MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Reiki

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The primary aim of this ‘mixed-methods, feasibility pilot study’ was to evaluate the feasibility of providing Reiki at a behavioral health clinic serving a low-income population. The secondary aim was to evaluate outcomes in terms of patients’ symptoms, emotions, and feelings before and after Reiki.
The study followed a pre-post experimental design. Reiki was offered to adult outpatients at a community behavioral health center in Rochester, Minnesota. Patients with a stable mental health diagnosis completed surveys before and after the Reiki intervention and provided qualitative feedback. Patients were asked to report their ratings of:
  • pain,
  • anxiety,
  • fatigue,
  • feelings (eg, happy, calm)

on 0- to 10-point numeric rating scales. Data were analyzed with Wilcoxon signed rank tests.

Among 91 patients who completed a Reiki session during the study period, 74 (81%) were women. Major depressive disorder (71%), posttraumatic stress disorder (47%), and generalized anxiety disorder (43%) were the most common diagnoses. The study was feasible in terms of recruitment, retention, data quality, acceptability, and fidelity of the intervention. Patient ratings of pain, fatigue, anxiety, stress, sadness, and agitation were significantly lower, and ratings of happiness, energy levels, relaxation, and calmness were significantly higher after a single Reiki session.
The authors concluded that the results of this study suggest that Reiki is feasible and could be fit into the flow of clinical care in an outpatient behavioral health clinic. It improved positive emotions and feelings and decreased negative measures. Implementing Reiki in clinical practice should be further explored to improve mental health and well-being.
One might have expected better science from the Mayo Clinic, Rochester; in fact, this is not science at all; it’s pure pseudo-science! Here are some critical remarks:
  • What on earth is a ‘mixed-method, feasibility, pilot study’? A hallmark of pseudo-researchers seems to be that they think they can invent their own terminology.
  • There is no objective, validated outcome measure.
  • The conclusion that ‘Reiki is feasible‘ has been known and does not need to be tested any longer.
  • The conclusion that ‘Reiki improved positive emotions and feelings and decreased negative measures’ is false. As there was no control group, these improvements might have been caused by a whole lot of other things than Reiki – for instance, the extra attention, placebo effects, regression towards the mean or social desirability.
  • The conclusion that ‘implementing Reiki in clinical practice should be further explored to improve mental health and well-being’ is therefore not based on the data provided. In fact, as Reiki is an implausible esoteric nonsense, it is a promotion of wasting resources on utter BS.

Does it matter?

Why not let pseudo-scientists do what they do best: PSEUDO-SCIENCE?

I think it matters because:

  • Respectable institutions like the Mayo Clinic should not allow its reputation being destroyed by quackery.
  • The public should not be misled by charlatans.
  • Patients suffering from mental health problems deserve better.
  • Resources should not be wasted on pseudo-research.
  • ‘Academic journals like ‘Glob Adv Integr Med Health’ have a responsibility for what they publish.
  • ‘The ‘Academic Consortium for Integrative Medicine & Health‘ that seems to be behind this particular journal claim to be “the world’s most comprehensive community for advancing the practice of whole health, with leading expertise in research, clinical care, and education. By consolidating the top institutions in the integrative medicine space, all working in unison with a common goal, the Academic Consortium is the premier organizational home for champions of whole health. Together with over 86 highly esteemed member institutions from the U.S., Australia, Brazil, Canada and Mexico, our collective vision is to transform the healthcare system by promoting integrative medicine and health for all.” In view of the above, such statements are a mockery of the truth.

 

This review is entitled “A narrative review of the impact of reiki and therapeutic touch on sleep quality and health in women” and aimed to evaluate the application methods of energy therapies, specifically Reiki and Therapeutic Touch, their health effects, and their positive impact on sleep quality, particularly in women.

The author who is from the Osmaniye Korkut Ata University, Faculty of Health Sciences, Midwifery Department, Osmaniye, Turkey, states in her abstract that:

“energy therapies are holistic approaches designed to restore energy balance and enhance overall health. Reiki utilizes universal energy flow to promote physical, mental, and spiritual harmony. By balancing energy centers, Reiki helps alleviate stress, anxiety, and depression while being a generally safe practice with no reported side effects.”

The author continues by claiming that studies involving menopausal women suggest that Reiki improves sleep quality, reduces the time to fall asleep, and stabilizes sleep patterns.

Therapeutic Touch, the author explains:

“focuses on sensing and balancing the body’s energy fields, operating on the principle that energy imbalances contribute to illness. Research indicates that Therapeutic Touch alleviates stress, fatigue, anxiety, and pain, while enhancing sleep quality, relaxation, and overall quality of life. Studies in menopausal women confirm its effectiveness in addressing sleep disturbances and promoting well-being.”

The author concludes that energy therapies, particularly methods like Reiki and Therapeutic Touch, have garnered attention for their positive impact on women’s health and overall well being. These noninvasive, safe, and low-cost practices have shown promise, especially in areas such as sleep quality, stress management, and the alleviation of menopausal symptoms. However, the limited scientific literature in this field necessitates further research to solidify their efficacy.

