a systematic review of the therapeutic effects of reiki · reiki practice is administered through a...
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Original Articles
A Systematic Review of the Therapeutic Effects of Reiki
Sondra vanderVaart, H.B.Sc., M.B.A.,1,2 Violette M.G.J. Gijsen, M.Sc.,2
Saskia N. de Wildt, M.D., Ph.D.,2,3 and Gideon Koren, M.D., F.R.C.P.C., F.A.C.M.T.1,2,4
Abstract
Introduction: Reiki is an ancient form of Japanese healing. While this healing method is widely used for a varietyof psychologic and physical symptoms, evidence of its effectiveness is scarce and conflicting. The purpose of thissystematic review was to try to evaluate whether Reiki produces a significant treatment effect.Methods: Studies were identified using an electronic search of Medline, EMBASE, Cochrane Library, and GoogleScholar. Quality of reporting was evaluated using a modified CONSORT Criteria for Herbal Interventions, whilemethodological quality was assessed using the Jadad Quality score.Data extraction: Two (2) researchers selected articles based on the following features: placebo or other adequatecontrol, clinical investigation on humans, intervention using a Reiki practitioner, and published in English. Theyindependently extracted data on study design, inclusion criteria, type of control, sample size, result, and natureof outcome measures.Results: The modified CONSORT Criteria indicated that all 12 trials meeting the inclusion criteria were lackingin at least one of the three key areas of randomization, blinding, and accountability of all patients, indicating alow quality of reporting. Nine (9) of the 12 trials detected a significant therapeutic effect of the Reiki intervention;however, using the Jadad Quality score, 11 of the 12 studies ranked ‘‘poor.’’Conclusions: The serious methodological and reporting limitations of limited existing Reiki studies preclude adefinitive conclusion on its effectiveness. High-quality randomized controlled trials are needed to address theeffectiveness of Reiki over placebo.
Introduction
There is growing interest in complementary and alter-native medicine (CAM). The National Center for Com-
plementary and Alternative Medicine (NCCAM) describesCAM as ‘‘a group of diverse medical and health care systems,practices, and products that are currently not part of con-ventional medicine.’’1,2 Canadians spent an estimated $5.6billion dollars out of pocket for CAM expenditures in the 12months ending June 2006 compared to almost $2.8 billion in1997.3 Both Gordon4 and Schiller 5 suggest that the awareness,use, and integration of CAM are beginning to shift from themarginal fringes to the mainstream of care.6
In a 2007 NCCAM survey, 0.5% of the United States gen-eral adult population reported having used Reiki therapy.1,7
Reiki is a therapy that claims to provide healing energy torecharge and rebalance the human energy fields, creatingoptimal conditions needed by the body’s natural healing
system.6 Reiki, which is the Japanese term for ‘‘universal lifeenergy,’’ is believed to have originated thousands of yearsago in Tibet and was re-established in the 1800s after havingbeen forgotten, by Dr. Mikao Usui, a Japanese monk.
Energy-based healing interventions have been foundthroughout history:
� Hippocrates referenced the ‘‘biofield’’ of energy flowfrom people’s hands,
� The Indian Chakra system is based on energy centers inthe body, and
� Eastern energy practices such as qigong rely on thebreath to balance the body’s energy field
Studies have suggested that Reiki, classified by theNCCAM as a biofield energy therapy, reduces anxiety anddepression and increases relaxation and comfort.6,8 Also,Reiki is now widely used, mostly outside of mainstreammedicine, to relieve pain, especially postoperative pain, and
1Department of Pharmacy, University of Toronto, Toronto, Ontario, Canada.2Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada.3Department of Pediatric Surgery, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands.4Ivey Chair in Molecular Toxicology, Department of Medicine, University of Western Ontario, London, Ontario, Canada.Both the first and second authors contributed equally to the analyses completed in this article. S.V. drafted this article, V.G. extracted the
publications, and S.N.W. initiated the research described in this article. All authors contributed with feedback and revisions.
THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINEVolume 15, Number 11, 2009, pp. 1157–1169ª Mary Ann Liebert, Inc.DOI: 10.1089=acm.2009.0036
1157
to facilitate patient recovery. Reiki practice is administeredthrough a gentle laying on of hands, or in absentia (i.e., re-mote Reiki where the Reiki practitioner is not present). Bothtypes of practice are based on the assumption that the Reikipractitioner maintains a meditative presence and allows theReiki energy to flow to where the patient needs it, in anondirected and nondiagnostic manner.6
Reiki is typically taught in three levels (sometimes four, asthe third level can be broken into part I and part II).9 Thefocus of Reiki Level I is on recovering the natural healingabilities of the body. Reiki Level II teaches a deeper under-standing of the energetic flow and introduces symbols to aidin treatment efficacy. The third level, Reiki Master, is almostcompletely focused on the inner spiritual development of theReiki practitioner and most of the practices at this levelconcern themselves with the development of spiritual con-sciousness. Reiki Master training also focuses on the devel-opment of the skills needed to teach this work to other Reikistudents. A necessary step in all levels is an ‘‘attunement’’ bya Reiki Master. The attunement (or initiation) process allowsthe Reiki energy to flow from the Reiki practitioner’s handsto the patient. Without an attunement from a Reiki Master, aperson cannot be said to be practicing Reiki, even if theylearn the technical aspects of where to put their hands.
Energy-based healing encompasses a belief in a greaterhealing force and is inherent in many cultures. For example,healing approaches of the indigenous people of China, Tibet,Africa, Native America, and India are thought to work becauseof the members’ belief in the expectation of healing.10 However,these cultures maintain that healing, like illness, is not limitedto those who believe in it, and that an illness is the result of ablockage in one’s energy field. By introducing an energy-basedintervention, the energy blockage is believed to be removedand this is believed to serve to rebalance the body’s energyfield, which in turn rebalances the physical body.10
If there is more to healing than belief, these effects shouldbe able to be measured. Current scientific thinking indicatesthat the best way to measure the true effect of a biomedicalintervention requires proper randomization, control, blind-ing, and concealment. These processes decrease the likeli-hood of bias and ensure internal study validity to helpdetermine whether healing claims are more than belief.10
While Reiki itself is not a biomedical intervention, it is usedin the treatment of a variety of psychologic and physicalsymptoms, which might otherwise be treated with biomed-ical interventions (e.g., pharmaceutical substances). In thisregard, its efficacy needs to be proven.
Reiki proposes to heal the whole patient, and is not directedsolely to cure=relieve a single ailment. This whole systemhealing may require advanced techniques, such as nestedqualitative research within a randomized controlled trial(RCT) to measure its effectiveness.11 Given the complexity ofmeasuring such effects, well-designed, well-executed clinicaltrials are a prerequisite, and any intentional deviations fromthe accepted ‘‘gold standard’’ RCT should be documented andexplained.
