Efficacy of massage therapy in improving outcomes in knee osteoarthritis: A systematic review and meta-analysis

Backgroundand purpose: Massage therapy is being used for knee osteoarthritis. However, level-1 evidence is lacking. This systematic review and meta-analysis aimed to synthesize evidence on the effect of massage therapy on knee osteoarthritis.MethodsPubMed, Embase, Ovid, Springer, and Google Scholar databases were searched up to May 8, 2021 for randomized controlled trials comparing massage with controls for knee osteoarthritis. Review manager was used for a random-effect meta-analysis. Risk of bias was assessed using the Cochrane collaboration risk assessment tool and certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).ResultsTwelve studies with 737 participants were included. After 1–4 weeks of therapy, there was a significant reduction in pain and stiffness scores in the massage group and after 6–8 weeks of therapy, there was a significant reduction in stiffness and functionality scores. There was no significant difference in outcomes with long-term therapy. A statistically significant reduction in stiffness scores was seen with aromatherapy massage. Aromatherapy massage was not superior to standard massage. The overall quality of evidence according to GRADE was low to moderate for standard massage therapy and very low for aromatherapy.ConclusionMassage therapy may lead to some improvement in pain, stiffness, and functionality scores in the short term but not in long term. Aromatherapy massage was not found to be any better than standard massage therapy. Current evidence is limited by methodological heterogeneity amongst trials and small sample size of the studies.     

Critical review of how nurses research massage therapy: are they using the best methods?

Complementary therapies comprise only a fraction of nursing care, yet it is interesting that their use is being considered by an ever-increasing number of nurses. Within the Rhondda NHS Trust, holistic massage therapy is offered to patients both in hospital and in the community, nurses and occupational therapists successfully combining their massage skills with everyday patient care. During the process of devising a research protocol for implementation within the Trust, certain questions began to emerge to which there were no answers. The attempt to answer them is the origin of this paper, which explores some commonly experienced difficulties with reference to the literature and puts forward merits of adapting current methodology to investigate the benefits of massage therapy.     

Effect of massage therapy on pain,anxiety, and tension after cardiac surgery: A randomized study

Integrative therapies such as massage have gained support as interventions that improve the overall patient experience during hospitalization. Cardiac surgery patients undergo long procedures and commonly have postoperative back and shoulder pain, anxiety, and tension. Given the promising effects of massage therapy for alleviation of pain, tension, and anxiety, we studied the efficacy and feasibility of massage therapy delivered in the postoperative cardiovascular surgery setting. Patients were randomized to receive a massage or to have quiet relaxation time (control). In total, 113 patients completed the study (massage, n = 62; control, n = 51). Patients receiving massage therapy had significantly decreased pain, anxiety, and tension. Patients were highly satisfied with the intervention, and no major barriers to implementing massage therapy were identified. Massage therapy may be an important component of the healing experience for patients after cardiovascular surgery.     

Caregiver delivered massage therapy options in inpatient palliative care: A mixed methods exploratory study

Backgroundand purpose: Massage therapy can benefit palliative care inpatients and this intervention could be provided by trained caregivers in this setting. This study aimed to determine the feasibility and acceptance of caregiver massage therapy, to explore patients' and caregivers’ experience of massage therapy, and examine staff perspectives about caregiver massage therapy in palliative care.Materials and methodsThis was a mixed methods, convergent, study design. Inpatient palliative care patients were offered massage provided by a caregiver, following training. Caregiver massage therapy was provided up to five days post training. Patients and caregivers completed self-report measures of satisfaction for the five-day intervention, while caregivers rated massage-related burden and confidence. Healthcare professionals working in inpatient palliative care participated in a focus group, during which enablers and barriers to caregiver massage therapy were explored.ResultsOver the three-month recruitment period, 62 participants were available for recruitment. Of these, 23 (37%) consented to caregiver massage. Caregiver burden was highest on day 2 (mean 2.9/5) while confidence was highest on day 4 (mean 4.1/5). Caregivers and patients were satisfied with the massage training sessions, and patients reported perceptions of comfort during subsequent sessions. Staff-identified enablers to caregiver massage therapy included patient symptom improvement and caregiver empowerment but considered caregiver massage potentially burdensome for caregivers.ConclusionCaregiver massage training is feasible, with a modest acceptance within an inpatient palliative care unit. Enablers of massage therapy in inpatient palliative care were caregiver empowerment, but this model was perceived as potentially burdensome for caregivers by healthcare professionals.     