The author also issues the following ecommendations:

• Theoretical and practical training on energy therapies should be integrated into nursing education
programs to enhance awareness and application.
• Randomized controlled trials should be conducted to investigate the effectiveness of energy
therapies across different age groups and health conditions.
• Research on women’s health should focus specifically on the effects of energy therapies on sleep
quality and menopausal symptoms.
• Public awareness of energy therapies should be increased, and their integration into healthcare systems
should be facilitated.
• Energy therapies should be recognized as complementary treatment options in health institutions,
contributing to patient satisfaction and stress management.

This paper is a good example to show why I have often warned that research of so-called alternative medicine (SCAM) is in serious danger to be no longer taken seriously. Scientists and rational healthcare professionals will simply dismiss it outright because it simply is pseudo-research masquarading as the real thing.

The review fails to contain a methods section which means we do not know on what evidence the conclusions are based. Once we have a closer look, we realize that the paper:

  • relies on highly selected studies;
  • does not even consider the implausibility of energy healing;
  • fails to assess the methodological quality of the primaary studies.

All this is done so that the author – presumably a nurse who practices energy healing – can arrive at the conclusion she set out to draw.

Such papers are deeply disturbing because they mislead the reader and undermine trust in science.

 

PS

In case you are interested in a reasonable and evidence-based conclusion about energy healing, here is one I suggest:

A review of the evidence shows that energy healing flies in the face of science and is not supported by sound clinical evidence. Energy healing has therefore no place in rational healthcare. 

Many individuals with depression explore so-called alternative medicine (SCAM), including spiritual healing. This pilot randomized controlled trial (RCT) aimed to assess the feasibility of a study that integrated spiritual healing with standard care versus standard care alone for adults with moderate depression.
28 adult patients with depression were randomized to receive either:
  • spiritual healing alongside usual care (n = 14);
  • or usual care alone (n = 14).

The healing sessions were highly individualized. The healer positioned her hands over various areas of the client’s body (head, chest, knee, hip, and feet) intending to adjust the energy flow within the client. Outcomes were measured by changes in the Beck Depression Inventory for Primary Care (BDI) scores pre-and post-intervention. Participants’ experiences with spiritual healing were explored through a process evaluation.

The BDI scores captured significant changes in depression severity, with the intervention group showing the greatest mean difference from baseline (BDI 23.0) to week 16 (BDI 14.9), compared to the control group which worsened from baseline (BDI 24.2) to week 16 (BDI 26.7). In addition, participants expressed satisfaction with the study components and procedures, and all completed the questionnaires at designated times. Recruiting from clinical practice proved suboptimal due to conflicts with primary care physicians’ schedules leading to fewer participants in the study than planned. Measures to minimize loss to follow-up were effective.
The authors concluded that spiritual healing may be a beneficial option for individuals who suffer from moderate depression. The participants in this study were satisfied with the spiritual healing treatment, and adherence rates were high. Future RCTs should consider recruiting participants through different avenues to enhance research feasibility to alleviate the burden on family care physicians’ offices.
Where to start?
Here are just some of the most obvious concerns that render the conclusion nonsensical and false:
  1. A pilot study is for testing the feasibility and not for calculating outcomes.
  2. In any case, this was not a pilot study but an effectiveness trial that failed because of recruitment difficulties.
  3. As it followed the infamous ‘A+B versus B’ design that produces a positive result even for a placebo treatment, the study (if we disregard the small sample size and take its findings seriously) merely shows that placebo can be effective.
  4. The conclusion is therefore wrong and should read: spiritual healing causes a placebo response in individuals who suffer from moderate depression.
  5. The National Research Center of Complementary and Alternative Medicine (NAFKAM), Faculty of Health Science, Institute of Community Medicine, The Arctic University of Norway which seems to be the main institution responsible for this nonsense should be questioned how they justify spending money and time on such pseudoscience.

I came across this remarkable chapter entitled “Reiki in Companion Animals “. As it comes from the Department of Clinical Studies and the Department of Veterinary Pathology, Faculty of Veterinary and Animal Sciences, PMAS Arid Agriculture University, Rawalpindi, Pakistan, the paper ought to be taken seriously, I thought. It seems that I was mistaken!

Here is the unaltered abstract:

The word “Reiki” is derived from two Japanese words “Rei” and “kei” meaning spiritually guided life energy. Reiki helps an individual to feel from disease, grow emotionally, spiritually and mentally. In case of animal, Reiki helps to build trust between pets and owner, promotes healing decrease psychological issues and keep an animal healthy. The major energies Reiki attunement include earth energy, heavenly energy and heart energy. Furthermore, the three degrees of chakra i.e., the heart chakra, the throat chakra and third eye chakra, allow an individual to love unconditionally, open path to consciousness and build trust, respectively. Some practitioner in Reiki train for years to understand the energy and how to navigate delicate and subtle energy which shifts within themselves and their participants, where instead of realigning your bones and muscles tension. The process of Reiki is something anyone can learn and something you can learn fairly swiftly, especially for animals. Reiki allows us to perform at a level where our positive energy flows freely. Reiki should not be an alternative to veterinarian medical care, but seen instead as an aid in the diagnosis to recovery.

Are you as baffled as I am? Here are some of my most immediate questions:

What is “Reiki attunement”?

What is “earth energy”?

What is “heavenly energy”?

What is “heart energy”?.

What is “the heart chakra”?

What is “the throat chakra”?

What is “the third eye chakra”?

What is an “open path to consciousness”?

What is “a level where our positive energy flows freely”?

