Massage Therapy and Essential Tremor

Essential tremor (ET) is a neurological disorder causing rhythmical shaking of part of the body. The condition is known to have an inheritable tendency and can present in more than one family member, known as familial tremor. Treatment of the disorder is commonly by way of prescription medication. ET is progressive and in its mildest form can be sensed and/or observed when performing simple motor skills or activities of daily living (ADL).

The study period included five consecutive weekly sessions. The subject, a 63-year-old female, indicated her hands and head as the primary areas affected by ET. The treatment aim was to reduce sympathetic nervous system firing; therefore, the massage techniques implemented were relaxation-based. Methods included Swedish massage, hydrotherapy, myofascial release, diaphragmatic breathing, remedial exercise education and affirmative symptom management recommendations. Drawings of an Archimedes spiral for comparison pre- and post-treatment provided an objective, visual representation of tremor intensity affecting fine motor control. Goniometric measurements were taken to mark changes in cervical range of motion.

Tremor intensity decreased after each session; demonstrated by improved fine motor skills. The client also reported an increased functionality in cervical range, which was documented during the first and last visits.

The results suggest that tremors, symptomatic to ET, can be eased through initiatives that encourage a parasympathetic response. Massage therapy has shown to be a valuable method of treatment for ET. Tremor severity can present in an irregular pattern due to subjective individual triggers; therefore, further controlled research is required to lessen the variability between subjects and to validate these findings.

Achilles Tendinopathy

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Am J Sports Med. 2008 May;36(5):881-7. doi: 10.1177/0363546507312165. Epub 2008 Feb 13.
Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy.
Stergioulas A1, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM.


Eccentric exercises (EEs) are recommended for the treatment of Achilles tendinopathy, but the clinical effect from EE has a slow onset.
The addition of low-level laser therapy (LLLT) to EE may cause more rapid clinical improvement.
Randomized controlled trial; Level of evidence, 1.
A total of 52 recreational athletes with chronic Achilles tendinopathy symptoms were randomized to groups receiving either EE + LLLT or EE + placebo LLLT over 8 weeks in a blinded manner. Low-level laser therapy (lambda = 820 nm) was administered in 12 sessions by irradiating 6 points along the Achilles tendon with a power density of 60 mW/cm(2) and a total dose of 5.4 J per session.
The results of the intention-to-treat analysis for the primary outcome, pain intensity during physical activity on the 100-mm visual analog scale, were significantly lower in the LLLT group than in the placebo LLLT group, with 53.6 mm versus 71.5 mm (P = .0003) at 4 weeks, 37.3 mm versus 62.8 mm (P = .0002) at 8 weeks, and 33.0 mm versus 53.0 mm (P = .007) at 12 weeks after randomization. Secondary outcomes of morning stiffness, active dorsiflexion, palpation tenderness, and crepitation showed the same pattern in favor of the LLLT group.
Low-level laser therapy, with the parameters used in this study, accelerates clinical recovery from chronic Achilles tendinopathy when added to an EE regimen. For the LLLT group, the results at 4 weeks were similar to the placebo LLLT group results after 12 weeks.

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