Case Report on Exploration of Massage, Bodywork and Mind-Body Interventions for Parkinson’s Disease

AWARD TYPE: Past Case Report Contest
AWARD TYPE: Practitioner

Honorable Mention
Rosi Goldsmith from Portland, OR

Background- Parkinson’s Disease (PD) is a disabling, neurodegenerative movement disorder, affecting over 1.5 million Americans. Non-motor symptoms (NMS) and quality of life (QoL) have increasingly become a focus of PD research over the last 10 years.

Objectives- To explore what contributions massage therapy could make to this focus as part of a multi-modal approach to PD treatment.

Methods- A 63 year old male, diagnosed with PD for 5 years, was seen for 56 sessions of 45-90 min. over 36 weeks. Validated, widely accepted Parkinson’s rating scales were administered at study onset, three intermediate points, and conclusion to track motor and NMS and QoL changes, and were supplemented by clinical assessments, narrative reports, medication records, and pain rating scales.

As a proxy measure for parasympathetic response, a fingertip pulse-oximeter monitored heart rate during bodywork interventions of Swedish massage, acupressure, myofascial release and Ortho-Bionomy®. Neurologically targeted exercises and exercises for posture, balance and coordination were developed to complement a home program of yoga routine, mindfulness practice, and meditation.

Results- Posture, gait and balance showed clinical improvements. Overall, graphs of QoL and NMS showed no worsening, or modest gains, but no trend emerged for motor symptoms. Symptoms worsened significantly after adverse life events. A surprising discovery was that sustained massage compressions along paraspinal muscles consistently calmed restless leg syndrome and initiated an overall parasympathetic response. Patient reported sometimes being able to calm tremors and restore normal movement by meditation and mental rehearsal of his yoga routine at home.

Conclusions- These results cannot be attributed to massage alone, considering the multi-modal approach, and medication changes. Although the patient attributes his symptom stabilization to a supportive therapeutic massage relationship, this hypothesis was not investigated. More research may be productive.


The Effect of Massage Therapy on Cancer Related Fatigue in Breast Cancer Survivors

AWARD TYPE: Past Research Grants

Paulette Swanson, PT, DPT, MS, cert. MDT
Middlesex Hospital Cancer Center, Middletown, CT
$30,000

Despite being experienced by 80-100% of cancer patients, Cancer Related Fatigue (CRF) is not well managed in traditional care settings. This has led to an increase in use of alternative modalities such as massage to manage and minimize its effects, which is supported by a promising yet limited body of scientific evidence. The Middlesex Hospital Cancer Center’s randomized, controlled pilot study will further examine the efficacy of Swedishstyle therapeutic massage in alleviating CRF in posttreatment breast cancer survivors. Severity of fatigue, the primary response variable, will be measured using the Brief Fatigue Inventory, a validated, tenitem tool from the MD Anderson Cancer Center.

Treatment group members will receive four, one hour massages over consecutive weeks; fatigue will be measured one week before the initial massage, immediately before and 24 hours after each massage, and four weeks after the final therapy session. Control group participants will not undergo massage while enrolled in the study but will complete BFIs on the same schedule as the treatment group. The delivery schedule of the BFI will allow for analysis of both short and longer term severity of fatigue.

Click here to view Paulette Swanson’s research study featured on CBS-WFSB in Connecticut.


The Effect of Massage Therapy on Cancer Related Fatigue in Breast Cancer Survivors

AWARD TYPE: Past Research Grants

Paulette Swanson, PT, DPT, MS, cert. MDT
Middlesex Hospital Cancer Center, Middletown, CT
$30,000

Despite being experienced by 80-100% of cancer patients, Cancer Related Fatigue (CRF) is not well managed in traditional care settings. This has led to an increase in use of alternative modalities such as massage to manage and minimize its effects, which is supported by a promising yet limited body of scientific evidence. The Middlesex Hospital Cancer Center’s randomized, controlled pilot study will further examine the efficacy of Swedishstyle therapeutic massage in alleviating CRF in posttreatment breast cancer survivors. Severity of fatigue, the primary response variable, will be measured using the Brief Fatigue Inventory, a validated, tenitem tool from the MD Anderson Cancer Center.

Treatment group members will receive four, one hour massages over consecutive weeks; fatigue will be measured one week before the initial massage, immediately before and 24 hours after each massage, and four weeks after the final therapy session. Control group participants will not undergo massage while enrolled in the study but will complete BFIs on the same schedule as the treatment group. The delivery schedule of the BFI will allow for analysis of both short and longer term severity of fatigue.

Click here to view Paulette Swanson’s research study featured on CBS-WFSB in Connecticut.


The Use of Massage Therapy to Relieve Chronic Low Back Pain

AWARD TYPE: Past Case Report Contest
AWARD TYPE: Practitioner

Silver Award Winner
Laura Allen from Rutherfordton, NC

Backround and Objective- To enable the subject to cut down on pain medication, currently prescribed at 7.5 mg of Percocet (acetaminophen and oxycodone) 4 times per day, through the help of massage therapy. The subject states he does not like to take it that frequently because it makes him feel lethargic and disoriented. A 53-year old male, formerly employed as a construction worker, was referred for massage therapy for treatment of debilitating low back pain. He has pain in all areas of the back; although he sometimes experiences cervical pain and/or thoracic pain, he reports the majority of his pain is in the lumbar area. He has multiple diagnoses of osteoarthritis, scoliosis, spinal stenosis, and degenerative disc disease.

Methods- The massage used was a combination of Swedish strokes (effleurage, petrissage, and friction), muscle stripping, and myofascial release, techniques chosen based on the practitioner’s 14 years of experience in working with clients who are in pain. A treatment plan of 6 weekly visits was agreed upon with re-evaluation after the sixth visit.

Results- Progress was measured using the Oswestry Low Back Pain Scale and by subjective statements on his decreased pain level and decreased need for medication, and positive effects on his activities of daily living. The massage therapy intervention was so successful that the subject switched to monthly maintenance care after four sessions instead of six as originally planned. Conclusion: The success of this intervention for this subject suggests that massage therapy can be an effective intervention for chronic low back pain.


Zen Shiatsu: A Viable Intervention for Stress Reduction in Children with Autism Spectrum Disorder

AWARD TYPE: Past Case Report Contest
AWARD TYPE: Practitioner

Gold Award Winner
Angela Burke from Boulder, CO

Objective- Autism Spectrum Disorder (ASD) is a developmental disability that manifests as impairments in social interaction, communication and behavior.  The objective of this study is to determine if Zen Shiatsu can reduce short and long-term stress levels in a child with ASD.

Methods- A seven-year-old male with a diagnosis of Autism was given twenty-minute Zen Shiatsu sessions weekly for six consecutive weeks.  Using a 5-point stress scale designed for children with Autism, the client indicated his stress level before each session, as well as afterward.  In addition, the parent was given the PEDS QL 4.0 Young Child Questionnaire to determine the child’s HRQoL (Health Related Quality of Life) prior to the six-week Zen Shiatsu treatment to establish a baseline.  The parent completed the same questionnaire after the six weeks of sessions to compare results.

Results-  Based on the 5-point pictorial stress scale, the client indicated that stress levels decreased after receiving Zen Shiatsu after all six sessions. The PEDS QL 4.0 showed higher HRQoL scores in all domains, indicating that the child’s overall quality of life improved within the six weeks of receiving Zen Shiatsu.

Conclusion-  Zen Shiatsu, a form of Traditional Chinese Medicine, has the potential to be a viable treatment for stress reduction in children with Autism Spectrum Disorder, therefore improving overall quality of life.