None of these terms or concepts are defined. Why not? The answer is that they are not definable; they are mystical notions without meaning aimed at a gullible public (a polite way of avoiding the word bullshit).

Needless to say that the rest of the chapter is packed with some of the worst proctophasia and pseudo-science I have ever come across. The fact is that Reiki is nonsense, and nonsense should not be used to treat either humans or animals. If you are not convinced, please explain to me what this sentence tries to tell us: “Some practitioner in Reiki train for years to understand the energy and how to navigate delicate and subtle energy which shifts within themselves and their participants, where instead of realigning your bones and muscles tension.”

QED!

I don’t normally report personal things but today I will make an exception. This story is simply too good to ignore.

A French friend of mine was recently looking to employ a new secretary. She short-listed and interviewed 10 candidates. To her surprise (and amusement), 5 of the 10 had some sort of ‘medical’ diploma. Since she knows of my interest in so-called alternative medicine (SCAM), she emailed me their qualifications:

An energy therapist
A practitioner of Acess Bars
A practitioner of the Enelph method
A facial reflexologist
A practitioner of light therapy

In case you don’t know what these titles mean – I too did not know of some of them – here are the definitions I found after a few quick searches:

ENERGY THERAPY

Energy healing is a complementary approach based on the belief that our bodies have energy flowing through them, and that healing can come from helping to balance this flow

ACCESS BARS

Access Bars are 32 points on your head that, when gently touched, effortlessly and easily release the thoughts, ideas, beliefs, emotions, and considerations that stop you from creating a life you love. Access Bars are used as a potent and pragmatic tool by families, wellness practitioners, schools, businesses, mental health professionals, athletes, prisons, veterans, artists, and many more. Access Bars can feel like hitting the delete button on your computer’s cluttered hard drive – only this time, you’re creating space in your brain. Things like negative thought patterns, or that endless mental chatter keeping you awake at night, can be released and make space for the calm you’ve been seeking.

ENELPH METHOD

The Enelph Method is a holistic healing method, using an energy rebalancing technique. Its ultimate goal is to help establish inner peace and harmony within individuals, which can then manifest externally to gradually facilitate awakening both individually and collectively. It is part of an immense aid package offered to us by guides from other dimensions in order to awaken consciousness on the planet .

FACIAL REFLEXOLOGY

Facial Reflexology works on the same principle as the feet. It focuses on the reflex points on the face to stimulate the body’s healing mechanisms which improve circulation and encourage the release and removal of toxins from the body via the lymphatic system. Reflex points in the face connect to and help balance the whole body.

LIGHT THERAPY

Light therapy, also known as phototherapy and bright light therapy, is a therapy used to treat a variety of mental health conditions. Primarily, it’s used to treat a common type of depression called seasonal affective disorder (SAD), which is also known as the winter blues or seasonal depression. Light therapy may also be helpful as a therapy for sleep disorders, other forms of depression, and more.

Except for light therapy, I am unable to find any reliable evidence that these treatments do more good than harm.

Why do I find this amusing?

It suggests, I think, that France is awash with SCAM (this is also my impression whenever I spend some time in France). Not only that, it also implies that many women get lured into obtaining (frequently expensive) diplomas for profoundly useless therapies, only to find later that they are unable to earn a living with them. Thus they eventually find themselves applying for a secretarial post.

I therefore feel that my little anecdote is both amusing and sad. My hope is that my friend’s little story might deter people from paying good money for phoney SCAM diplomas!

PS

I was told that the above-mentioned secretarial post was given to a person without a pseudo-medical diploma.

This study aimed to determine the effects of Reiki on pain and biochemical parameters in patients undergoing bone marrow transplantation. This investigation was designed as a “single-blind, repeated measures, randomized prospective controlled study”. It was conducted between August 2022 and April 2023 with patients who underwent autologous bone marrow transplantation (BMT).

  • In the Reiki group (n = 21), Reiki therapy was applied directly to the energy centers for 30 min on the 0th and 1st day of BMT, and from a distance for 30 min on the 2nd day.
  • No intervention was performed on the control group (n = 21).

Data were collected using the Personal Information Form, Visual Analog Scale (VAS), and biochemical parameters. Pain and biochemical parameters were evaluated on days 0, 1, 2, and 10 before the Reiki application.

There were no statistically significant differences in pain scores between the groups before the intervention (p > .005). The Reiki group showed a significant improvement in the mean VAS score compared with the control group on days 1 and 2 (p = .002; p < .001, respectively). The measurement of procalcitonin showed a decrease in the Reiki group and an increase in the control group (p = .026, p = .001, p < .001, respectively). Although the Reiki group had better absolute neutrophil, thrombocyte, and C-reactive protein values than the control group, no significant difference was observed between the groups (p > .05).

The authors concluded that Reiki is effective for pain control and enhancing the immune system response.

For the following reasons, I beg to differ:

  • The patients of the verum group were fully aware of receiving the therapy; thus they were expecting/hoping to benefit from it.
  • The patients of the control group received no therapy; thus they were disappointed which may have influenced thie VAS ratings.
  • The procalcitonin levels are of doubtful relevance; they changed only within the group which, in a controlled clinical trial that is supposed to compare groups is meaningless and most likely a chance finding.
  • The only people who could have been blinded in this ‘single blind’ study were the evaluators of the results (even though the authors state that “patients were blinded to the group assignments”) which is meaningless if patients and therapists are not blinded.

