Perlman A, Mojica E, Williams A-L, Njike V, Katz DL.
Massage therapy for osteoarthritis of the knee: results
of randomized controlled trial.
University of Medicine and Dentistry of New Jersey,
65 Bergen St, SSB Room 101, Newark, NJ 07101-1709. a.perlman@umdnj.edu
OBJECTIVE & DESIGN: To determine whether massage
therapy relieves pain and symptoms of osteoarthritis (OA) of the knee,
a randomized, controlled trial of 8 weeks massage therapy was conducted
on 68 adult outpatients at an integrative medicine center in a Northern
New Jersey suburban hospital.
PARTICIPANTS: Adults over age 35 with a diagnosis
of OA of the knee, with a pre-randomization score of between 4 to 9
on the Western Ontario & McMaster Universities OA Index (WOMAC) pain
visual analog scale (0= no pain, 10= worst pain ever). Excluded were
patients with the presence of rheumatoid arthritis, fibromyalgia, pseudo-gout,
cancer or other serious medical conditions, having recent history of
steroids or oral corticosteroids use, recent arthroscopy or injury of
the knee.
INTERVENTION: Randomization to either 8 wks
of massage therapy or 8 wks of usual care. Twice weekly (wks 1-4) sessions
of massage therapy (to build a loading dose of massage treatments),
followed by once weekly sessions for wks 5 through 8 was conducted.
Two licensed therapists provided a standard Swedish full-body therapeutic
massage following a study protocol incorporating specific strokes. Interventions
consisted of a one-hour massage session or usual medical care for their
OA symptoms.
MEASUREMENTS: Primary outcomes were changes
in the WOMAC pain and functional scores, and changes in the Visual Analog
Scale (VAS) assessment of pain.
RESULTS: 68 subjects participated in the study
(34 per group) from 210 screened. Groups were comparable in demographic
and baseline clinical characteristics - participants were Caucasian
(85%), female (78%) and elderly (62% > 65 yrs), and generally overweight.
After 8 wks, the massage therapy group demonstrated significant improvements
in the WOMAC Global Score (-21.15± 2.46 mm; p<.0001), Stiffness (-21.60±26.99
mm; p<.0001), Physical Function domains (-20.50±22.50 mm; p<.0001) and
Pain (-17.62±31.06 mm; p=0.0023). Similar improvements were observed
in the VAS, ROM and time to walk 50 feet (p<0.05). Findings persisted
after controlling for demographic and baseline clinical values. At 16
wks, improvements seen in the massage therapy group, generally persisted.
CONCLUSIONS: Massage therapy appears to be efficacious
and well tolerated in the treatment of OA of the knee, and might offer
an alternative or adjunct to pharmacotherapy. Further study of this
modality is clearly warranted.
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