Massage, reflexology and other manual methods for pain management in labour.

Abstract:

BACKGROUND:Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain management in labour. This review is an update of the review first published in 2012. OBJECTIVES:To assess the effect, safety and acceptability of massage, reflexology and other manual methods to manage pain in labour. SEARCH METHODS:For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register (30 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 6), MEDLINE (1966 to 30 June 2017, CINAHL (1980 to 30 June 2017), the Australian New Zealand Clinical Trials Registry (4 August 2017), Chinese Clinical Trial Registry (4 August 2017), ClinicalTrials.gov, (4 August 2017), the National Center for Complementary and Integrative Health (4 August 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (4 August 2017) and reference lists of retrieved trials. SELECTION CRITERIA:We included randomised controlled trials comparing manual methods with standard care, other non-pharmacological forms of pain management in labour, no treatment or placebo. We searched for trials of the following modalities: massage, warm packs, thermal manual methods, reflexology, chiropractic, osteopathy, musculo-skeletal manipulation, deep tissue massage, neuro-muscular therapy, shiatsu, tuina, trigger point therapy, myotherapy and zero balancing. We excluded trials for pain management relating to hypnosis, aromatherapy, acupuncture and acupressure; these are included in other Cochrane reviews. DATA COLLECTION AND ANALYSIS:Two review authors independently assessed trial quality, extracted data and checked data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS:We included a total of 14 trials; 10 of these (1055 women) contributed data to meta-analysis. Four trials, involving 274 women, met our inclusion criteria but did not contribute data to the review. Over half the trials had a low risk of bias for random sequence generation and attrition bias. The majority of trials had a high risk of performance bias and detection bias, and an unclear risk of reporting bias. We found no trials examining the effectiveness of reflexology.MassageWe found low-quality evidence that massage provided a greater reduction in pain intensity (measured using self-reported pain scales) than usual care during the first stage of labour (standardised mean difference (SMD) -0.81, 95% confidence interval (CI) -1.06 to -0.56, six trials, 362 women). Two trials reported on pain intensity during the second and third stages of labour, and there was evidence of a reduction in pain scores in favour of massage (SMD -0.98, 95% CI -2.23 to 0.26, 124 women; and SMD -1.03, 95% CI -2.17 to 0.11, 122 women). There was very low-quality evidence showing no clear benefit of massage over usual care for the length of labour (in minutes) (mean difference (MD) 20.64, 95% CI -58.24 to 99.52, six trials, 514 women), and pharmacological pain relief (average risk ratio (RR) 0.81, 95% CI 0.37 to 1.74, four trials, 105 women). There was very low-quality evidence showing no clear benefit of massage for assisted vaginal birth (average RR 0.71, 95% CI 0.44 to 1.13, four trials, 368 women) and caesarean section (RR 0.75, 95% CI 0.51 to 1.09, six trials, 514 women). One trial reported less anxiety during the first stage of labour for women receiving massage (MD -16.27, 95% CI -27.03 to -5.51, 60 women). One trial found an increased sense of control from massage (MD 14.05, 95% CI 3.77 to 24.33, 124 women, low-quality evidence). Two trials examining satisfaction with the childbirth experience reported data on different scales; both found more satisfaction with massage, although the evidence was low quality in one study and very low in the other.Warm packsWe found very low-quality evidence for reduced pain (Visual Analogue Scale/VAS) in the first stage of labour (SMD -0.59, 95% CI -1.18 to -0.00, three trials, 191 women), and the second stage of labour (SMD -1.49, 95% CI -2.85 to -0.13, two trials, 128 women). Very low-quality evidence showed reduced length of labour (minutes) in the warm-pack group (MD -66.15, 95% CI -91.83 to -40.47; two trials; 128 women).Thermal manual methodsOne trial evaluated thermal manual methods versus usual care and found very low-quality evidence of reduced pain intensity during the first phase of labour for women receiving thermal methods (MD -1.44, 95% CI -2.24 to -0.65, one trial, 96 women). There was a reduction in the length of labour (minutes) (MD -78.24, 95% CI -118.75 to -37.73, one trial, 96 women, very low-quality evidence). There was no clear difference for assisted vaginal birth (very low-quality evidence). Results were similar for cold packs versus usual care, and intermittent hot and cold packs versus usual care, for pain intensity, length of labour and assisted vaginal birth.Music One trial that compared manual methods with music found very low-quality evidence of reduced pain intensity during labour in the massage group (RR 0.40, 95% CI 0.18 to 0.89, 101 women). There was no evidence of benefit for reduced use of pharmacological pain relief (RR 0.41, 95% CI 0.16 to 1.08, very low-quality evidence).Of the seven outcomes we assessed using GRADE, only pain intensity was reported in all comparisons. Satisfaction with the childbirth experience, sense of control, and caesarean section were rarely reported in any of the comparisons. AUTHORS' CONCLUSIONS:Massage, warm pack and thermal manual methods may have a role in reducing pain, reducing length of labour and improving women's sense of control and emotional experience of labour, although the quality of evidence varies from low to very low and few trials reported on the key GRADE outcomes. Few trials reported on safety as an outcome. There is a need for further research to address these outcomes and to examine the effectiveness and efficacy of these manual methods for pain management.

