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Volume 185
Issue 3-4
March-April 2020


ARTICLE CONTENTS

 * Abstract
 * INTRODUCTION
 * REIKI RESEARCH
 * REIKI IN MILITARY HEALTH CARE
 * METHODS
 * RESULTS
 * DISCUSSION
 * LIMITATIONS
 * CONCLUSION
 * ACKNOWLEDGMENTS
 * CONFLICT OF INTEREST
 * FUNDING
 * REFERENCES
 * Supplementary data

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Journal Article


EDUCATE, TRY, AND SHARE: A FEASIBILITY STUDY TO ASSESS THE ACCEPTANCE AND USE OF
REIKI AS AN ADJUNCT THERAPY FOR CHRONIC PAIN IN MILITARY HEALTH CARE FACILITIES

MeLisa Gantt, AN, USA (Ret.),
MeLisa Gantt, AN, USA (Ret.)
Gantt Clinical Research Institute LLC
, P.O. Box 771966, Orlando, FL 32877
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Judy Ann T Orina, CCRP
Judy Ann T Orina, CCRP
Center for Nursing Science and Clinical Inquiry
, Landstuhl Regional Medical Center, CMR 402, APO, AE 09180
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Military Medicine, Volume 185, Issue 3-4, March-April 2020, Pages 394–400,
https://doi.org/10.1093/milmed/usz271
Published:
23 October 2019

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   MeLisa Gantt, AN, USA (Ret.), Judy Ann T Orina, CCRP, Educate, Try, and
   Share: A Feasibility Study to Assess the Acceptance and Use of Reiki as an
   Adjunct Therapy for Chronic Pain in Military Health Care Facilities, Military
   Medicine, Volume 185, Issue 3-4, March-April 2020, Pages 394–400,
   https://doi.org/10.1093/milmed/usz271
   
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ABSTRACT

Introduction

Reiki, a biofield energy therapy, continues to struggle in finding its permanent
place among the portfolio of complementary and alternative medicine modalities
in many military health care facilities. Although it has been shown to help in
the management of pain, lack of knowledge and limited first-hand experience
impact its foothold. The purpose of this feasibility study was to (1) educate
participants about the concept of Reiki, (2) give participants the opportunity
to experience six Reiki therapy sessions and subsequently assess outcomes on
chronic pain, and (3) assess participants’ impression of and willingness to
continue using and recommending Reiki therapy as adjunct for the treatment of
chronic pain.

Methods

Using a prospective repeated measures pre- and postintervention design, a
convenience sample of 30 military health care beneficiaries with chronic pain
were educated about Reiki and received six 30-minute Reiki sessions over 2 to
3 weeks. Pain was assessed using a battery of pain assessment tools as well as
assessment of impression of and willingness to share the concept of Reiki. This
study was approved by the U.S. Army Medical Research and Materiel Command
Institutional Review Board (No. M10617).

Results

Repeated measures ANOVA analyses showed that there was significant decrease
(P < 0.001) in present, average, and worst pain over the course of the six
sessions with the most significant effect occurring up to the fourth session.
When a variety of descriptor of pain was assessed, Reiki had a significant
effect on 12 out of the 22 assessed, with the most significant effect on pain
that was described as tingling/pins and needles (P = 0.001), sharp (P = 0.001),
and aching (P = 0.001). Pain’s interference with general activity, walking,
relationships, sleep, enjoyment of life, and stress significantly decreased (P <
0.001 to P = 0.002). Impression of improvement scores increased 27% by session
6, and one’s knowledge about Reiki improved 43%. Eighty-one percent of the
participants stated that they would consider scheduling Reiki sessions if they
were offered with 70% desiring at least four sessions per month.

Conclusion

A 30-minute Reiki session, performed by a trained Reiki practitioner, is
feasible in an outpatient setting with possible positive outcomes for
participants who are willing to try at least four consecutive sessions. Reiki
has the ability to impact a variety of types of pain as well as positively
impacting those activities of life that pain often interferes with. However,
education and the opportunity to experience this energy healing modality are key
for its acceptance in military health care facilities as well as more robust
clinical studies within the military health care system to further assess its
validity and efficacy.

Topic:
 * pain
 * teaching
 * chronic pain
 * reiki
 * military health

Issue Section:
Feature Article and Original Research


INTRODUCTION

Reiki (pronounced ray-kee) is a biofield energy therapy that was formalized in
Japan by a Buddhist named Mikao Usui in the mid 1800s and introduced to the
United States by Hawayo Takata in the late 1930s.1 The principles of the
practice are based on the fact that everything in the universe is made up of
energy, and when that energy is out of balance, illness or disease occurs.2 This
imbalance can be restored by a trained practitioner skilled in the ability to
passively flow energy to a recipient in turn allowing the rebalanced body to
heal itself.1 During a Reiki therapy session, the practitioner places her/his
hands slightly above or directly on the recipient in a systematic series of hand
placements.2 Practitioners are trained by a Reiki master and can achieve three
levels of skills.2 At level 1 (first degree), the practitioner learns how to
open the energy channels on a physical level to connect to the universal life
force energy.3,4 At this level, the practitioner also learns the concept of
Reiki self-care. At level 2 (second degree), the practitioner learns “Reiki
symbols” and achieves level 2 attunement.3,4 Reiki symbols allow the
practitioner to connect more deeply to the universal energy, as well as draw on
the qualities that the symbols represent.3,4 At this level, the practitioner
also learns how to provide Reiki at a distance.3,4 Finally, at level 3 (third
degree or Reiki master), the practitioner is now at the teacher’s level and has
the knowledge, experience, and skills to attune new practitioners.3–4


