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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?
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 Duplicaton2
� � 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
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 Duplicaton3
� � 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
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 Duplicaton4
� � 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
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 Duplicaton5
� � 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
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 Duplicaton6
� � 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
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 Duplicaton7
� � 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
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 Duplicaton8
� � 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
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 Duplicaton9
� � 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
Recommended