authors

Smith CA,Levett KM,Collins CT,Dahlen HG,Ee CC,Suganuma M

doi

10.1002/14651858.CD009290.pub3

subject

Has Abstract

pub_date

2018-03-28 00:00:00

pages

CD009290

issn

1469-493X

journal_volume

3

pub_type

杂志文章,meta分析,评审
  • Beta2-agonists for acute bronchitis.

    abstract:BACKGROUND:There are no clearly effective treatments for the cough of acute bronchitis, and beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction contributing to the symptoms. OBJECTIVES:To determine whether beta2-agonists improve symptoms of acu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001726.pub3

    authors: Smucny J,Becker L,Glazier R

    更新日期:2006-10-18 00:00:00

  • Mobility management to prevent, reduce, or delay driving a car in teenagers.

    abstract:BACKGROUND:Rates of injury and death caused by car crashes with teenage drivers remain high in most high-income countries. In addition to injury and death, car use includes other non-traffic risks; these may be health-related, such as physical inactivity or respiratory disease caused by air pollution, or have global si...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD009438.pub2

    authors: Ward A,Lewis SR,Weiss H

    更新日期:2020-08-16 00:00:00

  • Nutrition support in hospitalised adults at nutritional risk.

    abstract:BACKGROUND:The prevalence of disease-related malnutrition in Western European hospitals is estimated to be about 30%. There is no consensus whether poor nutritional status causes poorer clinical outcome or if it is merely associated with it. The intention with all forms of nutrition support is to increase uptake of ess...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011598.pub2

    authors: Feinberg J,Nielsen EE,Korang SK,Halberg Engell K,Nielsen MS,Zhang K,Didriksen M,Lund L,Lindahl N,Hallum S,Liang N,Xiong W,Yang X,Brunsgaard P,Garioud A,Safi S,Lindschou J,Kondrup J,Gluud C,Jakobsen JC

    更新日期:2017-05-19 00:00:00

  • Care delivery and self-management strategies for children with epilepsy.

    abstract:BACKGROUND:In response to criticism that epilepsy care for children has little impact, healthcare professionals and administrators have developed various service models and strategies to address perceived inadequacies. OBJECTIVES:To assess the effects of any specialised or dedicated intervention for epilepsy versus us...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006245.pub4

    authors: Fleeman N,Bradley PM

    更新日期:2018-03-01 00:00:00

  • Methods of milk expression for lactating women.

    abstract:BACKGROUND:Breastfeeding is important, however not all infants can feed at the breast and methods of expressing milk need evaluation. OBJECTIVES:To assess acceptability, effectiveness, safety, effect on milk composition, contamination and costs of methods of milk expression. SEARCH METHODS:We searched the Cochrane Pr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006170.pub5

    authors: Becker GE,Smith HA,Cooney F

    更新日期:2016-09-29 00:00:00

  • Devices and pressure sources for administration of nasal continuous positive airway pressure (NCPAP) in preterm neonates.