Presently, despite increased interest and awareness, theresults of specific studies on Reiki are inconclusive. The ob-jectives of this systematic review were to (1) evaluate thequality of reporting of clinical trials using Reiki as thetreatment modality and (2) evaluate the quality of existingevidence on the efficacy of Reiki in humans.
Methods
Literature review
Studies were identified by an electronic search of theMedline, EMBASE, and the Cochrane Library databasesfrom their inception to the end of December 2008. The fol-lowing search terms (Fig. 1) were employed in MEDLINE�:
FIG. 1. Flow diagram of selection process.
1158 VANDERVAART ET AL.
Reiki, Reiki AND randomized controlled trial, Reiki ANDclinical trial, Reiki AND clinical, Reiki AND trial. In EMBASEthe following terms were used: Reiki.mp, Reiki AND ran-domized controlled trial, Reiki AND clinical trial. We em-ployed the additional search terms to eliminate all the studiesthat were not clinical trials. We also used Google and GoogleScholar to identify any articles or other publications that mayhave been missed. The reference lists of the selected articleswere checked for additional studies that were not originallyfound in the search. In addition, given Reiki’s Japanese ori-gins, Medline and EMBASE were searched for Reiki studiespublished in Japanese; however, none were found.
Study selection and data extraction
Two researchers (S.V., V.G.) independently reviewed thelist of unique articles for studies that fit the inclusion criteria(see below). The researchers were not blinded to the reportname or author. Studies were selected based on the followinginclusion criteria:
1. Presence of test group and control group (using eitherplacebo, crossover, sham, or normal care)
2. Human subjects3. A Reiki healer being responsible for the intervention4. English language5. Studies published up to December 2008.
Uncertainties over study inclusion were discussed be-tween the researchers and resolved through consensus.
Quality assessment
Each study was assessed on whether or not it reported astatistically significant outcome measure for the Reiki inter-vention group. Each study was evaluated and counted onlyonce regardless of how many statistically significant out-come measures it reported. The raw count was used to de-termine the percentage of studies yielding a statisticallysignificant outcome.
We evaluated the accepted studies using a modifiedCONSORT (Consolidated Standards of Reporting Trials) Criteriafor Herbal Interventions.12 The original CONSORT was de-veloped by a group of scientists and editors to improve thequality of reporting of RCTs.13 The CONSORT for HerbalInterventions was developed to aid editors and reviewers inassessing the internal=external validity and reproducibilityof herbal medicine trials, allowing an accurate assessment ofsafety and efficacy.12 The authors chose the CONSORT forHerbal Interventions (HI) because it specifically breaks outimportant details about the Intervention, which adds im-portant information about the Reiki trials. For example, theCONSORT for HI specifically details (1) dosage and fre-quency: Interpreted as how long the Reiki session lasted, andhow many Reiki sessions were given; (2) practitioner: Whatis the level of training of the Reiki practitioner as well as thenumber of years of experience; (3) placebo or control: Reiki isusually administered by having a person present in a roomwith a patient (except not in the case of distant Reiki). Reikiplacebo is important in determining whether the patientsand assessors were blinded.
One researcher (S.V.) modified the herbal dosage compo-nents of the CONSORT for HI, to reflect the Reiki practi-tioner as the intervention instead of the herb (see Table 1
Original CONSORT for HI and Table 2 for modifiedCONSORT for HI).
For each CONSORT criterion, the 2 researchers indepen-dently assessed whether the reporting was adequate or notand scored the criterion as: Y (yes), N (no), P (partial), or NA(not applicable). We identified items that were adequately ornot adequately reported according to the CONSORT defini-tion of what is required for each item.
We considered the percentage of affirmative answers asthe raw score for the internal validity. A percentage calcu-lation was used to determine the proportion of CONSORTcriteria that are adequately addressed. Items that were ratedas NA were excluded from the analysis.
To assess the methodological quality of existing Reikistudies, we used the Jadad score. The Jadad score is themethod most authors use to assess methodological quality.14
This validated score ranges between 0 and 5. Studies arescored according to the presence of the three key methodo-logical features of randomization, blinding, and account-ability of all patients, including withdrawals (essentiallysubsets of the greater CONSORT criteria). Criteria are givena ‘‘0’’ or ‘‘1’’ score based on the absence or presence of thecriteria. Scores are interpreted as: 0–2: poor methodologicalquality; 3–4 good methodological quality; and 5 excellentmethodological quality.15
Results
A total of 485 unique articles were identified using Reiki asthe only search term. To limit the articles to clinical trialsonly, we employed additional search terms as describedabove. As a result, study count was reduced to 76 (Fig. 1).The majority of these studies were either (a) small studieswith no control arm, (b) descriptive case studies whereresearchers described a single patient Reiki interventionand=or recounted its history, or (c) studies using TherapeuticTouch (a similar but distinct therapy) and thus were ex-cluded. Thirteen (13) studies fulfilled the aforementionedinclusion criteria. One study16 was removed from the anal-ysis because the intervention included two different typesof practitioners (Reiki and Le Shan) and thus the results ofthe Reiki practitioner could not be isolated. This left a total of12 studies to analyze.
Since four of the studies did not indicate the level of ex-perience and=or the number of years of experience of theReiki practitioner, the researchers attempted to contact theprimary authors to obtain this information. The researcherswere successful in contacting two of the authors,17,18 andunsuccessful with authors for two of the studies.19,20
All of the studies differed in their studied populations andoutcome measures. Of the 12 studies, 3 studies administeredReiki for physiological symptoms such as stroke recovery,seizure rate and heart rate and 9 studies administered Reikifor psychological symptoms such as anxiety and depression.A total of 31 different outcome measures were evaluated inthe trials, none of which were used in more than 3 studies(Table 3). Hence, the heterogeneity of the studies’ outcomesprecluded a formal meta-analysis.