Does regular massage from late pregnancy to birth decrease maternal pain perception during labour and birth?--A feasibility study to investigate a programme of massage, controlled breathing and visualization, from 36 weeks of pregnancy until birth

The present study was undertaken to produce a detailed specification of a programme of massage, controlled breathing and visualization performed regularly by birth partners, from 36 weeks gestation and assisted by a trained professional, following hospital admission during labour and birth. As current research on massage interventions for pain relief in labour is poorly characterized, we began by undertaking a feasibility study on an established massage programme [Goldstone LA. Massage as an orthodox medical treatment past and future. Complementary Therapies in Nursing & Midwifery. 2000;6:169-75]. The intervention was designed in light of experimental findings that repeated massage sessions over 14 days increases pain threshold, by an interaction between oxytocin and opioid neurons [Lund I, Yu L-C, Uvnas-Moberg K, Wang J, Yu C, Kurosawa M, et al. Repeated massage-like stimulation induces long-term effects on nociception: contribution of oxytocinergic mechanisms. European Journal of Neuroscience 2002;16:330-8]. A 4 week time-frame was selected to coincide with a physiological increase in maternal pain threshold [Cogan R, Spinnato JA. Pain and Discomfort Thresholds in Late Pregnancy. Pain 1986;27:63-8, Whipple B, Josimovich JB, Komisaruk BR. Sensory thresholds during the antepartum, intrapartum, and postpartum periods. International Journal of Nursing Studies 1990;27(3):213-21, Gintzler AR, Komisaruk BR. Analgesia is produced by uterocervical mechano-stimulation in rats: roles of afferent nerves and implications for analgesia of pregnancy and parturition. Brain Research 1991;566:299-302, Gintzler AR, Liu N-J. The maternal spinal cord: biochemical and physiological correlates of steroid-activated antinociceptive processes. In: Russell JA, Douglas AJ, Windle RJ, Ingram CD, editors., Progress in Brain Research. Volume 133. The Maternal Brain. Neurobiological and Neuroendocrine adaptation and disorders in pregnancy and postpartum. Amsterdam: Elsevier Science, 2001. p. 83-97]. The main objective was to measure the effects of the programme on maternal pain perception during labour and birth. To detect any effect of massage during labour, on maternal cortisol and catecholamines, cord venous blood was taken to measure plasma concentrations following birth. Twenty-five nulliparous (N) and 10 multiparous (M) women participated in the study. Cortisol values were similar to published studies following labour without massage but pain scores on a Visual Analogue Scale (VAS), at 90min following birth were significantly lower than scores recorded 2 days postpartum [Capogna G, Alahuhta S, Celleno D, De Vlieger H, Moreira J, Morgan B, et al. Maternal expectations and experiences of labour pain and analgesia: a multi-centre study of nulliparous women. International Journal of Obstetric Anaesthesia 1996;5:229-35]. The mean score was 6.6. Previous studies suggest that a reduction from 8.5 to 7.5 would significantly reduce pharmacological analgesia in labour [Capogna G, Alahuhta S, Celleno D, De Vlieger H, Moreira J, Morgan B, et al. Maternal expectations and experiences of labour pain and analgesia: a multi-centre study of nulliparous women. International Journal of Obstetric Anaesthesia 1996;5:229-35].     

What are the reasons for nurses using complementary therapy in practice?

The increasing popularity of complementary therapies has generated many surveys to establish how many nurses are involved in its use. This paper explores reasons why nurses are using complementary therapy in orthodox nursing practice to determine the catalysts influencing its use. The following areas are addressed: definitions, terminology and historical aspects of complementary medicine relationship with orthodox medicine, examining dominance, conflict, partnerships and socialization rise in popularity nurse involvement and implications to the profession methodology and findings conclusion. Information about nurses practising complementary therapies was obtained from the King's Fund London and from hospitals within the researcher's local area. Questionnaires for the pilot study were self administered locally, while those for the main study were sent through the postal system.     

