The cardiovascular health of this urban adolescent athletic population is a major concern because their rates of obesity and elevated blood pressure place them at increased risk of cardiovascular complications later in life despite their participation in school athletics.

finger (Hugo point) for three 5-minute periods, while the control group received a touch on the same area in a similar time format without performing shiatsu massage. The primary outcome was the level of agitation, which was assessed using the Richmond Agitation-Sedation Scale (RASS) before and after the intervention (with blinded researchers as to the type of intervention). RASS scores range on a 10-point scale from +4 to -5, with higher scores indicating greater symptoms of agitation (+45combative to -55unarousable). Shiatsu massage reduced the mean RASS score of agitation by 1 point (95% CI, 0.78-1.3). The control did not demonstrate a reduction in pain compared with placebo. There were no harms or side effects in the study. This RCT was limited by varied medicine administration.A single-center RCT (n558) examined the effectiveness of back massage for reduction of anxiety compared with control in patients with chronic obstructive pulmonary disease requiring noninvasive mechanical ventilation in an ICU in Turkey. 3 Patients had an average age of 71 years old (62% male). Excluded were patients with psychiatric conditions, those receiving anxiolytic medications, and those unable to communicate. The intervention group received a daily 15-minute back, neck, and shoulder massage for 4 days by a single trained researcher. The control group received standard nursing care without massage. Anxiety was measured by the State-Trait Anxiety Inventory (STAI) before the first intervention and after the fourth. The STAI uses a 1 to 4 scale for 40 questions to create a sum of 0 to 160 (high-er5more severe). Massage demonstrated greater reduction in the mean anxiety score compared with control: Student's t test (a comparison of small means) 5 -2.856; P5.006. No adverse events occurred. This RCT was limited by failure to measure long-term effects, lack of a placebo arm, and lack of blinding participants and data collectors.

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