The Influence of Patient Attitude Toward Massage on Pressure Pain Sensitivity and Immune System after Application of Myofascial Release in Breast Cancer Survivors: A Randomized, Controlled Crossover Study

Department Physical Therapy, Universidad de Granada, Spain.
Journal of manipulative and physiological therapeutics (Impact Factor: 1.48). 02/2012; 35(2):94-100. DOI: 10.1016/j.jmpt.2011.09.011
Source: PubMed


The purpose of this study was to evaluate the influence of patient's attitudes toward massage on pressure pain sensitivity and the immune effects of myofascial release in breast cancer survivors (BCS).
Twenty BCS participated. They presented to the laboratory at the same time of the day on 2 occasions separated by 2 weeks. At each session, they received either a myofascial release technique or control (special attention) intervention. Salivary flow rate, cortisol and immunoglobulin A (IgA) concentrations, and α-amylase activity were obtained before and immediately after intervention from saliva samples. Pressure pain thresholds (PPT) over the cervical spine and temporalis muscle were assessed bilaterally. The attitude toward massage (ATOM) scale was collected before the first session in all BCS.
The analysis of covariance revealed a significant intervention × time interaction for salivary flow rate (P = .010), but not α-amylase (P = .111), IgA (P = .655), and cortisol (P = .363) in favor of the experimental group: BCS exhibited an increase of salivary flow rate after myofascial release intervention. When the ATOM scale was included in the analysis, significant influence on IgA (P = .001) was found: BCS with positive attitude had a significant increase in IgA (P > .05). The analysis of covariance did not find a significant intervention × time interaction for PPT over the cervical spine or temporalis muscle, with no effect of ATOM scales for PPT (P > .05).
The current study suggests that myofascial release may lead to an immediate increase in salivary flow rate in BCS with cancer-related fatigue. We also found that the effect of myofascial release on immune function was modulated by a positive patient's attitude toward massage.

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    • "However, they included different primary studies: four randomized controlled trials (RCTs) [49–52] for systematic review by Wilkinson et al. [21], five RCTs [21, 50, 53–55] for systematic review by Ernst et al. [24], and three RCTs [51, 53, 56] for systematic review by Falkensteiner et al. [33]. The fifth systematic review [46] pooled the data and showed no benefits of massage on pain for breast cancer patients based on four different RCTs [57–60]. So based on available evidence, we could see that the conclusions for the benefits of massage on cancer pain were conflicted. "
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