Touching lives: understanding factors for successful touch interventions
In a recent study posted to the medRxiv* preprint server, researchers conducted an extensive systematic review and meta-analysis to understand the impact of touch interventions on mental and physical health and the moderators that influence the effectiveness of touch interventions.
Study: The physical and mental health benefits of touch interventions: A comparative systematic review and multivariate meta-analysis. Image Credit: Master1305/Shutterstock.com
*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
Background
The pandemic of the coronavirus disease 2019 (COVID-19) and the social distancing practices implemented as disease mitigation measures have highlighted the importance of touch and human contact in mental and physical well-being.
Touch interventions such as kangaroo care for infants and massages have been associated with better physical and emotional development and have been seen to reduce stress and anxiety in humans and animals.
However, despite extensive research in the area, the studies have been extremely variable regarding the cohorts being studied, duration and type of touch interventions being observed, and the health outcomes being measured. The studies also differ regarding who applies or performs the touch intervention.
Furthermore, the moderators influencing the effectiveness of various touch interventions remain unknown. Understanding the variables that modify the efficacy of touch interventions is essential in tailoring these interventions to promote physical and mental well-being.
About the study
In the present study, the researchers conducted a large-scale, pre-registered systematic review to understand the factors that influence the efficacy of touch interventions. They explored how and whether the dynamics associated with touch interventions, such as familiarity, the directionality of touch, and a human, robot, or object being involved in the touch, influence the health outcomes.
The influence of demographic factors such as age, clinical status, sex, the body part being touched, type of touch, number of sessions, and duration of each session was also examined. Newborns were assessed separately from adults and children.
Studies that examined the association between at least one mental or physical outcome and a touch intervention were included in the review.
The studies needed to include touch interventions involving explicit physical contact by another human, object, or animal and a control group that differed only based on touch. The meta-analysis also required a clear distinction between the touch and no-touch groups. Studies that were not randomized control trials were excluded.
Mental health outcomes were coded as depression, state or trait anxiety, or positive effects, while physical health outcomes were categorized as pain, cortisol, or respiration. The touch dyads examined in the study included human-human, human-animal, human-robot, and human-object types of touch.
Touch interventions involving the head, hands, or neck, with or without massage oils, were coded as skin-to-skin contact, while touch dyads involving objects and robots were coded as non-skin-to-skin by default.
The two most prevalent touch interventions used were kangaroo care for infants and massage therapy for adults. Other touch interventions examined in the study included hand-holding, hugs, tactile-kinesthetic stimulation, and gentle touch.
Clinical statuses that were considered in the meta-analysis included cancers, neurological disorders such as Dementia and Parkinson’s disease, pain disorders such as fibromyalgia and back pain, depression disorders including major depressive disorders and postpartum depression, as well as major surgeries including hip replacement and aortic surgery.
Results
The results indicated that medium-sized and comparable impacts of touch intervention could be observed for mental and physical health outcomes.
Touch interventions were significantly effective for infants in increasing weight during the growing phase and regulating cortisol levels. In contrast, in adults and children, touch interventions were linked to reducing depression, pain, and trait and state anxiety.
Lower mental health benefits were noted in touch interventions involving robots or objects, but the physical health benefits were comparable with human touch interventions. Clinical cohorts among adults seemed to benefit more strongly in domains associated with mental health than healthy adults.
However, regarding physical well-being and health benefits, the impact of touch interventions was the same for clinical adult cohorts and healthy adults.
The impact of the touch intervention was not seen to vary among adults and children based on whether a familiar person applied the touch or a health professional conducted the intervention.
Furthermore, while the duration of the intervention sessions was not linked to increased health benefits, the frequency of the interventions was positively associated with improvements in health.
Conclusions
Overall, the findings suggested that touch interventions significantly benefit mental and physical health, for infants, adults, and children, across clinical and healthy cohorts and all ages.
Furthermore, the touch intervention session frequency positively correlated to improvements in mental and physical health.
*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