REIKI RESEARCH

The Center for Reiki Research is the main storehouse for evidence-based Reiki
research that has been published in peer-reviewed journals.5 In a review of 13
peer-reviewed placebo-controlled Reiki studies published between 1998 and 2016,
8 of the 13 studies showed that Reiki was more effective than placebo.6 For
studies that assessed Reiki’s efficacy for pain specifically, a 2003 study of 24
cancer patients who received opioids plus Reiki therapy, showed that Reiki
reduced pain (P = 0.035) on day 1 as well as showed a significant difference
(P = 0.002) on day 4 when compared with the group who used opioids plus rest.7
In a 2006 study assessing the effect of Reiki therapy on pain in women after
having a hysterectomy, there was a significant decrease in pain at 24 hours
postsurgery (P = 0.04), whereas those who received Reiki therapy took less pain
medication at time 2 (P = 0.001), time 3 (P = 0.007), and time 6 (P = 0.04).8 In
a 2007 randomized crossover study of 16 patients, Reiki was found to be
efficacious in reducing pain after receiving chemotherapy (P < 0.05).9 In
another 2007 study comparing Reiki and sham Reiki to usual care, there was a
within-group decrease in pain (P = 0.002 and P = 0.039, respectively) with no
significant decrease in the group that just had usual care (P = 0.622).10
Finally, in a 2010 study comparing Reiki therapy to a control group, there was a
significant within-group decrease in pain (P = 0.007) in the Reiki group and a
significant increase in pain (P = 0.015) in the control group.11


REIKI IN MILITARY HEALTH CARE

Although there are currently 60 hospitals and clinics throughout the United
States that offer Reiki services,5 Reiki continues to struggle to find its
permanent place among the portfolio of complementary and alternative medicine
(CAM) modalities in many military health care facilities. CAM approaches, such
as Reiki therapy, are nonpharmacological, well-tolerated alternatives that are
safe, cost-effective, and generally favorable in the alleviation of symptoms
associated with pain.5

The 2010 Army Surgeon General’s Pain Management Task Force Final Report
reignited the pursuit of CAM modalities for chronic pain.12 The report addressed
the increase in the overreliance of pain medication in military health care and
Section 4.2.1 of the report specifically addressed the need to incorporate CAM
modalities as part of the plan of care.12 Although there has been a great need
for CAM in the military health care setting for things such as chronic pain,
stress, anxiety, and sleep disturbance, the lack of provider availability has
often been the biggest hinderance.13 Reiki therapy has been shown to help with
such health issues; however, the lack of knowledge about the therapy, therapist
requirements, and misinformation about the practice impact its acceptability and
use.14

Several military health care organizations have led the charge to bring Reiki to
the forefront. One military health care facility in the eastern United States
took a unique approach to educate its health care professionals about Reiki by
simply teaching them Reiki self-care.15 That, in turn provided the staff with a
first-hand experience to be able to confidently recommend the practice to their
patients.15 A second approach to increase Reiki exposure in military health care
was to offer free Reiki therapy sessions. Comfort for America’s Uniformed
Services (CAUSE), a nonprofit organization that provides services to ill and
injured service members, recurrently provided free Reiki sessions for service
members and their families.16 Since such programs have been well received, Reiki
organizations have even received Veteran’s Administration funding to provide
veterans with free Reiki sessions as well as training on the practice.17 If
military health care beneficiaries were educated on Reiki and experienced Reiki
therapy, the researchers postulate that these beneficiaries would be persuaded
to seek Reiki therapy sessions for the management of chronic pain.

The purpose of this feasibility study was to (1) educate participants about the
concept of Reiki, (2) give participants the opportunity to experience six Reiki
therapy sessions and subsequently assess outcomes on chronic pain, and (3)
assess participants’ impression of willingness to continue using and recommend
Reiki therapy as adjunct therapy for chronic pain. The long-term goal of this
study was to establish Reiki therapy as a recognized modality among other CAM
options in military health care facilities.


METHODS


RESEARCH DESIGN

RECRUITMENT AND PARTICIPANTS

Recruitment flyers were posted around the health care facility in locations
commonly visited by patients with complaints of chronic pain (eg, pain clinic,
primary care clinic, pharmacy, etc.). Advertisements were posted monthly in the
community newspaper and on the facility’s social media platforms. A segment that
discussed the research study and the concept of Reiki was developed and
advertised on the Armed Force Network radio station. To be included in the
study, participants had to (1) be a military health care beneficiary (active
military, reservist, retiree, or military family member), (2) have chronic pain
(as defined by pain that has lasted more than 6 months since first onset), (3)
be receiving a stable pain medication regimen (defined as a regimen that has not
increased 10% to 20% in the week before enrollment), (4) be affiliated with at
least one of the outlying installations associated with the selected military
health care facility, (5) be eligible to receive health care at the military
health care facility, (6) be 18 years and older, (7) be able to read and speak
English, and (8) be able to commit to six sessions (lasting ~11–21 days).
Participants were excluded if they (1) were being scheduled for any surgeries or
painful procedures during the study or (2) already had a working knowledge of
Reiki or received Reiki therapy in the past.


INTERVENTION

After being properly screened and consented, participants completed a
Participant Demographic Sheet to obtain demographic data to include age, gender,
race ethnicity, military status, branch affiliation, location of pain, and pain
relief modalities.

