Editor's note: This periodic column keeps you abreast of the latest research documenting the benefits of massage and bodywork. Published research is summarized, with references to the full study text provided; abstracts of research projects planned or in progress are reproduced verbatim whenever possible.

PICC and mid-arm line insertions with massage in a community hospital.
Jan Locke, LMT and Glenda Dennis, RN, CCRN

As the public begins to focus on integrative medicine, many health care systems are seeking to incorporate more holistic ways to deliver care. After incorporating massage therapy into the ICU, staff observed increased relaxation in patients and restoration of a degree of tranquility. Patients often encounter many invasive and frightening experiences while in the hospital, including the placement of PICC (Percutaneously Inserted Central Catheters) and Mid-Arm catheters. The goal of this study was to determine the impact of using massage on improving the patient's physical comfort, and reducing stress and anxiety levels during PICC and Mid-Arm catheter insertion. A Likert-scale survey was administered pre-procedure and post-procedure to 21 patients who required PICC/Mid-Arm catheter insertion at McKenzie-Willamette Hospital over a 15-month period of time. Results indicate a 39% improvement in anxiety levels and 23% improvement in physical comfort levels in the group who received massage during the catheter insertion. Those patients who experienced massage as a relaxation technique were also generally easier to cannulate for line placement.

Methodology: Patients were surveyed pre- and post-procedure using a Likert scale. Twenty-one adult patients were surveyed; 9 of the patients received massage during the procedure; 12 patients did not receive massage. Massage was offered according to the patient's comfort level. The massage therapist and the patient determined where the patient would feel most comfortable receiving touch during the procedure. Generally, massage (light effleurage) was provided to the hand; arm (not receiving the catheter); feet; neck; or scalp. The focus of massage was to redirect the attention of the patient and provide soothing, calming, comforting touch during the procedure.

Findings: Those patients receiving massage indicated: 23% improvement in physical comfort levels post-procedure; 39% improvement in anxiety levels post-procedure. Those patients not receiving massage indicated: 8% improvement in physical comfort levels post-procedure; 29% improvement in anxiety levels post-procedure. Patients receiving massage demonstrated significant improvement in physical comfort and anxiety levels over those that did not receive massage. It was also observed that there was less vascular constriction and a more peaceful recovery among those patients receiving massage during the procedures. 77% of patients, when asked if massage affected their physical comfort level, indicated, "very much" (the highest score they could give); 67% of patients, when asked if massage affected their anxiety levels, indicated "very much."

Patient Comments: "I think the massage caused a definite improvement in my comfort level. It kept me from focusing on the procedure and relaxed me"; "I'm glad that the massage was given. I have had this done three times before without massage. This was the lowest level of anxiety"; "Very good to me. Kept my mind off what you're doing"; and "Having had two PICC installs without massage, I can say it helped to have it. Thanks!"

Recommendations: Highly recommend using massage to reduce anxiety and improve patient comfort during PICC/Mid-Arm catheter placements. Highly recommend trying massage to complement other potential anxiety or pain-producing procedures such as thorocentesis; pre-cardioversion; or with nasogastric or naso-duodenal feeding tube placement.

Our plan is to modify our survey to include demographics such as gender and age to see of there is any correlation regarding perception of massage or its benefits. We also plan to gather data regarding massage as it affects physical comfort levels and anxiety levels during other invasive procedures, in addition to the PICC/Mid-Arm catheter placements.

Effects of massage for older adults.
Patricia A. Sharpe, PhD, MPH, LMT; Harriet Williams, PhD; Michelle Granner, MS; Michele Hobart Prevention Research Center, Norman J. Arnold School of Public Health, Univ. of South Carolina

(Editor's note: This study appeared in the Fall issue of the Massage Therapy Journal.)

Objective: The objective was to test the effects of massage therapy on physical function; stress perception; sleep; and general well-being among older adults, compared to a guided relaxation control condition.

Design: After screening for eligibility and contraindications, physical clearance for participation was obtained. Eligible participants were randomly assigned to massage or guided relaxation. Sessions were provided twice weekly for four consecutive weeks. Functional assessments and interviews were conducted before the first session and after the last session.

Setting: Participants came to the university for all sessions where a massage room had been reserved for the study.

Participants: Forty-nine participants, aged 60+ completed the study (25 massage and 24 guided relaxation). Three-fourths of the participants were female; 88% white; 10% African American; and 2% Asian. Participants were independently living, relatively "well" older adults, rather than a clinically defined group of patients.

Main Outcome Measures: The main outcome measures were range of motion at shoulder, hip and ankle by goniometer measurement; flexibility (chair sit-and-reach); tandem balance; agility (timed up-and-go test); general well-being (General Well-Being Scale, with subscales for anxiety; depression; positive well-being; self-control; vitality; and general health); Perceived Stress Scale; and Sleep (two items from the Philadelphia Sleep Quality Index).

Results: The massage group improved significantly more than the guided relaxation group on anxiety; depression; vitality; general health; positive well-being; timed up-and-go test; chair sit-and-reach test; shoulder abduction; and hip flexion.

Conclusion: Massage therapy has positive effects on psychosocial and functional health of older adults.

Editor's note: Both of the above abstracts were presented at the 2002 AMTA National Convention; they appear in Massage Today with permission from the respective authors.