Benign Paroxysmal Positional Vertigo After Use of Handheld Massage Gun.

This report describes 2 cases of benign paroxysmal positional vertigo symptoms in middle-aged patients who experienced onset after using a handheld massage gun.

Abdominal massage to prevent ileus after colorectal surgery. A single-center, prospective, randomized clinical trial: the MATRAC Trial.

BACKGROUND: There is scarce literature on the effect of mechanical abdominal massage on the duration of ileus after colectomy, particularly in the era of enhanced recovery after surgery (ERAS). The aim of this study was to determine whether abdominal massage after colorectal surgery with anastomosis and no stoma helps toward a faster return of intestinal transit. METHODS: This study was a superiority trial and designed as a prospective open-label, single-center, randomized controlled clinical trial with two parallel groups. Patients scheduled to undergo intestinal resection and follow an ERAS protocol were randomly assigned to either the standard ERAS group or the ERAS plus massage group. The primary endpoint was the return of intestinal transit, defined as the first passage of flatus following the operation. Secondary endpoints included time of the first bowel motion, maximal pain, 30 day complications, complications due to massage, anxiety score given by the Hospital Anxiety and Depression (HAD) questionnaire, and quality of life assessed by the EQ-5D-3L questionnaire. RESULTS: Between July 2020 and June 2021, 36 patients were randomly assigned to the ERAS group or the ERAS plus massage group (n = 19). Patients characteristics were comparable. There was no significant difference in time to passage of the first flatus between the ERAS group and the ERAS plus abdominal massage group (1065 versus 1389 min, p = 0.274). No statistically significant intergroup difference was noted for the secondary endpoints. CONCLUSION: Our study, despite its limitations, failed to demonstrate any advantage of abdominal massage to prevent or even reduce symptoms of postoperative ileus after colorectal surgery. TRIAL REGISTRATION NUMBER: 38RC20.021.

Eye Rubbing in Chinese Patients With Keratoconus: A Multicenter Analysis.

PURPOSE: To investigate the eye rubbing habits of Chinese patients with keratoconus. METHODS: This study was carried out from 2018 to June 2022 at Shandong Eye Hospital, Qingdao Eye Hospital, and Henan Eye Hospital. The study compared the number of patients who rubbed their eyes between medical records and second time questionnaires, eye rubbing of patients with myopia and patients with keratoconus, and disease severity between patients with keratoconus. A questionnaire survey of ophthalmologists was conducted to determine their degree of awareness that eye rubbing is a risk factor for keratoconus. RESULTS: The study assessed 799 patients with keratoconus and 798 control patients, and 97 ophthalmologists. The average proportion of patients with keratoconus who rubbed their eyes was 31.0% in the medical records with an increasing trend related to the increase in ophthalmologists' awareness, 66.6% after the second follow-up, and 25.4% among patients with myopia. After multivariate analysis, the following variables showed significant results: eye rubbing frequency more than 10 times/day (odds ratio [OR], 9.168; P < .001); rubbing with knuckles (OR, 9.804; P = .001); and prone sleep position (OR, 12.427; P < .001). The proportion of patients who rubbed their eyes with stage IV keratoconus was 71.9%, 18.9% higher than those with stage I, 4.8% higher than stage II, and 17.8% higher than stage III. CONCLUSIONS: The proportion of Chinese patients with keratoconus who rubbed their eyes was relatively high. The main reasons for the low proportions reported were lack of attention. Clinical attention should be paid to eye rubbing in patients with keratoconus who should be educated to avoid it. [J Refract Surg. 2023;39(10):712-718.].

Guidelines Relevant to Diagnosis, Assessment, and Management of Lymphedema: A Systematic Review.

Significance: Lymphedema is a common, distressing and debilitating condition with various etiologies. Effective diagnosis, assessment, and management rely on evidence-based clinical practice guidelines ("guidelines"). This study aims to describe and compare international guidelines on lymphedema diagnosis, assessment, and management. Recent Advances: The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and registered on the International Prospective Register of Systematic Reviews (PROSPERO). Systematic searches of electronic literature databases and the web were completed in December 2020 for lymphedema guidelines published in English since 2000. Quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE)-II reporting checklist. Synthesis took a narrative approach to compare guideline recommendations and associated levels of evidence. Critical Issues: This systematic review of 1,564 articles and 159 web pages yielded 14 guidelines. All guidelines were from high-income countries. Ten focused exclusively on lymphedema, and four on cancer. Most (n = 13) guidelines recommended an integrated medical, psychological assessment, and physical examination, with a limb volume measurement of >10% in the affected limb compared, confirming a lymphedema diagnosis. Recommended management involved Complex Decongestive Therapy (CDT) followed by self-management using skincare, self-lymphatic drainage massage, exercise, and compression. Future Directions: The underlying etiology of lymphedema appeared to make little difference to guideline recommendations regarding care. High-quality guidelines are available to guide lymphedema care. However, their suitability for low-resource settings is unclear.