EDUCATION INTERVENTION

To educate the participants about Reiki, a short slide presentation and
discussion regarding the history, concept, usage, and common misunderstandings
about Reiki was presented to each participant before their first Reiki therapy
session. The presentation was designed by the study’s Reiki Consultant who is a
published author and former research staff member for the Center for Reiki
Research. To measure participant’s knowledge, a short 5-item Reiki Knowledge
Assessment Questionnaire was administered before the educational intervention
and after the final Reiki session (Table I). The questionnaire was developed by
the investigator and focused on the most common confusing aspects about Reiki:
(1) definition of Reiki, (2) required credentials of a Reiki practitioner, (3)
origin of Reiki, (4) uses for Reiki, and (5) Reiki in relation to healing touch
(HT) and therapeutic touch (TT).

TABLE I

Data Collection Timetable

Instrument . Baseline . Session 1 . Session 2 . Session 3 . Session 4 . Session
5 . Session 6 . Participant Demographic Sheet X       Brief Pain
Inventory X X X X X X X Defense and Veteran Pain Rating
Scale  X X X X X X DoD/VA Pain Supplemental Questions  X X X X X X McGill Pain
Questionnaire-Short Form  X X X X X X Patient Global Impression of Improvement
Scale    X   X Pain Medication Diary  X X X X X X Reiki Knowledge
Assessment X      X Post-Study Questionnaire       X 

Instrument . Baseline . Session 1 . Session 2 . Session 3 . Session 4 . Session
5 . Session 6 . Participant Demographic Sheet X       Brief Pain
Inventory X X X X X X X Defense and Veteran Pain Rating
Scale  X X X X X X DoD/VA Pain Supplemental Questions  X X X X X X McGill Pain
Questionnaire-Short Form  X X X X X X Patient Global Impression of Improvement
Scale    X   X Pain Medication Diary  X X X X X X Reiki Knowledge
Assessment X      X Post-Study Questionnaire       X 

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TABLE I

Data Collection Timetable

Instrument . Baseline . Session 1 . Session 2 . Session 3 . Session 4 . Session
5 . Session 6 . Participant Demographic Sheet X       Brief Pain
Inventory X X X X X X X Defense and Veteran Pain Rating
Scale  X X X X X X DoD/VA Pain Supplemental Questions  X X X X X X McGill Pain
Questionnaire-Short Form  X X X X X X Patient Global Impression of Improvement
Scale    X   X Pain Medication Diary  X X X X X X Reiki Knowledge
Assessment X      X Post-Study Questionnaire       X 

Instrument . Baseline . Session 1 . Session 2 . Session 3 . Session 4 . Session
5 . Session 6 . Participant Demographic Sheet X       Brief Pain
Inventory X X X X X X X Defense and Veteran Pain Rating
Scale  X X X X X X DoD/VA Pain Supplemental Questions  X X X X X X McGill Pain
Questionnaire-Short Form  X X X X X X Patient Global Impression of Improvement
Scale    X   X Pain Medication Diary  X X X X X X Reiki Knowledge
Assessment X      X Post-Study Questionnaire       X 

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REIKI INTERVENTION

Each participant was scheduled to receive a total of six Reiki therapy sessions
over the course of 2 to 3 weeks, with no less than 1 day and no more than 3 days
in between sessions. The Reiki interventions were performed on a massage table
in a quiet, darkened room located in the research department. Participants
remained fully clothed with the exception of shoes, while lying in a supine
position with any requested bolstering support. The interventions were performed
by four level 1 Reiki practitioners (one registered nurse, one psychologist, and
two military spouses) who were trained by the same Reiki master using a
standardized 10-hand placement protocol. The hand placement protocol was
designed by study’s Reiki consultant who is a published author and former
research staff member for the Center for Reiki Research. The hand placements
started at the participant’s head working their way down to shoulders, chest,
hips, and feet. Each hand placement position lasted ~3 minutes, for a total of
30 minutes. To ensure continuity among the four practitioners, each practitioner
followed the same verbal script at the start of the session and talking was kept
to a minimum. Each practitioner received at least one fidelity check observation
by research coordination, using a checklist of the hand placement and script, to
ensure that the interventions were being performed in accordance with the
approved protocol. After each session, participants were given the opportunity
to share any comments, questions, or concerns with the research coordinator.

To measure Reiki’s impact on pain over time, participants completed a battery of
well-validated pain assessment questionnaires before each session and one
additional questionnaire at the midpoint and end. Questionnaires were
administered by the research coordinator as the participant waited for the
practitioner to prepare the room for the session.

Brief Pain Inventory Short Form assesses the time relation sensory component of
pain intensity (average over the last week, worst and least, and present pain)
using a numeric rating scale 0 (no pain) to 10 (pain as bad as you can imagine),
percentage of pain relief 0 (no relief) to 10 (complete relief), and seven pain
interferences concerning work, activity, mood, enjoyment, sleep, walk, and
relationships are assessed using 0 (no interference) to 10 (complete
interference).18 The Cronbach alpha for the original instrument ranged from 0.80
to 0.87 for the pain severity items and from 0.89 to 0.92 for the interference
items.19

Defense and Veteran Pain Rating Scale (DVPRS) and DoD/VA Pain Supplemental
Questionnaire were created by the Defense and Veteran Center for Integrative
Pain Management. The DVPRS is a Likert scale graphic tool to describe one’s
current level of pain.20 The score ranges from 0 (no pain) to 10 (as bad as it
could be nothing else matters).20 The scale was also color coated depicting mild
1 to 3 (green), moderate 4 to 7 (yellow), and severe 8 to 10 (red).20 The
Supplemental Questionnaire, which is often used in conjunction with the DVPRS,
measures the biopsychosocial impact of pain on four areas: activity, sleep,
mood, and stress.20 The Cronbach alpha reported for the five items was 0.90, and
the slightly edited version of the supplemental items was 0.82.20

