- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05853250
Clinical and Hospital Stay Effects of Reiki and Manual Therapy After Open Heart Surgery
Clinical (Sleep, Pain and Atrial Fibrillation) and Hospital Stay Effects of Reiki and Manual Therapy After Open Heart Surgery
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background: Reiki is an energy-based healing therapy using light touch. Manual therapy is a technique using light effleurage. These complimentary healing services are utilized to promote relaxation, sleep, improve emotions, and decrease pain. After reviewing the Reiki research literature, more research is required since sample sizes were small, subjects were generally healthy (not hospitalized), and subjects had multiple medical backgrounds. Only 1 study focused on cardiac surgery patients. In the current research study, we aim to learn if Reiki and manual therapy enhances postoperative clinical outcomes for patients after first time coronary artery bypass graft (CABG) and/or cardiac valve surgery.
Design and Methods: A randomized, controlled non-blinded study will be used. The sample size (272 total; 136 per group) was based on a power analysis using the primary outcome. The intervention group will receive usual care plus Reiki and manual therapy, with Reiki being delivered first. Hand placements include: head, chest, shoulders, hands, knees, and feet for 15 minutes. Manual therapy will consist of light effleurage to the head and feet for 5 minutes. Total therapies time is 20 minutes. Reiki and manual therapy will be delivered for 3 consecutive days beginning on the day after endotracheal tube removal. The usual care group will receive 20 minutes of uninterrupted rest, which is part of usual postoperative care. There will not be a sham-treatment group, based on previous research findings.
Outcome Measures: depression and anxiety (Brief Symptom Inventory, 12-item self-administered tool); pain (self-reported and recorded in electronic health record by staff nurses as part of usual care -- 0 [no pain] - 10 [worst pain] scale), highest (worst) and lowest (least) pain in the past 24 hours will be assessed; night time sleep (Richards-Campbell Sleep Questionnaire; 5 item self-administered tool)-to be measured at baseline and after the last Reiki/manual therapy treatment or 3 days of usual care; hospital length of stay, all-cause 30-day hospital readmissions (data top be retrieved from a billing database), narcotic drug burden (mean dose) use on postoperative days 3 and 4 (retrieved from electronic medical records), patient characteristics, medical history, surgical procedure, new onset atrial fibrillation and other post-operative complications (retrieved from the Institutional Review Board--approved Cardiothoracic Surgery database).
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ohio
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic Foundation
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Over 18 years of age
- Speaks English language and capable of reading and hearing
- Up to 4 "To Come In" patients enrolled per day (2 standard care and 2 intervention group)
- Arrive for surgery from outpatient (home) environment
- Scheduled for surgery (arrives in "To Come In" area) on Monday and Tuesday.
- Lives in one of 6 counties of North East Ohio to ensure access post-discharge hospitalization
Exclusion Criteria:
- History of dementia, cognitive decline, Down's syndrome or other neurologic, psychological or congenital deficiency that impacts ability to make decisions about enrollment
- Severe sight and hearing impairment despite assistive devices
- Cardiac surgery on a Wednesday, Thursday or Friday
- Treated in the hospital prior to the day of surgery
- Prolonged intubation (over 48 hours), or reinsertion of an endotracheal tube during or before the intervention is initiated (will result in intervention withdrawal)
- Sedated due to new onset delirium.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Reiki/manual therapy
Reiki, a Japanese energy-based healing technique, is universal vital energy that flows throughout and encompasses all living forms (Rand, 1991).
It is delivered by gentle hand placement either on/slightly above the body by certified Reiki practitioners.
In this study, Reiki will be delivered first, for 15 min.
and will involve light placement of hands on patients' head, chest, shoulders, hands, knees, and feet (~ 3 minutes to each body part).
Manual therapy (MT) includes light effleurage to head and feet (for 5 minutes; ~ 2.5 minutes to each body part) by the Reiki practitioner.
