There
are a number of research classics, both old and new, that are of particular
importance. The
recent explosion in massage therapy research makes it difficult for a
newcomer to find them and to appreciate their importance. Sometimes,
it truly is difficult to see the forest for the trees.
This page references, in no particular order, a number of research reports that are often cited or quoted by leading instructors and practitioners, in the media and within S4OM. They may have scientific shortcomings (some of which are noted) but each makes it's point particularly well.
Please send your suggestions to webmaster@s4om.org.
Suggested by George Lee
Oncologist. 2010;15 Suppl 2:19-23.
Integrative and Behavioral Approaches to the Treatment of Cancer-Related Neuropathic Pain (Full Text)
Cassileth BR, Keefe FJ.
Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Abstract
Integrative oncology is the synthesis of mainstream cancer care and evidence-based complementary therapies. Complementary strategies include massage therapies, acupuncture, fitness, and mind-body techniques, which take advantage of the reciprocal relationship between the mind and body. Neuropathic pain--and pain more generally--is part of a complex process involving the whole physical and psychosocial being, therefore requiring an integrative management approach. Several studies have demonstrated, for example, that social context plays an important role in the perception of pain and that a patient's coping strategies can influence the persistence of pain. In this article, we briefly describe research illustrating the promise of integrative approaches for the treatment of cancer-related neuropathic pain.Conclusion
Neuropathic pain or sensory dysfunction is a chronic, often debilitating condition that affects an increasing number of cancer patients. ... The advantage of complementary approaches such as massage therapy, acupuncture, and mind–body therapies such as meditation and self-hypnosis is that they are inexpensive, safe, noninvasive, and absent of side effects, in contrast to pharmaceuticals administered for pain management. Evidence for the efficacy of these approaches continues to accumulate. Furthermore, these techniques should be especially welcome in light of current and pending health care realities, especially increasing costs and the decreasing availability of physicians.
Suggested by Bruce Hopkins
J Pain Symptom Manage. 2004 Sep;28(3):244-9.
Massage therapy for symptom control: outcome study at a major cancer center. (Full Text)
Cassileth BR, Vickers AJ.
Memorial Sloan-Kettering Cancer Center, New York, New YorkAbstract
Massage is increasingly applied to relieve symptoms in patients with cancer. This practice is supported by evidence from small randomized trials. No study has examined massage therapy outcome in a large group of patients. At Memorial Sloan-Kettering Cancer Center, patients report symptom severity pre- and post-massage therapy using 0-10 rating scales of pain, fatigue, stress/anxiety, nausea, depression and "other." Changes in symptom scores and the modifying effects of patient status (in- or outpatient) and type of massage were analyzed. Over a three-year period, 1,290 patients were treated. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients improved about 10% more than inpatients. Benefits persisted, with outpatients experiencing no return toward baseline scores throughout the duration of 48-hour follow-up. These data indicate that massage therapy is associated with substantive improvement in cancer patients' symptom scores.Conclusion
Massage therapies apparently lead to large, immediate improvements in symptoms scores in cancer patients, even those with very high baseline scores indicating substantial levels of pain, anxiety, or other symptoms. Outpatients experienced persisting benefit across the total of 48 hours studied. We plan a prospective controlled trial for longer periods of time to determine the duration of effect. Meanwhile, it is clear that massage therapy achieves major reductions in cancer patients’ pain, fatigue, nausea, anxiety and depression. Massage therapy appears to be an uncommonly non-invasive and inexpensive means of symptom control for patients with serious chronic illness. It is non-invasive, inexpensive, comforting, free of side effects and greatly appreciated by recipients. This non-randomized study suggests that it is also markedly effective.
Suggested by Tracy Walton
Psychological Bulletin 2004, Vol. 130, No. 1, 3–18
A Meta-Analysis of Massage Therapy Research (Full Text)
Moyer, Rounds and Hannum
University of Illinois at Urbana–ChampaignAbstract
Massage therapy (MT) is an ancient form of treatment that is now gaining popularity as part of the complementary and alternative medical therapy movement. A meta-analysis was conducted of studies that used random assignment to test the effectiveness of MT. Mean effect sizes were calculated from 37 studies for 9 dependent variables. Single applications of MT reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level. Multiple applications reduced delayed assessment of pain. Reductions of trait anxiety and depression were MT’s largest effects, with a course of treatment providing benefits similar in magnitude to those of psychotherapy. No moderators were statistically significant, though continued testing is needed. The limitations of a medical model of MT are discussed, and it is proposed that new MT theories and research use a psychotherapy perspective.MT from a psychotherapy perspective.
Another theory that has not previously been put forth may also account for MT effects. MT may provide benefit in a way that parallels the common-factors model of psychotherapy. Substantial evidence suggests that the considerable efficaciousness of psychotherapy results not from any specific ingredient of treatment, but rather from the factors that all forms of psychotherapy share (Wampold, 2001). In this model, factors such as a client who has positive expectations for treatment, a therapist who is warm and has positive regard for the client, and the development of an alliance between the therapist and client are considered to be more important than adherence to a specific modality of psychotherapy. The same model can be extended to MT, given the possibility that benefits arising from it may come about more from factors such as the recipient’s attitude toward MT, the therapist’s personal characteristics and expectations, and the interpersonal contact and communication that take place during treatment, as opposed to the specific form of MT used or the site to which it is applied. Several of the findings in the present study are consistent with such a model applied to MT. The finding that MT has an effect on trait anxiety and depression that is similar in magnitude to what would be expected to result from psychotherapy suggests the possibility that these different treatments may be more similar than previously considered. Further support comes from the fact that MT training was not predictive of effects. Possibly, MT effects are more closely linked with characteristics of the massage provider that are independent of skill or experience in performing soft tissue manipulation.