The Short-Form McGill Pain Questionnaire (SF-MPQ-2) is a 22-item screening tool
to assess pain in four dimensions: continuous pain (6 items), intermittent pain
(6 items), neuropathic pain (6 items), and affective descriptors (4 items).21
Scoring is based on 10-point Likert scale ranging from 0 (none) to 10 (worst
possible); the SF-MPQ-2 had a Cronbach alpha of 0.96.22

The Patient Global Impression of Improvement Questionnaire (PGII) is a one-item
questionnaire designed to capture one’s global impression of their improvement
after receiving an intervention. The item is measured on a 7-point Likert scale
with 1 (very much improved) to 7 (very much worse). The PGII was administered
before sessions 3 (midpoint) and 6 (final).

Pain Medication Diary was reviewed before each session only to assess if any
pain-relieving interventions (pharmaceutical and nonpharmaceutical) was used in
between sessions. These data were strictly for informational purposes only.

At the final Reiki session, a Post-Study Questionnaire was administered. This
5-item questionnaire, designed by the investigator, assessed one’s impression of
Reiki; their willingness to tell a family member, friend, or co-worker; and
their thoughts of Reiki being offered as a permanent adjunct therapy option at
their health care facility. At the final session, participants also received a
$20 gift card for travel compensation.


STATISTICAL ANALYSES

Since this was a feasibility study with a convenience sample of 30 participants,
a power analysis was not conducted. Given that a reduction of ~2 points on an
11-point scale (18% reduction) is considered clinically significant, a 1.8-point
reduction (18%) on the 10-point scale instruments used for the study was
considered clinically significant.23 For all data analyses, data were examined
for outliers, non-normality, and homoscedasticity/heterogeneous variances, and
missing data.24–26 For examining and testing the relationship of pain outcomes
and pre- and postmeasures, bivariate correlations were tested for significance
(α = 0.05).24–26 For comparing subgroup means (type of pain), one-way ANOVA was
conducted for the quantitative outcomes that met the assumptions (homogeneity of
variance, normality).24–26 If the assumptions were not met, remedial measures
such as transformations (log to the base 10) or alternative techniques
(nonparametric or robust methods) were considered24–26. As there were more than
two subgroups assessed and the omnibus F test was significant (α = 0.05), the
Sidak multiple comparison procedure test was performed to test all pairwise
differences.24–26 All analyses were conducted using SPSS 23.0, HLM 7.01, and/or
Mplus 7.4, with level of significance of α = 0.05.


RESULTS

This study was approved by the U.S. Army Medical Research and Materiel Command
Institutional Review Board (No. M-10617). All participants signed an approved
informed consent before participation, and the study was carried out in
accordance with ICH/GCP guidelines.


PARTICIPANTS

Of the 30 participants enrolled, 100% completed the study. Since data were
collected by the research coordinator while participants waited for their
session, there was no missing data. Participants mean age was 46.93 (standard
deviation = 11.9) with the majority being U.S. Air Force (57%). The sample was
made up of predominately Caucasian (87%), female (60%), and military dependents
(47%) with 43% complaining of generalized pain (Table II). Although there was
minimal use of pain-relieving modalities in between sessions, the most commonly
listed pain-relieving modalities were the use of nonsteroidal anti-inflammatory
drugs, yoga, and the application of ice/heat.

TABLE II

Demographics

. n . % . Gender  Female 18 60  Male 12 40 Race  Asian 3 10  Hawaiian/Pacific
Islander 1 3  White/Caucasian 26 87 Hispanic
(ethnicity)  No 29 97  Yes 1 3 Military status  Active
duty 9 30  Dependent 14 47  Reservist 1 3  Retiree 6 20 Military branch  Air
Force 17 57  Army 11 37  Navy 2 6 Area of chronic pain  Upper body 6 20  Lower
body 3 10  Back 8 27  Generalized 13 43 

. n . % . Gender  Female 18 60  Male 12 40 Race  Asian 3 10  Hawaiian/Pacific
Islander 1 3  White/Caucasian 26 87 Hispanic
(ethnicity)  No 29 97  Yes 1 3 Military status  Active
duty 9 30  Dependent 14 47  Reservist 1 3  Retiree 6 20 Military branch  Air
Force 17 57  Army 11 37  Navy 2 6 Area of chronic pain  Upper body 6 20  Lower
body 3 10  Back 8 27  Generalized 13 43 

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TABLE II

Demographics

. n . % . Gender  Female 18 60  Male 12 40 Race  Asian 3 10  Hawaiian/Pacific
Islander 1 3  White/Caucasian 26 87 Hispanic
(ethnicity)  No 29 97  Yes 1 3 Military status  Active
duty 9 30  Dependent 14 47  Reservist 1 3  Retiree 6 20 Military branch  Air
Force 17 57  Army 11 37  Navy 2 6 Area of chronic pain  Upper body 6 20  Lower
body 3 10  Back 8 27  Generalized 13 43 

. n . % . Gender  Female 18 60  Male 12 40 Race  Asian 3 10  Hawaiian/Pacific
Islander 1 3  White/Caucasian 26 87 Hispanic
(ethnicity)  No 29 97  Yes 1 3 Military status  Active
duty 9 30  Dependent 14 47  Reservist 1 3  Retiree 6 20 Military branch  Air
Force 17 57  Army 11 37  Navy 2 6 Area of chronic pain  Upper body 6 20  Lower
body 3 10  Back 8 27  Generalized 13 43 

Open in new tab


FINDINGS

A comparison of the pre- and post-Reiki Knowledge Assessment showed that pretest
scores ranged from 60% to 90%, whereas posttest scores ranged from 87% to 97%.
Thirty-three percent of the participants obtained a perfect score on the pretest
compared with 77% on the posttest. The most commonly missed question was
determining the difference between the similar healing modalities of Reiki
therapy, HT, and TT, which was addressed during the slide deck presentation at
the initial appointment.

