Effects of shiatsu on the health-related quality of life of a person with secondary progressive multiple sclerosis: A mixed methods N-of-1 trial within a whole systems research case study

Abstract

Abstract Introduction Multiple Sclerosis (MS) is a chronic neurological disorder with high prevalence in Finland. Most people with MS will develop Secondary-Progressive MS (SPMS) over time. People with MS report lower than the average Health-Related Quality of Life (HRQoL) and use Complementary and Alternative Medicine (CAM) for their symptoms. Personalised interventions such as shiatsu have an insufficient evidence base. The n-of-1 trial is a promising study design for personalised interventions in chronic conditions but has not little used in CAM research. The aim was to investigate if shiatsu affects the HRQoL of a person with SPMS. Methods Six-periods counterbalanced mixed-methods n-of-1 trial within a Whole Systems Research (WSR) case study was used. The short version of the MSQLI, data collected from a semi-structured interview and case notes were used to assess the effect of the treatment. The collected data analysed quantitatively and qualitatively and synthesised as a descriptive case study. Results The study was able to document improvements in spasticity, bowel function, fatigue, pain, sleep and relaxation. No adverse events occurred. Preliminary estimations of the onset and wash-out of shiatsu effects were inferred. Advantages and drawbacks of the design are discussed to improve future applicability. Conclusions Shiatsu was able to improve some domains of the HRQoL of the specific person with SPMS. It was a safe treatment with no adverse events. Mixed methods n-of-1 trial within a WSR case study was an appropriate design for the study.