MT techniques are defined as light circular stroking movements made with the hands.
Reiki and MT will be delivered for 3 consecutive days beginning on the day after endotracheal tube removal.
Reiki and MT will be delivered by 4 Reiki practitioners with training at a Level 2+.
Reiki and manual therapy was delivered as one intervention.
They are not two separate interventions.
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Reiki is delivered by gentle hand placement either on or slightly above the body by certified Reiki practitioners.
In this study, Reiki will be delivered first, for 15 minutes and will involve light placement of hands on patients' head, chest, shoulders, hands, knees, and feet (~ 3 minutes to each body part).
Manual therapy techniques include light effleurage to head and feet (for 5 minutes; ~ 2.5 minutes to each body part) by the Reiki practitioner who delivered the Reiki therapy.
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No Intervention: Usual care quiet time
All usual care provided pre and post-operative management will continue, uninterrupted; including the 20 minute rest period.
The only non-usual care component will be placement of a sign on the door to discourage visitors and providers from entering the room and disturbing the rest period.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Depression
Time Frame: Pre-operative (baseline)
|
The Brief Symptom Inventory has a depression dimension that includes 6 items.
Participants are asked to consider the "past week" when responding and each item is scored on a 5-point scale, from 0 (not at all) to 4 (extremely).
The higher the score, the worse the depression; score range is 0-24.
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Pre-operative (baseline)
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Depression
Time Frame: Post-operative (day 3)
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The Brief Symptom Inventory has a depression dimension that includes 6 items.
Participants are asked to consider the "past week" when responding and each item is scored on a 5-point scale, from 0 (not at all) to 4 (extremely).
The higher the score, the worse the depression; score range is 0-24.
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Post-operative (day 3)
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Anxiety
Time Frame: Pre-operative (baseline)
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The Brief Symptom Inventory has a anxiety dimension that includes 6 items.
Participants are asked to consider the "past week" when responding and each item is scored on a 5-point scale, from 0 (not at all) to 4 (extremely).
The higher the score, the worse the anxiety; score range is 0-24.
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Pre-operative (baseline)
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Anxiety
Time Frame: Post-operative (day 3)
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The Brief Symptom Inventory has a anxiety dimension that includes 6 items.
Participants are asked to consider the "past week" when responding and each item is scored on a 5-point scale, from 0 (not at all) to 4 (extremely).
The higher the score, the worse the anxiety; score range is 0-24.
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Post-operative (day 3)
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Sleep
Time Frame: Paper surveys distributed pre-operative (baseline)
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The Richards-Campbell Sleep Questionnaire (RCSQ) Valid and Reliable survey with 5 domains (sleep depth, sleep latency, awakenings from sleep, ability to return to sleep, and sleep quality) and 1 question for each domain, therefore the tool has a total of 5 items. The visual analog scale uses statements on either side of a 0 to 100 mm horizontal line. For example, deep sleep ____ light sleep. Participants place a vertical line on the horizontal 100mm scale, to reflect which item on the scale best matches the response to each question. A ruler is used to record the mm marking of each item. A sleep score is created by dividing the sum of the length in mm of visual analog lines by 5. Higher scores indicates greater sleep disturbances. |
Paper surveys distributed pre-operative (baseline)
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Sleep
Time Frame: Paper surveys distributed post-operative (day 3) after final reiki and manual therapies intervention or quiet time sessions were completed.
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The Richards-Campbell Sleep Questionnaire (RCSQ) Valid and Reliable survey with 5 domains (sleep depth, sleep latency, awakenings from sleep, ability to return to sleep, and sleep quality) and 1 question for each domain, therefore the tool has a total of 5 items. The visual analog scale uses statements on either side of a 0 to 100 mm horizontal line. For example, deep sleep ____ light sleep. Participants place a vertical line on the horizontal 100mm scale, to reflect which item on the scale best matches the response to each question. A ruler is used to record the mm marking of each item. A sleep score is created by dividing the sum of the length in mm of visual analog lines by 5. Higher scores indicates greater sleep disturbances. |
Paper surveys distributed post-operative (day 3) after final reiki and manual therapies intervention or quiet time sessions were completed.