There was a significant decrease (P ≤ 0.001) in present, average, and worst pain
over the course of the six sessions with a steady decline up to session 4 (Table
III, Fig. S1). When the description of the type of pain was assessed, Reiki had
a significant effect on 12 out of the 22 that were assessed, with the most
significant effect on pain that was described as tingling/pins and needles
(−0.90 points; P = 0.001), sharp (−1.70 points; P = 0.001), and aching (−1.97
points; P = 0.001), which was also clinically significant (Table IV). Whether
pain was classified as continuous or intermittent, both were significant
(P < 0.001).

TABLE III

Present, Average, and Worst Pain Over Time

Session Group Mean Standard Deviation Lower 95% CL for Mean Upper 95% CL for
Mean Baseline Average 4.133 1.408 3.608 4.659 Present 3.700 1.841 3.013 4.387 Worst 5.467 1.717 4.826 6.108 1 Average 3.967 1.189 3.523 4.410 Present 4.100 1.539 3.525 4.675 Worst 5.333 1.749 4.680 5.986 2 Average 3.833 1.234 3.373 4.294 Present 3.433 1.775 2.771 4.096 Worst 4.900 1.807 4.225 5.575 3 Average 3.667 1.626 3.060 4.274 Present 3.000 1.912 2.286 3.714 Worst 4.467 1.871 3.768 5.165 4 Average 3.300 1.489 2.744 3.856 Present 2.667 1.749 2.014 3.320 Worst 4.100 1.882 3.397 4.803 5 Average 3.267 1.596 2.671 3.863 Present 2.567 1.832 1.882 3.251 Worst 4.300 2.054 3.533 5.067 6 Average 2.967 1.691 2.335 3.598 Present 2.600 2.061 1.830 3.370 Worst 3.900 2.023 3.145 4.655 

Session Group Mean Standard Deviation Lower 95% CL for Mean Upper 95% CL for
Mean Baseline Average 4.133 1.408 3.608 4.659 Present 3.700 1.841 3.013 4.387 Worst 5.467 1.717 4.826 6.108 1 Average 3.967 1.189 3.523 4.410 Present 4.100 1.539 3.525 4.675 Worst 5.333 1.749 4.680 5.986 2 Average 3.833 1.234 3.373 4.294 Present 3.433 1.775 2.771 4.096 Worst 4.900 1.807 4.225 5.575 3 Average 3.667 1.626 3.060 4.274 Present 3.000 1.912 2.286 3.714 Worst 4.467 1.871 3.768 5.165 4 Average 3.300 1.489 2.744 3.856 Present 2.667 1.749 2.014 3.320 Worst 4.100 1.882 3.397 4.803 5 Average 3.267 1.596 2.671 3.863 Present 2.567 1.832 1.882 3.251 Worst 4.300 2.054 3.533 5.067 6 Average 2.967 1.691 2.335 3.598 Present 2.600 2.061 1.830 3.370 Worst 3.900 2.023 3.145 4.655 

Open in new tab
TABLE III

Present, Average, and Worst Pain Over Time

Session Group Mean Standard Deviation Lower 95% CL for Mean Upper 95% CL for
Mean Baseline Average 4.133 1.408 3.608 4.659 Present 3.700 1.841 3.013 4.387 Worst 5.467 1.717 4.826 6.108 1 Average 3.967 1.189 3.523 4.410 Present 4.100 1.539 3.525 4.675 Worst 5.333 1.749 4.680 5.986 2 Average 3.833 1.234 3.373 4.294 Present 3.433 1.775 2.771 4.096 Worst 4.900 1.807 4.225 5.575 3 Average 3.667 1.626 3.060 4.274 Present 3.000 1.912 2.286 3.714 Worst 4.467 1.871 3.768 5.165 4 Average 3.300 1.489 2.744 3.856 Present 2.667 1.749 2.014 3.320 Worst 4.100 1.882 3.397 4.803 5 Average 3.267 1.596 2.671 3.863 Present 2.567 1.832 1.882 3.251 Worst 4.300 2.054 3.533 5.067 6 Average 2.967 1.691 2.335 3.598 Present 2.600 2.061 1.830 3.370 Worst 3.900 2.023 3.145 4.655 

Session Group Mean Standard Deviation Lower 95% CL for Mean Upper 95% CL for
Mean Baseline Average 4.133 1.408 3.608 4.659 Present 3.700 1.841 3.013 4.387 Worst 5.467 1.717 4.826 6.108 1 Average 3.967 1.189 3.523 4.410 Present 4.100 1.539 3.525 4.675 Worst 5.333 1.749 4.680 5.986 2 Average 3.833 1.234 3.373 4.294 Present 3.433 1.775 2.771 4.096 Worst 4.900 1.807 4.225 5.575 3 Average 3.667 1.626 3.060 4.274 Present 3.000 1.912 2.286 3.714 Worst 4.467 1.871 3.768 5.165 4 Average 3.300 1.489 2.744 3.856 Present 2.667 1.749 2.014 3.320 Worst 4.100 1.882 3.397 4.803 5 Average 3.267 1.596 2.671 3.863 Present 2.567 1.832 1.882 3.251 Worst 4.300 2.054 3.533 5.067 6 Average 2.967 1.691 2.335 3.598 Present 2.600 2.061 1.830 3.370 Worst 3.900 2.023 3.145 4.655 