The effectiveness of massage for reducing pregnant women's anxiety and depression; systematic review and meta-analysis

ObjectiveTo critically appraise and synthesize the best available evidence on the effectiveness of massage to reduce antenatal women's anxiety and/ or depression.DesignSystematic review with meta-analysisParticipants, interventionsPregnant women over the age of 18 years who receive massage interventions.Measurements and findingsEight studies were included in the review; seven were randomized controlled trials. Data were collected via pregnant women's self-reported ratings of anxiety or depression using validated tools. Meta-analysis of four studies revealed a moderate effect of massage therapy on women's depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) (MD = -5.95, 95%CI = -8.11 to -3.80, I² = 0%) compared with usual care. A moderate effect of massage interventions on women's anxiety were also found based on five studies using various measures (SMD = -0.59, 95%CI = -1.06 to -0.12, I² = 75%) when compared with usual care. However, none of the trials had a low risk of bias.Key conclusionsNon-pharmacologic treatments for mental health symptoms are an important option for women to use during pregnancy. As shown in meta-analysed data, massage therapy might be more effective in reducing pregnant women's anxiety and depression than usual care, although the current results may be prone to bias. Further high-quality research is required to fully evaluate the impact of massage therapy on pregnant women's mental health symptoms in the immediate and also longer term.Implications for practiceMassage therapy may be an acceptable and feasible approach for pregnant women to employ to reduce their anxiety and depressive symptoms. More research evidence examining the safety and effectiveness of massage is required before practice recommendations can be made.     

The power to terrify: eclampsia in 19th-century American practice

Throughout the 19th century, eclampsia was among the most dreaded complications of pregnancy. Conflicts arose over proposed etiologies and therapeutic modalities. Bloodletting and other harsh therapies reflected the prevailing humoral, neurovascular, and toxicologic theories. The role of untrained and professional nurses in the lying-in room of an eclamptic woman emerges from the literature of the time. An appreciation of the history of eclampsia provides context for the modern obstetric nurse.     

Effects of Massage Therapy on Indirect Hyperbilirubinemia in Newborns Who Receive Phototherapy

ObjectiveTo evaluate the effects of massage therapy on total serum bilirubin (TSB) levels and frequency of defecation, urination, and feeding in newborns who receive phototherapy for indirect hyperbilirubinemia.DesignA randomized controlled clinical trial.SettingAnkara University Cebeci Research and Training Hospital and 29 May State Hospital in Ankara, Turkey.ParticipantsFifty full-term newborns with indirect hyperbilirubinemia who underwent phototherapy.MethodsThe newborns were randomly allocated to an intervention group (n = 25) or a control group (n = 25). Newborns in the intervention group received massage therapy throughout the duration of phototherapy for 15 minutes twice per day; newborns in the control group received routine care during phototherapy. Every 24 hours, TSB levels were measured, and the frequencies of defecation, urination, and feeding were also calculated for each newborn.ResultsWe found no differences in the characteristics of the newborns or in TSB levels between groups at enrollment. After treatment, TSB levels were lower in the intervention group (p < .001). Frequencies of defecation, urination, and feeding were significantly greater in the intervention group than in the control group.ConclusionMassage therapy had significant effects on TSB levels, feeding, breastfeeding, defecation, and urination in newborns who received phototherapy for indirect hyperbilirubinemia. Massage therapy can be added as routine care for full-term newborns with hyperbilirubinemia under phototherapy and may be an effective supplementary intervention.     

Baby massage classes and the work of the International Association of Infant Massage

This article describes the role of the International Association of Infant Massage (IAIM) in promoting the importance of touch for the developing relationship between the parents and infants. Infants are unique personalities and it is important that the parent learns how to respond appropriately to the infant's needs. Infant massage classes can demonstrate and promote interaction with infants using eye-to-eye contact, recognizing infant cues, talking and singing, and responding in a loving and sensitive manner. The photographs are of an infant massage class held recently in Leicestershire.     

