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Fan M, Liu A, Lu T, Zhou X, Tian C, Liu B, Xie Q, Cai J, Yin L, Ge L, Wu D. Quality appraisal of clinical practice guidelines addressing massage interventions using the AGREE II instrument. Syst Rev 2024; 13:83. [PMID: 38459534 PMCID: PMC10921609 DOI: 10.1186/s13643-024-02503-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/23/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE The purpose of this study was to systematically evaluate the methodological quality of massage-related clinical practice guidelines (CPGs)/consensus on massage using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument and to summarize the current status of recommendations in the CPGs. METHODS The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM), PubMed, Embase, and guideline websites (such as the Chinese Medical Ace Base, the China Association of Chinese Medicine, the World Health Organization, Guideline International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network) were searched from inception to October 31, 2022. In addition, the reference lists of relevant studies were reviewed to identify domestic and overseas massage CPGs/consensus. The search terms adopted a combination of subject words and free words, mainly including traditional Chinese medicine, complementary therapies, Tuina, massage, manipulation, chiropractic/osteopathic, spinal, acupressure, guideline, and consensus. Two researchers independently completed the eligible records and extracted the data. Before the formal research, calibrations were performed twice on AGREE II, and all reviewers completed the pilot test three times until they understood and reached an agreement on the assessment items. Three researchers appraised the methodological quality of the included guidelines using the AGREE II instrument and calculated the overall intraclass correlation coefficient (ICC) of agreement. RESULTS The evaluation results showed that among the 49 eligible CPGs/consensus, 4 (8.2%) CPGs/consensus were considered "recommended", 15 (30.6%) CPGs/consensus were considered "recommended with modifications", and 30 (61.2%) CPGs/consensus were considered "not recommended", while the consensus was considered "not recommended". Generally, the scores in the six domains of the guidelines were all higher than the consensus. Evaluation results for the overall quality of 36 CPGs showed that 4 (11%) were "good quality", 15 (42%) were "sufficient quality" and 17 (47%) were "lower quality". The AGREE II quality scores of domains ranged from 0.30 to 0.75 ([ICC = 0.993, 95% CI (0.992, 0.995)]). The domain of scope and purpose (domain 1), with a median score of 0.75 (0.52~0.91), performed best in the guidelines with AGREE II, and stakeholder involvement (domain 2) [median 0.39 (0.31~0.56)] and application (domain 5) [median 0.30 (0.17~0.47] obtained lower scores. The consensus score of domain 1 was better at 26.0 (21.6~44.8), followed by rigor of development (domain 3) with a score of 18.0 (10.0~28.9). A total of 119 massage-related recommendations were extracted from 49 guidelines/consensuses, including "in favor" (102, 85.7%), "against" (9, 7.6%), and "did not make recommendations" (8, 6.7%). CONCLUSION The overall quality of the included guidelines was low, and most of the guidelines were not "recommended". In future guideline updates, the existing evidence should be used, the professional composition of members of the expert group should be enriched, and patients' values and preferences should be fully considered. It is necessary to clearly propose recognizable recommendations and strengthen the rigor and standardization of guideline formulation. Thus, clear standard guidelines can be formulated to better guide clinical practice.
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Affiliation(s)
- Mingyue Fan
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Aolin Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Taoying Lu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Xiaowen Zhou
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Chen Tian
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Bingqing Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Qianwen Xie
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jianxiong Cai
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Lingjia Yin
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
- Karolinska Institutet, Stockholm, Sweden
| | - Long Ge
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, People's Republic of China
| | - Darong Wu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
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Gross AR, Lee H, Ezzo J, Chacko N, Gelley G, Forget M, Morien A, Graham N, Santaguida PL, Rice M, Dixon C. Massage for neck pain. Cochrane Database Syst Rev 2024; 2:CD004871. [PMID: 38415786 PMCID: PMC10900303 DOI: 10.1002/14651858.cd004871.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Massage is widely used for neck pain, but its effectiveness remains unclear. OBJECTIVES To assess the benefits and harms of massage compared to placebo or sham, no treatment or exercise as an adjuvant to the same co-intervention for acute to chronic persisting neck pain in adults with or without radiculopathy, including whiplash-associated disorders and cervicogenic headache. SEARCH METHODS We searched multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL, Index to Chiropractic Literature, trial registries) to 1 October 2023. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing any type of massage with sham or placebo, no treatment or wait-list, or massage as an adjuvant treatment, in adults with acute, subacute or chronic neck pain. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. We transformed outcomes to standardise the direction of the effect (a smaller score is better). We used a partially contextualised approach relative to identified thresholds to report the effect size as slight-small, moderate or large-substantive. MAIN RESULTS We included 33 studies (1994 participants analysed). Selection (82%) and detection bias (94%) were common; multiple trials had unclear allocation concealment, utilised a placebo that may not be credible and did not test whether blinding to the placebo was effective. Massage was compared with placebo (n = 10) or no treatment (n = 8), or assessed as an adjuvant to the same co-treatment (n = 15). The trials studied adults aged 18 to 70 years, 70% female, with mean pain severity of 51.8 (standard deviation (SD) 14.1) on a visual analogue scale (0 to 100). Neck pain was subacute-chronic and classified as non-specific neck pain (85%, including n = 1 whiplash), radiculopathy (6%) or cervicogenic headache (9%). Trials were conducted in outpatient settings in Asia (n = 11), America (n = 5), Africa (n = 1), Europe (n = 12) and the Middle East (n = 4). Trials received research funding (15%) from research institutes. We report the main results for the comparison of massage versus placebo. Low-certainty evidence indicates that massage probably results in little to no difference in pain, function-disability and health-related quality of life when compared against a placebo for subacute-chronic neck pain at up to 12 weeks follow-up. It may slightly improve participant-reported treatment success. Subgroup analysis by dose showed a clinically important difference favouring a high dose (≥ 8 sessions over four weeks for ≥ 30 minutes duration). There is very low-certainty evidence for total adverse events. Data on patient satisfaction and serious adverse events were not available. Pain was a mean of 20.55 points with placebo and improved by 3.43 points with massage (95% confidence interval (CI) 8.16 better to 1.29 worse) on a 0 to 100 scale, where a lower score indicates less pain (8 studies, 403 participants; I2 = 39%). We downgraded the evidence to low-certainty due to indirectness; most trials in the placebo comparison used suboptimal massage doses (only single sessions). Selection, performance and detection bias were evident as multiple trials had unclear allocation concealment, utilised a placebo that may not be credible and did not test whether blinding was effective, respectively. Function-disability was a mean of 30.90 points with placebo and improved by 9.69 points with massage (95% CI 17.57 better to 1.81 better) on the Neck Disability Index 0 to 100, where a lower score indicates better function (2 studies, 68 participants; I2 = 0%). We downgraded the evidence to low-certainty due to imprecision (the wide CI represents slight to moderate benefit that does not rule in or rule out a clinically important change) and risk of selection, performance and detection biases. Participant-reported treatment success was a mean of 3.1 points with placebo and improved by 0.80 points with massage (95% CI 1.39 better to 0.21 better) on a Global Improvement 1 to 7 scale, where a lower score indicates very much improved (1 study, 54 participants). We downgraded the evidence to low-certainty due to imprecision (single study with a wide CI that does not rule in or rule out a clinically important change) and risk of performance as well as detection bias. Health-related quality of life was a mean of 43.2 points with placebo and improved by 5.30 points with massage (95% CI 8.24 better to 2.36 better) on the SF-12 (physical) 0 to 100 scale, where 0 indicates the lowest level of health (1 study, 54 participants). We downgraded the evidence once for imprecision (a single small study) and risk of performance and detection bias. We are uncertain whether massage results in increased total adverse events, such as treatment soreness, sweating or low blood pressure (RR 0.99, 95% CI 0.08 to 11.55; 2 studies, 175 participants; I2 = 77%). We downgraded the evidence to very low-certainty due to unexplained inconsistency, risk of performance and detection bias, and imprecision (the CI was extremely wide and the total number of events was very small, i.e < 200 events). AUTHORS' CONCLUSIONS The contribution of massage to the management of neck pain remains uncertain given the predominance of low-certainty evidence in this field. For subacute and chronic neck pain (closest to 12 weeks follow-up), massage may result in a little or no difference in improving pain, function-disability, health-related quality of life and participant-reported treatment success when compared to a placebo. Inadequate reporting on adverse events precluded analysis. Focused planning for larger, adequately dosed, well-designed trials is needed.
