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January 2004, Vol 94, No. 1 | American Journal of Public Health 50-52
© 2004 American Public Health Association

RESEARCH AND PRACTICE

Evaluation of Healing by Gentle Touch for the Treatment of Musculoskeletal Disorders

Clare Weze, MSc, Helen L. Leathard, PhD and Gretchen Stevens, BA

Clare Weze and Helen L. Leathard are with St Martin’s College, Lancaster, UK. Gretchen Stevens is with The Centre for Complementary Care, Cumbria, UK.

Correspondence: Requests for reprints should be sent to Clare Weze, MSc, Faculty of Health and Social Care, St Martin’s College, Lancaster, LA1 3JD United Kingdom (e-mail: clare.weze{at}ic24.net).


   INTRODUCTION
TOP
 INTRODUCTION
METHODS
 RESULTS
 DISCUSSION
 References
 
The Centre for Complementary Care, Eskdale, Cumbria, United Kingdom, has a reputation for improving the health and quality of life of its patients1,2 through healing by gentle touch3 and receives many referrals from health professionals in an area of rural and urban social deprivation, poor health, high unemployment, and poverty. Healing is used alone or in addition to medical or other treatment modalities.

In 1996, a North Cumbria Health Authority study of 110 patients with various ailments4 showed that healing at The Centre for Complementary Care was associated with improved physical and psychological functioning. Data collection continued, and records from 76 patients with musculoskeletal disorders have now been analyzed to evaluate the effectiveness and safety of healing in this patient group.


   METHODS
TOP
 INTRODUCTION
 METHODS
RESULTS
 DISCUSSION
 References
 
All new patients attending The Centre for Complementary Care between 1995 and 2001 were invited to participate in the questionnaire-based study to evaluate a first course of 4 treatment sessions. The purpose of the study and the assurance that there was no compulsion to participate were explained to each patient both verbally and in writing; all patients gave informed consent. Confidentiality and anonymity were ensured and maintained by using code numbers in place of names on all questionnaires.

The questionnaires included specific characteristics of the patients, expectations of treatment outcomes (entry questionnaire), and subjective scores for physical (pain, disability, immobility, sleep disturbances, ability to carry out usual activities) and psychological (stress, panic, fear, anger, relaxation, coping ability, depression/anxiety) functioning and quality of life. Symptom scoring was based on a 10-item visual analog scale questionnaire and the EuroQoL (EQ-5D), an extensively used and validated5–8 generic health status measure.

Differences between pre- and posttreatment scores were analyzed statistically with Wilcoxon signed rank tests for paired data with SPSS, Version 9.0 for Windows (SPSS Inc, Chicago, Ill). To determine whether the initial extent of their disease influenced the degree of benefit obtained, separate analyses were undertaken, in which patients were subgrouped by initial (entry questionnaire) severity of stress, pain, sleep disturbance, and coping ability. Changes after treatment were calculated separately for mild, moderate, and severe subgroups.


   RESULTS
TOP
 INTRODUCTION
 METHODS
 RESULTS
DISCUSSION
 References
 
Seventy-six patients were given and completed before- and after-treatment questionnaires. Local doctors referred 20%, and 80% were self-referred following recommendations by friends or health care professionals. Their median age was 52 years (range 21–86). Forty-five were female, 27 were male, and 4 did not disclose their gender. Diagnostic labels provided by the patients were back pain/injury (30 patients), joint pain/injury (15), osteoarthritis (26), and rheumatoid arthritis (5). Duration of symptoms was reported (by 66 of the patients) as more than 5 years (15 patients), 1 to 5 years (37), or less than 1 year (14). Sixty-six patients recorded concurrent medical treatment. They stated no particular expectations of outcome of healing sessions. No adverse effects of treatment were reported.

Visual analog scale scores (all patients) for stress, pain, and disability were reduced significantly (P < .001), whereas ability to cope, relaxation levels, and sleep patterns were improved (Table 1Go). EuroQoL results (Figure 1Go) showed significant shifts toward less severe problems with mobility, pain, usual activities, and anxiety or depression. General health ratings increased for most patients (P < .001; Table 1Go).


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  		TABLE 1— Median Scores Pre- and Posttreatment and Improvement After 4 Healing Sessions, by Symptom
 



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  		FIGURE 1— Number of participants responding in the affirmative for each EuroQoL questionnaire category, (a) pre- and (b) posttreatment.

