Massage therapy for osteoarthritis of the knee: A randomized control trial

Institute for Complementary and Alternative Medicine, University of Medicine and Dentistry of New Jersey, School of Health Realted Profession, Newark, NJ 07107-1709, USA.
Archives of Internal Medicine (Impact Factor: 13.25). 12/2006; 166(22):2533-8. DOI: 10.1001/archinte.166.22.2533
Source: PubMed

ABSTRACT Massage therapy is an attractive treatment option for osteoarthritis (OA), but its efficacy is uncertain. We conducted a randomized, controlled trial of massage therapy for OA of the knee.
Sixty-eight adults with radiographically confirmed OA of the knee were assigned either to treatment (twice-weekly sessions of standard Swedish massage in weeks 1-4 and once-weekly sessions in weeks 5-8) or to control (delayed intervention). Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and functional scores and the visual analog scale of pain assessment. The sample provided 80% statistical power to detect a 20-point difference between groups in the change from baseline on the WOMAC and visual analog scale, with a 2-tailed alpha of .05.
The group receiving massage therapy demonstrated significant improvements in the mean (SD) WOMAC global scores (-17.44 [23.61] mm; P < .001), pain (-18.36 [23.28]; P < .001), stiffness (-16.63 [28.82] mm; P < .001), and physical function domains (-17.27 [24.36] mm; P < .001) and in the visual analog scale of pain assessment (-19.38 [28.16] mm; P < .001), range of motion in degrees (3.57 [13.61]; P = .03), and time to walk 50 ft (15 m) in seconds (-1.77 [2.73]; P < .01). Findings were unchanged in multivariable models controlling for demographic factors.
Massage therapy seems to be efficacious in the treatment of OA of the knee. Further study of cost effectiveness and duration of treatment effect is clearly warranted. .

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Available from: Adam I Perlman, Aug 11, 2015
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    • "Acupuncture, as a CAM approach, has been widely used for treating pain including knee pain from knee OA [16–20, 25]. Another CAM approach, Swedish massage, was recently found effective in improving pain, stiffness, and physical functional disability of knee OA subjects [14] [15]. Acupressure shares some characteristics of both acupuncture and massage. "
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    ABSTRACT: Background. Osteoarthritis (OA) is more prevalent in women, particularly after menopausal age. Women are more likely to seek complementary and alternative medicine (CAM) approaches. We examined the feasibility of training self-administered acupressure exercise and assessed its impact on OA symptoms among women with knee OA. Methods. Thirty-six eligible postmenopausal women were randomly assigned in the acupressure exercise group (n = 15) or the control group (n = 21) for 12 weeks. Feasibility outcomes (e.g., compliance and adverse effects) and clinical outcomes (e.g., pain, stiffness, and physical function) were assessed. Data were collected at baseline, 6 weeks and 12 weeks. Both per-protocol and intention-to-treat analysis were employed. Results. The training materials were well received. The feedback from participants suggests that self-administered acupressure exercise is easy to learn and safe to perform at home, although no statistically significant results of the clinical outcome were observed. Our findings didn't reveal superiority or inferiority of acupressure compared with usual care. Conclusion. Acupressure exercise is feasible to be trained among postmenopausal women with knee osteoarthritis. Due to the limitations of this study such as small sample size and high attrition rate, acupressure's efficacy needs to be further explored in larger scale studies with more rigorous design.
    Evidence-based Complementary and Alternative Medicine 10/2012; 2012:570431. DOI:10.1155/2012/570431 · 1.88 Impact Factor
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    • "Clinical measures provide the much-needed outcomes based information on functional changes that directly affect a patient's level of disability. Therapeutic massage has been reported to improve range of motion in patients with osteoarthritis of the knee (Perlman et al., 2006) and back pain (Hernandez-Reif et al., 2001); while investigations of TM treatment of chronic neck pain report conflicting findings (Hakkinen et al., 2007; Vernon et al., 2007). Use of a standardized but clinically appropriate intervention may help to clarify our understanding as to the effectiveness of TM in improving cervical range of motion. "
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    ABSTRACT: Little is known regarding the physiological and clinical effects of therapeutic massage (TM) even though it is often prescribed for musculoskeletal complaints such as chronic neck pain. This study investigated the influence of a standardized clinical neck/shoulder TM intervention on physiological measures assessing α-motoneurone pool excitability, muscle activity; and the clinical measure of range of motion (ROM) compared to a light touch and control intervention. Flexor carpi radialis (FCR) α-motoneurone pool excitability (Hoffmann reflex), electromyography (EMG) signal amplitude of the upper trapezius during maximal muscle activity, and cervical ROM were used to assess possible physiological changes and clinical effects of TM. Sixteen healthy adults participated in three, 20 min interventions: control (C), light touch (LT) and therapeutic massage (TM). Analysis of Covariance indicated a decrease in FCR α-motoneurone pool excitability after TM, compared to both the LT (p = 0.0003) or C (p = 0.0007) interventions. EMG signal amplitude decreased after TM by 13% (p < 0.0001), when compared to the control, and 12% (p < 0.0001) as compared to LT intervention. The TM intervention produced increases in cervical ROM in all directions assessed: flexion (p < 0.0001), lateral flexion (p < 0.0001), extension (p < 0.0001), and rotation (p < 0.0001). TM of the neck/shoulders reduced the α-motoneurone pool excitability of the flexor carpi radialis after TM, but not after the LT or C interventions. Moreover, decreases in the normalized EMG amplitude during MVIC of the upper trapezius muscle; and increases in cervical ROM in all directions assessed occurred after TM, but not after the LT or C interventions.
    Manual therapy 05/2011; 16(5):487-94. DOI:10.1016/j.math.2011.04.002 · 1.76 Impact Factor
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    • "Recruitment of participants varied between studies. Two used media advertisements (Pollard et al., 2008; Tucker et al., 2003), one recruited from orthopaedic and rheumatology clinics (Hoeksma et al., 2004) and one recruited from primary care physicians, senior living facilities and rheumatology centres (Perlman et al., 2006). Two studies recruited participants with mild to moderate OA (Pollard et al., 2008; Tucker et al., 2003) and one included subjects of all degrees of severity (Hoeksma et al., 2004). "
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    ABSTRACT: The aim of this systematic review was to determine if manual therapy improves pain and/or physical function in people with hip or knee OA. Eight databases were searched for randomised controlled trials (RCTs). Data were extracted and risk of bias assessed by independent reviewers. Four RCTs were eligible for inclusion (280 subjects), three of which studied people with knee OA and one studied those with hip OA. One study compared manual therapy to no treatment, one compared to placebo intervention, whilst two compared to alternative interventions. Meta-analysis was not possible due to clinical heterogeneity of the studies. One study had a low risk of bias and three had high risk of bias. All studies reported short-term effects, and long-term effects were measured in one study. There is silver level evidence that manual therapy is more effective than exercise for those with hip OA in the short and long-term. Due to the small number of RCTs and patients, this evidence could be considered to be inconclusive regarding the benefit of manual therapy on pain and function for knee or hip OA.
    Manual therapy 04/2011; 16(2):109-17. DOI:10.1016/j.math.2010.10.011 · 1.76 Impact Factor
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