CONSORT reporting quality: Findings
The evaluators disagreed in 33% of the evaluations, withthe majority of the disagreements resulting from a difference
SYSTEMATIC REVIEW OF THERAPEUTIC EFFECTS OF REIKI 1159
Table 1. Original CONSORT Criteria for Herbal Interventions
Consort no. CONSORT criteria Definition
Title and abstract1 Word ‘‘random’’ or ‘‘randomization’’ used Word ‘‘random’’ or ‘‘randomized’’ mentioned
Introduction2 Background (nature, scope, severity of problem) Nature, scope, and severity of problem
Methods3a Participants (eligibility) Eligibility criteria for participants (must include exclusion
criteria)3b Participants (setting and locations) Settings and locations of participant interventions4a Intervention–Herbal medicine product name Latin binomial name4b Intervention–Characteristics of herbal product Type of product, concentration, method of authenticating
raw product4c Intervention–Dosage Description of type and frequency of herbal intervention4d Intervention–Qualitative testing Product’s chemical fingerprint and who performed the
analysis4e Intervention–Placebo=control Rationale for type of control=placebo used4e Intervention–practitioner Description of practitioner: Training and practice level and
years of experience5 Primary and secondary objectives defined Specific objectives and hypothesis6 Outcomes Clearly defined primary and secondary outcome measures6b Quality enhancement (if applicable) If applicable, methods used to enhance the quality of
measurements (e.g., multiple observers, training ofassessors)
7 Sample size determination How sample size was determined7b Interim analysis and stopping rules (if applicable) If applicable, explanation of interim results and stopping
rules8 Randomization sequence allocation Method used to generate the random sequence8b Details of restriction (if applicable) If applicable, details of restriction9 Allocation concealment Method used to implement the random allocation sequence
(e.g., numbered containers, central telephone)10 Who generated the allocation sequence? Who generated the allocation concealment10b Who enrolled the patients? Who enrolled patients10c Who assigned the patients to the groups? Who assigned patients to groups11 Blinding (were participants and therapists blinded?) Whether or not participants and therapists were blinded11b Blinding (were the assessors blinded?) Whether or not assessors were blinded11c How was success of blinding evaluated (if applicable) If applicable, how successful was blinding12 Statistical methods Statistical methods used to compare groups for primary
outcome(s)
Results13 Participant flow Flow of participants through each stage (diagram
recommended). For each group report number ofparticipants randomly assigned, receiving intendedtreatment, completing study protocol, and analyzedfor primary outcome.
13b Report of study violations (if applicable) Report study violations with reasons14 Recruitment Dates defining the periods of recruitment and follow-up15 Baseline data Baseline demographic and clinical characteristics of each
group (including concomitant medication, CAM use,etc.)
16 Numbers analyzed No. of participants in each group16b Was it intention-to-treat analysis? State whether analysis was ‘‘intention-to-treat’’ state
numbers in absolute (e.g., 10=20).17 Outcomes and estimations State summary of effect for each group and effect size17b Precision of the effect size State precision of the effect (i.e., 95% CI)18 If applicable, ancillary analysis stated in protocol? Address multiplicity by stating any other analyses
performed including subgroup analyses and adjustedanalyses
19 Adverse events (if applicable) State any adverse events or side-effects in each interventiongroup
Discussion20 Interpretation Interpretation of results taking into account study
hypothesis, source of potential bias, and dangersassociated with multiplicity of analyses
21 Generalizability External validity of trial results; explain how treatmentoffered is similar in self-care=practice
22 Overall evidence General interpretation of results in the context of currentevidence
CAM, complementary and alternative medicine; CI, confidence interval.
1160 VANDERVAART ET AL.
in interpretation in what constituted partial (p) versus full (y)rating for the CONSORT analysis. After consensus discus-sions, the remaining disagreements (1%) were resolved by athird researcher (S.N.W.).
The 12 trials that studied a Reiki intervention in either arandomized controlled fashion or as a test versus controlexperiment are presented in Table 3. Eight (8) of the 12studies identified themselves as RCTs. However, upon
analysis of each of the study’s text, the researchers were onlyable to identify 5 of the 12 (42%) publications as trueRCTs.20–24 Individual total applicable CONSORT criteriavaried by study (see Table 2 for an individualized reportingof each criterion and Table 3 for a summary of adequatelyreported criteria by study).
Fifteen percent (15%) of the CONSORT Criteria items werenot applicable for many of the trials (e.g., interim analyses,
Table 2. Study Scores
Itemno.
Individual studies Sum of studies
Consort no. CONSORT criteria 17 25 23 21 22 19 20 26 27 24 18 * Yes No Partly NA
Title and abstract1 Word ‘‘random’’ or ‘‘randomization’’ used 1 y n y n na na y y n y n y 6 4 0 2Introduction2 Background (nature, scope,
severity of problem)2 y y y p y p y y p y p p 7 0 5 0
Methods3a Participants (eligibility) 3 y y y y y y y y y y p y 11 0 1 03b Participants (setting and locations) 4 p y n p p y p p y p n p 3 2 7 04c Intervention–Dosage regimen 5 y y y y y p y y y y p y 10 0 2 04e Intervention–Control group 6 y y y y y y y y p y y y 11 0 1 04f Intervention–Practitioner 7 n y y p y n p y y y n y 7 3 2 05 Primary and secondary objectives defined 8 y y y y y y y y y y y y 12 0 0 06 Outcomes 9 p y p y n y y y y p y y 8 1 3 06b Quality enhancement of the
outcome measurement10 y y y y y y y y y y y y 12 0 0 0
7 Sample size determination 11 n y n y n n y y n n n n 4 8 0 07b Interim analysis and stopping rules
(if applicable)12 na na na na na na na na na na na na 0 0 0 12
8 Randomization sequence allocation 13 n n n y y n y n n n n y 4 8 0 08b Details of restriction (if applicable) 14 na na na na na na y na na y na y 3 0 0 99 Allocation concealment 15 n n p p n n y n n n n y 2 8 2 010 Who generated the allocation sequence? 16 n n n n y n y n n n n y 3 9 0 010b Who enrolled the patients? 17 n n n y y n y n n n n y 4 8 0 010c Who assigned the patents to the groups? 18 n n n n y n n n n n n n 1 11 0 011 Blinding (were participants blinded?) 19 y y y n n n n n n y y y 6 6 0 011b Blinding (were the assessors blinded?) 20 n n y p n n y n n n n y 3 8 1 011c Was success of blinding evaluated? 21 n y n na na na na na na n n n 1 5 0 612 Statistical methods 22 y p y y n y y y y y y y 10 1 1 0Results13 Participant flow 23 n p n p n n y y p y p p 3 4 5 013b Report of study violations (if applicable) 24 na na na p na n y y n p y y 4 2 2 414 Recruitment 25 n n n p n n y p n y n y 3 7 2 015 Demographic and clinical characteristics 26 y y p y n y y y p y y y 9 1 2 016 No. of participants in each group? 27 p y y y y y y y y y y y 11 0 1 016b Was it intention-to-treat analysis? 28 n y n n n n y y y y n n 5 7 0 017 Effect size for each group for each
outcome measure29 p p y p y y y y p p p y 6 0 6 0
17b Precision of the effect size 30 n p p p p n y p p p p p 1 2 9 018 If applicable, ancillary analysis
stated in protocol?31 na na na na na na na na na y na p 1 0 1 10
19 Adverse events (if applicable) 32 na na na na na na n na n n n n 0 5 0 7Discussion20 Discussion=interpretation 33 p y y y y y p y n y p y 8 1 3 021 Generalizability 34 p y y y y n y y n y p y 8 2 2 022 Overall evidence 35 n p n y p y y n n y n p 4 5 3 0
Sum 191 118 61 50Percent of applicable CONSORT
criteria (n¼ 370)52% 32% 16%
*Mauro MT. The effect of Reiki therapy on maternal anxiety associated with amniocentesis. Masters thesis. University of Alberta, School ofNursing, 2001.
