Long Covid Research

We take a look at two pilot studies looking into complementary therapy approaches to support clients with symptoms of long Covid

The Anosmia, Acupressure, Aromastick and Aromapot Project

By project leads, Dr Peter Mackereth, Paula Maycock and Ann Carter

Before COVID 19 emerged, anosmia (the inability to detect odours) was a relatively unknown term outside of medicine; however, olfactory disorders are not new health concerns. Nasal polyps, enlarged turbinates*, as well as degenerative disorders such as multiple sclerosis, Parkinson’s disease and Alzheimer’s can result in difficulties to detect odours. Patients who have had laryngectomies or tracheotomies may also experience hyposmia (decreased ability to detect odours) due to a reduced or absent nasal airflow. Head trauma and local disease, such as cancer (and some cancer treatments), can be linked with long-term disorders of taste and smell.

For several years, our project team has worked in cancer care with patients experiencing symptoms such as anosmia and xerostomia (dry mouth) – often referred to as ‘difficult to treat’ concerns. To help ease these distressing side-effects of treatment, with some success, we have used various therapies such as acupuncture/acupressure, massage, essential oils and reflexology, often in combination.

The challenge is that most of these symptoms require a series of treatment combinations and ongoing advice and self-care. What we do know is that these challenging symptoms can affect quality of life, in particular depressing a cancer patient’s mood and reducing their appetite (Bernhardson et al, 2009).

Long COVID patients can ill afford the detrimental effects of anosmia, which is often experienced alongside fatigue, breathlessness, muscle and joint pain and insomnia. As therapists, we know that interventions that combine touch techniques with aromatherapy can have benefits on wellbeing. From our review of the literature, we have found that even odour-evoked memories can alter mood and be useful for helping with psychological and physical health concerns (Carter et al, 2019). For someone who has altered ability to smell, even using regular recall of an aroma could be potentially of benefit.

Importantly, there are many factors that can increase and decrease nasal resistance. Both smoking and alcohol increase nasal resistance, as does infective rhinitis – all can compromise the ability to detect odours. Research studies have shown that marked sensation of increased airflow was demonstrated when substances such as camphor, eucalyptus, L-menthol, vanilla, or lignocaine were applied to the nasal mucosa (Chaaban & Corey, 2011).

In the last 12 months, our team has embarked on a pilot project with volunteers. The process seeks to evaluate the combination of twice daily aroma trainings, using three separate pots, each with a pad infused with a different single essential oil. Prior to the inhalations from each of the three aromapots, the volunteers are asked to carry out a tapping routine of specific acupressure points which link to olfaction and gustatory function. During the day, our participants supplement this routine with using an aromastick with the same combination of essential oils used in the three pots. Participants are advised to hold the aromastick 2 to 6cms away from the nostrils, then use a gentle breathing technique, which we call ‘3 Breaths to Calm’. This involves breathing in through the nose and then out through the mouth (Carter & Mackereth, 2019). Usually, this activity can be done before a coffee or tea break and before lunch, so approximately three times a day, linked to consumption of food and drink.

Using questionnaires, we are collecting data at the start of an individual’s personal project and after five weeks of adhering to the routine. Our initial pilot work with six participants revealed improvements in anosmia after three to four weeks of using the protocol. We are also intending to gather qualitative data via interviews with volunteers about the experience of living with anosmia and using our aromatherapy and acupuncture protocol. Our purpose in using the protocol is to stimulate the participants’ parasympathetic response to the triggers of selected aromas, combined with gentle acupressure, so promoting olfactory and gustatory function. Currently we have four students, all aromatherapists, from our recent online ‘Therapeutic Uses of Aromasticks and Aromapots’ course assisting with the project.

We hope to present our work in 2022, once the data has been collected from a larger sample.

*Turbinates are several thin bony elongated ridges forming the upper chambers of the nasal cavities – these increase the surface area allowing for rapid warming and humidification of inhaled air.