    abstract:BACKGROUND:Nasal continuous positive airway pressure (NCPAP) is used to support preterm infants recently extubated, those experiencing significant apnoea of prematurity and those with respiratory distress soon after birth as an alternative to intubation and ventilation. This review will focus exclusively on identifying...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002977

    authors: De Paoli AG,Davis PG,Faber B,Morley CJ

    更新日期:2002-01-01 00:00:00

  • Intravenous immunoglobulin for preventing infection in preterm and/or low birth weight infants.

    abstract:BACKGROUND:Nosocomial infections continue to be a significant cause of morbidity and mortality among preterm and/or low birth weight (LBW) infants. Preterm infants are deficient in immunoglobulin G (IgG); therefore, administration of intravenous immunoglobulin (IVIG) may have the potential of preventing or altering the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD000361.pub4

    authors: Ohlsson A,Lacy JB

    更新日期:2020-01-29 00:00:00

  • Endovascular stents for intermittent claudication.

    abstract:BACKGROUND:Endovascular stents have been suggested as a means to improve the patency of arteries after angioplasty in patients with intermittent claudication. This is an update of a Cochrane review published in 2002. OBJECTIVES:The null hypothesis to be tested by this review is that for individuals with claudication t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003228.pub2

    authors: Bachoo P,Thorpe PA,Maxwell H,Welch K

    更新日期:2010-01-20 00:00:00

  • Interactive computer-based interventions for sexual health promotion.

    abstract:BACKGROUND:Sexual health promotion is a major public health challenge; there is huge potential for health promotion via technology such as the Internet. OBJECTIVES:To determine effects of interactive computer-based interventions (ICBI) for sexual health promotion, considering cognitive, behavioural, biological and eco...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006483.pub2

    authors: Bailey JV,Murray E,Rait G,Mercer CH,Morris RW,Peacock R,Cassell J,Nazareth I

    更新日期:2010-09-08 00:00:00

  • Interventions to support the decision-making process for older people facing the possibility of long-term residential care.

    abstract:BACKGROUND:The decision to enter long-term care is often a major life event for older people, made in the context of personal crisis and loss. We hypothesised that the process through which a decision to enter long-term residential care emerges affects the overall psycho-social adjustment to, and acceptance of, this de...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005213.pub2

    authors: Gravolin M,Rowell K,de Groot J

    更新日期:2007-07-18 00:00:00

  • Heparin for prolonging peripheral intravenous catheter use in neonates.

    abstract:BACKGROUND:Peripheral intravenous (PIV) catheters are widely used in modern medical practice. However, mechanical or infectious complications often necessitate their removal and/or replacement. Heparin has been shown to be effective in prolonging the patency of peripheral arterial catheters and central venous catheters...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002774.pub2

    authors: Shah PS,Ng E,Sinha AK

    更新日期:2005-10-19 00:00:00

  • Alternative positions for the baby at birth before clamping the umbilical cord.

    abstract:BACKGROUND:The third stage of labour is from birth of the baby until delivery of the placenta. Clamping the umbilical cord is one component of active management of the third stage. Deferring cord clamping allows blood flow between the baby and the placenta to continue; net transfer to the baby is called placental trans...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007555.pub2

    authors: Airey RJ,Farrar D,Duley L

    更新日期:2010-10-06 00:00:00

  • Intra-articular corticosteroid for knee osteoarthritis.

    abstract:BACKGROUND:Knee osteoarthritis is a leading cause of chronic pain, disability, and decreased quality of life. Despite the long-standing use of intra-articular corticosteroids, there is an ongoing debate about their benefits and safety. This is an update of a Cochrane review first published in 2005. OBJECTIVES:To deter...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005328.pub3

    authors: Jüni P,Hari R,Rutjes AW,Fischer R,Silletta MG,Reichenbach S,da Costa BR

    更新日期:2015-10-22 00:00:00

  • Complementary and miscellaneous interventions for nocturnal enuresis in children.