The effect of abdominal massage on enteral nutrition tolerance in patients on mechanical ventilation: A Randomized Controlled Study.

OBJECTIVE: To assess whether abdominal massage impacts enteral feeding tolerance in mechanically ventilated patients. METHODS: Patients were randomized to receive standard or intervention care (standard care plus a 15-minute abdominal massage twice daily) for three days. We recorded the vomiting, reflux, gastric retention, aspiration, diarrhea, abdominal distension, gastric residual volume and abdominal circumference from days one to three. A P-value of less than 0.05 was statistically significant. RESULTS: Seventy-four patients (37 per group) were recruited (intervention vs control: age 58.03 ± 10.44 vs 55.33 ± 12.45 years; %M: 69.70 % vs 69.70 %). The aspiration, gastric retention and abdominal distension incidence in the intervention group was 3.03 %, 6.06 % and 9.09 %, whereas in the control group it was 24.24 %, 30.30 % and 27.27 % (P <.05). The vomiting, reflux and diarrhea incidence for patients in the intervention group were all 3.03 %, whereas in the control group they were 3.03 %, 9.09 % and 9.09 % (P >.05). From day 1 to day 3, the gastric residual volume decreased from 87.23 ± 3.29 mL to 72.59 ± 5.40 mL in the intervention group and increased from 91.94 ± 3.45 mL to 105.00 ± 6.94 mL in the control group. Similarly, the abdominal circumference decreased from 84.41 ± 1.73 cm to 82.44 ± 1.73 cm in the intervention group and increased from 87.90 ± 1.60 cm to 88.90 ± 1.75 cm in the control group. The differences in time, group, and interaction effects between the two groups were statistically significant for abdominal circumference and gastric residual volume (P <.05). CONCLUSIONS: Abdominal massage can effectively reduce gastric retention, abdominal distension, aspiration, gastric residual volume and abdominal circumference in mechanically ventilated patients, but not the incidence of vomiting, reflux and diarrhea.

Association of position change and back massage and early ambulation with post-transfemoral coronary angiography complications.

INTRODUCTION: Transfemoral coronary angiography (TFCA) may be associated with postoperative complications, such as oozing, bleeding, ecchymosis, hematoma, and back pain. Thus, nursing practice must help enhance patient safety post-TFCA. OBJECTIVE: This study aimed to assess the association of position change and back massage (PCBM) and early ambulation (EA) with the development of post-TFCA complications. METHODS: This study adopted a randomized controlled trial design and was conducted at the coronary care unit of a university hospital in Egypt. A sample of 185 patients undergoing TFCA was evaluated during the first 6 h post-TFCA and randomly assigned to either the PCBM (n = 92) or EA (n = 93) group, with the latter receiving the intervention after the first 3 h post-TFCA. The patients were assessed using the Post-transfemoral Coronary Angiography Complication assessment tool. RESULTS: Comparing the two groups based on post-TFCA complications, the PCBM group had a lower frequency of bleeding, ecchymosis, hematoma and severe lower back pain whereas the EA group had a lower frequency of oozing, all of which were statistically significant (P < 0.05). CONCLUSION: PCBM post-TFCA can lower the frequency of significant vascular complications. RECOMMENDATION: Adopting PCBM may be valuable in post-TFCA nursing practice.

Facial Nerve Massage for the Treatment of Hemifacial Spasm Refractory to Microvascular Decompression: Outcomes and Complications.