 
Patients with the most severe symptoms on entry recorded the greatest improvements in visual analog scale scores for stress, pain, sleep patterns, and coping ability (P < .001) (Table 1Go). Those with mild or minor problems with these aspects of their ailment tended to report little improvement, and overall the changes were not statistically significant.


   DISCUSSION
TOP
 INTRODUCTION
 METHODS
 RESULTS
 DISCUSSION
References
 
Healing sessions were associated with marked subjective improvement in physical and psychological functioning for most patients in this study and were not associated with any adverse effects. Musculoskeletal disorders are, however, characterized by stable and acute episodes,9–11 so causality cannot be claimed with certainty.

Nevertheless, this study provides strong circumstantial evidence of benefit because significant improvements occurred in a comparatively short treatment period after patients had endured their condition for a long time; also, those patients with the most severe symptoms on entry experienced the greatest improvement.

The relief reported by patients with previously severe, intractable pain suggests that, when used as an adjunct to standard medical treatment, healing reduces the intensity and significance of pain and might provide a useful nonpharmacological ancillary for patients experiencing adverse effects from analgesics or anti-inflammatory drugs. Improvements in mobility and resumption of usual activities after treatment indicate that healing might synergize with the therapeutic effects of physiotherapy and enhance compliance with recommended exercise regimens, which are of considerable value in the management of osteoarthritis.12,13

The study population was representative of those encountered in routine clinical practice at The Centre for Complementary Care; thus, these findings are highly generalizable and justify evaluation of healing by prospective, randomized controlled trials and study of long-term effects.


   Footnotes
 
Contributors
C. Weze analyzed the data and wrote the brief. H. L. Leathard supervised data analysis and reviewed and revised drafts. G. Stevens contributed to writing.

Human Participant Protection
This study was approved by St Martin’s College, Lancaster, UK, in accordance with their "Ethical Principles and Guidelines for Research Involving People" (revised 2002).

Peer Reviewed

Accepted for publication March 5, 2003.


   References
TOP
 INTRODUCTION
 METHODS
 RESULTS
 DISCUSSION
 References
 
1. Luff D, Thomas K. Models of Complementary Therapy Provision in Primary Care. Medical Care Research Unit, Sheffield, UK: University of Sheffield; 1999.

2. Stevens G, Leathard HL. Child of a vision. Chrism. 2001;38(4):8–9.

3. MacManaway B, Turcan J. Healing: The Energy That Can Restore Health. Wellingborough, Northamptonshire, UK: Thorsons Publishers Ltd; 1983:38–43.

4. Tiplady P. Healing assessed by NHS. Chrism. 1996;33(3):9–11.

5. Brazier J, Jones N, Kind P. Testing the validity of the EuroQoL and comparing it with the SF-36 health survey questionnaire. Qual Life Res. 1993;2:169–180.[ISI][Medline]

6. Van Agt H, Essink-Bot M-L, Krabbe P, Bonsel G. Test-retest reliability of health state valuations collected with the EuroQoL questionnaire. Soc Sci Med. 1994;39:1537–1544.

7. Hurst NP, Jobanputra P, Hunter M, Lambert M, Lochhead A, Brown H. Validity of EuroQoL—a generic health status instrument—in patients with rheumatoid arthritis. Br J Rheumatol. 1994;33:655–662.[Abstract/Free Full Text]

8. Dorman PJ, Slattery J, Farrell B, Dennis MS, Sandercock PA. A randomised comparison of the EuroQol and Short Form-36 after stroke. BMJ. 1997;315:461.[Free Full Text]

9. Jones A, Doherty M. ABC of rheumatology: osteoarthritis. BMJ. 1995;310:457–460.[Free Full Text]

10. Birchfield PC. Osteoarthritis overview. Geriatr Nurs. 2001;22:124–131.[ISI][Medline]

11. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis Rheum. 2000;4:1905–1915.

12. Marks R. Quadriceps strength training for osteoarthritis of the knee: a literature review and analysis. Physiotherapy. 1993;79:13–18.

13. Doucette SA, Goble EM. The effect of exercise on patellar tracking in lateral patellar compression syndrome. Am J Sports Med. 1992;20:434–440.[Abstract/Free Full Text]




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This Article
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