Abstract

The back rub, which has been an established part of evening patient care for many years, is given to promote relaxation and sleep as well as to promote skin care. Yet its place in modern nursing seems questionable. Today's nurse is less willing to practice using empirically established procedures.

There have been few investigations showing the effect of massage to the back and no studies have shown that a brief back rub, as given by nurses, promotes relaxation. In cardiovascular nursing there is some controversy as to whether or not the back rub causes stimulation to the cardiovascular system that could be harmful. The purpose of this study is to determine whether a back rub promotes relaxation without producing clinically significant cardiovascular changes.

A review of the literature indicates that muscle tension as measured by electromyography (EMG) correlates with degree of relaxation, and that heart rate (HR) and blood pressure (BP) are two acceptable noninvasive measures of cardiovascular response. It was hypothesized that an individual who has received a back rub will show a greater degree of relaxation, indicated by a voltage decrease of EMG, than when he has not received a back rub. Whether a back rub increases or decreases BP and HR is equivocal from the available literature, therefore a hypothesis was not formulated concerning these relationships but these changes were considered in an exploratory manner.

No single recommended back rub procedure is found in current nursing literature and practice, therefore, a review of the related literature indicated that long, slow, rhythmical massage movements should be used to promote relaxation. The back rub procedure used in this study was seven and one-half minutes and included a well defined sequence of effleurage (stroking) and petrissage (kneading) movements.

Twenty, non-hospitalized females who gave negative responses to questions regarding signs, symptoms or history of cardiovascular disease, aged 19 to 68 years, were observed on two separate evenings in control and experimental (after back rub) sessions thirty minutes in length. EMG, HR, and BP were used as indications of the subjects' response. The effect of the back rub, the effect of sequence, receiving the back rub during the first or second session, and the changes in physiological parameters over the thirty minute observation periods were studied by analysis of variance.

The hypothesis relating the back rub with promotion of relaxation was not supported since no significant decrease in EMG microvoltage occurred following the back rub although a slight trend for decrease was observed. There were also no significant changes in HR and systolic BP. Diastolic BP was increased significantly (p < 0.01) after the back rub during the first time interval. A trend for immediate increase occurred with HR and systolic BP following the back rub. EMG and BP readings were higher during the first session for both experimental and control groups. This effect was related to sequence.

It was recommended that the interrelationship of the back rub, relaxation and cardiovascular response be studied more thoroughly. Several suggestions for design changes in future related studies were made and they included (1) increasing the number of experimental sessions (2) measuring anxiety level by use of a psychological tool (3) studying hospitalized patients, both non-cardiac and cardiac (4) reviewing electrode placement and (5) controlling the hemodynamics of posture.

LLU Discipline

Nursing

Department

Nursing

School

Graduate School

First Advisor

Dorothy M. Martin

Second Advisor

Patricia Foster

Third Advisor

Keith Gaden

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1973

Date (Title Page)

6-1973

Language

English

Library of Congress/MESH Subject Headings

Relaxatio; Techniques Back

Type

Thesis

Page Count

ix; 73

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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