The Effects of Massage Therapy in Decreasing Pain and Anxiety in Post-Surgical Patients With Breast Cancer: A Systematic Review and Meta-Analysis.

Background: Massage therapy is an effective non-pharmacological intervention in treating pain and anxiety of patients with cancer. Prior studies have reviewed the benefits of massage therapy in patients with breast cancer undergoing chemotherapy, radiation, and other patient-specific cancer treatments. What has yet to be examined is the effects of massage therapy on the pain and anxiety of patients with breast cancer after surgery. Objective: : The purpose of this systematic review and meta-analysis was to examine the effect of massage therapy on post-surgical pain and anxiety in patients with breast cancer. Methods: Systematic searches were performed using databases PubMed, CINAHL, and Medline (EBSCO), with no date constraint through September 30, 2023, to identify randomized control trials, randomized pilot, and quasi-experimental studies. The database searches retrieved 1205 titles, and after screening, 7 studies were chosen for full analysis using Cohen's d, 95% Confidence Interval (CI), and effect size. The heterogeneity of the studies was calculated in the meta-analysis using Cochran's Q equation. Results: Massage therapy techniques reported were massage therapy, classic massage, reflexology, myofascial release, and myofascial therapy, and were performed at day 0 up to 16 weeks post-surgery. Massage therapy decreased pain and anxiety for patients in the massage group. Analyses showed a positive effect size using massage therapy as an intervention for pain and anxiety in women with breast cancer post-surgery. Overall effect size for pain was 1.057 with a P-value of <.0001, and overall effect size for anxiety was .673 with a P-value of <.0001. Conclusion: The current evidence in this study reflects that massage therapy is effective as a non-pharmacological tool in decreasing post-surgical pain and anxiety in women with breast cancer.

Maximizing Cochlear Implant Outcomes with Short-Term Aural Rehabilitation.

BACKGROUND: Increasing numbers of adults are receiving cochlear implants (CIs) and many achieve high levels of speech perception and improved quality of life. However, a proportion of implant recipients still struggle due to limited speech recognition and/or greater communication demands in their daily lives. For these individuals a program of aural rehabilitation (AR) has the potential to improve outcomes. PURPOSE: The study investigated the effects of a short-term AR intervention on speech recognition, functional communication, and psychosocial outcomes in post lingually deafened adult CI users. RESEARCH DESIGN: The experimental design was a multisite clinical study with participants randomized to either an AR treatment or active control group. Each group completed 6 weekly 90-minute individual treatment sessions. Assessments were completed pretreatment, 1 week and 2 months post-treatment. STUDY SAMPLE: Twenty-five post lingually deafened adult CI recipients participated. AR group: mean age 66.2 (48-80); nine females, four males; months postactivation 7.7 (3-16); mean years severe to profound deafness 18.4 (2-40). Active control group: mean age 62.8 (47-85); eight females, four males; months postactivation 7.0 (3-13); mean years severe to profound deafness 18.8 (1-55). INTERVENTION: The AR protocol consisted of auditory training (words, sentences, speech tracking), and psychosocial counseling (informational and communication strategies). Active control group participants engaged in cognitive stimulation activities (e.g., crosswords, sudoku, etc.). DATA COLLECTION AND ANALYSIS: Repeated measures ANOVA or analysis of variance, MANOVA or multivariate analysis of variance, and planned contrasts were used to compare group performance on the following measures: CasperSent; Hearing Handicap Inventory; Nijmegen Cochlear Implant Questionnaire; Client Oriented Scale of Improvement; Glasgow Benefit Inventory. RESULTS: The AR group showed statistically significant improvements on speech recognition performance, psychosocial function, and communication goals with no significant improvement seen in the control group. The two groups were statistically equivalent on all outcome measures at preassessment. The robust improvements for the AR group were maintained at 2 months post-treatment. CONCLUSION: Results of this clinical study provide evidence that a short-term AR intervention protocol can maximize outcomes for adult post lingually deafened CI users. The impact of this brief multidimensional AR intervention to extend CI benefit is compelling, and may serve as a template for best practices with adult CI users.

Vestibular and Ocular/Oculomotor Assessment Strategies and Outcomes Following Sports-Related Concussion: A Scoping Review.

BACKGROUND: Recent literature has identified that the vestibular system is often involved following a sport-related concussion. Furthermore, the consequences of vestibular and ocular/oculomotor involvement have been explored and identified as potential predictors for prolonged recovery. Although vestibular and ocular/oculomotor involvement is common following head injury, the clinical assessment strategies for vestibular function are less commonly practiced in the sports medicine setting and have limited research. Therefore, despite the suspected link between vestibular consequences of concussion and prolonged recovery time, there is limited understanding on how these consequences affect outcomes following concussion and how to properly assess these functions. OBJECTIVES: The objectives of this scoping review were to: (1) outline the current clinical assessment strategies for vestibular and ocular/oculomotor function in sports medicine to identify the best strategies for assessment, and (2) investigate the evidence regarding the influence of vestibular and ocular/oculomotor function on outcomes for patients with a sport-related concussion. METHODS: Two separate and independent reviews of the current literature were conducted to provide evidence for each specified objective. Studies for potential inclusion were identified through electronic database searches. Inclusion criteria for each objective were used to identify the most effective studies and inquiries to address the outlined objectives. RESULTS: The identified and included studies provided evidence-based information regarding the current assessment strategies as well as outcomes following concussion. CONCLUSION: Despite agreement among studies, there was limited evidence to support each aim, identifying a need for further exploration into these objectives.