BACKGROUND: After microvascular decompression (MVD) for hemifacial spasm (HFS), a minority of patients realize little to no relief of spasms. In some patients, the absence of relief of spasms results from incomplete or inadequate decompression of vascular compression of the facial nerve, and these patients represent excellent candidates for repeat MVD. However, in other patients, repeat MVD is not appropriate because adequate decompression and resolution of neurovascular compression, as determined by postoperative high-resolution MRI, was achieved with the initial operation. OBJECTIVE: To present a cohort of patients with a history of HFS refractory to MVD, with no evidence of neurovascular compression on postoperative MRI, who underwent facial nerve massage (FNM) in the posterior fossa in an attempt to relieve spasms. METHODS: Thirteen patients with a history of incomplete relief of spasms after technically adequate MVD surgery for hemifacial spasm underwent FNM. Immediate and long-term degree of spasm relief and complications after FNM were documented through in-person or telemedicine interview. RESULTS: At follow-up after FNM, 7 of 12 patients (58.3%) reported complete spasm relief (grade I), 2 of 12 patients (16.7%) reported >75% spasm relief (grade II), 0 patient (0%) reported >50% spasm relief (grade III), 3 of 12 (25.0%) patients reported <50% spasm relief (grade IV), and 1 patient was lost to follow-up. One patient experienced a delayed facial paresis, and another patient experienced high-frequency hearing loss. CONCLUSION: After FNM, durable and, at least, partial relief of spasms with a relatively low complication rate was observed in most patients with HFS with incomplete relief of spasms after technically adequate prior MVD.

Lens subluxation after use of a percussion massage gun: A case report.

RATIONALE: To report the first case of lens dislocation and secondary acute angle-closure glaucoma (AACG) following use of a percussion massage gun (PMG) around the eye. PATIENT CONCERNS: A 69-year-old Chinese man had been using a PMG around his right eye for 2 months in order to relieve headache. After eye pain and blurred vision for 5 days, he went to the ophthalmological emergency department. His best-corrected visual acuity at distance was counting fingers. DIAGNOSIS: The patient was diagnosed with lens subluxation, secondary AACG and pterygium in the right eye. Cataracts were diagnosed in both eyes. INTERVENTIONS: The patient underwent phacoemulsification and anterior vitrectomy. After surgery, the patient was given eye drops containing tobramycin, dexamethasone, 0.1% bromfenac sodium hydrate ophthalmic solution and Mydrin-P for 1 month. OUTCOMES: At 3-month follow-up, uncorrected visual acuity in the right eye was counting fingers. The outcome of optometry in the right eye was +11.50 DS/-0.50 DC * 110°, with corrected-distance visual acuity of 4/20. IOP was 20.7 mm Hg in the right eye and 15.7 mm Hg in the left. Endothelium in the right cornea showed endothelial damage. Nevertheless, the patient reported no right eye pain anymore, and he indicated that he was satisfied with his situation. LESSONS: Caregivers, sports professionals and the general public should be aware of the dangers of PMGs and the need to use them appropriately and safely, for example during self-massage and rehabilitation therapy. In particular, we recommend not using PMGs above the neck, which should be clearly indicated in instruction manuals.

Effectiveness and safety of massage in the treatment of anxiety and depression in patients with cancer: A protocol for systematic review and meta-analysis.

BACKGROUND: Anxiety and depression, complications of cancer, are prevalent but often overlooked mental illnesses. Studies have demonstrated that massage therapy is useful in relieving anxiety and depression of cancer survivors. However, the mechanism is still unclear and no systematic review has provided sufficient evidence for the treatment. Therefore, this protocol is carried out to comprehensively evaluate the reliability of cancer patients with anxiety and depression treated by massage. METHODS: We will systematically search the relevant literature from PubMed, Cochrane Library, EMBASE, Web of Science, Wanfang, Chongqing VIP, CNKI and Chinese Biomedical Literature Database from the establishment of the databases to June 1, 2020. In addition, we will only include randomized controlled trials about massage for cancer survivors with anxiety and depression, regardless of language and publication status. Two experienced researchers will separately screen the literature, collect data, analyze data and synthesize data using RevMan V.5.3 software. The quality of the included trials in the study will be assessed by the Cochrane bias risk assessment tool. RESULTS: The protocol for the meta-analysis will systematically evaluate the reliability of massage therapy for cancer patients with anxiety and depression. CONCLUSION: This conclusion will provide an important basis for evaluating whether massage is reliable in treating cancer survivors who feel anxious and depressed. INPLASY REGISTRATION NUMBER: INPLASY202060101.

Femoral shaft fracture following oil massage in neonates: a single-centre experience.

Femoral shaft fractures following oil massage in newborns are very rare. We describe our observations at a tertiary centre in northern India. Three such cases encountered during the study period from July 2014 to June 2019 were evaluated. Sociocultural details, neonatal illnesses, mode of delivery, history of child abuse, type of fracture and management were recorded and analysed. All patients had a mid-shaft fracture after forceful oil massage by caring grandmothers. They all had complete union of fractures by the end of four weeks. This case series shows that mid-shaft fracture femur in neonates has excellent long-term prognosis, but the practice of oil massage needs to be modulated.

