Guan Ling, Collet Jean-Paul, Yuskiv Nataliya, Skippen Peter, Brant Rollin, Kissoon Niranjan
Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4.
Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Division of Critical Care, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6H 3V4.
Evid Based Complement Alternat Med. 2014;2014:656750. doi: 10.1155/2014/656750. Epub 2014 Dec 21.
Objectives. Our main objective was to describe the effect of foot and hand (F&H) massage on the autonomic nervous system (ANS) activity in children hospitalized in a pediatric intensive care unit (PICU); the secondary objectives were to assess the relationship between ANS function and the clinical severity and to explore the effects of repeated massage sessions on the ANS. Methods. Design was a descriptive experimental study. Intervention was single or six session(s) of F&H massage. ANS function was assessed through the frequency-domain analysis of heart rate variability. Main metrics included high and low frequency power (HF and LF), HF + LF, and LF/HF ratio. Results. Eighteen children participated in the study. A strong Spearman's correlation (ρ = -0.77) was observed between HF + LF and clinical severity. During massage, the parasympathetic activity (measured by HF) increased significantly from baseline (P = 0.04) with a mean percentage increase of 75% (95% CI: 20%∼130%). LF increased by 56% (95% CI: 20%∼92%) (P = 0.026). Repeated sessions were associated with a persistent effect on HF and LF which peaked at the second session and remained stable thereafter. Conclusions. HF + LF is positively correlated with clinical severity. F&H massage can improve the ANS activity and the effect persists when repeated sessions are offered.
目的。我们的主要目的是描述手足（F&H）按摩对入住儿科重症监护病房（PICU）的儿童自主神经系统（ANS）活动的影响；次要目的是评估ANS功能与临床严重程度之间的关系，并探讨重复按摩疗程对ANS的影响。方法。设计为描述性实验研究。干预措施为单次或六次F&H按摩。通过心率变异性的频域分析评估ANS功能。主要指标包括高频和低频功率（HF和LF）、HF+LF以及LF/HF比值。结果。18名儿童参与了该研究。观察到HF+LF与临床严重程度之间存在强烈的斯皮尔曼相关性（ρ=-0.77）。在按摩期间，副交感神经活动（通过HF测量）从基线显著增加（P=0.04），平均增加百分比为75%（95%CI：20%～130%）。LF增加了56%（95%CI：20%～92%）（P=0.026）。重复疗程与对HF和LF的持续影响相关，这种影响在第二次疗程时达到峰值，此后保持稳定。结论。HF+LF与临床严重程度呈正相关。F&H按摩可改善ANS活动，且重复疗程时这种效果会持续存在。
