Hematopoietic Cell Transplant and Use of Massage for Improved Symptom Management: Results from a Pilot Randomized Control Trial

Abstract

Background. Pediatric hematopoietic cell transplant (HCT) is a lifesaving treatment that often results in physical and psychological discomfort. An acupressure-massage intervention may improve symptom management in this setting. Methods. This randomized controlled pilot trial compared a combined massage-acupressure intervention to usual care. Children were offered three practitioner-provided sessions per week throughout hospitalization. Parents were trained to provide additional acupressure as needed. Symptoms were assessed using nurses' reports and two questionnaires, the behavioral affective and somatic experiences scale and the Peds quality of life cancer module. Results. We enrolled 23 children, ages 5 to 18. Children receiving the intervention reported fewer days of mucositis (Hedges' g effect size ES = 0.63), lower overall symptom burden (ES = 0.26), feeling less tired and run-down (ES = 0.86), having fewer moderate/severe symptoms of pain, nausea, and fatigue (ES = 0.62), and less pain (ES = 0.42). The intervention group showed trends toward increasing contentness/serenity (ES = +0.50) and decreasing depression (ES = −0.45), but not decreased anxiety (ES = +0.42). Differences were not statistically significant. Discussion. Feasibility of studying massage-acupressure was established in children undergoing HCT. Larger studies are needed to test the efficacy of such interventions in reducing HCT-associated symptoms in children.

Effects of the application of therapeutic massage in children with cancer: a systematic review

“…In one of the papers (16) the average age was 6.9 years. In the remainder studies, subjects were between 4 and 18 years old 13 , 17 - 19 .…”

“…In one of the intervention groups massage therapy and humor is applied and in the other in addition to the above the parents were instructed in massage and relaxation. The intervention consisted of massage applied on the body 13 - 19 .…”

“…The maneuvers were applied in combination (13- 19 , predominating effleurage, petrissage and digital kneading 15 - 16 , 18 . In only one of the studies (16) effleurage was applied on legs, ending with stretching of the Achilles tendon and circular movements with fingers centrifugally.…”

“…In only one of the studies (16) effleurage was applied on legs, ending with stretching of the Achilles tendon and circular movements with fingers centrifugally. They performed techniques with light pressure 18 , moderate 15 ,17, 19 and firm 14 .…”

Used of Complementary and Alternative Medicine on Symptoms Management and Quality of Life

“…The most commonly evaluated these outcomes: pain, anxiety, fatigue, nausea, sleep, and quality of life in the articles. However, in some studies [4,20,21], CAM utilization was not efective. …”