shannon usher, msot, otr/l, ntmtc ·...

Neonatal Touch & Massage Cer3fica3on By Crea3ve Therapy Consultants

Shannon Usher, MSOT,OTR/L, NTMTC

These Handouts are not intended to be used Outside of NTMC On-‐Line Educaiton

Property of Crea3ve Therapy Consultants Not for Duplicaton1

Shannon Usher, MSOT, OTR/L, NTMTC

� To all researchers who have spent years bringing the benefits of infant massage into evidence based medicine

Thank You!

� � Massage, as a general activity can be defined as the

manipulation of superficial and deeper layers of muscle and connective tissue using various techniques, to enhance function, aid in the healing process, decrease muscle reflex activity, inhibit motor neuron excitability and promote relaxation and well being.

OR � Massage is defined as a systematic touch by human

hands, which stimulates the tactile sense of the infant and which has been documented for several decades to have a positive effect on both full term and preterm infants (Abdallah, 2013)

What is Massage?





� � The history of massage use can be referenced as far

back as 3,000 BC and possibly earlier emerging in writings from ancient China, Japan, India, Arabic nations, Egypt, Greece and Rome

The History of Massage Therapy

� � Kramer et. al., 1975 � Brazelton, 1979 � Field, 1980 � White-Traut & Tubeszewski, 1986

History of Research Related to Infant Massage

� � Touch is the earliest sense to develop at 7 ½ weeks � Critical in the long term development of neonates � Less than 5% of all touch received by infants is meant

to be comforting (Murphy, 2000 and Werner and Conway, 1990).

The Importance of Touch





� �  Levels of Evidence �  Level 1 - Systematic review & meta-analysis of randomized

controlled trials; clinical guidelines based on systematic reviews or meta-analyses

�  Level 2 - One or more randomized controlled trials �  Level 3 - Controlled trial (no randomization) �  Level 4 - Case-control or cohort study �  Level 5 - Systematic review of descriptive & qualitative studies �  Level 6 - Single descriptive or qualitative study �  Level 7 - Expert opinion

�  Source: Melnyk, B.M. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Lippincott, Williams & Wilkins.

Levels of Evidence

� �  Increased weight gain �  Increased elimination of

waste product �  Improved digestion �  Improved Bone Density �  Improved neurological

development � Reduced secretion of stress

hormones such as cortisol �  Improved Muscle tone �  Increased pain tolerance � Accelerated maturation of

the autonomic nervous system

Benefits of Infant Massage Supported in the Literature

�  Improved sleep/wake cycles �  Improved Sensory Awareness �  Improved circulation �  Enhanced Feeding Outcomes �  Enhanced parent-infant

boding �  Improved immune function

and less sepsis �  Improved Temperature

Stability �  Decreased LOS �  Decreased Pain Response

� �  Pizzolorusso, Turi, Ceritelli, Renzetti, Cozzolino, D’Orazio, Fusilli, Carinci & D’Incecco, 2011 �  Massaro, Hammad, Jazzo & Aly, 2009 �  Field, Diego & Kuhn, 2008 �  Vaivre-Douret et. al., 2008 �  Diego, Field, Hernandez-Reif, Deeds, Ascencio & Begert, 2007 �  Field, Diego, Hernandez-Reif, Deeds & Figuerido, 2006 �  Diego, Field & Hernandez-Reif, 2005 �  Dieter et. al., 2003 �  Ferber et. al., 2002 �  Mathai, Fernandez, Mondkar & Kanbur, 2001 �  Scafidi et. al., 1990

Increased Weight Gain





� �  Moyer-Mileur, Haley, Slater, Beachy & Smith, 2013 �  Haley, Neff, Gulliver, Gough, Slater, Lane & Moyer-Mileur, 2013 �  Pizzolorusso, Turi, Ceritelli, Renzetti, Cozzolino, D’Orazio, Fusilli, Carinci & D’Incecco, 2011 �  Mendes & Proclanoy, 2008 �  Field, Diego, Hernandez-Reif, Dieter, Kumar, Scanberg 2008 �  Chen, Su, Su, Lin & Kuo, 2008 �  Vaivre-Doret et. al., 2008 �  Lahat, Mimouni, Ashbel & Dollberg, 2007 �  Field, Hernandez-Reif, Feijo & Freedman, 2006 �  White-Traut, Berbaum, Lessen, McFarlin & Cardenas, 2005 �  Diego et. al., 2005 �  Field et. al., 2004 �  Dieter et. al., 2003 �  White-Traut, Nelson, Silvestri, Vasan, Patel et. al. 2002 �  White-Traut, Nelson, Silvestri, Vasan, Littau, et. al. 2002 �  Ferber et. al., 2002 �  Mathal et. al. 2001 �  Nelson et. al., 2001 �  Scafidi et. al., 1990

Improved Digestion

� � Chen, Sadakata, Ishida, Sekizuka, Sayama 2011

Increased elimination of waste product

� � Haley, Beachy, Ivaska, Slater, Smith & Moyer-

Mileur, 2012 � Schulzke, Trachsel & Patole, 2010 � Vignochi, Miura & Canani, 2008 � Moyer-Mileur, Ball, Brunstetter & Chan, 2008 � Litmanovitz et. al., 2007 � Schulzke, Trachsel & Patole, 2007 � Aly, Mousafa & Hassanein, 2004