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Pain Level, Mean Score
Time Frame: Post-operative thru day 3 after the 1st intervention/usual care was administered
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Pain intensity was assessed on a numerical scale of 0-10 by nurses as part of usual care documentation which was generally completed every 4 hours (higher score = worst pain).
Mean scores are presented as median with (P25, P75) by group
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Post-operative thru day 3 after the 1st intervention/usual care was administered
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Pain Level, Median Score
Time Frame: Post-operative thru day 3 after the 1st intervention/usual care was administered
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Pain intensity was assessed on a numerical scale of 0-10 by nurses as part of usual care documentation which was generally completed every 4 hours (higher score = worst pain).
Data represent median (P25, P75) score values by group.
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Post-operative thru day 3 after the 1st intervention/usual care was administered
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Hospital Length of Stay, Days - Mean (Standard Deviation)
Time Frame: Days of hospital stay
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Length of stay equals date of surgery (day 0) to date before the day of hospital discharge (we do NOT include the day of discharge).
The number is continuous and is based on the actual length of the POSTOPERATIVE hospital stay and is based on being in the hospital at 12 MN.
There is no pre-specified maximum number.
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Days of hospital stay
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New-onset Postoperative Atrial Fibrillation Complication
Time Frame: Post-operation (from day of surgery until hospital discharge)
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Dichotomous variable (Yes versus No) based on medical record documentation of new-onset postoperative atrial fibrillation anytime in the postoperative period.
The total number of "yes" responses were compared between groups as a "count".
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Post-operation (from day of surgery until hospital discharge)
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All-cause 30-day Hospital Readmission
Time Frame: 30 days after discharge
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All-cause 30-day hospital readmission rate based on medical record data.
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30 days after discharge
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Total Opioid IV Narcotic Burden (Mean) in mg
Time Frame: Total opioid IV narcotic medication dose (in milligrams), using morphine equivalent data, during the length of stay, an average 6.4 days
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Data retrieved via a hospital billing database
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Total opioid IV narcotic medication dose (in milligrams), using morphine equivalent data, during the length of stay, an average 6.4 days
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Total Oral Narcotic Burden (Mean) in Milligarms
Time Frame: Total oral narcotic medication dose in milligrams, using morphine equivalent data, during the length of stay, an average 6.4 days
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Data retrieved via a hospital billing database
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Total oral narcotic medication dose in milligrams, using morphine equivalent data, during the length of stay, an average 6.4 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Number of Participants With Hospital Re-admission Within 30 Days
Time Frame: 30 days
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Number of participants with hospital re-admission within 30 days of discharge.
Data retrieved medical record chart review.
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30 days
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Sandra Zampino, The Cleveland Clinic
Publications and helpful links
General Publications
- Richards KC, O'Sullivan PS, Phillips RL. Measurement of sleep in critically ill patients. J Nurs Meas. 2000 Fall-Winter;8(2):131-44.
- Mackay N, Hansen S, McFarlane O. Autonomic nervous system changes during Reiki treatment: a preliminary study. J Altern Complement Med. 2004 Dec;10(6):1077-81. doi: 10.1089/acm.2004.10.1077.
- Borm GF, Fransen J, Lemmens WA. A simple sample size formula for analysis of covariance in randomized clinical trials. J Clin Epidemiol. 2007 Dec;60(12):1234-8. doi: 10.1016/j.jclinepi.2007.02.006. Epub 2007 Jun 6.
- Vitale A. An integrative review of Reiki touch therapy research. Holist Nurs Pract. 2007 Jul-Aug;21(4):167-79; quiz 180-1. doi: 10.1097/01.HNP.0000280927.83506.f6.