Open in new tab
TABLE IV

Description of Pain

Description of Pain . Baseline Score, Mean (95% CI) . Point Change From
Baseline, Mean (95% CI) . P valuea . Aching 4.83 (3.961, 5.705) −1.97 (−3.112,
−0.821)b 0.001 Tingling pins and needles 2.13 (1.309, 2.958) −0.90 (−1.403,
−0.397) 0.001 Sharp 2.93 (1.851, 4.016) −1.70 (−2.691,
−0.709) 0.001 Cramping 2.30 (1.248, 3.352) −1.10 (−1.995,
−0.205) 0.006 Throbbing 2.63 (1.695, 3.571) −1.07 (−1.943,
−0.190) 0.006 Stabbing 2.43 (1.312, 3.554) −1.03 (−2.162,
0.095) 0.018 Numbness 1.80 (0.989, 2.611) −0.53 (−1.021,
−0.046) 0.020 Shooting 2.23 (1.230, 3.237) −0.87 (−1.935,
0.202) 0.020 Tiring 3.33 (2.119, 4.548) −1.47 (−2.694, −0.239) 0.021 Hot
burning 1.23 (0.415, 2.052) −0.77 (−1.511, −0.022) 0.024 Pain caused by light
touch 1.77 (0.744, 2.789) −0.70 (−1.527, 0.127) 0.036 Gnawing 1.83 (0.763,
2.903) −1.10 (−2.215, 0.015) 0.046 Sickening 0.43 (0.071, 0.796) −0.30 (−0.562,
−0.038) 0.076 Tender 2.30 (1.243, 3.357) −0.67 (−1.724, 0.391) 0.084 Heavy 1.93
(0.948, 2.919) −0.83 (−1.800, 0.133) 0.086 Piercing 1.50 (0.587, 2.413) −0.43
(−1.388, 0.521) 0.163 Fearful 0.50 (−0.026, 1.026) −0.37 (−0.832,
0.098) 0.184 Splitting 1.03 (0.234, 1.833) −0.47 (−1.069, 0.136) 0.194 Cold
freezing 0.27 (0.267, 0.605) −0.23 (−0.522, 0.056) 0.198 Punishing cruel 0.40
(−0.096, 0.896) −0.37 (−0.832, 0.098) 0.300 Electric shock 0.73 (0.083,
1.383) −0.33 (−0.948, 0.282) 0.391 Itching 0.67 (0.014, 1.320) −0.10 (−0.816,
0.616) 0.711 

Description of Pain . Baseline Score, Mean (95% CI) . Point Change From
Baseline, Mean (95% CI) . P valuea . Aching 4.83 (3.961, 5.705) −1.97 (−3.112,
−0.821)b 0.001 Tingling pins and needles 2.13 (1.309, 2.958) −0.90 (−1.403,
−0.397) 0.001 Sharp 2.93 (1.851, 4.016) −1.70 (−2.691,
−0.709) 0.001 Cramping 2.30 (1.248, 3.352) −1.10 (−1.995,
−0.205) 0.006 Throbbing 2.63 (1.695, 3.571) −1.07 (−1.943,
−0.190) 0.006 Stabbing 2.43 (1.312, 3.554) −1.03 (−2.162,
0.095) 0.018 Numbness 1.80 (0.989, 2.611) −0.53 (−1.021,
−0.046) 0.020 Shooting 2.23 (1.230, 3.237) −0.87 (−1.935,
0.202) 0.020 Tiring 3.33 (2.119, 4.548) −1.47 (−2.694, −0.239) 0.021 Hot
burning 1.23 (0.415, 2.052) −0.77 (−1.511, −0.022) 0.024 Pain caused by light
touch 1.77 (0.744, 2.789) −0.70 (−1.527, 0.127) 0.036 Gnawing 1.83 (0.763,
2.903) −1.10 (−2.215, 0.015) 0.046 Sickening 0.43 (0.071, 0.796) −0.30 (−0.562,
−0.038) 0.076 Tender 2.30 (1.243, 3.357) −0.67 (−1.724, 0.391) 0.084 Heavy 1.93
(0.948, 2.919) −0.83 (−1.800, 0.133) 0.086 Piercing 1.50 (0.587, 2.413) −0.43
(−1.388, 0.521) 0.163 Fearful 0.50 (−0.026, 1.026) −0.37 (−0.832,
0.098) 0.184 Splitting 1.03 (0.234, 1.833) −0.47 (−1.069, 0.136) 0.194 Cold
freezing 0.27 (0.267, 0.605) −0.23 (−0.522, 0.056) 0.198 Punishing cruel 0.40
(−0.096, 0.896) −0.37 (−0.832, 0.098) 0.300 Electric shock 0.73 (0.083,
1.383) −0.33 (−0.948, 0.282) 0.391 Itching 0.67 (0.014, 1.320) −0.10 (−0.816,
0.616) 0.711 

CI, confidence interval, p < 0.05 is significant.

aP value for testing change over time from repeated measures ANOVA.

bClinically significant.