Improved Bone Density





� �  Aliabadi & Askary, 2013 �  Abdalla, Badrb & Hawwari, 2013 �  McGrath, Cone, Samra 2011 �  Procianoy, Mendes & Silveira, 2010 �  Guzzetta et. al., 2009 �  Vaivre-Douret et. al., 2008 �  Field et. al., 2004 �  Mathai, Fernandez, Modkar & Kanbur,

2001 �  Kim, Shin & White-Traut, 2003 �  Nelson et. al., 2001 �  Field, Grizzle, Scafidi, Abrams &

Richardson, 1996

Improved Neurological Development

� � Guzzetta et. al., 2009 � White-Traut, Schwertz, McFarlin & Kogan, 2009 � Hernandez-Reif, Diego & Field, 2007 � Yoo, 2005 � Field et. al., 1996 � Acolet et. al., 1993

Reduced Stress Behaviors and Secretion of Stress Hormones

� � Yuen-Ging, Lee, Chow & Pang, 2009 � Vaivre-Douret et. al., 2008 � Hernandez-Reif, Field, Largi, Mora, Bornstein & Waldman, 2006 � Braarud & Stormark, 2006 � Hernandez-Reif, Fiedl, Largie, Mora, Bornstein & Waldman, 2004 � Field et. al., 2004

Improved Muscle Tone





� � Abdalla, Badrb & Hawwari, 2013 � Diego et. al., 2009 � Arditi, Feldman & Eidelman, 2006 � Jain, Kumar & McMillan, 2006

Increased Pain Tolerance

� � Smith, Haley, Slater & Moyer-Mileur, 2013

Accelerated Maturation of the Autonomic Nervous System

� � Guzzetta, 2011 � Kelmanson & Adulas, 2006 � Field et. al., 2004 � Dieter et. al., 2003 � White-Traut, Nelson, Silvestri, Vasan, Patel et. al., 2002 � White-Traut et. al., 1999 � White-Traut et. al., 1993 � White-Traut & Pate, 1987

Improved Sleep





� � Field, Hernandez-Reif, Diego, Feijo, Vera & Gilet,

2004 � Dieter, Field, Hernandez-Reif, Emory & Redzepi,

2003 � White-Traut, Nelson, Silvestri, Vasan, Patel, et. al., 2002 � White-Traut et. al., 1999 � White-Traut et. al., 1993 � White-Traut & Pate, 1987

Improved Sensory

Awareness

� � Agarwal, Gupta, Pushkarna, Bhargava, Faridi &

Prabhu, 2000 � Ri, & Kura, 2006

Improved Circulation

� � Lau, Fucile & Gisel, 2012 � Fucile, Gisel, McFarland & Lau, 2011 � Mendes & Procianoy, 2008 � Field et. al., 2008 � Diego et. al., 2005 � White-Traut, Nelson, Silvestri, Vasan, Patel et. al., 2002 � White-Traut, Nelson, Silvestri, Vasan, Littau et. al., 2002

Enhanced Feeding Outcomes





� � Gurol & Polat, 2012 �  Jean, Stack & Fogel, 2009 � O’Higgins, St. James Roberts & Glover, 2008 �  Feijo, Herenadez-Reif, Field, Burns, Valley-Gray & Simco, 2006 �  Lee, 2005 �  Ferbera, Feldmanb, Koheletc, Kuintd, Dollberge, Arbelc & Wellerb, 2005

Enhanced Parent-Infant Bonding

� � Ang, Lua, Mathur, Thomas, Asmar, Savasan, Buck,

Long & Shankara, 2012 � Mendes & Procianoy, 2008 � Hernandez-Reif, Diego & Field, 2007

Improved Immune Function

� � Diego, Field & Hernandez-Reif, 2008 � White-Traut et. al., 2004 � White-Traut et. al., 1999

Improved Temperature Stability





� � Pizzolorusso, Turi, Balafante, Cerritelli, Renzetti,

Cozzolino, D’Orazio, Fussilli, Carinci & D’Inecco, 2011

� Medes & Procianoy, 2008 � Vaivre-Douret et. al., 2008 � White-Traut, Nelson, Silvestri, Vasan, Littau, et. al., 2002 � White-Traut et. al., 1999 � Scafidi et. al., 1990

Decreased Length of Stay

� �  The specific mechanism are not fully understood to know what is the ideal

form of implementation. However, some aspects to infant massage is well researched and supported including; �  Parent provided massage has shown improved benefits compared to healthcare

providers �  Moyer-Mileur, Ball, Brunstetter & Chan 2008 �  Ferber, Kuint, Weller, Feldman, Dollber, Arbel & Kohelet, 2002

�  Moderate pressure is proven to be more beneficial compared to light pressure strokes �  Field, Diego, Figuereido, 2006 �  Diego, Field & Hernandez-Reif, 2005 �  Field, Hernandez-Reif, Diego, Fejo, Vera, Gilet 2004

�  Using Oil as a lubricant with all massage �  Fallah, Karbasi, Golestan & Fromandi, 2013 �  Danby, AlEnezi, Sultan, Lavender, Chittock, Brown & Cork, 2012

�  Time and Frequency are still not full understood, more research is required in this area

Additional Research

shannon usher, msot, otr/l, ntmtc ·...

Documents