Reiki

• FINAL NUMBER STUDIES INCLUDED = 13 
• TOTAL PATIENTS INCLUDED IN REVIEW = 1,003
• SAMPLE RANGE ACROSS STUDIES = 16–230 patients
• KEY SAMPLE CHARACTERISTICS: Various tumor types, patients in active treatment undergoing chemotherapy or radiation therapy

PHASE OF CARE: Active antitumor treatment
 
APPLICATIONS: Palliative care

Interventions considered to be BT were healing touch, Reiki, and therapeutic touch. The effect on pain was examined in seven studies. There were some mixed findings, but most showed a reduction in pain over short time periods. Fatigue was assessed in five studies. These demonstrated fatigue reduction post-treatment, but data were conflicting over a longer period of four to eight weeks. Anxiety and depression were examined in seven studies. All but one found a significant reduction in mood disorders, but a study comparing Reiki, sham Reiki, and usual care found no difference between the sham and actual Reiki groups. Most studies were of descriptive or quasi-experimental design; potential confounding variables were not examined, and placebo effects could not be ruled out.

Studies using biofield therapies for relief of pain, anxiety, fatigue, and depression generally showed benefit; however, the evidence is not strong due to the limitations of the studies included.

Low-quality design studies and the short duration of study follow-up

BT therapies have not demonstrated effectiveness in well-designed clinical studies; however, though it is weak, evidence suggests potential benefit. There were no adverse effects of these interventions reported. Biofield therapies are not expensive and are low-risk, so they can be considered in the management of cancer-related symptoms. Well-designed clinical trials are needed to establish efficacy.

Studies reviewed did not ensure that patients studied had depression or anxiety, so validity of examining impact of Reiki intervention on these problems is questionable. Two of the three studies had high risk of bias. No studies showed a statistically significant benefit.

There is insufficient evidence to evaluate efficacy of Reiki for anxiety and depression.

• Very few studies
• Poor quality studies

The evidence regarding effects of Reiki for anxiety or depression is insufficient to draw any conclusions. If Reiki is to be seen as a serious option for treatment, well-designed research to investigate effects is needed.

STUDY PURPOSE: To summarize evidence and quantify the effects of reiki on pain and anxiety

• FINAL NUMBER STUDIES INCLUDED = 7
• TOTAL PATIENTS INCLUDED IN REVIEW = 328
• SAMPLE RANGE ACROSS STUDIES: 16–60 patients
• KEY SAMPLE CHARACTERISTICS: 48% women; mean age 63 years; three studies were in patients with cancer; two studies tested the intervention in a surgical setting; two studies used reiki in community-dwelling adults

The effects sized for within-group differences ranged from d = 0.24 for decreased anxiety in women undergoing breast biopsy to d = 2.08 for decreased pain in community-dwelling adults. For reiki versus a rest intervention in patients with cancer, the effect for a decrease in pain was d = 0.032, and the effect in community-dwelling adults was d = 0.45. A detailed discussion of individual studies showed some mixed findings, particularly for one study in which reiki was compared to both sham reiki and usual-care groups. The median number of study participants was 24. It was noted that it took more than a year to recruit a small number of subjects in some trials. The timing, number of sessions, and specific applications of reiki varied.

Data were insufficient to draw any generalizations regarding the effects of reiki on anxiety or pain. The magnitude of the effect sizes calculated suggests Reiki may be helpful, but more rigorous trials with larger samples are needed to fully evaluate its efficacy.

• Limited number of studies with only three in patients with cancer
• Sample sizes were small
• No quality evaluation of studies was include
• Timing and length of the intervention varied substantially, and most were for very short durations with few reiki sessions

This review did not demonstrate clear efficacy of reiki for pain or anxiety. However, the effect sizes shown here suggest that additional, wel- designed research is warranted. The authors made a note of the difficulty in recruiting patients to these trials and high attrition rates, particularly in the control groups. They suggested that the of a crossover design would be helpful to address these problems. The timing and length of treatment needs to be considered based on the desired effects and context of the patient situation. As much as possible, the standardization of the reiki intervention and the use of a sham control would be helpful to evaluate potential placebo effects.

To examine the effects of Reiki on pain, anxiety, and global wellness among patients with cancer who are receiving chemotherapy

Reiki sessions were offered to patients in a day oncology and infusion services unit that provided chemotherapy. Patients sat in a chair or lay on a bed during Reiki sessions. Each session lasted approximately 30 minutes. Each patient received a maximum of four Reiki sessions. Prior to each session, Reiki practitioners assessed levels of anxiety and pain according to a numeric scale. After each session, levels of pain and anxiety were recorded on a visual analog scale. The study was done over three years.

• The study reported on a sample of 118 patients, but only 22 completed all sessions.
• Mean patient age was 55 years, with a range of 33–77 years.
• The sample was 57% male and 43% female.
• Patients had various types of cancer, and all were receiving chemotherapy.

• Single site
• Outpatient setting
• Italy

Patients were receiving active antitumor treatment.

A prospective pre/post-test design was used.

• Numeric rating scale
• Visual analog scale (VAS)

Only 48% of patients had more than one Reiki session, and only 22 patients (17%) completed four sessions and were included in statistical analysis. From session 1 to session 4, mean anxiety scores post-Reiki session declined, but scores immediately after each time point were higher than those reported immediately prior to the session.

