Ray D’Alonzo, Ph.D., is an Associate Director of Research and Development at Procter & Gamble Pharmaceuticals where he has worked for 29 years and led research programs in bone metabolism, infectious disease, respiratory disease, arthritis, and nutrition. He has published scientific papers on a wide variety of topics from the chemical composition of fats and oils to the pharmacoeconomics of osteoporosis. Dr. D’Alonzo is the recipient of the Chancellor’s Medal from the University of Massachusetts, Amherst, in part, for his contributions to the development of new pharmaceutical agents. As both a patient and scientist, he has made a personal effort to increase the awareness of Chiari in the health care sector and to assist others afflicted with the syndrome.  He has published the story of his personal struggle with Chiari in a book, Contents Under Pressure, with 100% of royalties going towards Chiari education, awareness, and research programs.

August 20, 2006 -- This is a two part article on Reiki, a form of healing touch belonging to the family of alternative medical treatment approaches. In part 1 to follow, I will review clinical trials on Reiki that have been published in the mainstream medical literature. Next month, I will comment on a much larger set of publications that could be classified as experienced based.

Reiki is derived from two Japanese words, rei which means God’s wisdom, and ki which means life force energy. Loosely translated it means spiritually directed life force energy. Reiki is a form of healing touch and is administered by masters and practitioners. During Reiki treatment, the healer extends his/her hands over or on the patient and transfers life force energy so as to heal the patient. There is no manipulation of the body or joints and sessions can last an hour or longer. It is offered by many mainstream healthcare organizations. Because it is unregulated, it is vital to understand that it can also be offered by anyone who wants to hang a shingle on their door claiming to be a healer.

Before I review the clinical trials published on Reiki, it is important to cover the scientific principles employed when designing and executing clinical studies. Well designed and controlled clinical trials or studies are required by regulatory authorities to determine if a drug, medical device or surgical procedure is both safe and effective. There are two basic types of studies: prospective and retrospective. Prospective trials are forward looking and thus capable of testing a hypothesis. Retrospective studies look backwards at data already collected and are useful for forming hypotheses. Prospective studies are the preferred type for proving if a treatment actually works.

The design of a prospective clinical study is critical. A study can be controlled or uncontrolled. When controlled, a placebo group or positive control group is usually tested in order to compare results against the group in which the test treatment is being evaluated. Groups can also serve as their own controls in a cross-over design. Controlled is preferred to uncontrolled. A study can also be blinded or open. By blinded, it is meant that participants do not know which group is receiving which treatment until all the data are collected and verified. A study can be single blinded in which the patients or subjects are blinded or it can be double blinded in which both the patients/subjects and investigators are blinded. Blinded study designs are preferred to eliminate bias. Double blinded is preferred to single blinded. A well designed study must also state in advance the hypothesis to be tested as well as the specific measurements to be taken, often referred to as end-points, and how the data will be analyzed. The type of patients or subjects must be defined up front. The number of patients or subjects must be determined by valid statistical modeling. Patients or subjects must be randomly assigned to placebo and test groups to minimize the possibility of bias. After patients or subjects are assigned, the groups must be shown to be balanced with respect to number and other attributes such as age, gender, and other predefined entry criteria. Other design attributes can also come into play, but the examples above should give the reader an idea of the rigor necessary to properly test a treatment in order to eliminate bias and/or chance from corrupting the results.

When reviewing papers or reports on clinical studies in the literature it is imperative to look for all the features of good design. It is also important to take into consideration the journal that the paper is published in as not all journals are created equal. Some journals require papers to be reviewed by experts before they can be accepted for publication while others do not. The credentials of the authors and their institutions must also be considered before coming to firm conclusions.

A search of PubMed for the term Reiki either in the title or abstract of a publication produced 67 papers. A more restrictive search requiring that the publication be a report on a clinical trial produced only 11 papers. Only six of these papers dealt with clinical trials testing the effectiveness of Reiki. All six were prospective in design. None of the papers were published in top journals. Three were published in journals dedicated to alternative medicine. From a view of eliminating bias, positive results from these studies would be considered stronger and more reliable if not published in these journals.

The most recently published clinical trial on Reiki was a paper by Mackay et al. in the Journal of Alternative & Complementary Medicine in December 2004. The investigators evaluated 45 normal healthy subjects for autonomic nervous system function. Endpoints included heart rate, cardiac vagal tone, and blood pressure. Subjects were randomly assigned to one of three groups, one group in which Reiki was administered, one group in which no treatment was given other than rest, and one group in which Reiki was mimicked by someone with no knowledge of Reiki. Significant differences in heart rate and diastolic blood pressure were observed in favor of the Reiki treatment group. The investigators concluded that the changes were small and only indicative of a partial effect on the nervous system and that larger trials would be needed for more definitive conclusions.