Premenstrual symptoms are relieved by massage therapy

Twenty-four women meeting Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria for premenstrual dysphoric disorder (PDD) were randomly assigned to a massage therapy or a relaxation therapy group. The massage group showed decreases in anxiety, depressed mood and pain immediately after the first and last massage sessions. The longer term (5 week) effects of massage therapy included a reduction in pain and water retention and overall menstrual distress. However, no long-term changes were observed in the massaged group's activity level or mood. Future studies might examine the effects of a longer massage therapy program on these symptoms. Overall, the findings from this study suggest that massage therapy may be an effective adjunct therapy for treating severe premenstrual symptoms.     

Anxiety reduction in patients undergoing cardiac catheterization following massage and guided imagery

ObjectiveThis study aimed to evaluate the effectiveness of massage with or without guided imagery in reducing anxiety prior to cardiac catheterization.MethodA total of 55 inpatients and outpatients received massage, guided imagery, or massage with guided imagery prior to cardiac catheterization. Self-reported anxiety levels and blood pressure (BP) and heart rate (HR) were evaluated in participants and a matched comparison group.ResultsMassage with and without guided imagery resulted in significant reductions in self-reported anxiety (p < 0.0001). Patients receiving intervention had lower diastolic BP and HR vs. the comparison group (p < 0.0001 and p < 0.05).ConclusionsMassage with or without guided imagery immediately reduced self-reported anxiety. This pilot study has certain limitations: a non-randomized, convenience sample and a matched control group that was created retrospectively. However, the study indicates a benefit to providing massage or massage with guided imagery prior to anxiety-inducing medical procedures such as cardiac catheterization.     

Paediatric nurses' attitudes to massage and aromatherapy massage

Complementary therapies have continued to increase in popularity in healthcare and it is widely accepted that they can be incorporated into the nursing role. However, this acceptance does not necessarily mean that the introduction of therapies into the nursing arena has been without confusion and without professional and legal implications. Consequently, this small-scale, qualitative study aimed to explore the perceptions and lived experiences of paediatric nurses of two therapies, namely massage and aromatherapy massage. There is a dearth of literature exploring nurses' perceptions to the incorporation of these therapies, especially in the arena of paediatric nursing where massage and aromatherapy massage are common practice. Semi-structured interviews were undertaken with qualified nurses and revealed the themes of 'benefit', 'family centred care', 'nursing care' and 'being held back'. It was found that at some stage during their professional career each nurse had performed massage and/or aromatherapy massage. All nurses were able to recall certain benefits of the therapies for the children that they had observed and many discussed the importance of involving the family as a way of including them in to the care of their child. However, for the nurses in this study, it was evident that the incorporation of complementary therapies into the nursing role was determined by the context in which they practised. Due to the dominance of the medical model, nurses faced pressures and conflicts in the realities of their nursing work, which meant they were often unable to carry out these therapies.     

Effects of massage therapy and presence of attendant on pain, anxiety and satisfaction during labor

Purpose

To investigate the effects of massage and presenting an attendant on pain, anxiety and satisfaction during labor to clarify some aspects of using an alternative complementary strategy.

Methods

120 primiparous women with term pregnancy were divided into massage, attendant and control groups randomly. Massage group received firm and rhythmic massage during labor in three phases. After 30?min massage at each stage, pain, anxiety and satisfaction levels were evaluated. Self-reported present pain intensity scale was used to measure the labor pain. Anxiety and satisfaction were measured with the standard visual analog scale.

Results

Massage group had lower pain state in second and third phases (p?p?p?p?p?p?p?Conclusions Findings suggest that massage is an effective alternative intervention, decreasing pain and anxiety during labor and increasing the level of satisfaction. Also, the supportive role of presenting an attendant can positively influence the level of anxiety and satisfaction.     

