Research
Massage helps reduce peri-operative anxiety
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tudies have shown that high levels of anxiety surrounding a surgical procedure can activate changes in a patient’s nervous and immune systems and potentially cause hypertension, impact pain thresholds and post-operative pain, delay surgery being started or completed, and delay patient discharge. Furthermore, pharmacological treatments that can be used to help control peri-operative anxiety may be short-acting or produce undesirable side-effects, such as nausea and vomiting (Guo et al, 2020). A meta-analysis recently published in Complementary Therapies in Clinical Practice aimed to “evaluate the effect of massage on peri-operative anxiety in adults who were about
to undergo, were undergoing or were recovering from major and minimally invasive surgical procedures to provide appropriate and practical suggestions for future research and practice.” A total of 25 studies met the eligibility criteria for the meta-analysis, comprising 2,494 participants. The authors noted the following key findings: n That massage can significantly reduce peri-operative anxiety for most types of surgical patients; n In order to be therapeutically beneficial, massage lasting 10 to 20 minutes per session was worthy of recommendation in a busy clinical setting; n Acupoint or specific body reflex area massage had a better effect on perioperative anxiety than general massage;
n Massage delivered by both massage professionals and nonmassage professionals (eg. short-term trained nurses and hospital staff ) were both effective. The authors concluded, “This meta-analysis demonstrated that massage is a simple, safe and effective approach for alleviating peri-operative anxiety in most types of surgical patients. More RCTs [randomised controlled trials] with high-quality and rigorous design are warranted to confirm our findings and to clarify the most suitable time at which to start massage in the peri-operative period, the duration of massage efficacy, the minimal effective dose, and the appropriate frequency of massage”.
Best practice guide developed for management of plantar heel pain
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lantar heel pain (PHP) is characterised by pain around the heel and arch of the foot during weight-bearing tasks, particularly after a period of rest. Research suggests it predominantly affects sedentary middleaged and older adults and accounts for 8% of all injuries related to running (Taunton et al, 2002). The authors of a review recently published in British Journal of Sports Medicine have developed a best practice guide (BPG) for the clinical management of PHP, based on their synthesised findings from high-quality randomised controlled trials, expert opinion and patient feedback (Morrissey et al, 2021). The core treatment recommended for people with PHP includes taping and stretching of the plantar fascia, alongside individualised education for the patient, “which should encourage: n individual assessment; n footwear advice to ensure comfort in shoes that allow a small rearfoot to forefoot drop while also considering social acceptability to improve adherence; n load management to break up long periods of static loading or problematically rapid training changes 50 International therapist
in more athletic populations; n support to address comorbidities such as type 2 diabetes; n teaching patients the parameters required to self-monitor the pain response to activity and how to interpret pain with respect to tissue damage in order to allay fears of long-term consequences. “The educational delivery should adopt a realistic tone as recovery may
take several weeks or months but [clinicians should] stress the positive prognosis […].” For those patients who do not see an optimal improvement in their PHP after intervention, the authors recommend offering shockwave therapy (ESWT), followed by custom orthoses. n Access the full review by visiting bjsm.bmj.com and typing ‘PHP’ in the search engine. Summer 2021
