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Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial.

Perlman AI, Ali A, Njike VY, Hom D, Davidi A, Gould-Fogerite S, Milak C, Katz DL - PLoS ONE (2012)

Bottom Line: Outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog pain scale, range of motion, and time to walk 50 feet, assessed at baseline, 8-, 16-, and 24-weeks.WOMAC subscales of pain and functionality, as well as the visual analog pain scale also demonstrated significant improvements in the 60-minute doses compared to usual care.No significant differences were seen in range of motion at 8-weeks, and no significant effects were seen in any outcome measure at 24-weeks compared to usual care.

View Article: PubMed Central - PubMed

Affiliation: Duke Integrative Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America. adam.perlman@duke.edu

ABSTRACT

Background: In a previous trial of massage for osteoarthritis (OA) of the knee, we demonstrated feasibility, safety and possible efficacy, with benefits that persisted at least 8 weeks beyond treatment termination.

Methods: We performed a RCT to identify the optimal dose of massage within an 8-week treatment regimen and to further examine durability of response. Participants were 125 adults with OA of the knee, randomized to one of four 8-week regimens of a standardized Swedish massage regimen (30 or 60 min weekly or biweekly) or to a Usual Care control. Outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog pain scale, range of motion, and time to walk 50 feet, assessed at baseline, 8-, 16-, and 24-weeks.

Results: WOMAC Global scores improved significantly (24.0 points, 95% CI ranged from 15.3-32.7) in the 60-minute massage groups compared to Usual Care (6.3 points, 95% CI 0.1-12.8) at the primary endpoint of 8-weeks. WOMAC subscales of pain and functionality, as well as the visual analog pain scale also demonstrated significant improvements in the 60-minute doses compared to usual care. No significant differences were seen in range of motion at 8-weeks, and no significant effects were seen in any outcome measure at 24-weeks compared to usual care. A dose-response curve based on WOMAC Global scores shows increasing effect with greater total time of massage, but with a plateau at the 60-minute/week dose.

Conclusion: Given the superior convenience of a once-weekly protocol, cost savings, and consistency with a typical real-world massage protocol, the 60-minute once weekly dose was determined to be optimal, establishing a standard for future trials.

Trial registration: ClinicalTrials.gov NCT00970008.

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Related in: MedlinePlus

Participant Flow Diagram.
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pone-0030248-g001: Participant Flow Diagram.

Mentions: Those passing telephone screening (nā€Š=ā€Š125), agreeing to the study protocol, and providing a written physician confirmation of OA were scheduled for an on-site evaluation to provide written informed consent and undergo clinical eligibility screening. All subjects received nominal compensation (consisting of gift certificates for future massages) for their participation. The intervention was delivered at two sites; St. Barnabas Ambulatory Care Center (Livingston, NJ), and the Integrative Medicine Center at Griffin Hospital (Derby, CT). Subject participation and flow are shown in Figure 1.


Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial.

Perlman AI, Ali A, Njike VY, Hom D, Davidi A, Gould-Fogerite S, Milak C, Katz DL - PLoS ONE (2012)

Participant Flow Diagram.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3275589&req=5

pone-0030248-g001: Participant Flow Diagram.
Mentions: Those passing telephone screening (nā€Š=ā€Š125), agreeing to the study protocol, and providing a written physician confirmation of OA were scheduled for an on-site evaluation to provide written informed consent and undergo clinical eligibility screening. All subjects received nominal compensation (consisting of gift certificates for future massages) for their participation. The intervention was delivered at two sites; St. Barnabas Ambulatory Care Center (Livingston, NJ), and the Integrative Medicine Center at Griffin Hospital (Derby, CT). Subject participation and flow are shown in Figure 1.

Bottom Line: Outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog pain scale, range of motion, and time to walk 50 feet, assessed at baseline, 8-, 16-, and 24-weeks.WOMAC subscales of pain and functionality, as well as the visual analog pain scale also demonstrated significant improvements in the 60-minute doses compared to usual care.No significant differences were seen in range of motion at 8-weeks, and no significant effects were seen in any outcome measure at 24-weeks compared to usual care.

View Article: PubMed Central - PubMed

Affiliation: Duke Integrative Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America. adam.perlman@duke.edu

ABSTRACT

Background: In a previous trial of massage for osteoarthritis (OA) of the knee, we demonstrated feasibility, safety and possible efficacy, with benefits that persisted at least 8 weeks beyond treatment termination.

Methods: We performed a RCT to identify the optimal dose of massage within an 8-week treatment regimen and to further examine durability of response. Participants were 125 adults with OA of the knee, randomized to one of four 8-week regimens of a standardized Swedish massage regimen (30 or 60 min weekly or biweekly) or to a Usual Care control. Outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog pain scale, range of motion, and time to walk 50 feet, assessed at baseline, 8-, 16-, and 24-weeks.

Results: WOMAC Global scores improved significantly (24.0 points, 95% CI ranged from 15.3-32.7) in the 60-minute massage groups compared to Usual Care (6.3 points, 95% CI 0.1-12.8) at the primary endpoint of 8-weeks. WOMAC subscales of pain and functionality, as well as the visual analog pain scale also demonstrated significant improvements in the 60-minute doses compared to usual care. No significant differences were seen in range of motion at 8-weeks, and no significant effects were seen in any outcome measure at 24-weeks compared to usual care. A dose-response curve based on WOMAC Global scores shows increasing effect with greater total time of massage, but with a plateau at the 60-minute/week dose.

Conclusion: Given the superior convenience of a once-weekly protocol, cost savings, and consistency with a typical real-world massage protocol, the 60-minute once weekly dose was determined to be optimal, establishing a standard for future trials.

Trial registration: ClinicalTrials.gov NCT00970008.

Show MeSH
Related in: MedlinePlus