How dangerous is Shiatsu? Science and polemics (Dr. Eduard Tripp)

Since then, according to Edzard Ernst, a systematic review of Shiatsu has been published, the review by Nicola Robinson et al. (2011)¹ on Shiatsu and acupressure. And although the authors are usually in favour of alternative treatments, as Edzard Ernt notes, they concluded that the evidence for Shiatsu was „more research is needed, particularly for Shiatsu, where evidence is poor„. The reason for this is that only a single RCT², three controlled but non-randomised studies, one within-subjects study, one observational study and three uncontrolled studies were found for the review.

In the study by T. Sundbert et al. (2009) on back and neck pain (Exploring integrative medicine for back and neck pain³), the only randomized and controlled study cited by N. Robinson et al., there are no significant effects compared to the standard care group, for which the number of participants was too small („The study used a fairly large sample (n = 80) but was underpowered to detect any statistically significant effects„).⁴

The studies by D. Lucini (Complementary medicine for the management of chronic stress: superiority of active versus passive techniques⁵), S. Ballegaard et al. (Cost-benefit of combined use of acupuncture, Shiatsu and lifestyle adjustment for treatment of patients with severe angina pectoris⁶) and J. Ingram et al. (The effects of Shiatsu on post-term pregnancy⁷), on the other hand, show no randomised allocation.

In D. Lucini’s work, the effect of Shiatsu on chronic stress is investigated – compared with active treatments (relaxation and breathing exercises) and „sham treatment“ (information on stress management). The number of only 70 participants, however, limits the statements of the study. Moreover, because the choice of treatment was left to the participants, the influence of a confounder is reflected in the fact that more stressed persons opted for sham treatments.

The study by S. Ballegaard et al. deals with the effectiveness and a cost-benefit analysis of shiatsu in the treatment of angina pectoris patients. The „comparison group“ consists of study results from an independent study⁸ with two invasive treatment approaches. In the Shiatsu study 7% of the participants had a heart attack, compared to 21% and 22% in the comparative study. In addition, a cost saving of approx. 12,000 dollars per patient was calculated. In addition to the fact that the patients were in one case from the USA and the other from Denmark, there were other methodological limitations, such as a lack of blinding.

J. Ingram compares Shiatsu with standard care. This shows that women who received Shiatsu needed significantly less introductory measures and also had a significantly shorter course of birth. However, the treatment had no effect on the sensation of pain. The allocation to the experimental and control group was not randomised, but depended on which midwife was on duty.⁹

Anmerkungen/Fußnoten

1
Nicola Robinson, Ava Lorenc und Xing Liao: The evidence for Shiatsu: a systematic review of Shiatsu and acupressure. BMC Complement Altern Med. 2011 Oct 7;11:88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200172/pdf/1472-6882-11-88.pdf. Zugriff: Access: 28/6/19.
2
RCT: randomized controlled trial.
3
Sundberg T, Petzold M, Wandell P, Ryden A, Falkenberg T: Exploring integrative medicine for back and neck pain – A pragmatic randomised clinical pilot trial. BMC Complementary and Alternative Medicine 2009, 9.
4
Nicola Robinson, Ava Lorenc und Xing Liao: The evidence for Shiatsu: a systematic review of Shiatsu and acupressure. BMC Complement Altern Med. 2011 Oct 7;11:88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200172/pdf/1472-6882-11-88.pdf, S.3: „The study used a fairly large sample (n = 80) but was underpowered to detect any statistically significant effects“. Access: 28/6/19.
5
Lucini D: Complementary medicine for the management of chronic stress: superiority of active versus passive techniques. Journal of Hypertension 2009, 27:2421-2428. 21.
6
Ballegaard S, Norrelund S, Smith DF: Cost-benefit of combined use of acupuncture, Shiatsu and lifestyle adjustment for treatment of patients with severe angina pectoris. Acupunct Electrother Res 1996, 21:187-197. 22.
7
Ingram J, Domagala C, Yates S: The effects of shiatsu on post-term pregnancy. Complement Ther Med 2005, 13:11-15.
8
King SB, Lembo NJ, Weintraub WS, Kosinski AS, Barnhard HX, Kutner MH, Alazraki NP, Guyton RA, Zhao X: A randomised trial comparing coronary angioplasty with coronary bypass surgery. New England Journal of Medicine 1994, 331:1044-1050.
9
Nevertheless, as N. Robinson notes, the two groups were homogeneous.

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