Dr Peter Mackereth was the clinical lead of the complementary therapy and wellbeing service at The Christie for more than 15 years. He is currently an honorary researcher and lecturer at The Christie and a volunteer therapist at St Ann’s Hospice. Paula Maycock is a senior complementary therapist at The Christie, Manchester. Ann Carter has worked as a complementary therapist and teacher since 1989 in hospices and the acute sector.

Bowen therapy study

By project lead, Jo Wortley

In February 2021, I joined forces with Dianne Bradshaw* to launch a quantitative observational study that would look at whether Bowen therapy might prove a helpful intervention in improving the symptoms and wellbeing of people affected by long COVID.

The initial aim was to recruit 60 to 70 qualified Bowen practitioners, who would provide a series of six weekly Bowen sessions to self-elected clients (participants) who had been experiencing symptoms of long COVID for six months or more and were eligible to take part in the study. Measure Yourself Medical Outcome Profile (MYMOP) questionnaires were to be completed by each participant, with all of the Bowen practitioners taking part receiving online training to help them understand the aims and objectives of the study and how to use the MYMOP questionnaires appropriately, in order for the data to be valid.

As with many complementary therapy interventions, in a ‘real world’ situation, Bowen sessions are adapted to meet the needs and presenting symptoms of the individual client, which may change from one session to the next. For this reason, the Bowen practitioners taking part were not required to follow a ‘standardized’ treatment, however they were asked to only use moves learned during their core Bowen training (modules 1 to 5).

At the time of writing (December 2021), I am pleased to report that 30 practitioners managed to complete a series of six treatments with at least one study participant, producing a total of 26 valid sets of data. While I am yet to fully collate and compare the data, the initial results look very promising, with the majority of participants seeing an improvement in one or both symptoms that they were seeking help with, as identified in their MYMOP questionnaires. When comparing data taken from Weeks 1 and Weeks 7 only:

  • 14 out of 15 participants reported an improvement in their fatigue;
  • 12 out of 14 participants reported an improvement in their mobility (walking, jogging or running);
  • 20 out of 22 participants reported an improvement in their general wellbeing 

While these results look very positive, we do need to understand what happens to people who have no intervention over a 7-week period, to establish whether this is ‘normal’ recovery.

It was also very pleasing to see that the vast majority (22 out of 24) also highly recommended Bowen, rating it between 8 and 10 out of 10.

While it’s involved a lot of time and effort, it’s exciting to be leading the way with this study and once it has been published, I will of course ensure that FHT members are made aware of the key outcomes. Although this study obviously focuses on Bowen therapy, it is important that as a community of professional therapists, we all share as much information and best practice as we can, to ensure the long-term safety of our clients and to also demonstrate the potential role that therapies may have in helping to support clients with long COVID, where appropriate.

* Dianne, an experienced Bowen and McTimoney practitioner who worked on both humans and animals, sadly passed away several months after the study was launched. 

Jo Wortley is a Director and Senior Tutor at the College of Bowen Studies, which offers an FHT accredited practitioner qualification in the Bowen Technique, alongside a range of Bowen masterclasses. thebowentechnique.com

Massage could help reduce occupational stress for people working in emergency medical services

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Massage could be an effective therapy for reducing stress in people working in emergency medical services, according to a study published in the International Journal of Therapeutic Massage and Bodywork.

People working in emergency services often suffer from occupational stress, so the study sought to establish whether massage could help.

Researchers recruited 58 people working in prehospital emergency medical service stations in southwest Iran to participate in a randomised controlled trial. The participants were randomly assigned to two groups, with a control group receiving no intervention and a massage group, where participants received 20-25 minutes of Swedish massage, twice a week for four weeks.

The results showed significant differences between the two groups, indicating that Swedish massage could be an effective therapy in reducing occupational stress in staff working in emergency medical service centres.

Access the full study

 

College of Medicine launches its October Complementary Medicine Roundup

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The College of Medicine has recently published its October Complementary Medicine roundup.