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Affiliation(s)
- Anita R Gross
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Haejung Lee
- Department of Physical Therapy, Silla University, Busan, Korea, South
| | - Jeanette Ezzo
- Research Director, JME Enterprises, Baltimore, Maryland, USA
| | - Nejin Chacko
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Geoffrey Gelley
- Applied Health Sciences PhD Program, University of Manitoba, Winnipeg, MB, Canada
- Integrative Medicine, University of Manitoba, Winnipeg, Canada
| | - Mario Forget
- Canadian Forces Health Services Group | Groupe de services de santé des Forces Canadiennes, National Defense | Défense Nationale, Kingston, Canada
| | - Annie Morien
- Research Department, Florida School of Massage, Gainesville, FL, USA
| | - Nadine Graham
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Pasqualina L Santaguida
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | | | - Craig Dixon
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
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Mete O, Kaya DO, Keskin M, Celenay ST. Western Massage Therapies in the Management of Neck Pain: A Systematic Review. J Manipulative Physiol Ther 2023:S0161-4754(23)00024-6. [PMID: 37422753 DOI: 10.1016/j.jmpt.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 04/16/2023] [Accepted: 05/15/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE The purpose of this review was to compare types of Western massage therapy (MT) to other therapies, placebo, and no-treatment controls in neck pain (NP) in randomized and nonrandomized clinical trials. METHODS An electronic, systematic search was performed in 7 English and 2 Turkish databases (PubMed, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence-Based Database, ULAKBIM National Medical Database, and the Reference Directory of Turkey). The search terms "NP" and "massage" were used. Studies published between January 2012 and July 2021 were searched. Methodological quality was evaluated with Downs and Black Scale and version 2 of the Cochrane risk-of-bias tool. RESULTS A total of 932 articles were identified; 8 of them were eligible. The Downs and Black score ranged from 15 to 26 points. Two studies were rated as "fair," 3 studies as "good," and 3 studies as "excellent." According to version 2 of the Cochrane risk-of-bias tool, 3 studies had a low risk of bias, 3 studies had some concerns, and 2 studies had a high risk of bias. Fair evidence found that myofascial release therapy improved pain intensity and pain threshold compared to no intervention in the short term. Excellent evidence found that connective tissue massage with exercise improved pain intensity and pain threshold compared to exercise alone in the short term. No Western MTs were superior to other active therapies according to short-term and immediate effects. CONCLUSION This review suggests that Western MTs (myofascial release therapy and connective tissue massage) may improve NP, but studies are limited. This review showed that Western MTs were not superior to other active therapies for improving NP. The reviewed studies reported only immediate and short-term effects of Western MT; thus, high-quality randomized clinical trials investigating the long-term effects of Western MT are needed.
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Affiliation(s)
- Oguzhan Mete
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Izmir Katip Celebi University, İzmir, Turkey
| | - Merve Keskin
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Izmir Katip Celebi University, İzmir, Turkey
| | - Seyda Toprak Celenay
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Ankara Yildirim Beyazit University, Ankara, Turkey.
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Ng JY, Uppal M, Steen J. Neck pain clinical practice guidelines: a systematic review of the quality and quantity of complementary and alternative medicine recommendations. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:2650-2663. [PMID: 35869329 DOI: 10.1007/s00586-022-07288-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Individuals with neck pain frequently turn to complementary and alternative medicine (CAM) to seek relief. However, conventional healthcare providers often lack adequate CAM therapy knowledge to deliver informed recommendations to patients. The purpose of this study was to identify mention of CAM in neck pain clinical practice guidelines (CPG) and assess the quality of CAM recommendations using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. METHODS MEDLINE, EMBASE and CINAHL were systematically searched from 2009 to 2020 in addition to the Guidelines International Network and National Center for Complementary and Integrative Health websites. Eligible CPGs providing CAM recommendations were assessed twice with the AGREE II instrument, once to assess the overall CPG and then once to assess the CAM sections specifically. RESULTS From 643 unique search results, 15 CPGs on the treatment and/or management of neck pain were identified, and 8 made recommendations on CAM therapy. Regarding scaled domain percentages, the overall CPG scored higher than the CAM section for 5 of 6 domains (overall, CAM): (1) scope and purpose (93.4%, 93.1%), (2) stakeholder involvement (81.6%, 81.9%), (3) rigour of development (70.8%, 66.3%), (4) clarity of presentation (64.9%, 60.8%), (5) applicability (39.3%, 33.6%), and (6) editorial independence (47.9%, 45.3%). CONCLUSIONS Most neck pain CPGs made CAM recommendations. The quality of CAM recommendations is lower than overall recommendations across all domains with the exception of stakeholder involvement. This disparity highlights the need for CAM recommendations quality improvement. Although many patients with neck pain seek CAM therapies, few CPGs are available for healthcare providers and patients.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Mitali Uppal
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Jeremy Steen
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
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Abbasi Z, Hakimi Najaf Abadi M, Ganji R, Asali R, Nabavi SH, Rezaeean SM, Poorbarat S. The Effect of Effleurage Massage Therapy on Symptoms of Osteoarthritis in Elderly Women with Osteoarthritis: A Cross-Clinical Trial. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Osteoarthritis is the main and most common cause of pain and disability in older people. It affects women 3.5 times more than men.