    abstract:BACKGROUND:Nocturnal enuresis (bedwetting) is a socially disruptive and stressful condition which affects around 15% to 20% of five year olds, and up to 2% of young adults. OBJECTIVES:To assess the effects of complementary interventions and others such as surgery or diet on nocturnal enuresis in children, and to compa...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005230.pub2

    authors: Huang T,Shu X,Huang YS,Cheuk DK

    更新日期:2011-12-07 00:00:00

  • Baby-led compared with scheduled (or mixed) breastfeeding for successful breastfeeding.

    abstract:BACKGROUND:Baby-led breastfeeding is recommended as best practice in determining the frequency and duration of a breastfeed. An alternative approach is described as scheduled, where breastfeeding is timed and restricted in frequency and duration. It is necessary to review the evidence that supports current recommendati...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009067.pub2

    authors: Fallon A,Van der Putten D,Dring C,Moylett EH,Fealy G,Devane D

    更新日期:2014-07-31 00:00:00

  • WITHDRAWN: Non-steroidal anti-inflammatory drugs for preventing heterotopic bone formation after hip arthroplasty.

    abstract:BACKGROUND:Heterotopic bone formation (HBF) in the soft tissues surrounding the hip joint is a frequent complication of hip surgery. Non-steroidal anti-inflammatory drugs (NSAIDs) administered in the immediate perioperative period reduce the risk of HBF. However, the magnitude of the effect on HBF, and the effects on o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001160.pub3

    authors: Fransen M,Neal B

    更新日期:2013-03-28 00:00:00

  • Lobeline for smoking cessation.

    abstract:BACKGROUND:Lobeline is a partial nicotine agonist, which has been used in a variety of commercially available preparations to help stop smoking. OBJECTIVES:The objective of this review was to assess the effects of lobeline on long term smoking cessation. SEARCH STRATEGY:We searched the Cochrane Tobacco Addiction Grou...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000124

    authors: Stead LF,Hughes JR

    更新日期:2000-01-01 00:00:00

  • Pharmacological interventions for clozapine-induced hypersalivation.

    abstract:BACKGROUND:Clozapine is widely used for people with schizophrenia. Although agranulocytosis, weight gain, and cardiac problems are serious problems associated with its use, hypersalivation, sometimes of a gross and socially unacceptable quantity, is also common (30-80%). OBJECTIVES:To determine the clinical effects of...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005579.pub2

    authors: Syed R,Au K,Cahill C,Duggan L,He Y,Udu V,Xia J

    更新日期:2008-07-16 00:00:00

  • Corticosteroid therapy for nephrotic syndrome in children.

    abstract:BACKGROUND:In nephrotic syndrome protein leaks from the blood to the urine through the glomeruli resulting in hypoproteinaemia and generalised oedema. While most children with nephrotic syndrome respond to corticosteroids, 80% experience a relapsing course. Corticosteroids have reduced the mortality rate to around 3%. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001533.pub5

    authors: Hahn D,Hodson EM,Willis NS,Craig JC

    更新日期:2015-03-18 00:00:00

  • Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus.

    abstract:BACKGROUND:Patients with type 2 diabetes mellitus (T2D) have an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report an association between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patients with T2D. Ou...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008143.pub3

    authors: Hemmingsen B,Lund SS,Gluud C,Vaag A,Almdal TP,Hemmingsen C,Wetterslev J

    更新日期:2013-11-11 00:00:00

  • Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock.

    abstract:BACKGROUND:Intra-aortic balloon pump counterpulsation (IABP) is currently the most commonly used mechanical assist device for patients with cardiogenic shock due to acute myocardial infarction.Although there is only limited evidence by randomised controlled trials, the current guidelines of the American Heart Associati...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007398.pub2

    authors: Unverzagt S,Machemer MT,Solms A,Thiele H,Burkhoff D,Seyfarth M,de Waha A,Ohman EM,Buerke M,Haerting J,Werdan K,Prondzinsky R

    更新日期:2011-07-06 00:00:00

  • In-hospital care pathways for stroke.

    abstract:BACKGROUND:Care within a stroke unit reduces death or dependency after stroke. However, studies have found significant variations in clinical practice, access to stroke unit care, organisation of patient care, and clinical outcome. Stroke care pathways have been introduced as a method to promote organised and efficient...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002924

    authors: Kwan J,Sandercock P

    更新日期:2002-01-01 00:00:00

  • Interventions for drooling in children with cerebral palsy.