Written by former barrister Richard Eaton and published quarterly, the roundup is packed with a wealth of information on the latest developments in complementary therapy, from evidence-base and advocacy, to changes in legislation and current challenges.

In the October edition Richard looks at healthcare policy, who is receiving CAM and why, the demand for complementary therapies, the appointment of Christopher Byrne as FHT President, along with the latest research and lots more.

To keep up to date, you can sign up to receive the roundup by email on the College of Medicine’s website

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World Mental Health Day

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Today is World Mental Health Day, a global event that raises awareness of mental health issues, highlights support available and campaigns for more to be done to ensure everyone gets the care that they need.

According to the Mental Health Foundation, nearly 50% of UK adults believe that they have had a diagnosable mental health problem in their lifetime, yet just 33% have received a diagnosis.

Furthermore, young people are particularly vulnerable to ill mental health, with one in five adolescents experiencing a mental health problem in any given year and one in 10 children and young people clinically diagnosed.

According to our 2018 Members’ Survey, more than 82% of FHT members regularly support clients experiencing stress and anxiety, while over 34% support clients with a diagnosed mental health condition.

Many studies have looked at the effects of complementary therapies for mental health problems, with one recent study suggesting that aromatherapy could aid people experiencing depression.

A team of scientists at the Hong Kong Polytechnic University conducted a systematic review of 12 randomised controlled trials (five on aromatherapy through inhalation, eight in aromatherapy massage and one involving both methods).

The 12 selected trials involved a combined total of 1,226 subjects, of which 984 were female and 224 male, with a mean age of 47. Treatment times and frequency varied across the studies. The selection of essential oils used were determined by the aromatherapists. Where the oils were inhaled, lavender and bergamot were primarily used, whereas the aromatherapy massage studies opted for a wider range of oils, including lavender and rose otto.

Two of the five inhalation-based studies and five of the eight massage trials reported improvements in symptoms. Aromatherapy massage was also found to be more effective than inhalation for alleviating depressive symptoms.

Read more about World Mental Health Day and access online resources

Massage therapy assists in elite para-athlete recovery

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Massage therapy can improve sleep and muscle tightness to aid recovery in elite para-athletes, according to a study published in BMJ Open Sport and Exercise Medicine (Kennedy et al, 2018).

In a mixed methods study, scientists invited nine members of Team Roger C Peace, an elite para-cycling team from South Carolina, USA, to receive one hour of massage therapy each week for four weeks, before switching to every other week until the respective athletes left the team or the two-year study ended.

Seventeen massage therapists were recruited, who on average had been practising for 14 years.

To monitor progress, the athletes agreed to complete a questionnaire before and after each massage session, with closed and open-ended questions on athlete goals, stress, sleep, muscle tightness, spasticity and pain. Additional information was collected from programme feedback and treatment notes from the massage therapists.

The results at the end of the study revealed improvements in sleep and muscle tightness from baseline, which was supported by individual testimony from the athletes describing how the massage had assisted their recovery while training.

See the full open-access study at fht.org.uk/IT-124-paracycling

References

For full references, go to fht.org.uk/IT-references

Photo by Seth kane on Unsplash

 

We hope you enjoyed this article, which was first published in the Spring 2018 issue of International Therapist!

International Therapist is the FHT’s membership magazine. Published on a quarterly basis, it offers a broad range of articles – from aromatherapy and electrolysis, to sports injuries and regulation updates. The magazine is a membership benefit and is not available off-the-shelf or by subscription.

Join today to start receiving the leading magazine for professional therapists.

Acupuncture may be more effective than ibuprofen for lumbar disc herniation

Acupuncture has a more favourable effect in the treatment of lumbar disc herniation than lumbar traction and ibuprofen, according to a recent study published by the BMJ.

