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: 17.33). 12/2006; 166(22):2533-8. DOI: 10.1001/archinte.166.22.2533
Source: PubMed


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
    • "Massage has been used as a pain modality for years. In a study conducted by Perlman,[8] massage was found to be a beneficial treatment for OA. A meta-analysis conducted in 2011, found several studies on the benefits of massage for management of pain associated with knee OA.[9] "
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    ABSTRACT: Arthritis affects both the physical and psychological abilities of people in all walks of life. There are currently no recommended effective 'disease-modifying' remedies. Therapists and physicians are therefore exploring possible benefits from non-conventional therapeutic approaches. The purpose is to assess the changes in fitness and psychosocial outcomes of six doctor-referred patients as a result of participating in the I Can Move Again (ICMA) program. Six female participants diagnosed with arthritis were recruited from a local family practitioner. The subjects participated in a series of daily classes for 12 weeks including massage, mindfulness, bounce-back chairs, resistance chairs, aerobic and anaerobic training, rebounders, and whole body vibration platform Tai Chi. Demographic, psychosocial, and physical data were collected at the ICMA and at Y-Be-Fit (Provo, UT). Significant pre to post mean differences were found for sit-ups (F (1,8) =5.42 P =0.048), chair stand (F (1,10) =6.622 P =0.028), arm curl (F (1,10) =14.379 P =0.004), six-minute walk test distance (F (1,9)= 19.188 P=0.002), and speed (F,(1,8) =13.984 P =0.006), and rotation right (F (1,10) =8.921 P =0.014) and left (F (1,10) =11.373 P =0.007), in 27 of the 61-item questionnaire. The preliminary data on the six subjects lacked sufficient statistical power to detect the significant differences that could exist, thus committing a Type II error, but it is important to note an overall, substantial trend in improvement in the patients' physical outcomes and psychosocial perceptions associated with improvements in activities of daily living.
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    • "The primary goal of treatment in KOA is reducing pain and improving functional capacity3). Non-pharmacological treatment, physical therapy (PT), and complementary and alternative medicine (CAM), which includes massage4), alternative exercise5), thermotherapy6), and acupuncture7), play an important role in health care for patients with KOA. The use of CAM in developed countries appears to be increasing as awareness increases. "
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    ABSTRACT: [Purpose] This study investigated the effectiveness of a class- and home-based exercise with massage between Thai traditional and standardized physical therapy (TPT and SPT) in older people with knee osteoarthritis (KOA). [Subjects and Methods] Thirty-one subjects with KOA (aged 50-85 years) in two selected villages were randomly assigned into the TPT or SPT programs. Seventeen TPT subjects received Thai exercise with traditional massage, and 14 SPT individuals performed strengthening exercise with Swedish massage. Both programs consisted of a class with supervision plus home self-care for 8 weeks; the subjects then managed home self-care for 1 year. [Results] After 2 months, the six-minute walk test (6MWT), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and SF-36 testing showed significant improvement in both groups, but the improvement of the TPT group was greater. After 1year, only the score for the 6MWT was greater in the TPT group than in the SPT group. [Conclusion] The TPT program yielded better results for the 6MWT, but, both programs had beneficial effects on the pain, function, and QOL of middle-aged and older patients with KOA in the community setting.
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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.
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