title: Effects of shiatsu in the management of fibromyalgia symptoms: a controlled pilot study.
abstract: OBJECTIVE
  This pilot study aimed to evaluate the potential effects of Shiatsu massage on the symptoms of adult patients with primary fibromyalgia, propose a Shiatsu treatment protocol, verify patient acceptability, and evaluate the feasibility for a larger study.
  
  
  METHODS
  Thirty-four patients aged 33 to 62 years were divided into a Shiatsu group (SG; n = 17), who received full-body Shiatsu twice a week for 8 weeks, and a control group (n = 17), who received an educational booklet. The patients were assessed at baseline and after 8 weeks. Pain intensity was evaluated by the visual analog scale, pressure pain threshold by dolorimetry, anxiety by the State-Trait Anxiety Inventory, sleep by the Pittsburgh Sleep Quality Index, and symptoms impact on patient's health by the Fibromyalgia Impact Questionnaire. The SG was also questioned about adverse effects and level of satisfaction.
  
  
  RESULTS
  After treatment, the SG presented statistically significant differences (P < .05) for the change scores of all variables, except state anxiety, compared with the control group. Relative percentage changes were considered clinically relevant for visual analog scale (40.6%), pressure pain threshold (76.4%), Pittsburgh Sleep Quality Index (34.4%), and Fibromyalgia Impact Questionnaire (22.30%). No clinically relevant effects were observed for anxiety after treatment. No adverse effects were reported during the treatment, and about 94% of the patients demonstrated satisfaction with Shiatsu.
  
  
  CONCLUSIONS
  This pilot study showed the potential of Shiatsu in the improvement of pain intensity, pressure pain threshold, sleep quality, and symptoms impact on health of patients with fibromyalgia. The proposed Shiatsu treatment protocol was feasible and well accepted by the patients.
authors.affiliation: Department of Physical Therapy, Occupational Therapy and Speech Therapy of the School of Medicine at the University of Sao Paulo, Sao Paulo, Brazil. susanlkyuan@yahoo.com.br
authors.forename: Susan L K
authors.initials: SL
authors.lastname: Yuan
authors.forename: Ana A
authors.initials: AA
authors.lastname: Berssaneti
authors.forename: Amelia P
authors.initials: AP
authors.lastname: Marques
mesh_terms: D019050:Acupressure / Q000379:methods*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis* / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Acupressure; Anxiety; Fibromyalgia; Massage; Pain; Sleep