AIM: Therefore, the present study aimed to determine the effect of effleurage massage therapy on symptoms of osteoarthritis in elderly women with osteoarthritis.
MATERIALS AND METHODS: The present study was a cross-sectional clinical trial with a control group on 58 elderly women with mild to moderate osteoarthritis in 2018. At the first stage of the study, we give a massage on each knee every day for 15 min a week by the Effleurage method with standard treatment (100 mg diclofenac) and the control group only received standard treatment. At the second stage, the intervention was shifted in groups according to the study type after 3 weeks of washout. The research instrument was a native questionnaire (The Knee Injury and Osteoarthritis Outcome Score [KOOS]). We analyzed data using the SPSS20.
RESULTS: The research results indicated that knee massage techniques could reduce the severity of symptoms at both stages of the study in the intervention group. At the first stage, the severity of symptoms in Group A (intervention group) significantly decreased after the intervention compared to the pre-intervention and also decreased after washout in Group B (intervention group) after the intervention compared to the pre-intervention (p < 0.0001).
CONCLUSION: Given the effect of massage on reducing symptoms of knee osteoarthritis (morning dryness, stiffness, and swelling,) in elderly women with osteoarthritis, massage therapy is recommended as an effective intervention to reduce symptoms of knee osteoarthritis in these patients.
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Efficacy of Manual Therapy and Transcutaneous Electrical Nerve Stimulation in Cervical Mobility and Endurance in Subacute and Chronic Neck Pain: A Randomized Clinical Trial. J Clin Med 2021; 10:jcm10153245. [PMID: 34362029 PMCID: PMC8347502 DOI: 10.3390/jcm10153245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022] Open
Abstract
Neck pain is a frequent health problem. Manual therapy (MT) and transcutaneous electrical nerve stimulation (TENS) are recommended techniques for treatment of mechanical neck disorders (MND) in Spanish Public Primary Care Physiotherapy Services. The aim of this study was to compare the efficacy of MT versus TENS in active mobility and endurance in cervical subacute or chronic neck pain. Ninety patients with MND were randomly allocated to receive ten 30-min sessions of either MT or TENS, in a multi-centered study through 12 Primary Care Physiotherapy Units in the Madrid community. Active cervical range of motion (CD-ROM) and endurance (Palmer and Epler test) were evaluated pre- and post-intervention and at 6-month follow-up. A generalized linear model of repeated measures was constructed for the analysis of differences. Post-intervention MT yielded a significant improvement in active mobility and endurance in patients with subacute or chronic MND, and at 6-month follow-up the differences were only significant in endurance and in sagittal plane active mobility. In the TENS group, no significant improvement was detected. With regard to other variables, MT improved mobility and endurance more effectively than TENS at post-intervention and at 6-month follow-up in the sagittal plane. Only MT generated significant improvements in cervical mobility and endurance in the three movement planes.
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Munk N, Nemati D, Benjamin EV, Davies A, Shue S, Bair MJ. Trigger point self-care for chronic neck pain: Pilot and feasibility. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shamsi S, Alyazedi F, Abdelkader S, Khan S, Akhtar A. Efficacy of sustained natural apophyseal glides in the management of mechanical neck pain: A randomized clinical trial. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2021. [DOI: 10.4103/injms.injms_30_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Effect and Safety of CX-DZ-II Intelligent Electroacupuncture Therapeutic Instrument for Neck Pain Caused by Cervical Spondylos: Study Protocol for A Randomized Controlled Trial. Chin J Integr Med 2019; 26:375-381. [DOI: 10.1007/s11655-019-3038-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2018] [Indexed: 11/26/2022]
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Miake-Lye IM, Mak S, Lee J, Luger T, Taylor SL, Shanman R, Beroes-Severin JM, Shekelle PG. Massage for Pain: An Evidence Map. J Altern Complement Med 2019; 25:475-502. [PMID: 30892910 PMCID: PMC6533778 DOI: 10.1089/acm.2018.0282] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: Massage therapy has been proposed for painful conditions, but it can be difficult to understand the breadth and depth of evidence, as various painful conditions may respond differently to massage. The authors conducted an evidence mapping process and generated an "evidence map" to visually depict the distribution of evidence available for massage and various pain indications to identify gaps in evidence and to inform future research priorities. Design: The authors searched PubMed, Embase, and Cochrane for systematic reviews reporting pain outcomes for massage therapy. The authors assessed the quality of each review using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria. The authors used a bubble plot to depict the number of included articles, pain indication, effect of massage for pain, and strength of findings for each included systematic review. Results: The authors identified 49 systematic reviews, of which 32 were considered high quality. Types of pain frequently included in systematic reviews were cancer pain, low back pain, and neck pain. High quality reviews concluded that there was low strength of evidence of potential benefits of massage for labor, shoulder, neck, low back, cancer, arthritis, postoperative, delayed onset muscle soreness, and musculoskeletal pain. Reported attributes of massage interventions include style of massage, provider, co-interventions, duration, and comparators, with 14 high-quality reviews reporting all these attributes in their review. Conclusion: Prior reviews have conclusions of low strength of evidence because few primary studies of large samples with rigorous methods had been conducted, leaving evidence gaps about specific massage type for specific pain. Primary studies often do not provide adequate details of massage therapy provided, limiting the extent to which reviews are able to draw conclusions about characteristics such as provider type.