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Scientists from Guangzhou, China conducted a systematic review and meta analysis of randomised controlled trials in leading scientific databases to evaluate the effectiveness of acupuncture in the treatment of lumbar disc herniation (LDH).

After an extensive search, the scientists narrowed down the study to thirty randomised controlled trials, involving 3503 clients, that were published in either English or Chinese and compared the effects of acupuncture with western medicine, lumbar traction, tui na and other techniques for LDH.

The results indicated that acupuncture alone had a ‘more favourable effect in the treatment of LDH than lumbar traction, ibuprofen, diclofenac sodium, meloxicam, mannitol plus dexamethasone and mecobalamin, fugui gutong capsule plus ibuprofen, mannitol plus dexamethasone, loxoprofen and huoxue zhitong decoction.’

Access the full study here

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Indoor air pollution as harmful as car fumes, study finds

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The shampoo, deodorants, air fresheners, cleaning products and even perfumes in our homes could be creating as much air pollution as the transportation sector, a new study finds.

Conventional wisdom maintains that outside air pollution from cars, industry and public transport are the main sources of air pollution. While this was true in previous decades, today particle-forming emissions from chemical products are about twice as high as those from transportation. According to this new study, as cars get cleaner, VOCs come increasingly from consumer products.

National Oceanic and Atmospheric Administration (NOAA) atmospheric scientist Jessica Gilman, a co-author of the new paper, attributes this disparity partially to differences in how we store those products versus fuels. “Gasoline is stored in closed, hopefully airtight, containers and the VOCs in gasoline are burned for energy,” she said. “But volatile chemical products used in common solvents and personal care products are literally designed to evaporate. You wear perfume or use scented products so that you or your neighbor can enjoy the aroma. You don’t do this with gasoline,” Gilman said.

What are volatile organic compounds (VOCs)?

Volatile organic compounds (VOCs) are any chemical compound that evaporates into the atmosphere at room temperature, potentially causing health effects within the environment.

Many VOC concentrations are up to ten times higher indoors than outdoors. They are emitted by a wide array of products, including paints, varnishes and wax, as well as many cleaning, disinfecting, cosmetic, degreasing and hobby products. It is thought around 350 different types of VOCs exist in our indoor environment.

What effects can VOCs have?

VOCs can react with the atmosphere to produce either ozone or particulate matter—both of which are regulated in many countries due to the potential health impacts, including lung damage.

There’s a wide range of long- and short-term health effects associated with exposure to VOCs, including eye, nose and throat irritation, headaches, loss of coordination, nausea, and some are suspected or known to cause cancer in humans.

How can you reduce VOCs in your home?

Store paint, paint thinners, pesticides, particle board, fuel, cleaners, and similar materials in a detached shed or garage to protect your family from VOCs.

Let fresh air in by opening a window, or using exhaust fans in the kitchen or bathroom.

Decorating with houseplants is an easy, inexpensive way to absorb VOCs and other toxins. Some of the best plants for cleaning your air are aloe, spider plants, chrysanthemums, Chinese evergreens, and peace lilies.

Cleaning regularly can reduce VOCs already in your home, and can be done without introducing new VOCs. Use lemon juice and olive oil as a healthy wood polish, or a few drops of tea tree oil mixed with water to prevent mildew in your bathroom.

Dig into DIY deodorisers. Herbs and flowers can make a lovely potpourri, and simmering cinnamon sticks, orange slices, cloves, or other spices on the stove will produce a welcoming aroma. Natural essential oils are also popular as air fresheners.

Read about the study here. You can also learn more about making your own products with essential oils at our 2018 Training Congress, where Penny Price will be running a session entitled Making Aromatherapy Skincare Products. Find out more on our website.

 

 

Music can help clients change their tune

piano-instrument-music-keys-159420In our last issue of International Therapist, our regular case study feature came from Nicolle Mitchell, who discussed her treatment of a client living with dementia. We documented her treatment plan and approach, as well as the client’s history.