Because of all this, I feel that the conclusions should be re-written:

Reiki is known to cause a placebo effect which most likely caused the observed outcomes.

 

What is it about Reiki that fascinates me?

It must be the exemplary poor science that its proponents use trying to convince us that it is valid.

This randomized controlled trial investigated the effect of Reiki on pain, functional status, and holistic well-being in patients with knee osteoarthritis (OA). The sample consisted of 42 patients.

  • The control group received standardized treatment only.
  • The intervention group received face-to-face Reiki (nine positions; 39 minutes) and distance Reiki on two consecutive days in addition to standardized treatment in addition to standard treatment.

The results show that the Reiki group had lower pain scores than the control group as measured by the Visual Analog Scale (p < .001) and the Western Ontario and McMaster Universities Arthritis Index pain score (p < .001). Those participating in the Reiki group had improved holistic well-being scores specifically for the subscales of Sadness, Perception of Sadness, Spiritual Disruption, Cognitive Awareness, and General mood.

The authors concluded that Reiki is a safe, noninvasive, and cost-effective alternative treatment technique that has the potential to reduce symptoms of pain and improve holistic well-being in patients with knee OA.

So many falsehoods in one sentence!

Is this a new record?

Let’s analyse these conclusions a little, shall we?

  • Reiki is safe: this does not follow from the data because the sample was far too small for assessing rare safety issues, safety was not measured, and half of the Reiki group might have dropped dead a week after the study.
  • Reiki is non-invasive: that might be true.
  • Reiki is cost-effective: cost-effectiveness was not an endpoint; the statement is thus not supported by the data.
  • Reiki reduces the symptoms of pain and improve holistic well-being in patients with knee OA: I disagree! The observed outcomes are much more likely caused by the considerable amount of extra attention and treatment time given to the Reiki group, and the results were entirely unrelated to any specific effects of the therapy.

So, I feel the need for re-phrasing the conclusions as follows:

Reiki is an implausible treatment and the outcomes of this study are unrelated to any alleged specific effects of this therapy.

Of all the many forms of so-called alternative medicine (SCAM), Reiki is perhaps the one that has the least plausibility. It assumes that a Reiki healer can send healing energy into the body of a patient which, in turn, stimulates the self-healing ability of the body and thus cures illness. Neither the source of the energy, its nature, or its effects have ever been convincingly demonstrated. These facts, however, do not stop enthusiasts to conduct clinical trials of Reiki.

The aim of this randomised clinical trial was to investigate the effect of the application of Reiki on fatigue and sleep quality in people with MS. A total of 60 people (control group = 30, intervention group = 30) participated in this study. Personal Information Form, Piper Fatigue Scale (PFS) and Pittsburg Sleep Quality Index (PSQI) were used as endpoints.

It was found that the PFS and PSQI total and subcomponent scores of the intervention group decreased after Reiki compared to the control group and this was statistically significant (p<0.05). The study showed that Reiki was significantly effective in improving fatigue and sleep quality in people with MS.

The authors concluded that, as Reiki is a simple, inexpensive and accessible method, it was suggested that its use in the management of MS should be encouraged and maintained in nursing practice.

In the introduction, the authors state this:

Reiki is a non-invasive, low-cost, easy-to-apply practice with no side effects and no negative effects on the existing treatment, and prevents acute and chronic conditions. It is frequently preferred in rehabilitation centres, emergency care units, nursing homes, elderly care centres, paediatrics, psychiatry, obstetrics and gynaecology clinics. Reiki can be applied by trained practitioners such as health professionals who have received first level reiki training in hospitals and clinics, caregivers or patients themselves. Reiki can be administered from with the patient or remotely when the patient and practitioner are in separate locations. Both types of Reiki are based on the premise of a universal source of healing energy that the Reiki practitioner can channel through intention.

For me, this begs the questions:

  • If all of this were true, why do we need a study?
  • If anyone believes such BS, are they the ideal people to conduct a study of Reiki?

Anyway, we should ask why this study generated a positive result. The most plausible explanation is that, as the study was not blind, the Reiki healers managed to maximise patient expectation. This, in turn, has generated a placebo respose which affected the subjective outcome measures. In other words, Reiki has no specific effect but patients tend to improve because of non-specific effects.

This review aimed to assess the therapeutic efficacy of Reiki therapy in alleviating anxiety.

In adherence to academic standards, a thorough search was conducted across esteemed databases such as PubMed, Web of Science, Science Direct, and the Cochrane Library. The primary objective of this search was to pinpoint peer-reviewed articles published in English that satisfied specific criteria: (1) employing an experimental or quasi-experimental study design, (2) incorporating Reiki therapy as the independent variable, (3) encompassing diverse patient populations along with healthy individuals, and (4) assessing anxiety as the measured outcome.

The study involved 824 participants, all of whom were aged 18 years or older. Reiki therapy was found to have a significant effect on anxiety intervention(SMD=-0.82, 95CI -1.29∼-0.36, P = 0.001). Subgroup analysis indicated that the types of subjects (chronically ill individuals and the general adult population) and the dosage/frequency of the intervention (≤ 3 sessions and 6–8 sessions) were significant factors influencing the variability in anxiety reduction.

