Effectiveness of Hand Self-Shiatsu for Post Sport-related Concussion Sleep Disturbance in Young Athletes

Abstract

Background: Sport-related concussion (SRC) is a prevalent injury with significant health consequences. One important, but under-addressed area of health affected by SRC, is sleep. Not only can SRC cause sleep disturbance but, in turn, sleep disturbance affects recovery from SRC and increases the risk of symptom recurrence. Sleep deficiency also affects learning ability, memory and can lead to suboptimal academic performance, which is significant for youth. Hand self-Shiatsu (HSS) is a form of Complementary and Alternative Medicine (CAM). Promising outcomes of HSS to improve sleep were found with chronic pain patients in a pilot study and the literature suggests that HSS is an approach worth studying further in larger studies of various populations. Objective: The purpose of this study is to test the HSS as a self-management approach promoting sleep in young post-concussion athletes and non-concussion population with self-reported sleep problems. Methods: Using the consecutive case series design, the study recruited a group of participants with self-reported sleep disturbance after SRC. Another group of participants without SRC history was added four months later to expand the study. There were seven participants in each group, whose ages were between 18 to 25 years. After seven days of sleep diary and baseline actigraphy data collection, participants were taught to apply the standardized HSS technique and instructed to use it every night before bed and during awakenings. Follow-up data collection occurred at 4 and 8 weeks. Additional standardized sleep and CAMs questionnaires were included at baseline and follow-up to collect data about self-reported sleep quality, daytime fatigue and participant attitudes toward HSS. Statistical analysis was carried out to compare the results from baseline to follow-ups within groups. Key Results: There was no significant improvement in the results of actigraphy sleep measures from baseline to the 2nd follow-up in the post-SRC group. However, total sleep time significantly increased at the 2nd follow-up in the non-SRC group. Both groups had significant improvements in self-report sleep quality questionnaire and daytime fatigue. Conclusion: The results suggests that the HSS may be useful to improve the self-reported sleep quality in both groups. Further study with larger sample size and control groups need to be conducted to build more evidence for the HSS.