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    Effect of Massage On Fatigue Relief

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    Miki Shimizu

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    2008, ee eer Kurume Medical Journal, 52, 19 Interventional Study on Fatigue Relief in Mothers Caring for Hospitalized Children — Effect of Massage Incorporating Techniques from Oriental Medicine — MIZUE IWASAKI Department of Health Sciences, Kurume University School of Medicine, Kurume 830-001 1, Japan Received 14 December 2004, accepted 4 April 2005 ‘Summary: The study objective was to clarify the effect of massage on mothers caring for their hospitalized children, We conducted a comparative analysis of whether palm and shoulder massage could mitigate the physical and mental exhaustion experienced by such mothers. Subjects were 68 mothers whose children were admitted to the Department of Pediatrics, Kurume University Hospital with illnesses of varying severity ‘Twenty mothers living in Kurume City with healthy children were used as controls. A Japanese version of the Profile of Mood States (POMS) was employed as a mental index. Deep body temperature (frontal and palmar), systolicidiastolic blood pressure and heart rate were measured as physical indices before and after massage. The POMS scores for “Tension-Anxiety (T-A)", “Depression-Dejection (D)", “Anger-Hostility (A-H)" , “Fatigue (F)" and “Confusion (C)" were significantly higher, and for “ Vigor (V)" were significantly lower in mothers with hospitalized children than in the control group. Systolic blood pressures, were also lower than those in the control group. After massage, T-A, D, A-H, F and C scores in the mothers with hospitalized children decreased and their V scores increased significantly. However, improvement in ‘overall POMS scores was less than in the control group. And also improvement in each of the POMS scales was less than in the control group. Moreover, T-A. scores in mothers of children with cancer were significantly higher than those in mothers of children suffering from other types of diseases. Our study ‘demonstrated that mothers with hospitalized children were much more stressed than those with healthy children. The difference in the childs illness tended to exacerbate the degree of the mothers’ mental fatigue. Massage has a favorable effect on stressed mothers and may be expected to serve as a useful supporting tool Key words mothers caring for their hospitalized children, POMS, fatigue relief, massage ing factors influencing fatigue have been identified: pas abe Circumstances in which a child cannot be left alone Tr has been reported that the fatigue experienced by _ even for a moment while mothers are under pressure mothers caring for their hospitalized children is exac- to fit in with hospital routines, neglect of household erbated by the seriousness oftheir children’s diseases, duties as a result of providing long-term care without the presence of another patient sharing the same any relief, sleep deprivation, and the inconvenience room, and prolonged hospitalization [1]. The follow- of irregular bathing and eating habits [2,3]. However, Correspondence o: Mizue Iwasaki, Intute of Health and Sports Science, Kurume University, 1638 Mi-machi, Kurume 839-8802, Japan, Tel: +81-942, 43-01 801) Pax: o81-942-43-4797 E-mal ean@ snow 2.02 jp Abbreviations: A-H. Anger Hostility: C, Confusion: D, Depression-Dejetion; DBP, diastolic blood pressure; F, Fatigue; FDT, frontal dep temperature: {GHO28, the general health quesionnsire; PDT, palmar deep teperatore: POMS, profile of mood states, a mood evaluation index; SADS, schedule for affective disorders and schizophrenia: SBP, systolic blood pressure: T-A, Tension- Annet: V, Vigor. 2% IWASAKI there have been few detailed reports on the actual status of mothers’ fatigue, and we have found no interventional studies on the relief of such fatigue. Therefore, based on a report that massage was effective in relieving fatigue and enhancing mental activity [4], this study evaluated the degree to which the physical and mental fatigue of mothers caring for hospitalized children could be eased by hand and shoulder massage using essential oils and incorpora- ing techniques from Oriental medicine. Moreover, this study also examined the effect of massage on mothers with healthy children, and the interventional effect of massage was comparatively analyzed in the two groups. SUBJECTS AND METHODS: The study subjects were mothers (mean age SD: 34.8+5.6 years) providing 24-hour care to their children (mean ageSD: 4.5-£4.0 years) at the pediatrics ward of Kurume University Hospital, and mothers (mean age-+SD: 31.13.7 years) whose children were healthy and attending nursery school (mean ageSD: 3.71.2 years) in Kurume City. Evaluations and examinations were carried out in cach group during different periods. For the group of mothers with healthy children, examinations were performed in a single room at N nursery school in Kurume City (room temperature 25°C, 14:00-17:00) during the period from March 19 to March 25, 2002, and for the group of mothers with hospitalized chil- dren, the examinations were performed in an inter- view room in the pediatrics ward at Kurume University Hospital (room temperature 25°C, every Monday from 14:00-17:00) during the period from July 2002 to April 2004. The examinations and eval- uations were undertaken after carrying out the inter- ventional procedures described below. First, prior to massage, both groups