Martial arts intervention decreases pain scores in children with malignancy

Abstract

BackgroundMartial arts intervention in disease has been mostly limited to adult inflammatory, musculoskeletal, or motor diseases, where a mechanical intervention effects positive change. However, the application and benefit to pain management in childhood malignancy are not well described. Here, we assess the effects of defined martial arts intervention in children with cancer with respect to their pain perception and management.MethodsSixty-four children with childhood malignancies were enrolled in a martial arts program, which encompassed both meditation and movement modalities. Pain scores (0–10) were recorded pre- and post- 1-hour session intervention. Pain scores were crossed by total visits and tabulated by whether participant pain reduced at least 1 unit, stayed the same, or increased in intensity immediately after (post) participation session. Differences in pain scores were further compared by age and sex.ResultsPrepain and postpain scale data were measured for 64 participants, 43 males (67.2%) and 21 females (32.8%), ranging from 3 years to 19 years. Preintervention and postintervention data were obtained for 223 individual session visits. Mean number of patient participation visits was 1.8±1.6 (range one to nine visits). Of 116 individual measured sessions where the participants began with a pain score of at least 1, pain intensity reduced ≥1 unit in 85.3% (99/116) of visits, remained the same in 7.8% (9/116), and increased in 6.9% (8/116). For the majority (96.3%; 77/80) of sessions, participants began with a prepain intensity score of at least 5–10 with reduction in pain intensity following the session. The overall mean pain score presession visit was reduced bŷ40% (pre: 5.95±2.64 and post: 3.03±2.45 [95% CI: 2.34–3.50]; P≤0.001). Median pain intensity scores had greater reductions with increased age of participants (3–6 years [–1], 7–10 years [–2], 11–14 years [–3], and 15–19 years [–4]).ConclusionMartial arts intervention can provide a useful modality to decrease pain in childhood cancer, with greater effect achieved with higher baseline pain scores and patient age. Martial arts intervention may improve patient compliance with respect to medical and surgical management, thus reducing disease morbidity and health care costs.

Martial Arts-Based Therapy Reduces Pain and Distress Among Children with Chronic Health Conditions and Their Siblings

“…Taken together, these data add to the growing evidence base supporting the use of martial arts-based therapy for the management of pediatric pain and distress. 27 More than half (59%) of patients in the present sample reported a reduction in pain over the course of a 1-hr KKC class session. The proportion reporting a reduction in pain was lower than observed in our previous study in pediatric cancer patients, 27 with 85% reporting a reduction in pain.…”

“…20,25 However, KKC is unique in that it is a martial arts-based therapy that pairs meditation and mindfulness approaches with physical movement and themes of purpose and empowerment, which may have additional benefit. 26,27 Another unique aspect of KKC is that programming includes healthy siblings who, although often part of the healthcare management of the patient, are increasingly recognized as a psychologically at-risk group themselves. 28,29 Research shows that siblings of children with chronic pain are at increased risk of experiencing pain themselves, as compared to their non-sibling peers.…”

“…35 We previously reported that a 1-hr KKC session can reduce pain among children with cancer, with 85.3% reporting a reduction in pain. 27 Using an independent sample, the present study aims to extend this prior important work to children with other chronic health conditions, as well as, healthy siblings -populations that can experience significant pain and emotional distress. We also extend the prior study by measuring emotional distress, in addition to pain.…”

Mindfulness and dynamic functional neural connectivity in children and adolescents

“…It is not surprising, then, that there has been increased interest in integrating mindfulness practices into education and mainstream pediatric health services. We have recently shown that Kids Kicking Cancer (KKC, www.kidskickingcancer.org), a martial arts therapy that centers around mindfulness based meditative practices, appears to be an effective interventional therapeutic modality for reducing pediatric cancer pain, with over 85% reporting reductions in pain with an average decrease of 40% [12]. KKC and other mindfulness-based interventions are particularly well suited for children because they can be used as a non-pharmacological strategy for early, preventive intervention with little or no adverse side effects.…”

Mindfulness and dynamic functional neural connectivity in children and adolescents

“…It is not surprising, then, that there has been increased interest in integrating mindfulness practices into education and mainstream pediatric health services. We have recently shown that Kids Kicking Cancer (KKC, www.kidskickingcancer.org), a martial arts therapy that centers around mindfulness based meditative practices, appears to be an effective interventional therapeutic modality for reducing pediatric cancer pain, with over 85% reporting reductions in pain with an average decrease of 40% (Bluth et al, 2016). KKC and other mindfulness-based interventions are particularly well suited for children because they can be used as a non-pharmacological strategy for early, preventive intervention with little or no adverse side effects.…”