Intervention Review

Massage and touch for dementia

  1. Niels Viggo Hansen1,*,
  2. Torben Jørgensen2,
  3. Lisbeth Ørtenblad3

Editorial Group: Cochrane Dementia and Cognitive Improvement Group

Published Online: 18 OCT 2006

Assessed as up-to-date: 2 AUG 2006

DOI: 10.1002/14651858.CD004989.pub2


How to Cite

Hansen NV, Jørgensen T, Ørtenblad L. Massage and touch for dementia. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004989. DOI: 10.1002/14651858.CD004989.pub2.

Author Information

  1. 1

    Danish Cancer Society, Copenhagen, Denmark

  2. 2

    Helsingør, Denmark

  3. 3

    University of Aarhus, The Research Unit for General Practice, Aarhus C, Denmark

*Niels Viggo Hansen, Danish Cancer Society, Kræftens Bekæmpelse, Strandboulevarden 49, Copenhagen, 2100, Denmark. nvh@cancer.dk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 OCT 2006

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Massage and touch have been suggested as a non-pharmacological alternative or supplement to other treatments offered in order to reduce or manage a range of conditions associated with dementia such as anxiety, agitated behaviour and depression. It has also been suggested that massage and touch may counteract cognitive decline.

Objectives

To assess the effects of a range of massage and touch therapies on conditions associated with dementia, such as anxiety, agitated behaviour and depression, identify any adverse effects, and provide recommendations about future trials.

Search methods

We identified trials from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 12 July 2005 using the terms massage, reflexology, touch and shiatsu. This Register contains records from all major healthcare databases and many ongoing trials databases and is updated regularly. In addition, general and specific literature databases were searched and patient and therapist organizations contacted.

Selection criteria

Randomized controlled trials (RCTs) in which a massage or touch intervention was given to persons suffering from dementia of any type, compared with other treatments or no treatment, and in which effect parameters included measures of behavioural problems, caregiver burden, emotional distress or cognitive abilities, were eligible for inclusion. Furthermore, we employed a set of minimal methodological quality criteria as a selection filter.

Data collection and analysis

We identified 34 references in the initial searches. Of these, seven were actual or possible RCTs, but only two were found to meet the requirements of the set of minimal methodological criteria.

Main results

The very limited amount of reliable evidence available is in favour of massage and touch interventions for problems associated with dementia. However, this evidence addresses only two specific applications: hand massage for the immediate or short-term reduction of agitated behaviour, and the addition of touch to verbal encouragement to eat for the normalization of nutritional intake. The existing evidence does not support general conclusions about the effect or possible side effects of such interventions. No severe side effects were identified.

Authors' conclusions

Massage and touch may serve as alternatives or complements to other therapies for the management of behavioural, emotional and perhaps other conditions associated with dementia. More research is needed, however, to provide definitive evidence about the benefits of these interventions.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Insufficient evidence to draw conclusions about the possibility that massage and touch interventions are effective for dementia or associated problems

Massage and touch interventions have been proposed as an alternative or supplement to pharmacological and other treatments to counteract anxiety, agitated behaviour, depression, and if possible to slow down cognitive decline in people with dementia. This review provides an overview of existing research on the use of massage for people with dementia. Eighteen studies of the effects of massage interventions were located, but only two small studies were of a sufficient methodological rigour to count as evidence to answer the question of effect.

The small amount of evidence currently available is in favour of massage and touch interventions, but is too limited in scope to allow for general conclusions. Further, high-quality randomized controlled trials are required.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

失智症病患之按摩和觸拍治療

按摩和觸拍已被建議為一種非藥物治療的替代或補充治療,藉以減少或處理失智症患者的衍生問題,如焦慮,激動行為和憂鬱症。也有人認為按摩和觸拍可減緩認知下降的速度。

目標

評估按摩和觸拍療法對失智症患者相關的症狀,如焦慮,激動行為和憂鬱的影響,辨認可能之副作用,並對未來的試驗提供建議。

搜尋策略

我們在2005年7月12日,從Specialized Register of the Cochrane Dementia and Cognitive Improvement Group資料庫中搜尋了包含按摩、足部反射、觸拍和指壓按摩等名稱。該系統紀錄所有主要健康照護的資料和正在進行的試驗數據,並定期更新。此外我們也檢索一般和特定資料庫,並聯繫病患和治療師所在機構。

選擇標準

隨機對照試驗(RCTs)給予不同類型的失智症的人按摩或觸拍,與採其他治療或未接受治療者比較,效果參數包括行為異常測量,照顧者的負擔,情緒困擾或認知能力。此外,我們採納了一套基本的方法學品質標準,作為選擇的工具。

資料收集與分析

我們在初步搜尋時獲得34篇參考文獻。其中7篇確定或可能為隨機對照試驗,但只有2篇符合我們所要求的基本方法學標準。

主要結論

從有限的可靠的證據中,結果支持按摩和觸拍對失智症相關的症候有所幫助。不過這方面的證據只針對兩個特定的應用:為即時或短期減少激動行為的手部按摩,及觸拍加上口頭的鼓勵,使病患能達到正常的營養攝取量。目前的證據無法就其療效或可能副作用達成廣泛的結論,而結果也無發現嚴重的副作用。

作者結論

按摩和觸拍可作為處理行為、情緒等失智症相關狀況的替代或補充療法。不過還需要進行更多的研究才能為這些治療的好處提供明確的證據。

翻譯人

本摘要由高雄長庚醫院顏如君翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有足夠實證可為按摩和觸摸對失智症或其衍生的問題得出結論。按摩和觸摸已被建議為藥物治療以外的替代或補充的治療方法,以降低失智症相關的問題如焦慮、激動行為、憂鬱。甚至減緩認知的下降速度。本評論就失智症按摩的現有研究提供概述。我們搜尋到18篇有關按摩療效的研究,但只有兩篇小規模的研究符合嚴謹的方法,來提供其療效的證據。現有少量證據贊成按摩和觸摸的治療,但因證據數量有限以致無法達成結論。此外高品質的隨機對照試驗是必需的。