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Affiliation(s)
- Isomi M Miake-Lye
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Selene Mak
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | | | - Tana Luger
- 2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Stephanie L Taylor
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Roberta Shanman
- 4 Southern California Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA
| | | | - Paul G Shekelle
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA
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Parikh P, Santaguida P, Macdermid J, Gross A, Eshtiaghi A. Comparison of CPG's for the diagnosis, prognosis and management of non-specific neck pain: a systematic review. BMC Musculoskelet Disord 2019; 20:81. [PMID: 30764789 PMCID: PMC6376764 DOI: 10.1186/s12891-019-2441-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 01/30/2019] [Indexed: 11/30/2022] Open
Abstract
Background Neck pain (NP) is a very common musculoskeletal condition with potential for a high burden in disability and length of disorder. Clinical practice guidelines (CPG) give recommendations to clinicians for providing optimal care for patients however best practice recommendations are often contradictory. The purpose for this review was to conduct a SR of CPGs to assess the management recommendations for NP (diagnosis, treatment, prognosis, imaging). Methods Standard SR methodology was employed including a grey literature search (including the National Guideline Clearing House). Medline, Cinahl, Embase, ILC, Cochrane, Central, and Lilacs were searched from 1995-to March 2018. Two raters evaluated all citations and a third rater resolved any disagreements. The AGREE II was used to assess risk of bias of each CPG. Data was extracted and included CPG purpose, type of NP problem and clinical recommendations. The AGREE II critical appraisal tool was used to assess risk of bias of each CPG. Results From 640 articles, 241 were available for screening. A total of 46 guidelines were selected. CPG’s were categorized by the NP population (General NP, whiplash, interventional, headache and risk for vertebral insufficiency) and type of clinical aim (diagnosis, prognosis, treatment, imaging). Each clinical NP population had a large overlap of clinical aims presented. The CPGs were directed to a variety of clinicians that included physicians, physiotherapists and chiropractors. Results suggest heterogeneity in CPG recommendations within each clinical aim. CPG characteristics accounting for these differences are outlined. Conclusion The majority of CPGs were developed for general NP that focused on treatment recommendations, with fewer number aimed at recommendations for diagnosis, prognosis, and outcomes. Heterogeneity of recommendations within the categories were noted as were potential factors associated with these differences, including CPG quality as assessed by the AGREE II. Electronic supplementary material The online version of this article (10.1186/s12891-019-2441-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pulak Parikh
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.
| | - Pasqualina Santaguida
- Department of Health Research Methods, Evidence and Impact (HEI), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Joy Macdermid
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.,Hand and Upper Limb Centre, St. Joseph Hospital, London, ON, Canada
| | - Anita Gross
- Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Arshia Eshtiaghi
- Department of Health Science, McMaster University, Hamilton, ON, Canada
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Zolfaghari M, Mirhosseini SJ, Baghbeheshti M, Afshani A, Moazzam S, Golabchi A. Effect of physiotherapy on quality of life after coronary artery bypass graft surgery: A randomized study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:56. [PMID: 30057640 PMCID: PMC6040150 DOI: 10.4103/jrms.jrms_96_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/26/2017] [Accepted: 03/22/2018] [Indexed: 11/18/2022]
Abstract
Background: This study aims to assess the impact that physiotherapy (PT) has on the quality of life (QoL) of patients who have undergone coronary artery bypass grafting (CABG) surgery. The objective of this study was to assess the effect of PT on physical and mental aspects of patients’ QoL. Materials and Methods: The study population consisted of 50 patients who aged between 60 and 70 years and who had previously undergone CABG surgery. The patients were randomly allocated to two groups: a PT group (n = 25) and a control group (n = 25). The physical characteristics of the participants were recorded at the outset of the study. The patients who were allocated to the PT group completed 16 sessions of classic PT. QoL assessments of all participants were performed before and after the program in the form of a short form-36 health survey. An independent sample t-test and an ANCOVA were performed for the purpose of statistical analyses. Results: The QoL scores of the patients (mean age = 62.08 years) who underwent PT significantly improved after the intervention (P < 0.001). A significant difference between groups was observed (P < 0.001) in both the mental component summary and physical component summary variables. Conclusion: PT can help relieve pain, reduce depression, help patients more effectively perform the tasks of everyday living, and help ease the symptoms of other disabilities associated with cardiac surgery. In the current study, the implementation of a PT program improved the patient's mental health and increased their QoL.
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Affiliation(s)
- Mohammad Zolfaghari
- Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | | | - Maryam Baghbeheshti
- Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | | | - Shadrooz Moazzam
- Student Research Committee, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Allahyar Golabchi
- Department of Cardiology, Cardiac Electrophysiology Center, Kashan University of Medical Sciences, Kashan, Iran
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Cavallo S, Brosseau L, Toupin-April K, Wells GA, Smith CA, Pugh AG, Stinson J, Thomas R, Ahmed S, Duffy CM, Rahman P, Àlvarez-Gallardo IC, Loew L, De Angelis G, Feldman DE, Majnemer A, Gagnon IJ, Maltais D, Mathieu MÈ, Kenny GP, Tupper S, Whitney-Mahoney K, Bigford S. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Structured Physical Activity in the Management of Juvenile Idiopathic Arthritis. Arch Phys Med Rehabil 2017; 98:1018-1041. [DOI: 10.1016/j.apmr.2016.09.135] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 08/15/2016] [Accepted: 09/27/2016] [Indexed: 12/31/2022]
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Wei X, Wang S, Li L, Zhu L. Clinical Evidence of Chinese Massage Therapy ( Tui Na) for Cervical Radiculopathy: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2017; 2017:9519285. [PMID: 28303163 PMCID: PMC5337873 DOI: 10.1155/2017/9519285] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/26/2017] [Indexed: 01/23/2023]
Abstract
Objective. The review is to assess the current evidence of Chinese massage therapy (Tui Na) for cervical radiculopathy. Methods. Seven databases were searched. Randomised controlled trials incorporating Tui Na alone or Tui Na combined with conventional treatment were enrolled. The authors in pairs independently assessed the risk of bias and extracted the data. Results. Five studies involving 448 patients were included. The pooled analysis from the 3 trials indicated that Tui Na alone showed a significant lowering immediate effects on pain score (SMD = -0.58; 95% CI: -0.96 to -0.21; Z = 3.08, P = 0.002) with moderate heterogeneity compared to cervical traction. The meta-analysis from 2 trials revealed significant immediate effects of Tui Na plus cervical traction in improving pain score (MD = -1.73; 95% CI: -2.01 to -1.44; Z = 11.98, P < 0.00001) with no heterogeneity compared to cervical traction alone. No adverse effect was reported. There was very low quality or low quality evidence to support the results. Conclusions. Tui Na alone or Tui Na plus cervical traction may be helpful to cervical radiculopathy patients, but supportive evidence seems generally weak. Future clinical studies with low risk of bias and adequate follow-up design are recommended.
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Affiliation(s)
- Xu Wei
- Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, China
| | - Shangquan Wang
- Department of General Orthopedics, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, China
| | - Linghui Li
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, China
| | - Liguo Zhu
- Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, China
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Meryanos CJ. Utilizing Chair Massage to Address One Woman's Health in Rural Ghana West Africa: a Case Report. Int J Ther Massage Bodywork 2016; 9:22-29. [PMID: 27974948 PMCID: PMC5142710 DOI: 10.3822/ijtmb.v9i4.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women’s health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. Case Presentation The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30–50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. Results The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45–65 degrees in the right arm, as well as 10–15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. Discussion This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries.