The authors concluded that short-term Reiki therapy interventions of ≤ 3 sessions and 6–8 sessions have demonstrated effectiveness in reducing health and procedural anxiety in patients with chronic conditions such as gastrointestinal endoscopy inflammation, fibromyalgia, and depression, as well as in the general population. It is important to note that the efficacy of Reiki therapy in decreasing preoperative anxiety and death-related anxiety in preoperative patients and cancer patients is somewhat less consistent. These discrepancies may be attributed to individual pathophysiological states, psychological conditions, and treatment expectations.

_______________________

This is a truly stunning finding considering that few treatments are less plausible that Reiki. I strongly suspect that these conclusions are not tenable. To see whether this is true, we must look at the primary studies (tedious, I know, but can’t be helped). Here are the abstracts of the 13 studies included in this review:

STUDY No 1

Purpose: The purpose of the study was to investigate changes in the anxiety levels of patients receiving preoperative Reiki.

Material and methods: This study used a quasi-experimental model with a pretest-posttest control group.

Methods: Subjects (n = 210) were recruited from a hospital in Turkey, from June 2013 to July 2014. Subjects were then assigned to experimental (n = 105) and control (n = 105) groups.

Results: The level of anxiety of experimental group patients did not change according to their state anxiety scores (p > 0.10); however, the anxiety level of control group patients increased (p < 0.001).

Conclusion: The results of this study imply that the administration of Reiki is effective in controlling preoperative anxiety levels and in preventing them from increasing.

I am not sure what is meant by “a quasi-experimental model with pretest- posttest control group”. Yet, I suspect this was not a properly randomised trial and should thus have been exclused from the review. There was no control of placebo effects.

STUDY No 2

Fatigue is an extremely common side effect experienced during cancer treatment and recovery. Limited research has investigated strategies stemming from complementary and alternative medicine to reduce cancer-related fatigue. This research examined the effects of Reiki, a type of energy touch therapy, on fatigue, pain, anxiety, and overall quality of life. This study was a counterbalanced crossover trial of 2 conditions: (1) in the Reiki condition, participants received Reiki for 5 consecutive daily sessions, followed by a 1-week washout monitoring period of no treatments, then 2 additional Reiki sessions, and finally 2 weeks of no treatments, and (2) in the rest condition, participants rested for approximately 1 hour each day for 5 consecutive days, followed by a 1-week washout monitoring period of no scheduled resting and an additional week of no treatments. In both conditions, participants completed questionnaires investigating cancer-related fatigue (Functional Assessment of Cancer Therapy Fatigue subscale [FACT-F]) and overall quality of life (Functional Assessment of Cancer Therapy, General Version [FACT-G]) before and after all Reiki or resting sessions. They also completed a visual analog scale (Edmonton Symptom Assessment System [ESAS]) assessing daily tiredness, pain, and anxiety before and after each session of Reiki or rest. Sixteen patients (13 women) participated in the trial: 8 were randomized to each order of conditions (Reiki then rest; rest then Reiki). They were screened for fatigue on the ESAS tiredness item, and those scoring greater than 3 on the 0 to 10 scale were eligible for the study. They were diagnosed with a variety of cancers, most commonly colorectal (62.5%) cancer, and had a median age of 59 years. Fatigue on the FACT-F decreased within the Reiki condition (P=.05) over the course of all 7 treatments. In addition, participants in the Reiki condition experienced significant improvements in quality of life (FACT-G) compared to those in the resting condition (P <.05). On daily assessments (ESAS) in the Reiki condition, presession 1 versus postsession 5 scores indicated significant decreases in tiredness (P <.001), pain (P <.005), and anxiety (P<.01), which were not seen in the resting condition. Future research should further investigate the impact of Reiki using more highly controlled designs that include a sham Reiki condition and larger sample sizes.

This was a pilot study which should not report efficacy outcomes merely test the feasibility of a definitive trial. There was no control of placebo effects.

STUDY No 3

Purpose: This study’s aim is to determine the effect of Reiki when applied before upper gastrointestinal endoscopy on levels of anxiety, stress, and comfort.

Design: This single-blind, a pretest and post-test design, randomized, sham-controlled study was held between February and July 2021.

Methods: Patients who met the inclusion criteria were separated by randomization into three groups: Reiki, sham Reiki, and control. A total of 159 patients participated in the study. In the intervention groups (Reiki and sham Reiki), Reiki and sham Reiki were applied once for approximately 20 to 25 minutes before gastrointestinal endoscopy.

Findings: When the Reiki group was compared to the sham Reiki and control groups following the intervention, the decrease in the levels of patient stress (P < .001) and anxiety (P < .001) and the increase in patient comfort (P < .001) were found to be statistically significant.

Conclusions: Reiki applied to patients before upper gastrointestinal endoscopy was effective in reducing stress and anxiety and in increasing comfort.

Here an attempt was made to control for placebo effects and to blind patients. Whether the latter was successful was not tested. Thus a placebo effects cannot be excluded.

STUDY No 4

The purpose of this study was to evaluate the effect of Reiki as an alternative and complementary approach to treating community-dwelling older adults who experience pain, depression, and/or anxiety. Participants (N = 20) were randomly assigned to either an experimental or wait list control group. The pre- and posttest measures included the Hamilton Anxiety Scale, Geriatric Depression Scale-Short Form, Faces Pain Scale, and heart rate and blood pressure. The research design included an experimental component to examine changes in these measures and a descriptive component (semi-structured interview) to elicit information about the experience of having Reiki treatments. Significant differences were observed between the experimental and treatment groups on measures of pain, depression, and anxiety; no changes in heart rate and blood pressure were noted. Content analysis of treatment notes and interviews revealed five broad categories of responses: Relaxation; Improved Physical Symptoms, Mood, and Well-Being; Curiosity and a Desire to Learn More; Enhanced Self-Care; and Sensory and Cognitive Responses to Reiki.