The Long and Tortuous History of the Discovery of Testosterone and Its Clinical Application

IntroductionThe testis importance in homeostasis was recognized for millennia, but a consistent interest in exploring their endocrine function only goes back to about a century.AimThe aim of this study is to provide a succinct perspective of the events leading to the discovery of testosterone, the mind‐boggling early attempts at therapy and today's situation.MethodThe literature was reviewed with searches in OvidSP Medline, PubMed, and Google Scholar under the headings of testosterone/androgens history. Due to the explosion of reports between the late 19th and early 20th centuries, a manual review of the collection of the period's journals at the university's library was performed. Pertinent books were consulted for specific biographical details.ResultsThere is a robust body of literature dealing with testicular function for the period starting in the late 1800s. It is illustrative to learn the painful efforts of many well‐intentioned and honest scientists with more conviction and determination than knowledge. Among them, unfortunately, a number of charlatans and profiteers tainted the concept of hypogonadism and its treatment with repercussions lasting until this day. The discovery and synthesis of testosterone represent the effort of brilliant minds (two Nobel Prizes) in various countries and frequently working for the pharmaceutical industry. Shortly after testosterone became available, controversy arose about its application, use, abuse, and potential detrimental effects. Over the decades, the hullabaloo about hypogonadism and its treatment has focused on a variety of issues ranging from absurd efficacy claims to solid studies and from doubts of its existence to convincing proof of a detrimental age‐associated deficit in testosterone production.ConclusionsThe history of testosterone discovery, synthesis, and introduction into the therapeutic armamentarium is an outstanding example of human curiosity, ingenuity, greed, and skepticism. Despite the vast progress in the field, many issues remain unresolved, but thoughtful science augurs well for its future.     

Comparing the effects of massage and aromatherapy massage with lavender oil on sleep quality of cardiac patients: A randomized controlled trial

IntroductionSleep disorder is a common problem in cardiac patients. This study aimed to investigate the effect of massage and aromatherapy massage on sleep quality of cardiac patients.Materials and methodsin this study, 150 subjects were randomly allocated into 1)massage, 2)aromatherapy massage and 3)control. In the massage group, the subjects received hands and feet massage using sweet almond oil. In the second group, the massage was performed on the same areas using a mixture of lavender and sweet almond oil. Data collection tool included Pittsburgh Sleep Quality Index (PSQI). Before and after the intervention, the PSQI was completed by the subjects.ResultsThere was a significant difference between the mean scores of PSQI before and after the intervention in the intervention and control groups, but this difference was not statistically significant between the two intervention groups.ConclusionMassage and aromatherapy massage can improve the sleep quality in cardiac patients.     

A minority report: teaching fathers baby massage

Infant or baby massage has emerged in the recent decade as an activity promoted by health care professionals, popular with parents and the subject of a growing body of research evidence (Complement. Ther. Nurs. Midwifery 2 (1996) 151; 3 & 8 Tough Ther. 2000). This paper reports on the experience of establishing and facilitating baby massage training. There is a focus in the discussion on teaching fathers, as only one male parent attended the classes over a 6-month period. Recommendations are made in the conclusion, identifying possible ways of promoting fathers involvement in babies massage. The paper, with its images of a father engaged in baby massage, is intended to add to the current limited amount of literature available on this subject.     

Burning the midnight oil

A requirement for all trained nurses is that they undertake to follow a structured programme of professional development. Unfortunately, the prospect of copious amounts of study is the stuff of which bad dreams are made and the thought of enrolling for any course, let alone one at degree level, remains a very real source of anxiety. Because of my interest in using massage therapy in the Trust where I then worked, I enrolled for a part-time course at the University of Exeter, a centre well known in nursing circles for its research into complementary medicine. The following account of my experience of combining study with a full-time job is intended to provide encouragement for anyone who may be currently in the process of considering a similar course of action.     

Working in partnership to develop evidence-based practice within the massage profession

In view of changing policy and recommendation for complementary medicine, the moves towards regulatory mechanisms and an evidence base for practice, there is a need to establish the extent to which this is happening within professions and identify away forward that will benefit the individuals and organisations involved. This paper outlines the views and opinions of professional masseurs at the Northern Institute of Massage in the North of England and discusses how such a professional organisation for massage can work in partnership with Higher Education to develop a stronger evidence base for practice. The study concludes that a significant number of practitioners of the Northern Institute are aware of the need for an evidence base for practice but need to be supported in finding, reading and applying research findings to their practice. A partnership between professional organisations for massage and higher education can benefit both parties and help to facilitate change for the future.