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Lugo LH, García HI, Rogers HL, Plata JA. Treatment of myofascial pain syndrome with lidocaine injection and physical therapy, alone or in combination: a single blind, randomized, controlled clinical trial. BMC Musculoskelet Disord 2016; 17:101. [PMID: 26911981 PMCID: PMC4766655 DOI: 10.1186/s12891-016-0949-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 02/16/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Myofascial pain syndrome (MPS) of the shoulder girdle and cervical region is a common musculoskeletal problem that is often chronic or recurrent. Physical therapy (PT) and lidocaine injections (LI) are two treatments with demonstrated effectiveness compared to a control group, however little is known about their combined value. The objective of this study was to determine whether LI into trigger points combined with a PT program would be more effective than each separate treatment alone in improving pain, function, and quality of life in a group of patients with MPS of the shoulder girdle and cervical region. METHODS A single-blind, randomized, controlled clinical trial (RCT) was conducted with three parallel groups in the Departments of Physical Medicine and Rehabilitation of two urban hospitals in Medellin, Colombia. One hundred and twenty seven patients with shoulder girdle MPS for more than 6 weeks and pain greater than 40 mm on the visual analog scale (VAS) were assigned to 1 of 3 intervention groups: PT, LI, or the combination of both (PT + LI). The primary outcome was VAS pain rating at 1-month post-treatment. The secondary outcomes included VAS pain rating at 3 months, and, at both 1 and 3 months post-treatment: (a) function, evaluated by hand-back maneuver and the hand-mouth maneuver, (b) quality of life, as measured by sub-scales of the Short Form - 36 (SF-36), and (c) depressive symptoms, as measured by the Patient Health Questionnaire - 9 (PHQ-9). Independent t-tests were used to compare outcomes between groups at 1 month and 3 months post-treatment. RESULTS In the per protocol analysis, there were no significant intergroup differences in VAS at 1 month PT + LI, 40.8 [25.3] vs. PT, 37.8 [21.9], p = 0.560 and vs. LI, 44.2 [24.9], p = 0.545. There were also no differences between groups on secondary outcomes except that the PT and PT + LI groups had higher right upper limb hand-back maneuver scores compared to the LI alone group at both 1 and 3 months (p = 0.013 and p = 0.016 respectively). CONCLUSIONS The results of this RCT showed that no differences in pain ratings were observed between the individual treatments (PT or LI) compared to the combined treatment of PT and LI. In general, no difference in primary or secondary outcomes was observed between treatments. TRIAL REGISTRATION NTC01250184 November 27, 2010.
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Affiliation(s)
- Luz Helena Lugo
- />Health Rehabilitation Group and Academic Group of Clinical Epidemiology, University of Antioquia, Carrera 53 # 61-30, Medellín, Antioquia Colombia, South America
| | - Hector Ivan García
- />Department of Methodology and Experimental Psychology, University of Deusto, Avda. De las Universidades, 24, Bilbao, Spain
| | - Heather L. Rogers
- />Department of Methodology and Experimental Psychology, University of Deusto, Avda. De las Universidades, 24, Bilbao, Spain
| | - Jesús Alberto Plata
- />Health Rehabilitation Group and Academic Group of Clinical Epidemiology, University of Antioquia, Carrera 53 # 61-30, Medellín, Antioquia Colombia, South America
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Kennedy AB, Cambron JA, Sharpe PA, Travillian RS, Saunders RP. Process for massage therapy practice and essential assessment. J Bodyw Mov Ther 2016; 20:484-96. [PMID: 27634069 DOI: 10.1016/j.jbmt.2016.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/14/2015] [Accepted: 01/23/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Little evidence exists about processes in massage therapy practice. Investigating current frameworks is warranted. This qualitative study is a secondary data analysis using grounded theory to understand how massage therapy experts describe massage therapy practice. METHODS 31 massage therapy experts were invited to a 2-day symposium to discuss best practices for the profession. Through qualitative analysis, memoing, and discussion, the data were summarized into themes. RESULTS Three themes were identified around massage therapy practice: 1) client centered, 2) structure for practice, and 3) influencing factors. Each theme is clarified and expanded. DISCUSSION Conceptual models were developed for research and clinical practice and a definition for massage therapy practice was identified. Challenges and limitations are discussed. CONCLUSION The goal of providing these models is to give massage therapists tools to deliver the best possible care. The models need testing to see if they help advance the profession.
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Affiliation(s)
| | | | | | | | - Ruth P Saunders
- University of South Carolina, Department of Health Promotion, Education, and Behavior, USA
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18
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Brosseau L, Toupin-April K, Wells G, Smith CA, Pugh AG, Stinson JN, Duffy CM, Gifford W, Moher D, Sherrington C, Cavallo S, De Angelis G, Loew L, Rahman P, Marcotte R, Taki J, Bisaillon J, King J, Coda A, Hendry GJ, Gauvreau J, Hayles M, Hayles K, Feldman B, Kenny GP, Li JX, Briggs AM, Martini R, Feldman DE, Maltais DB, Tupper S, Bigford S, Bisch M. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Foot Care in the Management of Juvenile Idiopathic Arthritis. Arch Phys Med Rehabil 2015; 97:1163-1181.e14. [PMID: 26707409 DOI: 10.1016/j.apmr.2015.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/15/2015] [Accepted: 11/09/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To create evidence-based guidelines evaluating foot care interventions for the management of juvenile idiopathic arthritis (JIA). DATA SOURCES An electronic literature search of the following databases from database inception to May 2015 was conducted: MEDLINE (Ovid), EMBASE (Ovid), Cochrane CENTRAL, and clinicaltrials.gov. STUDY SELECTION The Ottawa Panel selection criteria targeted studies that assessed foot care or foot orthotic interventions for the management of JIA in those aged 0 to ≤18 years. The Physiotherapy Evidence Database scale was used to evaluate study quality, of which only high-quality studies were included (score, ≥5). A total of 362 records were screened, resulting in 3 full-text articles and 1 additional citation containing supplementary information included for the analysis. DATA EXTRACTION Two reviewers independently extracted study data (intervention, comparator, outcome, time period, study design) from the included studies by using standardized data extraction forms. Directed by Cochrane Collaboration methodology, the statistical analysis produced figures and graphs representing the strength of intervention outcomes and their corresponding grades (A, B, C+, C, C-, D+, D, D-). Clinical significance was achieved when an improvement of ≥30% between the intervention and control groups was present, whereas P>.05 indicated statistical significance. An expert panel Delphi consensus (≥80%) was required for the endorsement of recommendations. DATA SYNTHESIS All included studies were of high quality and analyzed the effects of multidisciplinary foot care, customized foot orthotics, and shoe inserts for the management of JIA. Custom-made foot orthotics and prefabricated shoe inserts displayed the greatest improvement in pain intensity, activity limitation, foot pain, and disability reduction (grades A, C+). CONCLUSIONS The use of customized foot orthotics and prefabricated shoe inserts seems to be a good choice for managing foot pain and function in JIA.
