Klinik für Geriatrie, Endokrinologie und Diabetologie, Geriatrischer Schwerpunkt, RKH-Kliniken Ludwigsburg/Bietigheim, Riedstr. 12, 74321, Bietigheim-Bissingen, Germany.
Z Gerontol Geriatr. 2021 Dec;54(8):753-758. doi: 10.1007/s00391-021-01995-4. Epub 2021 Nov 23.
Massage and touch-based treatment are popular despite limited evidence from high quality clinical trials. This article reviews the rationale and evidence of treating older patients with psychiatric symptoms by touch-based therapy.
Narrative literature review, based on Medline search with the following key words: massage, social touch, affective touch, clinical trial, meta-analysis. Citations of identified articles were searched for additional relevant studies.
Evidence from clinical trials in adult patients with mainly chronic disorders of the musculoskeletal system suggests that massage therapy results in significant short-term improvement of symptoms; however, treatment effects appear not to be sustained. In addition, conclusions are difficult to draw owing to very heterogeneous study interventions, difficulties with definition of control conditions and treatment outcomes. There appears to be better evidence for improvement of psychological variables and subjective symptoms, such as pain and quality of life. A neuronal system of affective and social touch has been identified with specific afferents from C‑fibre coupled low threshold mechanoreceptors projecting into the insular cortex and the limbic system. This system may also mediate effects of massage in adult patients. Positive clinical trials for depressive symptoms of dementia and for behavioral symptoms of advanced dementia are available with encouraging results.
The neuronal system of social and affective touch suggests a potential mechanism of action of touch-based interventions in geriatric psychiatry. In addition, it provides a rationale for applying and designing novel touch-based treatment strategies as adjunctive treatment for psychiatric disorders of old age.
尽管高质量临床试验提供的证据有限，但按摩和基于触摸的治疗方法仍然很受欢迎。本文综述了通过基于触摸的疗法治疗老年精神病患者的基本原理和证据。
基于 Medline 搜索，使用以下关键词进行叙事性文献综述：按摩、社会触摸、情感触摸、临床试验、荟萃分析。对已确定文章的引文进行了额外相关研究的搜索。
主要针对慢性肌肉骨骼系统疾病的成年患者的临床试验证据表明，按摩疗法可显著改善短期症状；然而，治疗效果似乎无法持续。此外，由于研究干预措施非常不同、难以定义对照条件和治疗结果，因此难以得出结论。改善心理变量和主观症状（如疼痛和生活质量）似乎有更好的证据。已经确定了情感和社会触摸的神经元系统，其具有来自 C 纤维耦合的低阈值机械感受器的特定传入纤维，投射到脑岛和边缘系统。该系统也可能介导成年患者按摩的作用。针对痴呆症的抑郁症状和晚期痴呆症的行为症状，已经有了积极的临床试验，结果令人鼓舞。
社会和情感触摸的神经元系统提示了基于触摸的干预措施在老年精神病学中的潜在作用机制。此外，它为应用和设计新型基于触摸的治疗策略提供了依据，作为老年精神障碍的辅助治疗。