Open in new tab
TABLE IV

Description of Pain

Description of Pain . Baseline Score, Mean (95% CI) . Point Change From
Baseline, Mean (95% CI) . P valuea . Aching 4.83 (3.961, 5.705) −1.97 (−3.112,
−0.821)b 0.001 Tingling pins and needles 2.13 (1.309, 2.958) −0.90 (−1.403,
−0.397) 0.001 Sharp 2.93 (1.851, 4.016) −1.70 (−2.691,
−0.709) 0.001 Cramping 2.30 (1.248, 3.352) −1.10 (−1.995,
−0.205) 0.006 Throbbing 2.63 (1.695, 3.571) −1.07 (−1.943,
−0.190) 0.006 Stabbing 2.43 (1.312, 3.554) −1.03 (−2.162,
0.095) 0.018 Numbness 1.80 (0.989, 2.611) −0.53 (−1.021,
−0.046) 0.020 Shooting 2.23 (1.230, 3.237) −0.87 (−1.935,
0.202) 0.020 Tiring 3.33 (2.119, 4.548) −1.47 (−2.694, −0.239) 0.021 Hot
burning 1.23 (0.415, 2.052) −0.77 (−1.511, −0.022) 0.024 Pain caused by light
touch 1.77 (0.744, 2.789) −0.70 (−1.527, 0.127) 0.036 Gnawing 1.83 (0.763,
2.903) −1.10 (−2.215, 0.015) 0.046 Sickening 0.43 (0.071, 0.796) −0.30 (−0.562,
−0.038) 0.076 Tender 2.30 (1.243, 3.357) −0.67 (−1.724, 0.391) 0.084 Heavy 1.93
(0.948, 2.919) −0.83 (−1.800, 0.133) 0.086 Piercing 1.50 (0.587, 2.413) −0.43
(−1.388, 0.521) 0.163 Fearful 0.50 (−0.026, 1.026) −0.37 (−0.832,
0.098) 0.184 Splitting 1.03 (0.234, 1.833) −0.47 (−1.069, 0.136) 0.194 Cold
freezing 0.27 (0.267, 0.605) −0.23 (−0.522, 0.056) 0.198 Punishing cruel 0.40
(−0.096, 0.896) −0.37 (−0.832, 0.098) 0.300 Electric shock 0.73 (0.083,
1.383) −0.33 (−0.948, 0.282) 0.391 Itching 0.67 (0.014, 1.320) −0.10 (−0.816,
0.616) 0.711 

Description of Pain . Baseline Score, Mean (95% CI) . Point Change From
Baseline, Mean (95% CI) . P valuea . Aching 4.83 (3.961, 5.705) −1.97 (−3.112,
−0.821)b 0.001 Tingling pins and needles 2.13 (1.309, 2.958) −0.90 (−1.403,
−0.397) 0.001 Sharp 2.93 (1.851, 4.016) −1.70 (−2.691,
−0.709) 0.001 Cramping 2.30 (1.248, 3.352) −1.10 (−1.995,
−0.205) 0.006 Throbbing 2.63 (1.695, 3.571) −1.07 (−1.943,
−0.190) 0.006 Stabbing 2.43 (1.312, 3.554) −1.03 (−2.162,
0.095) 0.018 Numbness 1.80 (0.989, 2.611) −0.53 (−1.021,
−0.046) 0.020 Shooting 2.23 (1.230, 3.237) −0.87 (−1.935,
0.202) 0.020 Tiring 3.33 (2.119, 4.548) −1.47 (−2.694, −0.239) 0.021 Hot
burning 1.23 (0.415, 2.052) −0.77 (−1.511, −0.022) 0.024 Pain caused by light
touch 1.77 (0.744, 2.789) −0.70 (−1.527, 0.127) 0.036 Gnawing 1.83 (0.763,
2.903) −1.10 (−2.215, 0.015) 0.046 Sickening 0.43 (0.071, 0.796) −0.30 (−0.562,
−0.038) 0.076 Tender 2.30 (1.243, 3.357) −0.67 (−1.724, 0.391) 0.084 Heavy 1.93
(0.948, 2.919) −0.83 (−1.800, 0.133) 0.086 Piercing 1.50 (0.587, 2.413) −0.43
(−1.388, 0.521) 0.163 Fearful 0.50 (−0.026, 1.026) −0.37 (−0.832,
0.098) 0.184 Splitting 1.03 (0.234, 1.833) −0.47 (−1.069, 0.136) 0.194 Cold
freezing 0.27 (0.267, 0.605) −0.23 (−0.522, 0.056) 0.198 Punishing cruel 0.40
(−0.096, 0.896) −0.37 (−0.832, 0.098) 0.300 Electric shock 0.73 (0.083,
1.383) −0.33 (−0.948, 0.282) 0.391 Itching 0.67 (0.014, 1.320) −0.10 (−0.816,
0.616) 0.711 

CI, confidence interval, p < 0.05 is significant.

aP value for testing change over time from repeated measures ANOVA.

bClinically significant.

Open in new tab

Finally, when one’s level of pain interference in their life was assessed, Reiki
significantly decreased pain interference with walking (−1.30 points;
P < 0.001), enjoyment of life (−1.37 points; P < 0.001), sleep (−1.47 points;
P = 0.002), relationships (−0.70 points; P = 0.002), and general activity (−1.43
points; P < 0.001) (Table S1).

Participant’s impression of their improvement was assessed at session 3 and
session 6. At session 3, 7% reported feeling “much better,” 60% “a little
better,” 30% “no change,” and 3% “a little worse.” However, by session 6, 10%
reported feeling “very much better,” 27% “much better,” 47% “a little better,”
and only 16% “no change.” When asked “If Reiki services became available at your
health care facility, would you make an appointment?” 81% of the participants
stated “yes” with 42% willing to come in “four times per month,” followed by 29%
“more than four times per month.” Finally, when asked “Would you recommend
Reiki?” 81% of the participants stated “yes.”