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Affiliation(s)
- Lucie Brosseau
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Karine Toupin-April
- Department of Pediatrics, Faculty of Medicine, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - George Wells
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Center, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Christine A Smith
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Arlanna G Pugh
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jennifer N Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ciarán M Duffy
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Wendy Gifford
- Faculty of Health Sciences, School of Nursing Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Methods Center, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Catherine Sherrington
- Musculoskeletal Division, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Sabrina Cavallo
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Gino De Angelis
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Laurianne Loew
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Prinon Rahman
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rachel Marcotte
- Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Jade Taki
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, Ottawa, Ontario, Canada
| | - Jacinthe Bisaillon
- Faculty of Health Sciences, School of Nursing Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Judy King
- Physiotherapy Program, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrea Coda
- Faculty of Health and Medicine - Health Precinct, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Gordon J Hendry
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Lanarkshire, United Kingdom
| | - Julie Gauvreau
- Podiatry Clinic of Outaouais, Hospital Boulevard, Gatineau, Québec, Canada
| | - Martin Hayles
- Hayles Foot and Ankle Clinic, Ottawa, Ontario, Canada
| | - Kay Hayles
- Hayles Foot and Ankle Clinic, Ottawa, Ontario, Canada
| | - Brian Feldman
- Department of Pediatrics and Medicine, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Glen P Kenny
- Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Jing Xian Li
- Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rose Martini
- Occupational Therapy Program, Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Debbie Ehrmann Feldman
- School of Public Health, Option Epidemiology, University of Montreal, Montreal, Quebec, Canada
| | - Désirée B Maltais
- Physiotherapy Program, Department of Rehabilitation, Pavillon Ferdinand-Vandry, Université Laval, Québec, Quebec, Canada
| | - Susan Tupper
- School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sarah Bigford
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Marg Bisch
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Bervoets DC, Luijsterburg PAJ, Alessie JJN, Buijs MJ, Verhagen AP. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. J Physiother 2015; 61:106-16. [PMID: 26093806 DOI: 10.1016/j.jphys.2015.05.018] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 05/04/2015] [Accepted: 05/20/2015] [Indexed: 11/25/2022] Open
Abstract
QUESTION Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? DESIGN Systematic review of randomised clinical trials. PARTICIPANTS People with musculoskeletal disorders. INTERVENTIONS Massage therapy (manual manipulation of the soft tissues) as a stand-alone intervention. OUTCOME The primary outcomes were pain and function. RESULTS The 26 eligible randomised trials involved 2565 participants. The mean sample size was 95 participants (range 16 to 579) per study; 10 studies were considered to be at low risk of bias. Overall, low-to-moderate-level evidence indicated that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain. Furthermore, low-to-moderate-level evidence indicated that massage improves function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain. Low-to-very-low-level evidence from single studies indicated no clear benefits of massage over acupuncture, joint mobilisation, manipulation or relaxation therapy in people with fibromyalgia, low back pain and general musculoskeletal pain. CONCLUSIONS Massage therapy, as a stand-alone treatment, reduces pain and improves function compared to no treatment in some musculoskeletal conditions. When massage is compared to another active treatment, no clear benefit was evident.
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Affiliation(s)
- Diederik C Bervoets
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
| | - Pim A J Luijsterburg
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
| | | | | | - Arianne P Verhagen
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
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Keeratitanont K, Jensen MP, Chatchawan U, Auvichayapat P. The efficacy of traditional Thai massage for the treatment of chronic pain: A systematic review. Complement Ther Clin Pract 2015; 21:26-32. [DOI: 10.1016/j.ctcp.2015.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/20/2015] [Indexed: 01/19/2023]
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Neck arthritis pain is reduced and range of motion is increased by massage therapy. Complement Ther Clin Pract 2014; 20:219-23. [PMID: 25444416 DOI: 10.1016/j.ctcp.2014.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/25/2014] [Accepted: 09/12/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND The literature on the effects of massage therapy on neck arthritis pain is mixed depending on the dose level, and it is also based on self-report. In the present study an attempt was made to enhance the effects of weekly massage therapy by having the participants massage themselves daily. And in addition to self-reports on pain, range of motion (ROM) and the associated ROM pain were assessed before and after the first massage session and pre-post the last session one month later. METHODS Staff and faculty members at a medical school who were eligible for the study if they had neck arthritis pain were randomly assigned to a massage or a waitlist control group (N = 24 per group). The massage group received moderate pressure massages weekly by a massage therapist plus daily self-massages. The waitlist control group received the same schedule massages one month after being control subjects. RESULTS The massage group showed significant short-term reductions after the first and last day massages in self-reported pain and in ROM-associated pain as well as an increase in ROM. Comparisons between the massage group (N = 23) and the control group (N = 14) on the last versus the first day data suggested significantly different changes including increased ROM and reduced ROM-associated pain for the massage group and reduced ROM and increased ROM-associated pain for the control group. These changes occurred specifically for flexion and right and left lateral flexion motions. DISCUSSION These data highlight the importance of designing massage therapy protocols that target the most affected neck muscle groups and then assessing range of motion and related pain before and after the massage therapy. Comparisons with other studies also suggest that moderate pressure may contribute to the massage effects, and the use of daily self-massages between sessions may sustain the effects and serve as a cost-effective therapy for individuals with neck arthritis pain.
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22
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Wong JJ, Côté P, Shearer HM, Carroll LJ, Yu H, Varatharajan S, Southerst D, van der Velde G, Jacobs C, Taylor-Vaisey A. Clinical practice guidelines for the management of conditions related to traffic collisions: a systematic review by the OPTIMa Collaboration. Disabil Rehabil 2014; 37:471-89. [PMID: 24963833 DOI: 10.3109/09638288.2014.932448] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the methodological quality and synthesize recommendations of evidence-based guidelines for the management of common traffic injuries. STUDY DESIGN We conducted a systematic review and best evidence synthesis of guidelines on musculoskeletal injuries, psychological disorders and mild traumatic brain injuries (MTBI) from 1995 to 2012. Independent reviewers critically appraised eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) criteria. RESULTS We retrieved 9863 citations. Of those, 16 guidelines were eligible for critical appraisal and eight were scientifically admissible (four targeting whiplash-associated disorders (WAD), one addressing anxiety and three addressing MTBI). The inadmissible guidelines had inadequate literature searches, inexplicit links between evidence and recommendations, and ambiguous recommendations. The literature used to develop most of the admissible guidelines was outdated. Major recommendations included: (1) Advice, education and reassurance for all conditions; (2) Exercise, return-to-activity, mobilization/manipulation, analgesics and avoiding collars for WAD; (3) Psychological first aid, pharmacotherapy and cognitive behavioral therapy as first-line interventions for anxiety; and (4) Monitoring for complications, discharge criteria, advice upon discharge from the emergency room and post-discharge care for MTBI. CONCLUSION Fifty percent of appraised guidelines were scientifically admissible, but most need updating. Most guidelines focus on WAD and MTBI. Few guidelines make comprehensive recommendations on a wide range of consequences from traffic collisions. IMPLICATIONS FOR REHABILITATION The core components of a program of care designed to manage common traffic injuries (whiplash-associated disorders - WAD, anxiety and mild traumatic brain injuries) should include advice, education and reassurance. Depending on the condition, the following specific interventions should be considered: (1) WAD: exercise, early return to activity, mobilization/manipulation, analgesics and avoidance of collars; (2) Anxiety: psychological first aid, pharmacotherapy and cognitive behavioral therapy; and (3) Mild traumatic brain injuries: use of specific discharge criteria (including no factors warranting hospital admission and support structures for subsequent care), education upon discharge from emergency room and post-discharge care (e.g. monitoring for complications, gradual return to normal activity based on tolerance of individual). The methodological quality of guidelines varies greatly; therefore, guideline developers need to adhere to established methodological standards and conform to the evaluation criteria outlined in the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.