NA, not applicable.
SYSTEMATIC REVIEW OF THERAPEUTIC EFFECTS OF REIKI 1161
randomization restrictions, ancillary analyses, blinding ofpractitioner). Items that were not applicable were not includedin the calculations. For the group of 12 studies evaluated in the35 item modified CONSORT checklist, over half of all items(52%) were reported adequately (Table 2). The remaining itemswere either not reported at all (32%) or reported partially (16%).
As a group, the 12 studies reported adequately the In-troduction, the beginning part of the Methods section
(CONSORT items 3–10), and most of the Results. Otherthan this, all the other sections were reported less thanadequately: Methods—randomization, concealment andblinding (CONSORT items 11–22: 39% of items reportedadequately); Results (specifically Intention-to-Treat: 42%adequately reported and Recruitment Dates: 25% adequatelyreported); and the Discussion section (56% of items reportedadequately).
Table 3. Study Type, Interventions, Outcomes, and Reporting Quality Based
on a Modified CONSORT-Based Checklist
Studyref. no. Type of triala
Comparison of intervention(whether Reiki … ) Outcome measure
Adequatelyreported
applicablecriteria
17 Test=control Produces changes in autonomicnervous system
Heart rate (HR), blood pressure (BP),cardiac vagal tone (CVT), cardiacsensitivity to baroreflex (CSB)and respiratory rate (RR)
10=30 (33%)
25 Test=control Aids in the recovery and rehabilitationin patients with subacute stroke
Functional Independence Measureand Depression (FIM), Centerfor Epidemiological Studies–Depression Scale (CES-D)
17=30 (57%)
23 RCT Reduces depression and stress Beck Depression Inventory (BDI),Beck Hopelessness Scale (HS),Perceived Stress Scale (PSS)
15=30 (50%)
21 RCT Reduces pain and improved qualityof life in patients with cancer
Visual Analogue Scale (VAS),Analgesic Use, BP, RR, HR
15=30 (50%)
22 RCT Reduces pain and anxiety in womenwith hysterectomies
State–Trait Anxiety Inventory(STAI), VAS
15=28 (54%)
19 Test=control Changes the isoprenoid pathwayin seizure patients
Hepatic hydroxymethyl glutarylCo-A reductase activity, serumdigoxin level
12=29 (41%)
20 RCT Reduces anxiety and depression inwomen undergoing breast biopsy
STAI, CES-D, Hospital Anxiety–Depression Scale (HADS)
27=32 (84%)
26 Pilot crossover Reduces cancer-related fatiguein patients with cancer
Edmonton System AssessmentSystem (ESAS); FunctionalAssessment of CancerTherapy–General (FACT-G)–Fatigue (FACT-F)
19=30 (63%)
27 Test=control Improves memory and behaviordeficiencies in patients withAlzheimer disease
Annotated Mini-Mental StateExamination (AMMSE) andRevised Memoryand Behavior ProblemsChecklist (RMBPC)
10=31 (32%)
24 RCT Reduces pain, anxiety, and depressionin chronically ill patients
General Information Questionnaire;Social Readjustment Rating Scale;McGill Pain Questionnaire; BDI II;STAI; Rotter I-E Scale; RosenbergSelf-Esteem Scale; Belief in PersonalControl Scale
20=34 (59%)
18 Test=control Reduces pain and improves mobilityin patient with painfuldiabetic neuropathy
McGill Pain Questionnaire; 6-minutewalk test; Epidemiology of DiabetesIntervention and ComplicationsQuality of Life Questionnaire; WellBeing Questionnaire; DiabetesTreatment Satisfaction Questionnaire
10=32 (31%)
* Pilot(test=control)
Reduces anxiety level of womenundergoing their first amniocentesis
Sheehan Patient-Related Anxiety Scale(SPRAS) and Subjective Unitof Disturbance Scale (SUDS)
24=34 (71%)
Total 194=370 (52%)
aAs determined by researchers after reviewing the study.*Mauro MT. The effect of Reiki therapy on maternal anxiety associated with amniocentesis. 2001. Masters Thesis. University of Alberta,
School of Nursing.
1162 VANDERVAART ET AL.
Individual studies ranged from 31% to 84% in adequa-tely reporting applicable criteria. Assessment scores for allCONSORT criteria in the 12 trials are shown in Table 3.
Items reported adequately
The 12 trials adequately reported issues that are defined inthe Introduction and beginning of Methods (all Methodsexcept for Randomization, Assignment, and Blinding). Theseinclude: Reiki historical context with supporting literature,problem definition, study objectives, participant eligibility,description of participants and control subjects, dosage reg-imen for intervention and differences from control grouptreatment, and quality enhancements undertaken to improveoutcome measurement. Over half the studies gave detailsabout the practitioner performing the intervention.
Select criteria from the Results and Comments sectionwere also adequately reported. These included: demographicand clinical characteristics of the groups, discussion, andgeneralization of the results. The number of patients in eachgroup was almost always explicitly stated. The majority ofstudies reported mean scores and p-values, but less than halfreported confidence intervals. The CONSORT criteria ex-plicitly state that reporting p-values alone is not sufficient.Researchers must report confidence intervals so that readerscan easily discern the overlap between mean scores.
Items seldom reported adequately
We identified major shortcomings in the reporting of theitems displayed in the latter part of the Methods section (i.e.,reporting the Randomization, Assignment, and Blinding).Only four trials20–22,* adequately detailed the randomizationprocess. Of those four trials, only two trials20,* described theconcealment of the allocation. For allocation concealment, weassumed that when no data were present, allocation was notconcealed. A distinction was made between the two trials20,*where allocation was clearly concealed and those wherethere is some mention of concealment, but it is unclearwhether this was achieved adequately.
Other examples of inadequate reporting: three trials20,22,*detailed who generated the allocation sequence and only onetrial22 specified who assigned the patients to their groups. Sixtrials17,18,23,24,25,* implemented blinding procedures for par-ticipants, but only one of them measured the success of theblinding.25 Three (3) trials20,21,23 mention blinding assessors.One trial (25) provided extensive background on the processand success of therapist blinding (for Reiki Level I practi-tioners) but only stated ‘‘patients were blinded’’ for the par-ticipant description. The CONSORT clearly states that thissentence is not enough to ensure that adequate blinding wasachieved. The researchers rated this criterion for this trial aspartially (p) adequately reported. In the other trials, maskingof the participants or the therapists was not achieved due to alack of a placebo arm (only a test and a control group).
