The journal of alternative and complementary medicine : research on paradigm, practice, and policy
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J Altern Complement Med · Nov 2020
Feasibility and Acceptability of Heart Rate Variability Biofeedback in a Group of Veterans with Fibromyalgia.
Objectives: To determine the feasibility and acceptability of a heart rate variability biofeedback (HRVB) protocol in a focus group of Veterans with fibromyalgia (FM). Design: A multimethod feasibility and acceptability study. Settings/location: A Veterans Health outpatient pain medicine clinic in the southern United States. Subjects: The researcher enrolled seven women and three men between the ages of 33 and 68 years with a diagnosis of FM. Interventions: Participants practiced HRVB on the emWave2 at home for 20 min twice daily for 7 weeks. Outcome measures: Feasibility to adhere to the HRVB protocol was measured using the practice frequency and time (minutes) data collected from the emWave2. The author compared the individual reports from participants with the Credibility/Expectancy Questionnaire to measure the acceptability of the intervention. In addition, the principal investigator evaluated data from the Short-form McGill Pain Questionnaire (SFMQ) and the Revised Fibromyalgia Impact Questionnaire (FIQR) at the baseline and weekly study visits for a signal of efficacy for pain control, functional status, and quality of life (QOL). Results: The majority of participants (80%) expected 50% or more improvement in their pain, and (70%) felt HRVB would reduce their FM-related pain by 50%-80%. ⋯ However, 20-min HRVB sessions were feasible and acceptable. Improved FIQR scores post-treatment suggest HRVB may be an effective strategy to improve functional status and QOL for Veterans with FM. ClinicalTrials.gov ID: Pro00079144.
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J Altern Complement Med · Oct 2020
Meta AnalysisPhysical Management of Scar Tissue: A Systematic Review and Meta-Analysis.
Objective: The aim of this systematic review with meta-analysis was to describe the status on the effects of physical scar treatments on pain, pigmentation, pliability, pruritus, scar thickening, and surface area. Design: Systematic review and meta-analysis. Subjects: Adults with any kind of scar tissue. ⋯ The observed risk of bias was high for blinding of participants and personnel (47%) and low for other bias (100%). Conclusions: Physical scar management demonstrates moderate-to-strong effects on improvement of scar issues as related to signs and symptoms. These results show the importance of specific physical management of scar tissue.
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J Altern Complement Med · Oct 2020
Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline.
Objective: To develop an evidence-based clinical practice guideline (CPG) through a broad-based consensus process on best practices for chiropractic management of patients with chronic musculoskeletal (MSK) pain. Design: CPG based on evidence-based recommendations of a panel of experts in chronic MSK pain management. Methods: Using systematic reviews identified in an initial literature search, a steering committee of experts in research and management of patients with chronic MSK pain drafted a set of recommendations. ⋯ Recommendations covered many aspects of the clinical encounter, from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral. Appropriate referral and comanagement were emphasized. Conclusions: These evidence-based recommendations for a variety of conservative treatment approaches to the management of common chronic MSK pain conditions may advance consistency of care, foster collaboration between provider groups, and thereby improve patient outcomes.
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J Altern Complement Med · Sep 2020
Complementary Therapies for Patients with Cancer: Reflexology and Relaxation in Integrative Palliative Care. A Randomized Controlled Comparative Study.
Objectives: Comparison of the effects of reflexology and relaxation on pain, anxiety, and depression, and quality of life (QoL) of patients with cancer. Design: A stratified random sample was selected, using an experimental design. Location: An outpatient Palliative Care Unit in Attica, Greece. Subjects: 88 patients suffering with cancer. Interventions: The sample was randomly divided into two equal groups, a reflexology and a relaxation group. The number of interventions for both groups was six 30-min weekly sessions. Outcome measures: The Greek Brief Pain Inventory (G-BPI) was used to measure pain, the Greek Hospital Anxiety and Depression Scale for screening anxiety and depression, and finally the Short Form Health Survey was used to measure QoL. ⋯ The baseline-to-sixth week G-BPI measurements were markedly decreased for the reflexology group (p = 0.207, η2 = 0.020). Conclusions: Both interventions, relaxation and reflexology, seemed to be effective in decreasing anxiety and depression in patients with cancer. However, reflexology was found to be more effective in improving QoL (physical component) and to have a greater effect on pain management than relaxation.
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J Altern Complement Med · Sep 2020
Multicenter Study Clinical TrialA Quality Brief of an Oncological Multisite Massage and Acupuncture Therapy Program to Improve Cancer-Related Outcomes.
Objectives: Cancer treatment can present its own physical and mental challenges resulting in symptoms such as fatigue, stress, pain, nausea, and vomiting. Aurora Health Care is a large health system with 19 cancer centers. Integrative therapies such as acupuncture and massage have demonstrated success in reducing cancer-related symptoms and side effects to conventional cancer treatment and improving patient outcomes. ⋯ MT was greater at reducing stress and pain, 42.5% and 34.4%, respectively. Conclusions: Across 15 cancer clinics, both AT and MT treatments consistently and significantly reduced cancer-related side effects. These findings highlight the value of conducting a larger randomized-controlled trial to further assess the impact of Oncological Multisite Massage and Acupuncture Therapy on cancer-related symptoms across multiple oncologic clinics.