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Affiliation(s)
- Jessica J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC) , Toronto , Canada
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Carlesso LC, Macdermid JC, Gross AR, Walton DM, Santaguida PL. Treatment preferences amongst physical therapists and chiropractors for the management of neck pain: results of an international survey. Chiropr Man Therap 2014; 22:11. [PMID: 24661461 PMCID: PMC3987839 DOI: 10.1186/2045-709x-22-11] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 02/24/2014] [Indexed: 12/11/2022] Open
Abstract
Background Clinical practice guidelines on the management of neck pain make recommendations to help practitioners optimize patient care. By examining the practice patterns of practitioners, adherence to CPGs or lack thereof, is demonstrated. Understanding utilization of various treatments by practitioners and comparing these patterns to that of recommended guidelines is important to identify gaps for knowledge translation and improve treatment regimens. Aim To describe the utilization of interventions in patients with neck pain by clinicians. Methods A cross-sectional international survey was conducted from February 2012 to March 2013 to determine physical medicine, complementary and alternative medicine utilization amongst 360 clinicians treating patients with neck pain. Results The survey was international (19 countries) with Canada having the largest response (38%). Results were analyzed by usage amongst physical therapists (38%) and chiropractors (31%) as they were the predominant respondents. Within these professions, respondents were male (41-66%) working in private practice (69-95%). Exercise and manual therapies were consistently (98-99%) used by both professions but tests of subgroup differences determined that physical therapists used exercise, orthoses and ‘other’ interventions more, while chiropractors used phototherapeutics more. However, phototherapeutics (65%), Orthoses/supportive devices (57%), mechanical traction (55%) and sonic therapies (54%) were not used by the majority of respondents. Thermal applications (73%) and acupuncture (46%) were the modalities used most commonly. Analysis of differences across the subtypes of neck pain indicated that respondents utilize treatments more often for chronic neck pain and whiplash conditions, followed by radiculopathy, acute neck pain and whiplash conditions, and facet joint dysfunction by diagnostic block. The higher rates of usage of some interventions were consistent with supporting evidence (e.g. manual therapy). However, there was moderate usage of a number of interventions that have limited support or conflicting evidence (e.g. ergonomics). Conclusions This survey indicates that exercise and manual therapy are core treatments provided by chiropractors and physical therapists. Future research should address gaps in evidence associated with variable practice patterns and knowledge translation to reduce usage of some interventions that have been shown to be ineffective.
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Affiliation(s)
- Lisa C Carlesso
- Toronto Western Research Institute, University Health Network, 399 Bathurst Street - MP11-328, Toronto, Ontario M5T 2S8, Canada.
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Sherman KJ, Cook AJ, Wellman RD, Hawkes RJ, Kahn JR, Deyo RA, Cherkin DC. Five-week outcomes from a dosing trial of therapeutic massage for chronic neck pain. Ann Fam Med 2014; 12:112-20. [PMID: 24615306 PMCID: PMC3948757 DOI: 10.1370/afm.1602] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This trial was designed to evaluate the optimal dose of massage for individuals with chronic neck pain. METHODS We recruited 228 individuals with chronic nonspecific neck pain from an integrated health care system and the general population, and randomized them to 5 groups receiving various doses of massage (a 4-week course consisting of 30-minute visits 2 or 3 times weekly or 60-minute visits 1, 2, or 3 times weekly) or to a single control group (a 4-week period on a wait list). We assessed neck-related dysfunction with the Neck Disability Index (range, 0-50 points) and pain intensity with a numerical rating scale (range, 0-10 points) at baseline and 5 weeks. We used log-linear regression to assess the likelihood of clinically meaningful improvement in neck-related dysfunction (≥5 points on Neck Disability Index) or pain intensity (≥30% improvement) by treatment group. RESULTS After adjustment for baseline age, outcome measures, and imbalanced covariates, 30-minute treatments were not significantly better than the wait list control condition in terms of achieving a clinically meaningful improvement in neck dysfunction or pain, regardless of the frequency of treatments. In contrast, 60-minute treatments 2 and 3 times weekly significantly increased the likelihood of such improvement compared with the control condition in terms of both neck dysfunction (relative risk = 3.41 and 4.98, P = .04 and .005, respectively) and pain intensity (relative risk = 2.30 and 2.73; P = .007 and .001, respectively). CONCLUSIONS After 4 weeks of treatment, we found multiple 60-minute massages per week more effective than fewer or shorter sessions for individuals with chronic neck pain. Clinicians recommending massage and researchers studying this therapy should ensure that patients receive a likely effective dose of treatment.
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Efficacy of massage therapy on pain and dysfunction in patients with neck pain: a systematic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:204360. [PMID: 24695806 PMCID: PMC3950594 DOI: 10.1155/2014/204360] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 12/28/2013] [Indexed: 11/17/2022]
Abstract
Objective. To systematically evaluate the evidence of whether massage therapy (MT) is effective for neck pain.
Methods. Randomized controlled trials (RCTs) were identified through searches of 5 English and Chinese databases (to December 2012). The search terms included neck pain, neck disorders, cervical vertebrae, massage, manual therapy, Tuina, and random. In addition, we performed hand searches at the library of Nanjing University of Traditional Chinese Medicine. Two reviewers independently abstracted data and assessed the methodological quality of RCTs by PEDro scale. And the meta-analyses of improvements on pain and neck-related function were conducted. Results. Fifteen RCTs met inclusion criteria. The meta-analysis showed that MT experienced better immediate effects on pain relief compared with inactive therapies (n = 153; standardised mean difference (SMD), 1.30; 95% confidence interval (CI), 0.09 to 2.50; P = 0.03) and traditional Chinese medicine (n = 125; SMD, 0.73; 95% CI 0.13 to 1.33; P = 0.02). There was no valid evidence of MT on improving dysfunction. With regard to follow-up effects, there was not enough evidence of MT for neck pain. Conclusions. This systematic review found moderate evidence of MT on improving pain in patients with neck pain compared with inactive therapies and limited evidence compared with traditional Chinese medicine. There were no valid lines of evidence of MT on improving dysfunction. High quality RCTs are urgently needed to confirm these results and continue to compare MT with other active therapies for neck pain.