- Gordon DB, Polomano RC, Pellino TA, Turk DC, McCracken LM, Sherwood G, Paice JA, Wallace MS, Strassels SA, Farrar JT. Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation. J Pain. 2010 Nov;11(11):1172-86. doi: 10.1016/j.jpain.2010.02.012. Epub 2010 Apr 18.
- Braun LA, Stanguts C, Casanelia L, Spitzer O, Paul E, Vardaxis NJ, Rosenfeldt F. Massage therapy for cardiac surgery patients--a randomized trial. J Thorac Cardiovasc Surg. 2012 Dec;144(6):1453-9, 1459.e1. doi: 10.1016/j.jtcvs.2012.04.027. Epub 2012 Sep 7.
- Albert NM, Gillinov AM, Lytle BW, Feng J, Cwynar R, Blackstone EH. A randomized trial of massage therapy after heart surgery. Heart Lung. 2009 Nov-Dec;38(6):480-90. doi: 10.1016/j.hrtlng.2009.03.001. Epub 2009 Jun 28.
- Anderson PG, Cutshall SM. Massage therapy: a comfort intervention for cardiac surgery patients. Clin Nurse Spec. 2007 May-Jun;21(3):161-5; quiz 166-7. doi: 10.1097/01.NUR.0000270014.97457.d5.
- Boitor M, Martorella G, Arbour C, Michaud C, Gelinas C. Evaluation of the preliminary effectiveness of hand massage therapy on postoperative pain of adults in the intensive care unit after cardiac surgery: a pilot randomized controlled trial. Pain Manag Nurs. 2015 Jun;16(3):354-66. doi: 10.1016/j.pmn.2014.08.014.
- Cutshall SM, Wentworth LJ, Engen D, Sundt TM, Kelly RF, Bauer BA. Effect of massage therapy on pain, anxiety, and tension in cardiac surgical patients: a pilot study. Complement Ther Clin Pract. 2010 May;16(2):92-5. doi: 10.1016/j.ctcp.2009.10.006. Epub 2009 Nov 14.
- Doering LV, Moser DK, Riegel B, McKinley S, Davidson P, Baker H, Meischke H, Dracup K. Persistent comorbid symptoms of depression and anxiety predict mortality in heart disease. Int J Cardiol. 2010 Nov 19;145(2):188-192. doi: 10.1016/j.ijcard.2009.05.025. Epub 2009 Jun 2.
- Lee MS, Pittler MH, Ernst E. Effects of reiki in clinical practice: a systematic review of randomised clinical trials. Int J Clin Pract. 2008 Jun;62(6):947-54. doi: 10.1111/j.1742-1241.2008.01729.x. Epub 2008 Apr 10.
- MacIntyre B, Hamilton J, Fricke T, Ma W, Mehle S, Michel M. The efficacy of healing touch in coronary artery bypass surgery recovery: a randomized clinical trial. Altern Ther Health Med. 2008 Jul-Aug;14(4):24-32.
- Rand W. (1991). The Healing Touch. First and Second Degree Manual. Vision Publication: Southfield, MI.
- Society of Thoracic Surgeons. The Society of Thoracic Surgeons Adult Cardiac Surgery Database data collection form version 2.81, April 23,2015. Society of Thoracic Surgeons, www.sts.org. Accessed 09-12-2016.
- vanderVaart S, Gijsen VM, de Wildt SN, Koren G. A systematic review of the therapeutic effects of Reiki. J Altern Complement Med. 2009 Nov;15(11):1157-69. doi: 10.1089/acm.2009.0036.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Heart Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Disease
- Myocardial Ischemia
- Coronary Artery Disease
- Heart Valve Diseases
- Therapeutics
- Mind-Body Therapies
- Complementary Therapies
- Spiritual Therapies
- Physical Therapy Modalities
- Rehabilitation
- Musculoskeletal Manipulations
- Therapeutic Touch
Other Study ID Numbers
- 17-184
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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