DISCUSSION

After introducing Reiki to 30 Reiki-naive participants, the study found that
their pre- and post-Reiki Knowledge scores improved, coupled with a willingness
to continue Reiki therapy for up to four or more times per month. The 30-minute
hand placement Reiki protocol, conducted by trained level I practitioners, was
feasible in an outpatient setting.

Because there was overall improvement between pre- and post-Reiki Knowledge
scores, it was determined that the first study aim was met. However, the ability
to distinguish the differences between Reiki, HT, and TT was still an issue. It
is critical to be able to recognize the differences between the three to be able
to provide the proper feedback needed for stakeholders to make informed
decisions about what would be needed to incorporating the service(s).
Organizations who want to incorporate such therapies are faced with the
challenges of choosing between the therapies as well as knowing what credentials
to look for and ways to validate those credentials. For these reasons, a
consolidated effort between the three camps is imperative to provide the public
with formal guidance addressing their similarities, differences, training, and
governing principles.27 Follow-on studies should be considered to compare Reiki,
HT, and TT with one another via a crossover study design method. Comparing the
three methods may provide some insight into which populations do better with a
specific type of energy healing practice. Leaders in the fields of Reiki, HT,
and TT should put forth a consolidated effort that will properly educate the
public, provide the necessary regulatory guidelines for health care leaders, and
conduct more rigorous as well as replication studies to substantiate the
practice.

With regard to the second aim, the study successfully introduced the concept of
Reiki therapy to 30 participants. According to Thrane and Cohen, a typical Reiki
therapy session lasts between 30 and 90 minutes.28 Although 90 minutes may be
too long for a Reiki therapy appointment at a military health care facility, the
30-minute Reiki hand placement protocol used for this study appear to be both
effective and feasible in outpatient clinic setting. During the study, some
participants demonstrated a preference to keep the same practitioner throughout
their Reiki sessions despite effort to conform all Reiki sessions (ie, same
script at start of Reiki, no talking during, and minimal interaction with
practitioners). Although this request is unrealistic in clinic settings, having
the same practitioner to conduct all planned sessions may have helped the
participant be more comfortable and relaxed to allow the healing to take place.
As such, this feasibility study fortuitously identified other possible avenues
for research, including implications of training medical professionals to become
level I Reiki practitioners to not only improve patient care but to also
maintain self-care and self-healing strategies, which could help with provider
burnout.

The results pertaining to the third study aim showed that after trying six Reiki
therapy sessions at approximately three to four times a week for 2 to 3 weeks,
participants were willing to continue their Reiki therapy sessions with four or
more appointments per month. The study showed promising effect of Reiki therapy
over a wide variety of pain outcomes. Specifically, the results showed
improvement for pain described as aching, tingling, pins and needles, sharp,
cramping, throbbing, numbness, shooting, tiring, hot-burning, gnawing, and even
pain caused by light touch. In a majority of the participants, a change occurred
on or shortly after the third Reiki session regardless of the type of pain.
Based on this trend, it is stipulated that pain can be improved after a minimum
of three sessions of Reiki therapy. However, the pain outcomes cannot be
absolutely attributed to the intervention without a comparison control group.
Regarding the overall effect of Reiki, it could be argued that those who
volunteered to be in a Reiki study were already opened to the concept of Reiki
thereby generating a placebo effect. Given that a placebo effect may occur
regardless, it is imperative to conduct follow-on studies that use randomized,
blinded, and sham interventions to control for the placebo effect. In addition,
there are many in the scientific community that prefer more objective measures
for validity and efficacy of energy healing modalities; therefore, future
researchers should consider using more objective measures. For example, if the
energy flow is found to be thermal, the use of thermal imaging may be useful as
well as the use of other tested measures such as galvanic skin response and
heart rate variability to name a few.


LIMITATIONS

This study had several limitations. First, the one-group study design hindered
the ability to solely attribute the intervention to the observed reduction in
pain given that there was no control group to compare with. Second, although the
military (53%) and civilian (47%) populations had adequate representations of
both beneficiary groups; the sample was predominantly Caucasian females, which
limits the generalizability. Given this information, replication studies with a
larger and more diverse population and the use of comparison control groups are
crucial. Finally, the use of level 1 Reiki practitioners instead of seasoned
Reiki masters may have impacted the outcome.


CONCLUSION

Military health care beneficiaries are looking for innovative options to manage
their chronic pain as evidenced by the participants’ willingness to schedule
four or more Reiki sessions per month if the service became available. A
30-minute Reiki session, performed by a trained Reiki practitioner, is feasible
in an outpatient setting with possible positive outcomes for participants who
are willing to try at least four consecutive sessions. Reiki has the ability to
impact a variety of types of pain as well as positively impacting those
activities of life that pain often interferences with. However, education and
the opportunity to experience this energy healing modality are key for its
acceptance in military health care facilities as well as more robust clinical
studies within the military health care system to further assess its validity
and efficacy.


ACKNOWLEDGMENTS

Members of the research team include Dr Rosemary Polomano, Dr Anne Vitale, Dr
Dale Glaser, MAJ Justin Miller, Ms Petra Krebs, Ms Shirlene Oduber, Ms Jasmin
Jacobs, Ms Casey Villanueva, and Ms Anja Seidl.


CONFLICT OF INTEREST

None.


FUNDING

TriService Nursing Research Program, Grant No. HT9404-12-1-TS11 (N12-P10).

The views expressed are solely those of the authors and do not reflect the
official policy or position of the U.S. Army, U.S. Navy, U.S. Air Force, the
Department of Defense, or the U.S. Government.


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