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Massage for osteoarthritis of the knee.

Perlman A, Sabina A, Williams A, Njike V, Katz D. Massage therapy for osteoarthritis of the knee. A randomized control trial. Archives of Internal Medicine 2006;166:2533-2538.

Why Was This Study Conducted?

The study was conducted to find out whether or not massage therapy is an effective treatment option for people suffering from osteoarthritis (OA).

What Were The Parameters Of This Study?

The 68 adults that took part in this study all had a radiographically confirmed diagnosis of OA of the knee. It was established that none of them suffered from other medical complications. None of the participants had taken oral corticosteroids in the 4 weeks prior to taking part in the study, nor did they receive inter-articular knee corticosteroids within the last 3 months. All participants were over the age of 35.

The participants were was randomly divided into two groups of 34. The intervention group received 8 weeks of Swedish massage therapy. Treatments were applied twice a week for 4 weeks and then once weekly for 4 weeks. Two licensed massage therapists conducted one hour standard full body Swedish massage treatments using pretrissage, effleurage and tapotement techniques.

This group continued with their 'usual medical care' in addition to massage intervention during weeks 1-8. From weeks 9-16 the intervention group received their usual medical care only. Usual medical care for OA sufferers in this study included pharmaceuticals for pain and inflammation and hot and cold therapies.

The control group continued to receive their usual medical care for weeks 1-8. During weeks 9-16, this group also received Swedish massage therapy using the same protocols and frequency as the original intervention group.

How Were The Measurements Taken?

The Western Ontario and McMaster Universities Osteoarthritis Questionnaire (WOMAC) was used to record pain, stiffness and physical function. This questionnaire comprises of 24 items rated on a numerical scale from 0 (no symptoms/no limitation) to 100 (maximal symptoms/maximal limitation). WOMAC measurements were taken prior to any intervention, at 8 weeks and at 16 weeks for both groups.

At each visit, another numerical scale, the visual analogue scale (VAS) was used to measure pain intensity with 0 indicating no pain and 100 indicating maximum pain.

Each week, a research coordinator phoned the participants to record any complaints or adverse effects they may be experiencing. All participants kept a diary to record their medication intake.

What Were The Results?

The overall WOMAC score for the intervention group at 8 weeks showed significant improvement as did the individual components of pain, stiffness and physical function. The most marked improvement was shown to be in the pain category, followed by stiffness and then physical function. At 8 weeks there were no significant improvements evident for the control group.

The VAS scores and range of motion measurements taken at the clinic at each visit showed a similar pattern to the WOMAC questionnaire. At 16 weeks, the beneficial results shown at week 8 for the intervention group largely persisted. After receiving Swedish massage therapy in weeks 9-16, results from the control group correlated with those of the intervention group.

What Did The Researchers Conclude?

The researchers concluded that this study 'suggests that massage therapy using the Swedish technique is safe and effective for reducing pain and improving function in patients with symptomatic OA of the knee'. The beneficial effects were shown to be greater than acupuncture when compared to a similar trial undertaken in 2005.

The researchers also acknowledge that a further study into the duration of the treatment benefits and the cost effectiveness of Swedish massage as an alternative or adjunct to conventional therapy is warranted.

What Were The Limitations Of This Study?

This study brings welcome results for the efficacy of massage therapy. However, because OA is a chronic condition that has developed over a long period, a longer study that spans a year or more would give more answers about the frequency of treatments needed to provide adequate care for OA sufferers.

Another study limitation sighted by the researchers is that most participants in this study were white women. This may limit the ability to generalise about the results.
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Article Details
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Author:Robertshawe, Penny
Publication:Journal of the Australian Traditional-Medicine Society
Article Type:Case study
Geographic Code:8AUST
Date:Jun 1, 2007
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