Eight (8) trials identified specific primary outcome mea-sures, but of these trials only four studies20,21,25,26 provided afull rationale for sample-size calculation. On the basis of the
reported numbers in the whole participant flow, we inferredthat an intention-to-treat analysis was present in 5 of thetrials.20,24,25–27 Three (3) trials21,24,* mentioned the date rangeof the patient recruitment.
Jadad methodological quality: Findings
Based on the Jadad scores, 11 of the 12 studies were ratedas methodologically ‘‘poor’’ with one study (20) rated asgood. No studies were rated as ‘‘excellent’’ (Table 4).
Study results linked to level and experienceof Reiki practitioner
Of the 128 studies evaluated, 9 stated significant positivefindings on at least one outcome measure (not necessarilythe primary outcome, as this often was not stated), whilethe other 3 studies18,20,25 showed no significant outcomes(Table 5).
Of the three studies that showed no significant effect ofReiki, one25 utilized a Reiki Master and 14 Level I Reikipractitioners; one used multiple Reiki Masters18 and theother study20 utilized 6 Level I or II Reiki practitioners. Ofthe 9 studies that showed a significant positive Reiki effect, 8used a Reiki Master (or a Level II Reiki practitioner withmore than 3 years experience). For the remaining study,19 theresearchers were not successful in their attempts to contactthe author to determine the information (i.e., level of trainingor years of experience of the Reiki practitioner). As far as wecould tell, no significant positive findings were found withLevel I or II Reiki practitioners with less than 3 years ofexperience.
Discussion
Reiki use by patients in North America is growing; how-ever, as shown by our analysis, this trend is not supportedby adequate scientific data. There are few studies availableto evaluate the efficacy of Reiki. Moreover, the few studiesthat are available are almost invariably of poor quality.Our analysis shows that the most important aspects thatdetermine study quality (randomization, blinding, andaccountability of all patients) are not well reported, nor is
Table 4. Jadad Scores
Study reference no.
Item no. 17 25 23 21 22 19 20 26 27 24 18 *
1 1 0 1 0 0 0 1 1 1 1 1 12 0 0 0 1 1 0 1 0 0 0 0 13 0 1 0 0 0 0 0 0 0 0 0 04 0 1 1 0 0 0 0 0 0 0 0 05 0 1 0 1 0 0 1 1 1 0 1 06 0 0 0 0 0 0 0 0 0 0 0 07 0 �1 0 0 0 0 0 0 0 0 0 0
Total 1 2 2 2 1 0 3 2 2 1 2 2
Score interpretation:0–2 poor.3–4 good.5þ excellent.*Mauro MT. The effect of Reiki therapy on maternal anxiety
associated with amniocentesis. Masters thesis. University of Alberta,School of Nursing, 2001.
*Mauro MT. The effect of reiki therapy on maternal anxietyassociated with amniocentesis. 2001. Masters Thesis. Universityof Alberta, School of Nursing.
SYSTEMATIC REVIEW OF THERAPEUTIC EFFECTS OF REIKI 1163
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eef
fect
on
the
auto
no
mic
ner
vo
us
syst
em.
2320
04G
old
man
Sh
ore
AA
lter
nat
ive
Th
erap
ies
inH
ealt
han
dM
edic
ine
Rei
ki
red
uce
sp
sych
olo
gic
dep
ress
ion
and
self
-per
ceiv
edst
ress
.
n¼
45,
age
19–7
8.A
llin
nee
do
ftr
eatm
ent
for
sym
pto
ms
of
dep
ress
ion
and
stre
ss.
Ran
do
miz
edco
ntr
oll
edtr
ial
(RC
T).
Sig
nifi
can
td
iffe
ren
ceo
nth
eP
erce
ived
Str
ess
Sca
le(P
SS
)b
etw
een
Tes
t1(
han
ds-
on
Rei
ki)
and
con
tro
l(p
lace
bo
gro
up
)(p>
0.01
;Z2¼
0.18
)an
db
etw
een
Tes
t2
(rem
ote
Rei
ki)
and
pla
ceb
og
rou
p(p<
0.01
;Z2¼
0.17
).N
osi
gn
ifica
nt
dif
fere
nce
bet
wee
ntw
otr
eatm
ent
gro
up
s.S
imil
arre
sult
s(T
est
1v
sco
ntr
ol;
Tes
t2
vs
con
tro
l)o
nth
eB
eck
Dep
ress
ive
Ind
ex(p¼
0.05
;Z2¼
0.9
and
p¼
0.00
4;Z2¼
0.18
resp
ecti
vel
y)
and
the
Ho
pel
essn
ess
Sca
le(p¼
0.02
;Z2¼
0.12
and
p¼
0.01
;Z2¼
0.14
,re
spec
tiv
ely
).N
osi
gn
ifica
nt
dif
fere
nce
bet
wee
nty
pes
of
trea
tmen
t(h
and
s-o
nv
s.re
mo
te).
On
e(1
)y
ear
afte
rth
etr
eatm
ent,
the
dif
fere
nce
mai
nta
ined
(p<
0.05
;Z2
ran
ged
fro
m0.
12–0
.44)
Han
ds-
on
Rei
ki
and
rem
ote
Rei
ki
can
red
uce
sym
pto
ms
of
dep
ress
ion
,h
op
eles
snes
s,an
dst
ress
.N
osi
gn
ifica
nt
dif
fere
nce
bet
wee
nh
and
s-o
nan
dre
mo
tere
iki.
Th
ere
sult
sw
ere
no
td
ue
top
lace
bo
effe
cts.
1920
03K
um
arR
,K
uru
pP
Neu
rolo
gy
Ind
iaR
eik
i-li
ke
trea
tmen
tsaf
fect
seiz
ure
pat
ien
ts.
n¼
15,
age
20–3
0y
ears
.8
mal
es,
7fe
mal
es.
All
wit
hre
frac
tory
seiz
ure
dis
ord
er.
Th
eav
erag
ese
izu
refr
equ
ency
dec
reas
edaf
ter
trea
tmen
t(2
per
mo
nth
inst
ead
of
9p
erm
on
th;
p<
0.01
).In
crea
sein
red
blo
od
cell
mem
bra
ne
Naþ
-Kþ
AT
Pas
eac
tiv
ity
(p<
0.01
),se
rum
mag
nes
ium
(p<
0.01
),an
da
red
uct
ion
inh
epat
ich
yd
rox
ym
eth
yl
glu
tary
lco
enzy
me
Are
du
ctas
eac
tiv
ity
(p<
0.01
)an
dd
igo
xin
syn
thes
is(p<
0.01
),p
ost
-th
erap
y.
