***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To determine whether massage therapy improves postoperative mood , pain , anxiety , and physiologic measurements ; shortens hospital stay ; and decreases occurrence of atrial fibrillation . METHODS Two hundred fifty-two adults undergoing cardiac surgery were r and omized to usual postoperative care ( n=126 ) or usual care plus two massages ( n=126 ) . Assessment s of mood , depression , anxiety , pain , physiologic status , cardiac rhythm , and hospital length of stay were completed . Logistic and linear regressions were performed . RESULTS Preoperative pain , mood , and affective state scores were positively associated with postoperative scores ; however , there were no postoperative differences between groups for any measures ( P=.11 to .93 ) . There were no differences in physiologic variables except lower postoperative blood pressure after massage ( P = .01 ) . Postoperative atrial fibrillation occurrence ( P = .6 ) and median postoperative hospital length of stay ( P = .4 ) were similar between groups . CONCLUSION Massage therapy is feasible in cardiac surgical patients ; however , it does not yield therapeutic benefit . Nevertheless , it should be a patient-selected and -paid option BACKGROUND The conduct of r and omized , controlled trials of nonpharmacologic treatments presents specific challenges that are not adequately addressed in trial reports . OBJECTIVE To develop an extension of the CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement for trials of nonpharmacologic treatments . DESIGN A consensus meeting was organized to develop an extension of the CONSORT Statement that addresses r and omized trials of nonpharmacologic treatments . To prepare for the meeting , a survey was conducted to identify the specific issues for discussion . SETTING Consensus meeting in Paris , France . PARTICIPANTS A total of 33 experts attended the meeting . The experts were method ologists ( n = 17 ) ; surgeons ( n = 6 ) ; editors ( n = 5 ) ; and clinicians involved in rehabilitation ( n = 1 ) , psychotherapy ( n = 2 ) , education ( n = 1 ) , and implantable devices ( n = 1 ) . MEASUREMENTS Experts indicated which of the 22 items on the CONSORT checklist should be modified or which additional items should be added specifically for nonpharmacologic treatments . During a 3-day consensus meeting , all items were discussed and additional method ological issues related to nonpharmacologic research were identified . RESULTS The consensus was that 11 items on the CONSORT checklist needed some modifications for nonpharmacologic trials : item 1 ( title and abstract ) , item 3 ( participants ) , item 4 ( interventions ) , item 7 ( sample size ) , item 8 ( r and omization ) , item 11 ( blinding ) , item 12 ( statistical methods ) , item 13 ( participant flow ) , item 15 ( baseline data ) , item 20 ( discussion : interpretation ) , and item 21 ( generalizability ) . In addition , the meeting participants added 1 item related to implementation of the intervention . LIMITATION Evidence was not always available to support the inclusion of each checklist item . CONCLUSION The methods and processes used to develop this extension could be used for other reporting guidelines . The use of this extension to the CONSORT Statement should improve the quality of reporting r and omized , controlled trials assessing nonpharmacologic treatments OBJECTIVE To examine the effects of adjunctive postoperative massage and vibration therapy on short-term postsurgical pain , negative affect , and physiologic stress reactivity . DESIGN Prospect i ve , r and omized controlled trial . The treatment groups were : ( 1 ) usual postoperative care ( UC ) ; ( 2 ) UC plus massage therapy ; or ( 3 ) UC plus vibration therapy . SETTING The University of Virginia Hospital Surgical Units , Gynecology-Oncology Clinic , and General Clinical Research Center . SUBJECTS One hundred and five ( N = 105 ) women who underwent an abdominal laparotomy for removal of suspected cancerous lesions . INTERVENTIONS All patients received UC with analgesic medication . Additionally , the massage group received st and ardized 45-minute sessions of gentle Swedish massage on the 3 consecutive evenings after surgery and the vibration group received 20-minute sessions of inaudible vibration therapy ( physiotones ) on the 3 consecutive evenings after surgery , as well as additional sessions as desired . OUTCOME MEASURES Sensory pain , affective pain , anxiety , distress , analgesic use , systolic blood pressure , 24-hour