extremity to the plantar surface of the foot, lengthening the associated muscles and plantar fascia. Hydrotherapy, Swedish massage, TrPR, myofascial release, and stretches were implemented. Pain was measured using the numerical rating scale pre- and post-treatments, and the Foot Function Index was used to assess function at the first, middle, and last appointments to assess the effectiveness of massage including proximal TrPR for PF. Results: PHP and functional impairments decreased throughout the fiveweek period. Conclusion: The results indicate massage, including proximal TrPR, may decrease pain and functional impairments in patients with PF. Further research is necessary to measure its efficacy and confirm TrPR as a treatment option.

Trends of Publication in the Education and Practice Sections of the IJTMB: A Call to Action

The scope of the IJTMB include not only publishing scientific research studies, but also to publish education innovation and practice-oriented approaches for all allied health providers whose practice include manually applied therapeutic massage and bodywork. The aims of the Practice and Education sections of the journal are described in this editorial. The Education section covers topics including curriculum and competencies development, instructional design and delivery, instructional technology, distance learning, and testing/evaluative procedures for both initial education as well as continuing education. Planning, organization, marketing, and management of a successful practice, the incorporation of new scientific findings and methods into clinical practice, new clinical approaches to prevention and treatment of specific health conditions, and ethical issues are included in the Practice section. In an effort to increase publication within these sections we have put forth this call to action. We invite educators and practitioners to submit manuscripts discussing innovations in massage therapy education, how schools and students dealt with the Covid-19 pandemic, practitioners and clients adapted to the pandemic, investigations of the massage therapy profession and about massage therapists, as well as interesting case studies.