Rei
ki-
lik
etr
eatm
ent
pra
ctic
esan
dtr
ansc
end
enta
lm
edit
atio
nin
flu
ence
seiz
ure
freq
uen
cy,
bio
chem
ical
pat
hw
ays
rela
ted
tom
emb
ran
eN
aþ-Kþ
AT
Pas
est
imu
lati
on
,an
dch
ang
esin
neu
ron
altr
ansm
issi
on
.
Tes
tv
sco
ntr
ol:
1co
ntr
ol
gro
up
ran
do
mly
cho
sen
fro
mth
eg
ener
alp
op
ula
tio
no
fT
riv
and
rum
city
.
Th
eco
nce
ntr
atio
no
fse
rum
try
pto
ph
an(p<
0.01
),q
uin
oli
nic
acid
(p<
0.01
),an
dse
roto
nin
(p<
0.01
)w
ere
red
uce
d,
po
st-t
her
apy
.T
he
con
cen
trat
ion
of
tyro
sin
e(p<
0.01
),d
op
amin
e(p<
0.01
),an
dn
ora
dre
nal
ine
(p<
0.01
)w
ere
incr
ease
d,
po
st-t
her
apy
.
2520
02S
hifl
ett
S,
Nay
akS
,Bid
C,
Mil
esP
Jou
rnal
ofA
lter
nat
ive
and
Com
ple
men
tary
Med
icin
e
1.R
eik
iin
flu
ence
sth
efu
nct
ion
alre
cov
ery
of
pat
ien
tsw
ith
sub
acu
test
rok
e.
n¼
50,
wit
hsu
bac
ute
isch
emic
stro
ke.
31m
ale,
19fe
mal
e.T
est
vs.
con
tro
l.
Th
eef
fect
on
the
Fu
nct
ion
alIn
dep
end
ence
Mea
sure
was
no
tsi
gn
ifica
nt
for
the
trea
tmen
tg
rou
p(p>
0.50
).
1.R
eik
ih
adli
ttle
or
no
effe
cto
nth
efu
nct
ion
alre
cov
ery
.
2.A
pro
ced
ure
exis
tsto
bli
nd
bo
thR
eik
ian
dsh
amR
eik
ip
ract
itio
ner
s.
Th
eR
eik
ip
ract
itio
ner
sw
ere
less
con
fid
ent
than
the
no
n-R
eik
ip
ract
itio
ner
sab
ou
tk
no
win
gin
wh
ich
gro
up
they
wer
ein
itia
ted
(p<
0.06
).C
om
par
edto
Rei
ki
pra
ctit
ion
ers,
sham
Rei
ki
pra
ctit
ion
ers
rep
ort
eda
gre
ater
freq
uen
cyo
ffe
elin
gh
eat
inth
eh
and
s(p<
0.03
).
2.R
eik
ip
ract
itio
ner
san
dsh
amp
ract
itio
ner
sd
idn
ot
dif
fer
inex
per
ien
ceo
rse
nsa
tio
ns.
2220
06V
ital
eA
T,
O’C
on
ner
PC
Hol
isti
cN
urs
ing
Pra
ctic
eR
eik
ih
asa
role
asa
ther
apy
for
pai
nm
anag
emen
t.
n¼
22w
om
enw
ith
sch
edu
led
abd
om
inal
hy
ster
ecto
my
.R
CT
.
At
24h
ou
rsaf
ter
surg
ery
,re
po
rts
of
pai
nw
ere
3.8
for
the
exp
erim
enta
lan
d5.
4fo
rth
eco
ntr
ol
gro
up
(t¼
1.79
;p¼
0.04
).N
od
iffe
ren
cein
rep
ort
so
fp
ain
at48
and
72h
ou
rsp
ost
-su
rger
y.
Rei
ki
infl
uen
ces
po
sto
per
ativ
ep
ain
for
atle
ast
24h
ou
rs.
2120
03O
lso
nK
,H
anso
nJ,
Mic
hau
dM
Jou
rnal
ofP
ain
and
Sy
mp
tom
Man
agem
ent
Rei
ki
resu
lts
inb
ette
rp
ain
con
tro
l,le
ssan
alg
esic
use
,an
dan
imp
rov
edq
ual
ity
of
life
.
n¼
24,
9m
en(a
ver
age
age
59.5
yea
rs)
and
15w
om
en(a
ver
age
age
56y
ears
),cu
rren
tly
rece
ivin
gp
alli
ativ
eca
red
ue
toad
van
ced
can
cer.
RC
T.
Asi
gn
ifica
nt
dro
pin
pai
nin
the
stan
dar
do
pio
idp
lus
Rei
ki
gro
up
on
day
s1
and
4(p¼
0.03
5;p¼
0.00
2,re
spec
tiv
ely
).A
lso
asi
gn
ifica
nt
dro
pin
dia
sto
lic
blo
od
pre
ssu
re(p¼
0.03
5;p¼
0.08
2,re
spec
tiv
ely
)an
dp
uls
e(p¼
0.01
9,o
nly
day
1).Q
ual
ity
of
life
sig
nifi
can
tly
imp
rov
edfr
om
day
s1
to7
for
the
stan
dar
do
pio
idp
lus
Rei
ki
gro
up
(p¼
0.00
2).
No
dif
fere
nce
inan
alg
esic
use
.
Rei
ki
imp
rov
edth
eq
ual
ity
of
life
and
red
uce
dth
ele
vel
of
pai
n,
bu
tsh
ow
edn
od
iffe
ren
cein
anal
ges
icu
se.
2020
07P
ott
erP
Jou
rnal
ofH
olis
tic
Nu
rsin
gR
eik
ire
du
ces
psy
cho
log
icst
ress
inw
om
enu
nd
erg
oin
gb
reas
tb
iop
sy.
n¼
35w
om
ensc
hed
ule
dfo
rb
reas
tb
iop
sy.
RC
T.
No
sig
nifi
can
td
iffe
ren
cein
any
of
the
3p
sych
olo
gic
dis
tres
sm
easu
res
(Sta
te–
Tra
itA
nx
iety
Inv
ento
ry[S
TA
I],
Cen
ter
for
Ep
idem
iolo
gic
alS
tud
ies–
Dep
ress
ion
Sca
le[C
ES
-D],
Ho
spit
alA
nx
iety
–Dep
ress
ion
Sca
le[H
AD
S])
.
Rei
ki
had
no
sig
nifi
can
tim
pac
t.U
sual
cop
ing
mec
han
ism
sw
ere
suffi
cien
t.
Nei
ther
test
no
rco
ntr
ol
gro
up
sho
wed
pre
test
sig
ns
of
dep
ress
ion
or
anx
iety
.
(con
tin
ued
)
Ta
bl
e5.