urine free cortisol , number of postoperative complications , and days of hospitalization . RESULTS On the day of surgery , massage was more effective than UC for affective ( p = 0.0244 ) and sensory pain ( p = 0.0428 ) , and better than vibration for affective pain ( p = 0.0015 ) . On postoperative day 2 , massage was more effective than UC  for distress ( p = 0.0085 ) , and better than vibration for sensory pain ( p = 0.0085 ) . Vibration was also more effective than UC for sensory pain ( p = 0.0090 ) and distress ( p = .0090 ) . However , after controlling for multiple comparisons and multiple outcomes , no significant differences were found . CONCLUSIONS Gentle Swedish massage applied postoperatively may have minor effects on short-term sensory pain , affective pain , and distress among women undergoing an abdominal laparotomy for removal of suspected malignant tissues This r and omized-controlled study examined the effects of foot massage on patients ' perception of care received following surgery . The sample of 59 women who underwent laparoscopic sterilization as day case patients were r and omly allocated into two groups . The experimental group received a foot massage and analgesia post-operatively , whilst the control group received only analgesia post-operatively . Each participant was asked to complete a question naire on the day following surgery . This examined satisfaction , memory and analgesia taken . The 76 % response rate was comparable with other patient satisfaction studies following day-case surgery . Statistical analysis showed no overall significant difference in the pain experienced by the two groups ; however , the mean pain scores recorded following surgery showed a significantly different pattern over time , such that the experimental group consistently reported less pain following a foot massage than the control group . This study has attempted to explore the use of foot massage in a systematic way and is therefore a basis for further study PURPOSE Cardiopulmonary resuscitation ( CPR ) during flight is challenging and has to be sustained for long periods . In this setting a mechanical-resuscitation-device ( MRD ) might improve performance . In this study we compared the quality of resuscitation of trained flight attendants practicing either st and ard basic life support ( BLS ) or using a MRD in a cabin-simulator .  METHODS Prospect i ve , open , r and omized and crossover simulation study . Study participants , competent in st and ard BLS were trained to use the MRD to deliver both chest compressions and ventilation .  39 teams of two rescuers resuscitated a manikin for 12 min in r and om order , st and ard BLS or mechanically assisted resuscitation . Primary outcome was " absolute h and s-off time " ( sum of all periods during which no h and was placed on the chest minus ventilation time ) . Various parameters describing the quality of chest compression and ventilation were analysed as secondary outcome parameters . RESULTS Use of the MRD led to significantly less " absolute h and s-off time " ( 164±33 s vs. 205±42 s , p<0.001 ) . The quality of chest compression was comparable among groups , except for a higher compression rate in the st and ard BLS group ( 123±14 min(-1 ) vs. 95±11 min(-1 ) , p<0.001 ) . Tidal volume was higher in the st and ard BLS group ( 0.48±0.14 l vs. 0.34±0.13 l , p<0.001 ) , but we registered fewer gastric inflations in the MRD group ( 0.4±0.3 % vs. 16.6±16.9 % , p<0.001 ) . CONCLUSION Using the MRD result ed in significantly less " absolute h and s-off time " , but less effective ventilation . The translation of higher chest compression rate into better outcome , as shown in other studies previously , has to be investigated in another human outcome study Integrative therapies such as massage have gained support as interventions that improve the overall patient experience during hospitalization . Cardiac surgery patients undergo long procedures and commonly have postoperative back and shoulder pain , anxiety , and tension . Given the promising effects of massage therapy for alleviation of pain , tension , and anxiety , we studied the efficacy and feasibility of massage therapy delivered in the postoperative cardiovascular surgery setting . Patients were r and omized to receive a massage  or to have quiet relaxation time ( control ) . In total , 113 patients completed the study  ( massage , n=62 ; control , n=51 ) . Patients receiving massage therapy had significantly decreased pain , anxiety , and tension . Patients were highly satisfied