JOURNAL CLUB

DR KAVYA C
1ST YEAR MD
[CLINICAL NATUROPATHY]
DATE : 16/02/2022
 TITLE : THE EFFECT OF HAND AND FOOT MASSAGE
ON FATIGUE IN HEMODIALYSIS PATIENTS : A
RANDOMIZED CONTROLLED TRIAL

 AUTHOR : SULTAN CECEN , DIGDEM LAFCI .

 PUBLISHED ON 9TH MARCH 2021 .

 JOURNAL : COMPLEMENTARY THERAPIES IN CLINICAL PRACTICE .

 IMPACT FACTOR : 2.445

 ABSTRACT

• OBJECTIVE

• METHODS

• RESULT

• CONCLUSIONS
 INTRODUCTION

• Chronic Renal Failure.

• Hemodialysis.
• Fatigue reduces the quality of life by adversely affecting individual’s daily life activities . Murtagh and weisbord
(2010) stated that 12–97% of patients receiving dialysis had fatigue problems .
• Massage works by reducing muscle spasms to encourage relaxation, as well as by accelerating the blood and
lymph circulation, thus aiding in the removal of metabolic waste from the body.
• Mechanical stimulation of the skin activates the gate-control mechanism and reduces pain by releasing endorphin
opioids such as encephalins .

F. Murtagh, S.D. Weisbord, Symptoms in renal disease; their epidemiology, assessment, and management, in: E.J. Chambers, E.A.
Brown, M.J. Germain (Eds.), Supportive Care for the Renal Patient, second ed., Oxford Press, Oxford, 2010, pp. 108–109
 METHODS
• AIMS .
• DESIGN .
 PARTICIPANTS

• INCLUSION CRITERIA
• EXCLUSION CRITERIA
 INTERVENTIONS
• THE PATIENT IDENTIFICATION FORM .
• THE VISUAL ANALOGUE SCALE FOR FATIQUE (VASFF) .
• HAND MASSAGE .
• FOOT MASSAGE .
• CONTROL GROUP .

o K. KOLCABA, V. SCHIRM, R. STEINER, EFFECTS OF HAND MASSAGE ON COMFORT OF NURSING HOME

RESIDENTS, GERIATR. NURS. 27 (2) (2006) 85–91, HTTPS://DOI.ORG/10.1016/J. GERINURSE.2006.02.006.
 DATA COLLECTION TOOLS

 STANDARDIZED MINI MENTAL TEST (SMMT).

• SMMT is a bedside screening test developed by folstein et al. (1975)
• The test, which covers five main areas and consists of 11 items, takes approximately 10 min to complete.
• In the smmt, a score of 24–30 points is considered normal,

- 20–23 is considered to indicate light/mild dementia,

-10–19 to indicate intermediate/mid-stage dementia,
-0–9 to indicate advanced dementia between .
Mini-Mental State Examination (MMSE) for the detection of Alzheimer’s disease and other dementias in people with
mild cognitive 1 impairment (MCI) (Protocol) Copyright © 2013 The Cochrane Collaboration. Published by John Wiley
& Sons, Ltd.

PATIENT IDENTIFICATION FORM.

• The patient identification form was created in accordance with the extant literature.
 VISUAL ANALOGUE SCALE FOR FATIGUE (VASFF).

• Lee et al. Developed the VASFF in 1990; it consists of 18 items to determine fatigue .
• This scale has two subcomponents, fatigue and energy .

• The fatigue subcomponent is calculated from the most positive to the most negative experience, while the
energy subcomponent is calculated from the most negative to the most positive.
• In the study by yurtsever, the cronbach’s alpha internal consistency coefficients of the scale were found to be
0.90 for fatigue and 0.74 for energy.
• The cronbach’s alpha internal consistency coefficients of vasff were 0.91 for fatigue and 0.73 for energy.

Visual Analogue Scale to Evaluate Fatigue Severity (VAS-F)

•Azmeh Shahid        Kate Wilkinson Shai Marcu Colin M. Shapiro
 DATA ANALYSIS.
• The IBM-SPSS 21.0 was used to evaluate the data and the medcalc statistical program
was used to calculate the sample size.
• The chi-square .
• One-way Anova
• The T –test .
• In the study p < 0.05 was considered statistically significant.

 ETHICAL CONSIDERATION.
• Hemodialysis patients who participated in the study were informed about the aim of
the study and their oral and written consent was obtained.
 RESULTS
• COMPARISON OF HAND MASSAGE, FOOT MASSAGE AND CONTROL GROUP
PATIENTS’ BASIC CHARACTERISTICS.
• COMPARISON OF PATIENTS IN THE HAND MASSAGE,
FOOT MASSAGE AND CONTROL GROUPS ACCORDING TO
DISEASE-RELATED CHARACTERISTICS
• COMPARISON OF KIDNEY FUNCTION VALUES, FATIGUE AND MEAN
ENERGY SCORE OF HAND MASSAGE, FOOT MASSAGE AND
CONTROL GROUP PATIENTS
• COMPARISON OF VASFF MEAN SCORES OF PATIENTS IN
THE HAND MASSAGE, FOOT MASSAGE AND CONTROL
GROUP: WITHIN-GROUP AND BETWEEN-GROUPS
 DISCUSSION
• Massage, by stimulating the sensitive receptors on and under the skin relaxing the muscles, and stimulating the
parasympathetic nervous system can have a calming, energy enhancing effect .

Y.H. Lee, B.N.R. Park, S.H. Kim, the effects of heat and massage application on autonomic nervous system, yonsei med.
J. 52 (6) (2011) 982–989

• Hasankhani et al. (2013) found that back massage decreases the level of fatigue.
• Shahdadi et al. (2016) reported that fatigue decreased after back massage .
• Lee (2016), in his research examining the effect of hand massage on fatigue, stress and depression in patients receiving
hemodialysis,
• Habibzadeh et al. (2019), in their study where they applied foot massage for 20 min, three times
a week, for eight weeks to patients who received hemodialysis, stated that the average fatigue
scores decreased .
• The present study is only the first study after that of habibzadeh et al. (2019) to examine the
effect of classical foot massage on fatigue in hemodialysis patients.
• It has been stated that massage reduces cortisol levels and increases serotonin and dopamine
levels .
 CONCLUSIONS

• The mean post-application fatigue scores of the patients in the hand massage and foot massage
group were lower than the score of the control group.
• The mean energy subdimension score within the foot massage group was higher than the pre-
application score.
 LIMITATIONS

• The data were obtained from patients diagnosed with CRF who were receiving hemodialysis and
who meet the research criteria, the research data can only be generalized to patients of this
nature.
• In this study nothing about pressure of masseur .
• Although the results can be converted into objective data using the scales, the data obtained
remain subjective in character.