We’ve now received an update via Facebook from Nicolle, which touches on other aspects of her client’s treatment. She writes:

This gentleman, is a lover of jazz & musician. He is usually very vocal & often does not know when he is being vocal which I interpret as frustration, distress and having unmet needs. He cannot walk or see. Within minutes he had quietened and started to pick out rhythms with his fingers. I quietly watched & delighted in his joy & engagement.

We’ve also looked at other benefits music can confer. In our latest issue of International Therapist, we hear from Dr Stella Compton Dickinson about ways that music can improve wellbeing.

You can read Nicolle’s original case study here. Her update on Facebook is here. And our latest article, on the benefits of music, is here.

We also love hearing from our members about their work. If you have a similar case study you’d like to submit, contact our deputy editor, Dan Ralls, at dralls@fht.org.uk.

Want to receive our magazine right to your front door? Join us today to keep up to date on the latest in therapy news and trends.

Greater muscle strength – better cognitive function for older people

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Greater muscle strength is associated with better cognitive function in ageing men and women, according to a new Finnish study. The association of extensively measured upper and lower body muscle strength with cognitive function was observed, but handgrip strength was not associated with cognitive function. Cognition refers to brain functions relating to receiving, storing, processing and using information. The findings were published in European Geriatric Medicine.

The study population comprised 338 men and women with an average age of 66 years. Their muscle strength was measured utilising handgrip strength, three lower body exercises such as leg extension, leg flexion and leg press and two upper body exercises such as chest press and seated row. Sum scores to depict lower body and upper body muscle strength were calculated separately, and cognitive function was assessed using the CERAD neuropsychological test battery with calculated total score.

Handgrip strength is relatively easy and fast to measure, and it has been widely used as a measure of muscle strength in various studies. However, this new study could not demonstrate an association between muscle strength and cognitive function when using a model based on mere handgrip strength and age. Instead, an association between muscle strength and cognitive function was observed only when sum scores depicting upper or lower body muscle strength were included in the model.

‘The findings suggest that it may be justified to go beyond the handgrip and to include the upper and lower body when measuring muscle strength, as this may better reflect the association between muscle strength and cognition,’ says Early Stage Researcher Heikki Pentikäinen, the first author of the article, who is currently preparing a PhD thesis on the topic for the University of Eastern Finland.

Exercise is known to have various health benefits, and strength training is a way for practically everyone to increase muscle mass and enhance muscle strength. However, the association of muscle strength with various aspects of cognitive function is a relatively under-researched area. The study provided new insight into the methodology of measuring muscle strength and into the role of muscle strength in cognitive function. The study constituted part of the extensive, population-based DR’s EXTRA study, which was a four-year randomised and controlled intervention study analysing the effects of exercise and nutrition on endothelial function, atherosclerosis and cognition. The study was carried out at Kuopio Research Institute of Exercise Medicine in 2005–2011 and it involved more than 1,400 men and women living in the eastern part of Finland.

Source

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College of Medicine calls for student essays on sustainable healthcare

The College of Medicine is currently accepting entries from students of all health and social care professions for the esteemed Michael Pittilo Essay Prize 2017.

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First launched in 2010, the Michael Pittilo Essay Prize recognises and celebrates the integration of conventional and complementary approaches to healthcare.

Entries are open to UK students studying any healthcare discipline at degree level or above, including CAM therapies that are statutory regulated or on an Accredited Register, approved by the Professional Standards Authority.

The College of Medicine’s summer conference will this year explore ways in which sustainability is redefining our health system and to correspond with this theme the essay question for the Michael Pittilo Prize is:

‘How can patients, communities, healthcare professionals and governing bodies work together to ensure sustainability of the healthcare system?’

Essays (1,500 words) need to be submitted by 9 July 2017 to lauren.quinn@collegeofmedicine.org.uk

The FHT is delighted to have been a member of the judging panel for eight consecutive years and looks forward to publishing the winning essay in International Therapist.

Read the winning essay from 2016