Findings of this study do not support the effectiveness of Reiki. The study included numerous limitations in study design and methods.

• The study had a small sample size, with fewer than 30 participants.
• The study had risk of bias due to no control group, no blinding, and no random assignment.
• Measurement validity/reliability was questionable.
• The intervention was expensive, impractical, or presented training needs.
• The study reported that pre-session measures, on a numeric scale, were collected by Reiki providers and that post-session measures, per a VAS, were collected by the practitioner. These are two different scales that cannot be directly compared. The study does not make clear what the actual data scale was or the size of the VAS, for interpretation of data.
• Scoring was done by the Reiki practitioners, which could introduce bias. Reiki practitioners required two years of training, one year of additional workshops, and one year of in-hospital practice with tutors.

 This study does not support the effectiveness of Reiki. The study and methods were not well designed or reported.

To determine the feasibility of testing Reiki, a complementary therapy intervention, for women undergoing breast biopsy

A two-group study design was used: conventional care group (CCG) and Reiki intervention group (RIG). The intervention (Reiki treatment lasting 45–50 minutes) was delivered at the local complementary therapy office. The Reiki treatments were given on two occasions: one within seven days of biopsy and one within seven days following biopsy. Six trained Reiki practitioners delivered the Reiki treatments.

• The study reported on a sample of 32 participants: 17 in the RIG and 15 in the CCG.
• Mean age in the RIG was 52 years (SD = 8.86; range = 37–75 years); mean age in the CCG was 51 years (SD = 6.19; range = 39–61 years).
• The sample was 100% female.
• All women were undergoing diagnostic breast biopsy.
• The majority of the sample was Caucasian (13 [76%] in RIG and 13 [87%] in CCG); the remainder self-described as African American, Hispanic, and other.

• Multisite
• Outpatient setting
• Sample was recruited from five different ambulatory sites.

Patients were undergoing the diagnostic phase of care.

A randomized controlled trial design was used.

• Spielberger State-Trait Anxiety Inventory (STAI)
• Center for Epidemiologic Studies Depression Scale (CES-D)
• Hospital Anxiety and Depression Scale (HADS)

Neither group displayed significant amounts of distress (as operationalized by the three measures) either before or after breast biopsy. Likewise, there were not significant differences in any of the measures between groups (RIG and CCG) over time. Over time (pre to post breast biopsy), there were significant decreases for both groups in the A-state (F (2) = 4.78, p = 0.0119), HADS total (F (1) = 6.18, p = 0.0187), and HADS anxiety subscale (F (1) = 12.96, p = 0.0011).

The study did not conclude that Reiki was an effective intervention for reducing biopsy-related distress.

• The study had a small sample size, with less than 30 participants.
• The lack of investigator blinding had an associated risk of bias.
• Sampling and data collection time points were not clear from the report.
• Data collection procedures for the CCG were not explained, and it was unclear who was interviewed (both groups or only RIG) or why.
• Study is stated to be a randomized controlled trial, but it seemed to be rather a pilot to determine the feasibility of the Reiki intervention with this group.
• The small sample had insufficient power to determine group difference or efficacy on the intervention in reducing biopsy-related anxiety and depression.
• Table 2 lists the three reported measures (STAI, CES-D, and HADS) but then also reports data on anxiety and depression. However, it is not clear what this data came from.
• The intervention was provided by multiple practitioners, with possible treatment variations.

Simple complementary interventions integrated within the clinical setting (thus not requiring patients to commit to off-site interventions) should be considered. Effective ways to recruit and maintain enrollment in clinical trials of complementary therapies should continue to be investigated.

Interventions were of two conditions:

1. In the Reiki condition, participants received Reiki for five consecutive daily sessions, a one-week washout period of no treatments, then two additional Reiki sessions, and two weeks of no treatments.
2. In the rest condition, participants rested for one hour each day for five consecutive days, followed by a one-week washout period of no resting, and an additional week of no treatments.

Sixteen patients participated in the trial; eight were randomized to each order of condition (Reiki then rest; rest then Reiki). All sessions were administered from the same Reiki master.

• The study reported on a sample of 16 patients (13 women).
• Median patient age was 59 years.
• Patients had a variety of cancers, with the most common being colorectal (62.5%). Cancer stage ranged from I through IV.
• Patients were screened for fatigue (ESAS tiredness item); those scoring > 3 were eligible for the study.

The study was a counterbalanced crossover pilot trial of two conditions.

• Functional Assessment of Cancer Therapy: Fatigue (FACT-F): Questionnaire was completed prior to any intervention; higher scores indicate less fatigue.
• Edmonton Symptom Assessment Scale (ESAS): A patient-rated visual analog scale (VAS) is used to assess nine symptoms on severity.

There was a statistically significant change between the pre-first treatment and post-seventh treatment. Scores in the Reiki condition for anxiety were t(16) = 3.38, p < 0.005 (measured on the ESAS VAS for anxiety pre and post Reiki or rest). The Reiki condition demonstrated decrease in daily fatigue compared to rest alone.

The study is a well-designed crossover trial with randomization to groups.

The study had a very limited sample size.