Sudden Aggravated Radicular Pain Caused by Hemorrhagic Spinal Angiolipomas After Back Massage.

BACKGROUND: Spinal angiolipomas (SALs) are benign tumors that usually present a slow progressive spinal cord or radicular compression. Acute myelopathy or acute aggravated radicular syndrome are exceedingly rare. CASE DESCRIPTION: The authors report an original case with sudden aggravated radicular pain caused by hemorrhagic SALs. A 54-year-old woman presented with a 2-month history of mild back pain, and the pain was significantly aggravated after a therapeutic back massage. Neurologic examination showed pain and hyperalgesia between T4 and T7 dermatome, from back to front, just like a band. Spinal magnetic resonance imaging (MRI) showed a dorsally located epidural lesion (T4-T6) and a small intratumoral hemorrhage at the lower part of the tumor. A bilateral T4-T6 laminectomy was performed to achieve total excision of the tumors. Histologic examination showed that the tumors were composed of mature adipose tissue and vascular tissue as angiolipomas. The postoperative course was uneventful with complete neurologic recovery 4 days after the surgery. MRI at 1-year follow-up indicated no recurrence. CONCLUSIONS: SALs are unusual benign tumors that are composed of mature fatty tissue and abnormal blood vessels; sudden aggravated spinal cord or radicular compression syndrome is rare. MRI is the best choice in the diagnosis of SALs. Surgery may be performed in different ways depending on the type of SALs, and the prognosis is generally good.

Evaluation and visualization of facial massage effects by using ultraviolet stereo-image correlation.

BACKGROUND/PURPOSE: This study proposes a technique for visualizing the effect of facial massage using stereo-image correlation with melanin pigment. METHOD: In this method, the melanin pigment of a subject's face is made visible by using an ultraviolet light and utilized as a random pattern for stereo-image correlation. Stereo-pair images of the face with the melanin pigment before and after facial massage are recorded using a desk-sized measurement equipment. Then, the deformation of the face by the massage can be obtained based on the principle of stereovision. The effectiveness of the proposed method is demonstrated by applying it to the massage effect evaluation of eight subjects (females in their 40s). RESULTS: The results show that the massage effect can be visualized from the displacement and strain distributions across the face obtained by the proposed method. In addition, it is observed that the face is displaced significantly by the massage and individual differences between the subjects can be captured. CONCLUSION: The proposed method is effective for evaluating the effect of a facial massage when the painted pattern disappears due to the applied cream during the massage.

Local dissemination of osteosarcoma observed after massage therapy: a case report.

BACKGROUND: Limited evidence is available regarding the dissemination of tumor tissues due to compression during massage therapy, a routine procedure in patients with various symptoms in Asian countries. CASE PRESENTATION: A 12-year-old male presented at a massage clinic with pain and swelling of his left knee, which worsened the same night. Consistent with conventional osteosarcoma, radiography revealed cortical bone destruction, osteoblastic changes, and periosteal reactions. Magnetic resonance imaging revealed a tumor in the distal femur, an extraskeletal mass, and an infiltrative lesion in the intramuscular and neurovascular areas surrounding the distal femur; this was considered as hemorrhage and dissemination of the tumor tissue. 18Fluorine-labelled fluorodeoxyglucose-positron emission tomography and computed tomography revealed multiple metastases in the spine, liver, and lung. Consistent with osteosarcoma, histopathological examination revealed tumor cell proliferation with extensive pleomorphism and mitoses. Despite undergoing chemotherapy, radiation therapy, and hip disarticulation, the patient died due to multiple metastases 13 months after the initial diagnosis. CONCLUSIONS: The present case suggests association of massage therapy with the local dissemination of tumor tissues, although influence of massage therapy on metastatic lesions remains unclear. Massage therapists should be aware of the possibility for dissemination of hidden malignancies due to the procedure.

Effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy on management of breast cancer-related lymphedema.