    abstract:BACKGROUND:Drooling is a common problem for children with cerebral palsy (CP). This can be distressing for these children as well as for their parents and caregivers. The consequences of drooling include risk of social rejection, damp and soiled clothing, unpleasant odour, irritated chapped skin, mouth infections, dehy...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008624.pub2

    authors: Walshe M,Smith M,Pennington L

    更新日期:2012-02-15 00:00:00

  • Chest radiograph in acute respiratory infections in children.

    abstract:BACKGROUND:Chest radiography is widely used in children with acute lower respiratory infections, but the benefits are unknown. OBJECTIVES:To assess the effects of chest radiography for children with acute lower respiratory infections. SEARCH STRATEGY:The searches were updated in November 2004. We searched the Cochran...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001268.pub2

    authors: Swingler GH,Zwarenstein M

    更新日期:2005-07-20 00:00:00

  • Screening programmes for the early detection and prevention of oral cancer.

    abstract:BACKGROUND:Oral cancer is an important global healthcare problem, its incidence is increasing and late-stage presentation is common. Screening programmes have been introduced for a number of major cancers and have proved effective in their early detection. Given the high morbidity and mortality rates associated with or...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004150.pub3

    authors: Brocklehurst P,Kujan O,Glenny AM,Oliver R,Sloan P,Ogden G,Shepherd S

    更新日期:2010-11-10 00:00:00

  • Telephone counselling for smoking cessation.

    abstract:BACKGROUND:Telephone services can provide information and support for smokers. Counselling may be provided proactively or offered reactively to callers to smoking cessation helplines. OBJECTIVES:To evaluate the effect of telephone support to help smokers quit, including proactive or reactive counselling, or the provis...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD002850.pub4

    authors: Matkin W,Ordóñez-Mena JM,Hartmann-Boyce J

    更新日期:2019-05-02 00:00:00

  • Bile acids for primary sclerosing cholangitis.

    abstract:BACKGROUND:Bile acids have been used for treating primary sclerosing cholangitis, but their beneficial and harmful effects remain unclear. OBJECTIVES:To assess the beneficial and harmful effects of bile acids for patients with primary sclerosing cholangitis. SEARCH STRATEGY:We searched The Cochrane Hepato-Biliary Gro...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003626

    authors: Chen W,Gluud C

    更新日期:2003-01-01 00:00:00

  • Dietary interventions for mineral and bone disorder in people with chronic kidney disease.

    abstract:BACKGROUND:Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a systemic dysfunction of mineral and bone metabolism in people with CKD. Recent research shows that phosphate retention plays a significant role in the development of CKD-MBD. Compared with drug therapies, dietary interventions may be simple, ine...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010350.pub2

    authors: Liu Z,Su G,Guo X,Wu Y,Liu X,Zou C,Zhang L,Yang Q,Xu Y,Ma W

    更新日期:2015-09-16 00:00:00

  • Effect of partogram use on outcomes for women in spontaneous labour at term.

    abstract:BACKGROUND:The partogram (sometimes known as partograph) is usually a pre-printed paper form, on which labour observations are recorded. The aim of the partogram is to provide a pictorial overview of labour, to alert midwives and obstetricians to deviations in maternal or fetal wellbeing and labour progress. Charts oft...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005461.pub2

    authors: Lavender T,Hart A,Smyth RM

    更新日期:2008-10-08 00:00:00

  • Zinc supplementation for preventing mortality, morbidity, and growth failure in children aged 6 months to 12 years of age.

    abstract:BACKGROUND:Zinc deficiency is prevalent in low- and middle-income countries, and contributes to significant diarrhoea-, pneumonia-, and malaria-related morbidity and mortality among young children. Zinc deficiency also impairs growth. OBJECTIVES:To assess the effects of zinc supplementation for preventing mortality an...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009384.pub2

    authors: Mayo-Wilson E,Junior JA,Imdad A,Dean S,Chan XH,Chan ES,Jaswal A,Bhutta ZA

    更新日期:2014-05-15 00:00:00