No attempt to control for placebo effects.

STUDY No 5

Purpose: The purpose of this randomized pilot was to determine feasibility of testing Reiki, a complementary therapy intervention, for women undergoing breast biopsy (BB).

Background: Increasingly women face the possibility of BB, the definitive test for breast cancer. Psychological distress associated with BB includes anxiety and depression. Reiki was proposed as an intervention to decrease anxiety and promote relaxation.

Method: Thirty-two women scheduled for BB were randomized to Reiki intervention versus conventional care control. Anxiety and depression were evaluated using self-report questionnaires.

Findings: Analysis found no significant mean differences between groups over time. Comparably low baseline anxiety levels (possible selection bias) decreased naturally with time allowing little room for observing treatment effect.

Conclusions: Reiki, when administered in the naturalistic setting of a complementary therapy office, did not suggest evidence of efficacy. An intervention offered within the bounds of the conventional care setting may be more feasible for addressing BB distress.

The study failed to produce a positive finding.

STUDY No 6

The aim of this study was to investigate the effect of Reiki on pain, anxiety, and hemodynamic parameters on postoperative days 1 and 2 in patients who had undergone cesarean delivery. The design of this study was a randomized, controlled clinical trial. The study took place between February and July 2011 in the Obstetrical Unit at Odemis Public Hospital in Izmir, Turkey. Ninety patients equalized by age and number of births were randomly assigned to either a Reiki group or a control group (a rest without treatment). Treatment applied to both groups in the first 24 and 48 hours after delivery for a total of 30 minutes to 10 identified regions of the body for 3 minutes each. Reiki was applied for 2 days once a day (in the first 24 and 48 hours) within 4-8 hours of the administration of standard analgesic, which was administered intravenously by a nurse. A visual analog scale and the State Anxiety Inventory were used to measure pain and anxiety. Hemodynamic parameters, including blood pressure (systolic and diastolic), pulse and breathing rates, and analgesic requirements also were recorded. Statistically significant differences in pain intensity (p = .000), anxiety value (p = .000), and breathing rate (p = .000) measured over time were found between the two groups. There was a statistically significant difference between the two groups in the time (p = .000) and number (p = .000) of analgesics needed after Reiki application and a rest without treatment. Results showed that Reiki application reduced the intensity of pain, the value of anxiety, and the breathing rate, as well as the need for and number of analgesics. However, it did not affect blood pressure or pulse rate. Reiki application as a nursing intervention is recommended as a pain and anxiety-relieving method in women after cesarean delivery.

No control for placebo effects.

STUDY No 7

Objective: to evaluate the effectiveness of massage and reiki in the reduction of stress and anxiety in clients at the Institute for Integrated and Oriental Therapy in Sao Paulo (Brazil).

Method: clinical tests randomly done in parallel with an initial sample of 122 people divided into three groups: Massage + Rest (G1), Massage + Reiki (G2) and a Control group without intervention (G3). The Stress Systems list and the Trace State Anxiety Inventory were used to evaluate the groups at the start and after 8 sessions (1 month), during 2015.

Results: there were statistical differences (p = 0.000) according to the ANOVA (Analysis of Variance) for the stress amongst the groups 2 and 3 (p = 0.014) with a 33% reductions and a Cohen of 0.78. In relation to anxiety-state, there was a reduction in the intervention groups compared with the control group (p < 0.01) with a 21% reduction in group 2 (Cohen of 1.18) and a 16% reduction for group 1 (Cohen of 1.14).

Conclusion: Massage + Reiki produced better results amongst the groups and the conclusion is for further studies to be done with the use of a placebo group to evaluate the impact of the technique separate from other techniques.

No control for placebo effects.

STUDY No 8

This randomized controlled study aimed to determine the effect of Reiki and aromatherapy on vital signs, oxygen saturation, and anxiety level in patients undergoing upper gastrointestinal endoscopy. The sample consisted of 100 patients divided into Reiki (n = 34), aromatherapy (n = 33), and control (n = 33) groups. Data were collected 3 times (before, during, and after the procedure) using a descriptive characteristics questionnaire, a follow-up form, and the State Anxiety Subscale. The Reiki group had a mean State Anxiety Subscale score of 53.59 ± 2.98 and 43.94 ± 4.31 before and after the procedure, respectively. The aromatherapy group had a mean State Anxiety Subscale score of 54.03 ± 4.03 and 43.85 ± 3.91 before and after the procedure, respectively. The control group had a mean State Anxiety Subscale score of 38.79 ± 4.68 and 53.30 ± 7.26 before and after the procedure, respectively (P < .05). The results showed that the Reiki and aromatherapy groups had significantly lower State Anxiety Subscale scores than the control group after the procedure, indicating that Reiki and aromatherapy help reduce anxiety levels. There was a significant difference in the mean respiratory rates and oxygen saturation levels between the groups (P < .05). In conclusion, patients who do Reiki or undergo aromatherapy are less likely to experience anxiety before upper gastrointestinal endoscopy.