PURPOSE: To assess the effectiveness and safety of a product containing diosmin, coumarin, and arbutin (Linfadren®) in addition to complex decongestive therapy (CDT) on the management of patients with a breast cancer-related lymphedema (BCRL). METHODS: Fifty outpatients (average age of 56.2 ± 2.7 years, range 28-71) with a BCRL were enrolled for this study. Patients were randomly assigned (1:1 ratio) to receive either CDT consisting of skin care, manual lymphatic drainage, remedial exercises, and elastic compression garment (control group, n = 25) or CDT plus Linfadren® (study group, n = 25). Patients were evaluated before and after treatment and 3 months after the end of treatment. Primary outcomes were reduction of upper limb excess volume (EV) and percentage reduction of excess volume (%REV). Secondary outcomes were improvement in Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and patient's perception of treatment effectiveness (PPTE). RESULTS: Addition of Linfadren® to CDT yielded an additional reduction of primary outcomes both after treatment (EV, - 521 ml vs. - 256 ml, P < 0.0001; %REV, - 66.4% vs. - 34%, P = 0.02) and at 3-month follow-up (EV, - 59 ml vs. + 24 ml, P < 0.0001; %REV, - 73.6% vs. - 31.4%, P = 0.004). Moreover, statistically significant differences were found between the two groups for the secondary outcomes after treatment (QuickDASH, P = 0.006; PPTE, P = 0.03) and at 3-month follow-up (QuickDASH, P = 0.006; PPTE, P = 0.02). No patient showed adverse events. CONCLUSIONS: Linfadren® in addition to CDT was a safe and effective therapy for reducing BCRL and was better than CDT alone.

Clinical massage therapy for patients with cancer-related fatigue protocol of a systematic review.

BACKGROUND: Cancer-related fatigue (CRF) is a prevalent and debilitating symptom experienced by cancer survivors, one that severely compromises functional independence and quality of life. Clinical massage therapy (CMT), as an important part of complementary and alternative medicine, is widely employed among massage therapists, physical therapists, nurses, and physicians when managing CRF. Clinical research indicates that CMT produced relief of CRF. In this systematic review, we aim to evaluate the effectiveness and safety of CMT for patients with CRF. METHODS: We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of CMT for CRF in cancer patients: CENTRAL, Embase, MEDILINE, CINAHL and China National Knowledge Infrastructure. Each database will be searched from inception to October 2018. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses. RESULTS: This proposed study will evaluate the effectiveness and safety of CMT for CRF. The outcomes will include change in quality of life, fatigue relief and adverse effect. CONCLUSIONS: This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of CMT for patients with CRF. DISSEMINATION AND ETHICS: The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.

Cauda Equina Syndrome Due to Vigorous Back Massage With Spinal Manipulation in a Patient With Pre-Existing Lumbar Disc Herniation: A Case Report and Literature Review.

Cauda equina syndrome (CES) resulting from acute lumbar disc herniation due to spinal massage is extremely rare. We present a case of CES caused by the acute worsening of a lumbar disc herniation after a vigorous back massage that included spinal manipulation. After vigorous back massage with spinal manipulation performed by a massage therapist, a 38-yr-old male patient experienced CES with severe numbness in both lower limbs, inability to walk due to weakness of bilateral lower limbs, and incontinence of urine and feces. The magnetic resonance imaging and computer tomography scan results showed that the L4-5 disc herniated down into the spinal canal, extensively compressing the ventral dural sac. The patient was successfully treated with an emergency operation including laminectomy, spinal canal decompression, discectomy, interbody fusion, and pedicle screw fixation. The muscle power in both lower limbs of the patient recovered rapidly to support standing only 1 wk later. Moreover, he regained continence of urine and feces. In conclusion, this case brings us novel knowledge that spinal massage or manipulation may worsen pre-existing disc herniation causing CES, and a timely emergency surgery is necessary and effective for treatment of CES-related symptoms.

Is neck massage safe? A rare case of tetraplegia and spinal shock after neck manipulation.

Neck manipulation is associated with spinal cord injury. However, occurrence of such cases is infrequent. This article presents a 33-year-old gentleman who sustained acute tetraplegia after neck manipulation. The aim of this case report is to create awareness that vigorous neck manipulation could cause injury to the spinal cord.

Bilateral rupture of the posterior capsule and intraocular lens dislocation from excessive eye rubbing.

UNLABELLED: We report an unusual case of a 36-year-old woman with severe atopic eczema who developed sudden-onset reduction of vision in the right eye following excessive eye rubbing 9 years after cataract surgery. Examination identified posterior capsule rupture with dislocation of the intraocular lens (IOL) posteriorly into the vitreous cavity in the right eye and posterior capsule rupture with mild dislocation of the IOL in the bag in the left eye. To our knowledge, this is the first reported case of simultaneous bilateral posterior capsule rupture following uneventful surgery and secondary to eye rubbing. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.