Options for Auditory Training for Adults with Hearing Loss.

Hearing aid devices alone do not adequately compensate for sensory losses despite significant technological advances in digital technology. Overall use rates of amplification among adults with hearing loss remain low, and overall satisfaction and performance in noise can be improved. Although improved technology may partially address some listening problems, auditory training may be another alternative to improve speech recognition in noise and satisfaction with devices. The literature underlying auditory plasticity following placement of sensory devices suggests that additional auditory training may be needed for reorganization of the brain to occur. Furthermore, training may be required to acquire optimal performance from devices. Several auditory training programs that are readily accessible for adults with hearing loss, hearing aids, or cochlear implants are described. Programs that can be accessed via Web-based formats and smartphone technology are reviewed. A summary table is provided for easy access to programs with descriptions of features that allow hearing health care providers to assist clients in selecting the most appropriate auditory training program to fit their needs.

The effect of LACE DVD training in new and experienced hearing aid users.

BACKGROUND: Numerous studies have demonstrated that improving the ability to understand speech in noise can be a difficult task for adults with hearing aids (HAs). If HA users want to improve their speech understanding ability, specific training may be needed. Auditory training (AT) is one type of intervention that may enhance speech recognition abilities for adult HA users. PURPOSE: The purpose of this study was to examine the behavioral effects of an AT program called Listening and Communication Enhancement (LACE) in the DVD format in new and experienced HA users. While some research has been conducted using the computer version of this program, no research to date has been conducted on the efficacy of the DVD version of the LACE training program in both new and experienced HA users. RESEARCH DESIGN: An experimental, prospective repeated measures group design, with random assignment. STUDY SAMPLE: Twenty-nine adults with hearing loss were assigned to one of three groups: new HA plus training, experienced HA plus training, or control (new HA users with no training during the study but provided with training afterward). New HA aid users were randomly assigned to either the training or control group. INTERVENTION: Participants in the training groups completed twenty 30 min training lessons from the LACE DVD program at home over a period of 4 wk. DATA COLLECTION: Participants in both training groups were evaluated at baseline, after 2 wk of training and again after 4 wk of training. Participants in the control group were evaluated at baseline and after 4 wk of HA use. Several objective listening measures were administered including speech in noise, rapid speech, and competing sentences tasks. Subjective measures included evaluating the participants' perception of the intervention as well as their perceptions of functional listening abilities. RESULTS: Findings indicate that both new and experienced users improved their understanding of speech in noise, understanding of competing sentences, and communication function after training in comparison to a control group. Effect size calculations suggested that a larger training effect was observed for new HA users compared to experienced HA users. New HA users also reported greater benefit from training compared to experienced users. AT with the LACE DVD format should be encouraged, particularly among new HA users, to improve understanding in difficult listening conditions.

A systematic review to determine the effectiveness of using amplification in conjunction with cochlear implantation.

BACKGROUND: The question regarding the use of amplification with implantation is timely and relevant in today's clinical settings where an increased number of adults with measurable hearing are receiving cochlear implants due to the expanding implant criteria, especially among individuals seeking bilateral implantation. PURPOSE: To review the evidence available to answer the clinical question: "Does amplification in the ear opposite of a cochlear implant provide improved communication function for adult users?" RESEARCH DESIGN: A systematic review of the evidence that met the search criteria related to the use of amplification in adult implant users. All types of experiments were included with the exception of expert opinion. This systematic review ranked the levels of evidence related to these studies and distinguished the levels of evidence from judgments about the grade and strength of recommendations for the stated clinical question. STUDY SAMPLE: Fifty-two articles were initially reviewed with a final 11 articles meeting the search criteria and identified for in-depth analysis. DATA COLLECTION AND ANALYSIS: Several electronic databases and textbooks were searched to locate the evidence related to bimodal stimulation. Each article was reviewed using a check sheet and assigned a ranking for level of evidence (Levels 1-6) based on the type of research design that was used and a grade of evidence (A-D) based on the quality, relevance, and extensiveness of the study. Finally the level and grade were collapsed into only three categories to indicating the strength of the recommendations coming from each study and were classified as either strong (I), moderate (II), or weak (III). RESULTS: Several trends about bimodal stimulation were observed, which include (1) significantly better speech understanding in the bimodal condition for many participants; (2) in noise, the largest bimodal benefits in speech recognition; (3) variable findings on localization tasks; and (4) overall significant improvement in functional ability based on self-assessments. The preponderance of evidence received grades of B or C. CONCLUSIONS: The evidence available indicates "moderate" (II) strength in support of bimodal stimulation for adult implant users. Clinicians should encourage their clients to consider bimodal fittings. Additional research is needed about optimal time frame for introducing bimodal fittings as well as establishing a clinical profile of patients who may benefit most from this intervention compared to bilateral implantation.