(Co
nt
in
ue
d)
Ref
.n
o.Y
ear
Au
thor
sJo
urn
alS
tud
yh
yp
oth
esis
Pop
ula
tion
and
stu
dy
typ
eO
utc
omes
Con
clu
sion
s
2620
07T
san
gK
L,
Car
lso
nL
E,
Ols
on
K
Inte
gra
tiv
eC
ance
rT
her
apie
sR
eik
ire
du
ces
pai
n,
fati
gu
e,an
dan
xie
tyan
din
crea
ses
qu
alit
yo
fli
fein
pat
ien
tsw
ith
can
cer.
Rei
ki
effe
ctla
sts
for
abo
ut
3d
ays.
n¼
16w
ith
var
iou
sfo
rms
of
can
cer;
(wo
men¼
13;
men¼
3);
12w
hit
e,2
Asi
an,
2O
ther
;ag
ed33
–84
(med
ian
age
of
59y
ears
).
Sig
nifi
can
tre
du
ctio
nb
etw
een
pre
trea
tmen
tan
dp
ost
-sev
enth
trea
tmen
tR
eik
io
nfa
tig
ue
(p<
0.01
),p
ain
(p<
0.05
),an
dan
xie
ty(p<
0.05
).In
com
par
iso
n,
ther
ew
asn
osi
gn
ifica
nt
dif
fere
nce
inth
ere
stco
nd
itio
n.
Qu
alit
yo
fli
fe:
Rei
ki
con
dit
ion
rep
ort
eda
sig
nifi
can
tim
pro
vem
ent
inF
un
ctio
nal
Ass
essm
ent
of
Can
cer
Th
erap
y–
Gen
eral
(FA
CT
-G)
pre
test
top
ost
-tes
tin
terv
enti
on
(p<
0.01
).N
osi
gn
ifica
nt
chan
ge
inco
ntr
ol
con
dit
ion
.
Rei
ki
was
effe
ctiv
ein
dec
reas
ing
fati
gu
e,p
ain
,an
dan
xie
tyin
pat
ien
tsw
ith
can
cer.
Ov
eral
lq
ual
ity
of
life
imp
rov
edco
mp
ared
tore
stin
gco
nd
itio
n.
Co
un
ter-
bal
ance
dcr
oss
ov
ertr
ial
wh
ere
each
ind
ivid
ual
par
tici
pat
edin
bo
thco
nd
itio
ns
(Rei
ki
and
rest
)b
ut
inra
nd
om
ord
er.
Was
ho
ut
per
iod
:A
fter
care
ful
mo
nit
ori
ng
,fo
un
dth
atR
eik
ief
fect
last
edfo
r7
day
sas
fati
gu
esc
ore
sd
idn
ot
dro
p.
Rei
ki
ben
efite
dfa
tig
ued
pat
ien
tsw
ith
can
cer
for
atle
ast
7d
ays.
1820
07G
ille
spie
E,
Gil
lesp
ieB
,S
tev
ens
M
Dia
bete
sC
are
Rei
ki
red
uce
sp
ain
inp
atie
nts
wit
hd
iab
etic
nep
hro
pat
hy
.
n¼
207
wit
hty
pe
2p
ain
ful
dia
bet
icn
eph
rop
ath
y(P
DN
);te
stv
s.co
ntr
ol
wit
h3
gro
up
s:R
eik
i(n¼
93);
mim
icR
eik
i(n¼
88);
Usu
alC
are
(n¼
26).
Usu
alC
are
was
dis
con
tin
ued
afte
rra
nd
om
izat
ion
of
26p
atie
nts
du
eto
po
or
rete
nti
on
.
Sig
nifi
can
tre
du
ctio
n(p<
0.05
)b
etw
een
bas
elin
ep
ain
sco
res
(McG
ill
Pai
nS
core
)an
d12
-wee
kp
ain
sco
res
for
Rei
ki
and
mim
ic-R
eik
ig
rou
ps.
No
sig
nifi
can
tre
du
ctio
nfo
rU
sual
Car
eg
rou
p.
No
sig
nifi
can
tre
du
ctio
nam
on
gfi
nal
pai
nsc
ore
sfo
ral
l3
gro
up
s(U
sual
Car
eg
rou
pst
arte
dw
ith
low
erp
ain
sco
res)
.W
alk
ing
dis
tan
ceim
pro
ved
sig
nifi
can
tly
(p<
0.05
)fo
rR
eik
ian
dm
imic
-Rei
ki
gro
up
s;n
ot
for
Usu
alC
are
gro
up
.All
oth
erm
easu
res
(Vis
ual
An
alo
gu
eS
cale
pai
nsc
ore
;W
ell-
Bei
ng
Qu
esti
on
nai
re;
Dia
bet
esT
reat
men
tS
atis
fact
ion
Qu
esti
on
nai
re)
sho
wed
no
sig
nifi
can
td
iffe
ren
ce.
Rei
ki
was
no
mo
reef
fect
ive
than
mim
ic-R
eik
iin
dec
reas
ing
per
ceiv
edp
ain
and
imp
rov
ing
wal
kin
gd
ista
nce
inp
atie
nts
wit
hP
DN
.
2419
98D
ress
enL
,S
ing
gS
Su
btle
En
erg
ies
and
En
erg
yM
edic
ine
Jou
rnal
Rei
ki
red
uce
sp
ain
,an
xie
ty,
and
dep
ress
ion
inch
ron
ical
lyil
lp
atie
nts
.
n¼
120
wh
oh
ave
bee
nin
pai
nfo
rat
leas
t1
yea
r;R
CT
wit
h4
gro
up
s:R
eik
i,P
rog
ress
ive
Mu
scle
Rel
axat
ion
;m
imic
-Rei
ki,
and
no
trea
tmen
t
Rei
ki
pro
ved
sig
nifi
can
tly
sup
erio
r(p<
0.00
1–0.
04)
too
ther
trea
tmen
tso
n10
of
12v
aria
ble
sm
easu
red
.M
cGil
lP
ain
Sco
re:
Glo
bal
Pai
nIn
ten
sity
(p<
0.00
1);
Sen
sory
Pai
nR
atin
gIn
dex
(PR
I)(p<
0.03
);E
val
uat
ive
PR
I(p<
0.00
1);
Bec
kD
epre
ssiv
eII
Inv
ento
ry(p<
0.00
01);
Sta
te–T
rait
An
xie
tyIn
ven
tory
(Sta
teA
nx
iety
,p<
0.00
01),
(Tra
itA
nx
iety
,p<
0.00
1);
Ro
sen
ber
gS
elf-
Est
eem
Sca
le(p<
0.00
2);
Ro
tter
Inte
rnal
–E
xte
rnal
Lo
cus
of
con
tro
l(p<
0.00
2);
Bel
ief
inP
erso
nal
Co
ntr
ol
Sca
le(B
IPC
S)
(p<
0.01
);B
IPC
S-S
cale
C(B
elie
fin
Go
d)
(p<
0.04
).