underwent a Japanese version of the Profile of Mood States (POMS) (an examination of mood profile) which is a ‘mental index, had been back translated and approved for its equivalency to the original version by its origi- nal author (MeNair] [5-7]. Then deep forehead and palm temperatures, which are physiological indices, were simultaneously measured. Further, after the POMS examination their systolic blood pressures (SBP), diastolic blood pressures (DBP) and heart rates were measured in a sitting position. ‘The massage was carried out for 20 min in each subject using an essential oil (rose). The sites of massage were the hands (forearm and fingers) and Kurume Medical Journal Vol shoulders (neck, scapular area, and back). As for the hand, only ten basic patterns were stimulated (Fig. 1) dE ® a JS Fig. 1. Massage Procedi ‘A, In accordance with the theory of “Ki (vital ener- gy)" flows, massage the antebrachium from the elbow joint to the wrist joint on the radial side, and then back to the elbow joint along the ulnal side, B. Follow the same line as in A, above, except apply pressure ina spiral pattern. C. Apply pressure to the top of the hand along a spi- raling are from the base of the thumb to the little finger. 1D, Press the acupoint between each finger. E. Apply pressure in a spiral pattern from the base of the finger to the fingertip. Then place one finger ‘on each side of the fingernail and squeeze. Repeat for each fingers. F. Apply pressure to the acupoint in the center of palm with each thumb in turn, G. Apply pressure in a spiral pattern along both sides of the palm, H. Apply pressure from the wrist toward the center of the palm, and back. 1. Apply pressure to the acupoint near the ulnal side fof the wrist joint, then to acupoints onthe antebrachial side near the wrist and near the elbow (three acupoints) J. Turn or rotate the hand back and forth while lightly supporting a wrist. Maintain fingertip ccontact withthe hand after completion No. 1,2, 2005, MASSAGE FOR MOTHERS WITH HOSPITALIZED CHILDREN [8]. For the shoulder, Keiketsu (acupoints) and Keimyaku (Meridian points) were stimulated focus- ing on the Tenchu (lateral trapezius muscle tendon) and Kensei (part of the neck where the middle finger touches when placing the fingertips on the side of neck whilst the elbow touches the side of the chest. The massage was performed by the authors, and while doing the massage, conversation with the subject was avoided as much as possible. Afier completion of the massage, the POMS was repeated in a similar manner, deep forehead and palm temperatures of the subject were measured simultaneously, and blood pressure and heart rate were again measured in a sitting posture. The POMS consists of six scales, Tension- Anxiety (T-A), Depression-Dejection (D), Anger- Hostility (A-H), Vigor (V), Fatigue (F), and Confusion (C) [5]. In this study, present mood was evaluated in five grades (0-4) according to the responses to the questionnaire, and the overall score was computed for every scale. Using CORETEMPU CM-210 (Terumo Corp, Tokyo, Japan) with which deep temperatures can be measured by the heat style compensating method (a heater and an electronic circuit intercept the heat diffused from the skin to the open air), the deep tem- peratures were measured at the forehead and the palm of the left hand, respectively, and the absolute values of the temperature differences between frontal deep temperature (FDT) and palmar deep tempera- ture (PDT) were calculated. Since peripheral skin temperature was considered most likely to be influ- enced directly by external stimuli, and especially by a physical stimulus such as massage, deep tempera- tures, which were considered unlikely to be influ- enced, were measured. Blood pressure and heart rate 2 were measured with an electronic tonometer P10S (Terumo Corp, Tokyo, Japan ). Using the above measurement results, pre- and ost massage changes in mood, emotions, deep tem- peratures, blood pressures, and heart rates were investigated in both groups (mothers with hospital- ized children and mothers with healthy children). Moreover, between-group comparisons of these para- meters were also conducted, Statistical evaluation was made using SPSS software (version12.03 for Windows). Each experi- mental value was presented as the meanS.E. Changes in each parameter before and after interven- tional massage were analyzed by paired t-test and, comparisons in the intervention with two groups were analyzed by unpaired t-test, and change in absolute value was employed for analysis Wilcoxon’s rank-sum test, P values less than 0,05 were consid- ered significant. Prior to conducting the present study approval was obtained from the head of each relevant institu- tion, mothers of both groups were informed of the purpose of this research and its methods, and were assured that refusal to cooperate in the study would in no way prejudice their care, rights and welfare. Consent was obtained in written form, RESULTS ‘Changes in each parameter before and after interven- tional massage in the mothers with healthy children (Tables 1, 2) With regard to POMS scores in the mothers with healthy children, results from the negative mood TABLE | (Change of POMS scores before and after intervention in the mothers with healthy children, Mothers with healthy children (N: 20) before after ; imervention intervention hee TA 105458 p<0.001 D 94474 p<0.001 AH 63459 1.530 p<0.001 Vo 173457 207477 p<0.01 Fo 8646.2 27437 p

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