No control for placebo effects.

STUDY No 9

The aim of this study is to investigate the effects of Reiki application on pain, anxiety, and quality of life in patients with fibromyalgia. The study was completed with a total of 50 patients: 25 in the experimental group and 25 in the control group. Reiki was applied to the experimental group and sham Reiki to the control group once a week for 4 weeks. Data were collected from the participants using the Information Form, Visual Analog Scale, McGill-Melzack Pain Questionnaire, State-Trait Anxiety Inventory, and Short Form-36. There was a significant difference between the mean Visual Analog Scale pain scores during and before the first week (P = .012), second week (P = .002), and fourth week (P = .020) measurements of the individuals in the experimental and control groups, after application. In addition, at the end of the 4-week period, the State Anxiety Inventory (P = .005) and the Trait Anxiety Inventory (P = .003) were significantly decreased in the Reiki group compared with the control group. Physical function (P = .000), energy (P = .009), mental health (P = .018), and pain (P = .029) subdimension scores of quality of life in the Reiki group increased significantly compared with the control group. Reiki application to patients with fibromyalgia may have positive effects on reducing pain, improving quality of life, and reducing state and trait anxiety levels.

Here an attempt was made to control for placebo effects and to blind patients. Whether the latter was successful was not tested. Thus a placebo effects cannot be excluded. The sample size was small.

STUDY No 10

Background: Reiki is a biofield therapy which is based on the explanatory model that the fields of energy and information of living systems can be influenced to promote relaxation and stimulate a healing response.

Objective: To conduct a pragmatic within-subject pilot trial of a remote Reiki program for frontline healthcare workers’ health-related symptoms during the COVID-19 pandemic.

Methods: Healthcare professionals in the UK (eg, physicians, nurses, and paramedics) were eligible to sign up for a distance Reiki program and were also invited to participate in the research study. Eight Reiki practitioners simultaneously gave each participant Reiki remotely for 20 minutes on 4 consecutive days. Feasibility of the research was assessed, including recruitment, data completeness, acceptability and intervention fidelity, and preliminary evaluation of changes in outcome measures. Participants’ stress, anxiety, pain, wellbeing, and sleep quality were evaluated with 7-point numerical rating scales. Measures were completed when signing up to receive Reiki (pre) and following the final Reiki session (post). Pre and post data were analyzed using Wilcoxon signed ranks tests.

Results: Seventy-nine healthcare professionals signed up to receive Reiki and took the baseline measures. Of those, 40 completed post-measures after the 4-day intervention and were therefore included in the pre-post analysis. Most participants were female (97.5%), and the mean age was 43.9 years old (standard deviations = 11.2). The study was feasible to conduct, with satisfactory recruitment, data completeness, acceptability, and fidelity. Wilcoxon signed ranks tests revealed statistically significant decreases in stress (M = -2.33; P < .001), anxiety (M = -2.79; P < .001) and pain (M = -.79; P < .001), and significant increases in wellbeing (M = -1.79; P < .001) and sleep quality (M = -1.33; P = .019).

Conclusions: The Reiki program was feasible and was associated with decreased stress, anxiety and pain, and increased wellbeing and sleep quality in frontline healthcare workers impacted by the COVID-19 pandemic.

Pilot study should not report efficacy findings and should be excluded.

STUDY No 11

Background: There is a scarcity of studies in the international literature regarding alternative treatment to the pharmacological and psychotherapeutic intervention in the face of depression symptoms. This study aimed to test a protocol based on natural therapy, alternatives to pharmacological and psychotherapeutic, through Mindfulness Meditation, Reiki, Acupuncture and Auriculotherapy, to treat the symptoms of depression for those who were with no pharmacological or psychotherapeutic treatment for these symptoms.

Methods: this is a randomized single-blind controlled pilot study. The final sample was 21 participants divided in two groups: experimental and control. Participants were evaluated by validated instruments during the screening process and after the intervention. The instruments were: Depression, Anxiety and Stress Scale and Beck Depression Inventory. Intervention was performed in eight sessions, during two months. All the techniques were used in the experimental group. Analysis of variance with repeated measures was used to compare pre-intervention to post-intervention moments.

Results: the result of analysis indicates a significant reduction in the symptoms of depression after the intervention among the experimental group.

Limitations: there is no way to determine which of the techniques used produced the most significant result.

Conclusions: The protocol proposed in this study was effective in reducing the symptoms of depression to whom are not eligible for traditional treatment.

This is a pilot study and should not report efficacy findings. It is also not a study of just Reiki. It should have been excluded.

STUDY No 12

This is a constructive replication of a previous trial conducted by Bowden et al. (2010), where students who had received Reiki demonstrated greater health and mood benefits than those who received no Reiki. The current study examined impact on anxiety/depression. 40 university students-half with high depression and/or anxiety and half with low depression and/or anxiety-were randomly assigned to receive Reiki or to a non-Reiki control group. Participants experienced six 30-minute sessions over a period of two to eight weeks, where they were blind to whether noncontact Reiki was administered as their attention was absorbed in a guided relaxation. The efficacy of the intervention was assessed pre-post intervention and at five-week follow-up by self-report measures of mood, illness symptoms, and sleep. The participants with high anxiety and/or depression who received Reiki showed a progressive improvement in overall mood, which was significantly better at five-week follow-up, while no change was seen in the controls. While the Reiki group did not demonstrate the comparatively greater reduction in symptoms of illness seen in our earlier study, the findings of both studies suggest that Reiki may benefit mood.

