Foot massage versus quiet presence on agitation and mood in people with dementia: a randomised controlled trial.
BACKGROUND
There is increasing interest in using complementary and alternative treatments to manage behavioural and psychological symptoms of dementia such as agitation, aggression and depressed mood.


OBJECTIVE
To compare the effect of foot massage (intervention) and quiet presence (control) on agitation and mood in people with dementia.


METHODS
A randomised controlled trial using a within-subjects, crossover design.


METHODS
Five long-term care facilities in Brisbane, Australia. The primary outcome was the Cohen-Mansfield Agitation Inventory (CMAI) and the secondary outcome was the Observed Emotion Rating Scale (OERS). The screening and data collection research assistants, families, and care staff were blinded to participant allocation.


METHODS
Participants of the study were 55 long-term care residents aged 74-103 years (mean age 86.5), with moderate to severe dementia and a history of agitated behaviour according to the Pittsburgh Agitation Scale. A computer-program randomised participants to 10-min foot massage (intervention) or quiet presence (control), every weekday for 3 weeks.


RESULTS
A carry-over effect was identified in the data, and so the data was treated as a parallel groups RCT. The mean total CMAI increased in both groups (reflecting an increase in agitation) with this increase greater in the quiet presence group than the foot massage group (p=0.03). There was a trend towards a difference on OERS General Alertness, with a positive change in alertness for participants in the foot massage group (indicating reduced alertness) and a negative change for participants in the quiet presence group (indicating increased alertness) (F(1,51)=3.88, p=0.05, partial ή(2)=0.07).


CONCLUSIONS
The findings highlight the need for further research on the specific conditions under which massage might promote relaxation and improve mood for people with dementia. The unfamiliar research assistants and variations in usual activity may have contributed to the increase in agitation and this needs further research.


BACKGROUND
ACTRN12612000658819.
Griffith Health Institute, Griffith University, Brisbane, Australia; Centre for Health Practice Innovation, 170 Kessels Road, Nathan, Griffith University, Brisbane, Australia; Dementia Collaborative Research Centre, Queensland University of Technology, Brisbane, Australia. Electronic address: w.moyle@griffith.edu.au.
Wendy
W
Moyle
Griffith Health Institute, Griffith University, Brisbane, Australia; Centre for Health Practice Innovation, 170 Kessels Road, Nathan, Griffith University, Brisbane, Australia.
Marie Louise
ML
Cooke
Dementia Collaborative Research Centre, Queensland University of Technology, Brisbane, Australia.
Elizabeth
E
Beattie
Griffith Health Institute, Griffith University, Brisbane, Australia; Behavioural Basis of Health, Griffith University, Mt Gravatt Campus, Brisbane, Australia.
David H K
DH
Shum
Griffith Health Institute, Griffith University, Brisbane, Australia; Centre for Health Practice Innovation, 170 Kessels Road, Nathan, Griffith University, Brisbane, Australia; Dementia Collaborative Research Centre, Queensland University of Technology, Brisbane, Australia.
Siobhan T
ST
O'Dwyer
Griffith Health Institute, Griffith University, Brisbane, Australia; Centre for Health Practice Innovation, 170 Kessels Road, Nathan, Griffith University, Brisbane, Australia.
Sue
S
Barrett
D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D005528:Foot; D006801:Humans; D008297:Male; D008405:Massage; D011595:Psychomotor Agitation
Agitation; Behavioural and psychological symptoms of dementia; Complementary therapies; Dementia; Massage