In a study with a similar objective reported in Journal of Advanced Nursing by Wardell in Feb 2001, 23 healthy volunteers were studied where biological correlates of stress reduction were measured such as salivary cortisol levels and blood pressure. Thirty minutes of Reiki was administered in a single group repeated measure design (no control group). The investigator reported that Reiki was effective however the study did not contain a control group.

Four studies were conducted in patients with psychological or physical disease. The first was a study in 46 patients with clinical depression reported in Alternative Therapies in Health and Medicine by Shore. The study measured depression and self perceived stress by the Beck, Beck Hopelessness, and Perceived Stress scales. Patients were assigned to one of 3 groups: hands on Reiki, Distance Reiki, or Distance Reiki placebo. Patients received 1 to 1.5 hours of treatment a week for 6 weeks. A significant reduction is depression and self-reported stress was observed in the Reiki treatment groups following treatment and at one year after treatment.

In a study reported in Journal of Pain Symptom Management involving 24 cancer patients, Reiki was studied to determine its efficacy in improving quality of life, relieving pain and reducing the amount of pain medication taken (standard opioid management). Patients were assigned to either Reiki or placebo groups. Patients in the Reiki treatment group reported improvement in quality of life and a reduction in the pain which was significantly better than those in the placebo group. However, the effect was only observed immediately following Reiki sessions and patients did not reduce the amount of pain medication they were taking.

A study reporting on post stroke recovery in 50 patients in which depression and functional independence were evaluated was published by Shiflett et al. in the Journal of Alternative & Complementary Medicine. In this study patients were assigned to one of four different groups: a group given Reiki by a master, a group administered Reiki by practitioners, a group receiving sham Reiki, and a group that received no treatment. Investigators reported no significant differences between any of the groups and concluded that Reiki had no clinically significant effect on stroke recovery.

In a trial evaluating wound healing as published in International Journal of Psychosomatics, patients served as their own controls in a valid cross-over design. Reiki was administered in person and reepithelialization rates were measured from lateral deltoid biopsies. The investigators reported a statistically significant decrease in healing time in the group receiving Reiki administered by the mimics.

The following chart summaries the six studies discussed above.
 

The studies above show mixed results and when taken together constitute weak evidence in favor of Reiki having any effect other than that which can be accomplished from the touch of an ordinary caring person. The fact that human touch can induce relaxation is well known. It happens every time a mother consoles an injured child. Some people are also known to become so relaxed from getting a hair cut or their teeth cleaned that they fall asleep during the procedure so it certainly isn’t surprising that Reiki healing touch can induce biological correlates of relaxation in normal healthy subjects.

When requesting approval for a new drug from the FDA, 2 large well designed clinical trials are required both of which must demonstrate a statistically significant effect in favor of the drug treatment group. The studies reviewed above do not constitute anything near this standard benchmark criterion for proof. At best, they formulate a theory that Reiki might be useful in stress reduction, temporary relief of pain, and mood improvement but that the level of that improvement may be no better than the caring touch of an average person.

Next month, in part 2, I will review the literature on non-clinical trial reports on Reiki to complete my evaluation of the medical literature for evidence that Reiki is effective. I will also reveal my own experience in participating in a Reiki healing session.

1J Altern Complement Med. 2004 Dec;10(6):1077-81.
2J Adv Nurs 2001 Feb;33(4):439-45.
3Altern Ther Health Med. 2004 May-Jun;10(3):42-8.
4J Pain Symptom Manage. 2003 Nov;26(5):990-7.
5J Altern Complement Med. 2002 Dec;8(6):755-63.
6Int J Psychosom 1994;41(1-4):61-7.
 

 --Ray D'Alonzo, PhD

 ** If you would like to share your comments, thoughts, or ideas with Ray,  please send them to dalonzo.rp@fuse.net.  Due to the volume and nature of email received, individual responses are not possible. **

[Ed. Note:  The opinions expressed above are solely those of the author.  They do not represent the opinions of the editor, publisher, or this publication.  Mr. D'Alonzo is not a medical doctor and does not give medical advice.  Anyone with a medical problem is strongly encouraged to seek professional medical care.]    
 

Return To Table Of Contents