Evidence-Based Medicine and Research for Shiatsu practitioners
Shiatsu Society Journal, Issue 156, Winter 2020
This article for the Shiatsu Society Journal is based on the first part of the webinar Creating Evidence in Your Practice: Case Reports, prepared by the Shiatsu Research Network (SRN) for the International Shiatsu Congress Online 2020.
The video of the webinar.
The handout of the webinar.
The slides of the webinar.
Manuscript (available under the CC-BY-NC-ND 4.0 license)
Shiatsu, the Evidence Base: a critical review of a webinar
This rapid review was written for the needs of the Shiatsu Research Network (SRN) and communicated with the organisers of the webinar.
The webinar with Andrea Kleinau PhD was hosted by Cliff Andrews MRSS (T) for the New Energy Work Project, 4th of June 2019.
It was part of a series of free webinars and an online course titled “Shiatsu: The Scientific Basis”.
The webinar is freely available online.
Manuscript (available under the CC-BY-NC-ND 4.0 license)
Safety and risks of shiatsu: Protocol for a systematic review
European Journal of Integrative Medicine, Volume 28, June 2019, Pages 20-26
doi:10.1016/j.eujim.2019.03.006
Abstract
Introduction: People use shiatsu for health maintenance and help with illness. Shiatsu is often considered safe, but there has been no published systematic review of its possible risks. The review aims to assess the evidence of safety and risk of harm for shiatsu.
Methods: All types of studies, independent of control and with any style of shiatsu are eligible. Reports in any language will be included. Peer-reviewed studies and non-peer-reviewed literature will be handled in separate parts of the review. Electronic databases (including among others MEDLINE, AMED, Alt HealthWatch, Web of Science, CiNii) will be searched for identification of peer-reviewed publications. Hand-search will be used for non-peer-reviewed literature. Risk of bias will be assessed using RoB 2.0 in conjunction with McHarm (randomised trials), ROBINS:I in conjunction with McHarm (non-randomised studies), a modified PHARMA checklist (adverse reports). When appropriate, reporting bias will be assessed using ORBIT. The relevance of the described intervention to shiatsu will be based on clinical experience, using CARE for massage and bodywork and TIDieR. Root cause analysis of adverse events will consider Bradford Hill's criteria in the light of clinical experience.
Results: Meta-analysis is not planned. Results for each study will be presented in tables. Relationships within and between studies will be explored. A theory about the safety profile of shiatsu will be developed. Identified incidents will be presented in a narrative way and tabular categories.
Discussion: The discussion will highlight the relevance to various stakeholders and will explore issues that occurred from the review.
Accepted Manuscript (available under the CC-BY-NC-ND 4.0 license)
Effects of Shiatsu on the Health-Related Quality of Life of a Person with Secondary Progressive Multiple Sclerosis: a Mixed Methods N-of-1 Trial within a Whole Systems Research Case Study
July 2019
Abstract
Background: MS is a chronic neurological disorder with high prevalence in Finland. Most people with MS will develop Secondary Progressive MS (SPMS) over the years. People with MS report lower than the average Health-Related Quality of Life (HRQoL) and use CAM for their symptoms. Interventions of personalised nature like shiatsu have an insufficient evidence base. The n-of-1 trial is a promising study design for personalised interventions in chronic conditions yet it has not been used a lot in CAM research.
Aims and Objectives: The aim was to investigate if shiatsu affects the HRQoL of a person with SPMS. Objectives were to design and implement a mixed methods n-of-1 trial within a whole systems research case study and to reflect on the implementation and the appropriateness of the design.
Methodology: Six-periods counterbalanced mixed methods n-of-1 trial within a whole systems research case study was used. The short version of the MSQLI, data collected from the semi-structured interview and case notes were used to assess the effect of the treatment. Structured personal reflection was included. The collected data analysed quantitatively and qualitatively and synthesised as a descriptive case study.
Findings: The study was able to document improvements in spasticity, bowel function, sleep and relaxation, fatigue and pain. No adverse events occurred. Preliminary estimations of the onset and wash-out of shiatsu effects were inferred. Advantages and drawbacks of the design are discussed to improve future applicability.
Conclusion: Shiatsu was able to improve some domains of the HRQoL of a person with SPMS. It was a safe treatment with no adverse events. Mixed methods n-of-1 trial within a whole systems research case study was an appropriate design for the study.
Manuscript (available under the CC-BY-NC-ND 4.0 license)