Rei
ki
isan
effe
ctiv
em
od
alit
yfo
rre
du
cin
gp
ain
,d
epre
ssio
n,
and
anx
iety
.R
eik
iis
effe
ctiv
ein
enh
anci
ng
des
irab
lech
ang
esin
per
son
alit
y(s
elf-
este
em,
locu
so
fco
ntr
ol)
.R
eik
ien
han
ces
on
e’s
fait
hin
Go
d.
Th
eef
fect
so
fR
eik
iar
en
ot
du
eto
pla
ceb
o.
2720
06C
raw
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niv
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tyo
fA
lber
ta,
Sch
oo
lo
fN
urs
ing
,20
01.
their absence discussed in any of the Reiki studies, a fact thatgreatly diminishes the quality assessment of these trials.
We were only able to uncover 12 studies on which toperform our evaluation; these 12 studies had 31 differentoutcomes. This clearly shows that Reiki researchers are in‘‘exploratory mode’’ in terms of understanding the benefits ofReiki. Although most of the outcomes indicated a positiveoutcome, it is quite possible that bias against the null hy-pothesis and the ‘‘file drawer syndrome’’ resulted in an un-known number of negative trials on Reiki never beingpublished.28 Hence, to further evaluate the validity ofclaimed therapeutic effects of Reiki, trials are needed withlarger study populations and better reporting quality. It isobvious that these trials should be registered with a clinicaltrials register to avoid publication bias. In contrast, someresearchers might argue that such studies should not beperformed at all, since the biological substrate for Reiki’seffect is unknown and plausible at best. However, while itmay be difficult to scientifically assess Reiki’s method ofaction with our current technology, it is possible to deter-mine Reiki’s efficacy. Given the increase in patient spendingin CAM, we believe it is our job as researchers to conductgood quality trials which add to or refute the efficacy data ofa given therapy.
Western medicine operates under the paradigm of evidence-based medicine. RCTs are considered the ‘‘gold standard’’ forproviding evidence on effectiveness of biomedical interven-tions.29 While Reiki itself is not a biomedical intervention, itsefficacy needs to be proven, in service of good science. Currentliterature has suggested that RCTs alone may be limited intheir ability to measure ‘‘whole person’’ healing, which ischaracteristic of CAM therapies (such as Reiki).11 Adequatestandards of reporting are necessary so that readers can makeassessments on the internal and external validity of the trial aswell as properly assess the results. The CONSORT statementwas developed to aid authors in adequately reporting (andhopefully designing) their studies. In general, current reportingof trials is not considered adequate. In a study that looked at253 RCTs reported in 5 leading medical journals (which haveactively embraced the CONSORT) between 2002 and 2003, lessthan 60% of the trials adequately reported on allocation con-cealment (48%), randomization implementation (55%), blind-ing status of participants (40%), blinding of health careproviders (17%), and blinding of outcome assessors (47%).30
Our findings are in agreement with an earlier observationthat reporting of CAM trials is also poor.31 In a project thatassessed a sample of 206 RCTs of herbal medicine inter-ventions, less than one third adequately reported whetherthose administering the intervention were blinded (28%), themethods for implementation (22%), and generation of therandom allocation sequence (21%), whether there were pro-tocol deviations (18%) or whether outcome assessors wereblinded (14%).29
Biofield Energy Therapies are controversial to conven-tional health care providers and policymakers for two mainreasons: (1) the dearth of rigorous scientific data that supportor refute their efficacy, and (2) because biofields currentlycannot be measured, so their scientific method of action re-mains questionable. While the second point may take moretime to resolve, the first point can be addressed immediately,through adequate scientific reporting. In order for efficacy tobe scientifically recognized, adequate reporting is required to
inform readers of the purposeful deviations from traditionalRCT design so readers can judge the influence of methodo-logical flaws on the results of trials. In order to be accepted astrue scientific evidence, adequate reporting of future ReikiRCTs or mixed methods RCTs is crucial. Of the items thatwere not reported adequately, all of them were reportedadequately in at least one study, indicating that it is possibleto report adequately.
A potentially significant finding from this study is that thelevel of training and=or years of experience of the Reikipractitioner seemed to be important for Reiki to be effective.A finding from the Efficacy of Distant Healing suggests thathealers should have at least 3 years of practice to be con-sidered performing optimally.32 While the author of thisstudy was not specifically referring to Reiki practitioners, itdoes make sense that a certain level of expertise improves theReiki practitioners’ efficacy.
We exempted Reiki Masters from the ‘‘3 years of practice’’criteria that we applied to Reiki Practitioners (Level I andLevel II) due to the intensive training that it takes to becomea Reiki Master. Level II training is usually only given aftera student has been practicing Level I Reiki for at least3 months, though this can vary somewhat depending on theindividual. Reiki Master training is primarily intended forpeople who have made Reiki their life’s work. Dependingupon the individual, Reiki Master level training is usuallygiven only after a student has been practicing Level II Reikifor at least 1 year and the training is quite intensive.9
Studies that used Reiki practitioners (Level I or II) withless than 3 years experience showed no significant outcome,while in all but one of the studies that used a Reiki Master,there was a significant difference in measured outcome in theReiki group. The goal of Reiki is to direct healing energy intothe recipient. It has been suggested that the number ofchanges of Extra-Low Frequency (ELF) Magnetic Fieldscoming from Reiki practitioners’ (i.e. Level I or Level II; non-Reiki Masters) hands differs significantly than the number ofchanges of ELFs coming from Reiki Masters’ hands; how-ever, the results of these studies have only been published inabstract and book form.33 Although this is not a definitivetest for efficacy of Reiki healers (no known test exists as faras we know), this does suggest that there is a differencebetween Reiki Masters and non-Master Reiki practitioners.
Conclusions
In order for Reiki studies to be evaluated and acceptedbased on their stated outcomes, authors need to ensure thatthe methodological quality and reporting of the study areadequate. This will only be achieved when authors are ed-ucated and disciplined in their approach to designing, exe-cuting, and reporting their studies. Alternative therapyjournals should also actively embrace the CONSORT criteriato ensure that CAM therapies are reported at the highestscientifically accepted level. To date, based on the poor qualityof studies and their reporting, it is currently impossible todraw definitive conclusions about the efficacy of Reiki.
Disclosure Statement
The authors state that no competing financial interestsexist.
1168 VANDERVAART ET AL.
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Address correspondence to:Gideon Koren, M.D., F.R.C.P.C., F.A.C.M.T.
Division of Clinical Pharmacology, Room 8232The Hospital for Sick Children
555 University AvenueToronto, Ontario M5G 1X8
Canada
E-mail: [email protected]
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