with the intervention , and no major barriers to implementing massage therapy were identified . Massage therapy may be an important component of the healing experience for patients after cardiovascular surgery UNLABELLED Factors contributing to pain following surgery are poorly understood , with previous research largely focused on adults . With approximately 6 million children undergoing surgery each year , there is a need to study pediatric persistent postsurgical pain . The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospect i ve , multicentered registry examining postsurgical outcomes . The Scoliosis Research Society Question naire-Version 30 , which includes pain , activity , mental health , and self-image subscales , was administered to 190 patients prior to surgery and at 1 and 2 years postsurgery . A subset ( n = 77 ) completed 5-year postsurgery data .  Pain prevalence at each time point and longitudinal trajectories of pain outcomes derived from SAS PROC TRAJ were examined using analyses of variance and post hoc pairwise analyses across groups . Thirty-five percent of patients reported pain in the moderate to severe range presurgery . One year postoperation , 11 % reported pain in this range , whereas 15 % reported pain at 2 years postsurgery . At 5 years postsurgery , 15 % of patients reported pain in the moderate to severe range . Among the 5 empirically derived pain trajectories , there were significant differences on self-image , mental health , and age . Identifying predictors of poor long-term outcomes in children with postsurgical pain may prevent the development of chronic pain into adulthood . PERSPECTIVE This investigation explores the prevalence of pediatric pain following surgery , up to 5 years after spinal fusion surgery . Five pain trajectories were identified and were distinguishable on presurgical characteristics of age , mental health , and self-image . This is the largest study to examine longitudinal pediatric pain trajectories after surgery INTRODUCTION : Poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery .  Pain , stress , anxiety and poor sleep quality may be improved by massage therapy . OBJECTIVE : This study evaluated whether massage therapy is an effective technique for improving sleep quality in patients following cardiopulmonary artery bypass graft surgery .  METHOD : Participants included cardiopulmonary artery bypass graft surgery patients who were r and omized into a control group and a massage therapy group following discharge from the intensive care unit ( Day 0 ) , during the postoperative period . The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy , respectively . The patients were evaluated on the following mornings ( i.e. , Day 1 to Day 3 ) using a visual analogue scale for pain in the chest , back and shoulders , in addition to fatigue and sleep . Participants kept a sleep diary during the study period . RESULTS : Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period , 17 of whom were excluded due to postoperative complications . The remaining 40 participants ( male : 67.5 % , age : 61.9 years ± 8.9 years , body mass index : 27.2 kg/m2 ± 3.7 kg/m2 ) were r and omized into control ( n = 20 ) and massage therapy ( n = 20 ) groups . Pain in the chest , shoulders , and back decreased significantly in both groups from Day 1 to Day 3 . The participants in the massage therapy group had fewer complaints of fatigue on Day 1 ( p = 0.006 ) and Day 2 ( p = 0.028 ) in addition , they reported a more effective sleep during all three days ( p = 0.019 ) when compared with the participants in the control group . CONCLUSION : Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep BACKGROUND Opioid analgesia alone may not fully relieve all aspects of acute postoperative pain .  Complementary medicine techniques used as adjuvant therapies have the potential to improve pain management and palliate postoperative distress . STUDY DESIGN This prospect i ve r and omized clinical trial compared pain relief after major operations in 202 patients who received one of three nursing interventions : massage , focused attention , or routine care .  Interventions were performed twice daily starting 24 hours after the operation through postoperative day 7 . Perceived pain was measured each morning . RESULTS The rate of decline in 
    Output:
    
Based on the available evidence , weak recommendations are suggested for massage therapy , compared to active comparators for reducing pain intensity/severity and anxiety in patients undergoing surgical procedures .