No control for placebo effects

STUDY No 13

This is a constructive replication of a previous trial conducted by Bowden et al. (2010), where students who had received Reiki demonstrated greater health and mood benefits than those who received no Reiki. The current study examined impact on anxiety/depression. 40 university students-half with high depression and/or anxiety and half with low depression and/or anxiety-were randomly assigned to receive Reiki or to a non-Reiki control group. Participants experienced six 30-minute sessions over a period of two to eight weeks, where they were blind to whether noncontact Reiki was administered as their attention was absorbed in a guided relaxation. The efficacy of the intervention was assessed pre-post intervention and at five-week follow-up by self-report measures of mood, illness symptoms, and sleep. The participants with high anxiety and/or depression who received Reiki showed a progressive improvement in overall mood, which was significantly better at five-week follow-up, while no change was seen in the controls. While the Reiki group did not demonstrate the comparatively greater reduction in symptoms of illness seen in our earlier study, the findings of both studies suggest that Reiki may benefit mood.

This is the only rigorous study included in the review. Its findings are not easy to interpret (“For the sample as a whole, as can be seen from the total group means, there was little change over the course of the study”)

__________________________

Even though I did not have access to the full text of all of these RCTs, this analysis tells me a few important things; here are some of the main points I discovered:

  • the new review is fatally flawed;
  • the authors’ statement that their “article presents a systematic review of randomized controlled trials (RCTs) that were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines” is nonsensical;
  • PRISMA guidelines were certainly not adhered to;
  • there is no truly critical assessment of the primary studies;
  • the literature searches were incomplete;
  • the risk of bias tool for evaluating the primary studies was employed incorrectly;
  • the review did not include all RCTs of Reiki (our own 2008 review included several trials that are not included here, and this blog has a few more);
  • the review includes several studies that should have been excluded;
  • most Reiki studies are of poor quality;
  • with both the review and most of the primary studies, one feels a strong bias towards trying to prove that Reiki works;
  • Reiki research is firmly in the hands of nurses (almost all the studies were conducted by nurses);
  • almost all of the RCTs test Reiki versus no treatment, and this means that most do not control for placebo (or other non-specific) effects. In other words, the conclusions stating that Reiki is effective are simply wrong.

I am dismayed to see that a decent journal (BMC Palliative Care) published such a fatally flawed review. The paper fails to discuss any of its obvious flaws. Specifically, it does not even specify what interventions were used in the various control groups. Do the journal editors, peer-reviewers and authors not appreciate that, without such information, the findings are uninterpretable? Or do they perhaps deliberately try to mislead us?

If you ask me, this paper should be best withdrawn.

Our own review of Reiki is no longer up-to-date. Yet, it’s conclusion is, in my view, far more accurate than the one offered by the authors of the fatally flawed new review:

the evidence is insufficient to suggest that reiki is an effective treatment for any condition. Therefore the value of reiki remains unproven.

This randomized controlled, pretest-post-test intervention study examined the effect of distance reiki on state test anxiety and test performance.
First-year nursing students (n = 71) were randomized into two groups. One week before the examination,

  • the intervention group participants received reiki remotely for 20 minutes for 4 consecutive days,
  • the control group participants received no intervention.
The intervention group had lower posttest cognitive and psychosocial subscale scores than pretest scores (p > .05). The control group had a significantly higher mean posttest physiological subscale score than pretest score (p < .05). Final grade point averages were not significantly different between the intervention and control groups (p > .05). One quarter of the intervention group participants noted reiki reduced their stress and helped them perform better on the examination.The authors concluded that Reiki is a safe and easy-to-practice method to help students cope with test anxiety.What a conclusion!What a study!

A controlled clinical trial has the purpose of comparing outcomes of two or more treatments. Therefore, intra-group changes are utterly irrelevant. The only thing of interest is the comparison between the intervention and control groups. In the present study, this did not show a significant difference. In other words, distant Reiki had no effect.

This means that the bit in the conclusion telling us that Reiki helps students cope with test anxiety is quite simply not true.

This leaves us with the first part of the conclusion: Reiki is a safe and easy-to-practice method. This may well be true – yet it is meaningless. Apart from the fact that the study was not aimed at assessing safety or ease of practice, the statement is true for far too many things to be meaningful, e.g.:

  • Not having Reiki (the control group) is a safe and easy-to-practice method.
  • Going for a walk is a safe and easy-to-practice method.
  • Cooking a plate of spagetti is a safe and easy-to-practice method.
  • Having a nap is a safe and easy-to-practice method.
  • Reading a book is a safe and easy-to-practice method.

(I think you get my gist)

To make the irony complete, let me tell you that this trial was published in Journal of Nursing Education. On the website, the journal states: The Journal of Nursing Education is a monthly, peer-reviewed journal publishing original articles and new ideas for nurse educators in various types and levels of nursing programs for over 60 years. The Journal enhances the teaching-learning process, promotes curriculum development, and stimulates creative innovation and research in nursing education.

I suggest that the journal urgently embarks on a program of educating its editors, reviewers, contributors and readers about science, pseudoscience, minimal standards, scientific rigor, and medical ethics.

 

 

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