title: The effect of massage therapy on autonomic activity in critically ill children.
abstract: Objectives. Our main objective was to describe the effect of foot and hand (F&H) massage on the autonomic nervous system (ANS) activity in children hospitalized in a pediatric intensive care unit (PICU); the secondary objectives were to assess the relationship between ANS function and the clinical severity and to explore the effects of repeated massage sessions on the ANS. Methods. Design was a descriptive experimental study. Intervention was single or six session(s) of F&H massage. ANS function was assessed through the frequency-domain analysis of heart rate variability. Main metrics included high and low frequency power (HF and LF), HF + LF, and LF/HF ratio. Results. Eighteen children participated in the study. A strong Spearman's correlation (ρ = -0.77) was observed between HF + LF and clinical severity. During massage, the parasympathetic activity (measured by HF) increased significantly from baseline (P = 0.04) with a mean percentage increase of 75% (95% CI: 20%∼130%). LF increased by 56% (95% CI: 20%∼92%) (P = 0.026). Repeated sessions were associated with a persistent effect on HF and LF which peaked at the second session and remained stable thereafter. Conclusions. HF + LF is positively correlated with clinical severity. F&H massage can improve the ANS activity and the effect persists when repeated sessions are offered.
authors.affiliation: Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4.
authors.forename: Ling
authors.initials: L
authors.lastname: Guan
authors.affiliation: Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4.
authors.forename: Jean-Paul
authors.identifier: 0000-0001-9900-0403
authors.initials: JP
authors.lastname: Collet
authors.affiliation: Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Yuskiv
authors.affiliation: Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Division of Critical Care, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6H 3V4.
authors.forename: Peter
authors.initials: P
authors.lastname: Skippen
authors.affiliation: Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4 ; Department of Statistics, University of British Columbia, Vancouver, BC, Canada V6T 1Z4.
authors.forename: Rollin
authors.initials: R
authors.lastname: Brant
authors.affiliation: Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4 ; Division of Critical Care, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6H 3V4.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Kissoon