Sagar Stephen M, Dryden Trish, Myers Cynthia
Department of Medicine and Oncology, McMaster University, Hamilton, ON.
J Soc Integr Oncol. 2007 Fall;5(4):155-62. doi: 10.2310/7200.2007.017.
There is preliminary evidence that therapeutic massage is a useful modality for the relief of a variety of symptoms and symptom-related distress affecting cancer patients. Mechanistic studies are necessary to delineate underlying biologic and psychological effects of massage and their relationship to outcomes. The current article discusses a model for using nuclear magnetic resonance techniques to capture dynamic in vivo responses to biomechanical changes induced in the soft tissues by massage. This model enables study of the communication of soft tissue changes to activity in the subcortical central nervous system. We hypothesize that the therapeutic components of massage are twofold: (1) a rapid direct effect on local fascia, muscle, and nerves and (2) a slower delayed effect on the subcortical central nervous system that ultimately incorporates remodeling of plastic neuronal connections. This testable model has important implications for mechanistic research on massage for symptom control of cancer patients since it opens up new research avenues that link objective physiologic indices with the effects of massage on the subjective experience of pain and other symptoms.
有初步证据表明,治疗性按摩是缓解影响癌症患者的各种症状及与症状相关痛苦的一种有效方式。需要进行机制研究来阐明按摩的潜在生物学和心理效应及其与治疗结果的关系。本文讨论了一种利用核磁共振技术来捕捉体内对按摩引起的软组织生物力学变化的动态反应的模型。该模型能够研究软组织变化与皮质下中枢神经系统活动之间的信息传递。我们假设按摩的治疗作用有两个方面:(1)对局部筋膜、肌肉和神经的快速直接作用;(2)对皮质下中枢神经系统的较慢延迟作用,最终涉及可塑性神经元连接的重塑。这个可检验的模型对癌症患者症状控制的按摩机制研究具有重要意义,因为它开辟了新的研究途径,将客观生理指标与按摩对疼痛和其他症状主观体验的影响联系起来。