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Snider KT, Johnson JC, Degenhardt BF, Snider EJ. The persistence of lumbar somatic dysfunction and its association with bone mineral density. J Osteopath Med 2014; 114:8-20. [PMID: 24384969 DOI: 10.7556/jaoa.2014.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT Clinically meaningful somatic dysfunction, if left untreated, should persist over time and be associated with objective measurable findings. OBJECTIVE To investigate the persistence of lumbar somatic dysfunction over 8 weeks and the association of that persistence with lumbar bone mineral density (BMD) T scores. METHODS Individuals were assessed at 0, 4, and 8 weeks for the presence and severity of paraspinal tissue texture abnormalities (TTA), vertebral rotational asymmetry, anterior motion restriction, and tenderness from L1 to L4. Participants underwent dual-energy x-ray absorptiometry of the lumbar spine at 0 and 8 weeks. Persistent somatic dysfunction findings from all 3 examinations were compared with BMD T scores obtained at 8 weeks and to changes in the BMD T scores from 0 to 8 weeks. RESULTS Forty-eight individuals (38 women [79%] and 10 men [21%]) participated in the study. The mean (standard deviation [SD]) age was 30.1 (6.4) years (range, 20.0-40.8 years), and the mean (SD) body mass index was 26.3 (5.2). The percentage of vertebrae with persistent somatic dysfunction varied by vertebral level and ranged from 44% to 83% for TTA, 63% to 79% for rotational asymmetry, 10% to 56% for motion restriction, and 2% to 10% for tenderness. Vertebral segments with persistent motion restriction had higher mean BMD T scores (95% confidence interval [CI]) than those without persistent motion restriction (0.6 [0.4 to 0.8] vs 0.2 [0.1 to 0.4], respectively; P=.02). There was a significant increase in the vertebral BMD T scores for those vertebrae that demonstrated persistent TTA (P=.02) and for those vertebrae that demonstrated persistent moderate/severe TTA (P=.02). A significant difference was found in the initial to final vertebral BMD T-score change between vertebrae that demonstrated persistent tenderness and those that did not (mean [95% CI] change, -0.2 [-0.4 to 0.1] vs 0.1 [0.0 to 0.1], respectively; P=.04). CONCLUSION A persistence of predominantly left lumbar rotation was observed. Persistent vertebral motion restriction was shown to have an association with final lumbar BMD T scores, and persistent TTA and tenderness were associated with changes in the BMD T scores over 8 weeks.
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Affiliation(s)
- Karen T Snider
- Department of Osteopathic Manipulative Medicine, A.T. Still University-Kirksville College of Osteopathic Medicine, 800 W Jefferson St, Kirksville, MO 63501-1443.
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A randomized placebo-controlled clinical trial of phonophoresis for the treatment of chronic neck pain. Rheumatol Int 2013; 34:605-11. [DOI: 10.1007/s00296-013-2928-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/14/2013] [Indexed: 10/25/2022]
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Manipulative Therapy (Feldenkrais, Massage, Chiropractic Manipulation) for Neck Pain. Curr Rheumatol Rep 2013; 15:339. [DOI: 10.1007/s11926-013-0339-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Massage therapy for neck and shoulder pain: a systematic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:613279. [PMID: 23533504 PMCID: PMC3600270 DOI: 10.1155/2013/613279] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 01/14/2013] [Indexed: 11/18/2022]
Abstract
Objective. To evaluate the effectiveness of massage therapy (MT) for neck and shoulder pain. Methods. Seven English and Chinese databases were searched until December 2011 for randomized controlled trials (RCTs) of MT for neck and shoulder pain. The methodological quality of RCTs was assessed based on PEDro scale. The meta-analyses of MT for neck and shoulder pain were performed. Results. Twelve high-quality studies were included. In immediate effects, the meta-analyses showed significant effects of MT for neck pain (standardised mean difference, SMD, 1.79; 95% confidence intervals, CI, 1.01 to 2.57; P < 0.00001) and shoulder pain (SMD, 1.50; 95% CI, 0.55 to 2.45; P = 0.002) versus inactive therapies. And MT showed short-term effects for shoulder pain (SMD, 1.51; 95% CI, 0.53 to 2.49; P = 0.003). But MT did not show better effects for neck pain (SMD, 0.13; 95% CI, −0.38 to 0.63; P = 0.63) or shoulder pain (SMD, 0.88; 95% CI, −0.74 to 2.51; P = 0.29) than active therapies. In addition, functional status of the shoulder was not significantly affected by MT. Conclusion. MT may provide immediate effects for neck and shoulder pain. However, MT does not show better effects on pain than other active therapies. No evidence suggests that MT is effective in functional status.
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Sherman KJ, Cook AJ, Kahn JR, Hawkes RJ, Wellman RD, Cherkin DC. Dosing study of massage for chronic neck pain: protocol for the dose response evaluation and analysis of massage [DREAM] trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 12:158. [PMID: 22985134 PMCID: PMC3546891 DOI: 10.1186/1472-6882-12-158] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 09/12/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND Despite the growing popularity of massage, its effectiveness for treating neck pain remains unclear, largely because of the poor quality of research. A major deficiency of previous studies has been their use of low "doses" of massage that massage therapists consider inadequate. Unfortunately, the number of minutes per massage session, sessions per week, or weeks of treatment necessary for massage to have beneficial or optimal effects are not known. This study is designed to address these gaps in our knowledge by determining, for persons with chronic neck pain: 1) the optimal combination of number of treatments per week and length of individual treatment session, and 2) the optimal number of weeks of treatment. METHODS/DESIGN In this study, 228 persons with chronic non-specific neck pain will be recruited from primary health care clinics in a large health care system in the Seattle area. Participants will be randomized to a wait list control group or 4 weeks of treatment with one of 5 different dosing combinations (2 or 3 30-min treatments per week or 1, 2, or 3 60-min treatments per week). At the end of this 4-week primary treatment period, participants initially receiving each of the 5 dosing combinations will be randomized to a secondary treatment period of either no additional treatment or 6 weekly 60-min massages. The primary outcomes, neck-related dysfunction and pain, will be assessed by blinded telephone interviewers 5, 12, and 26 weeks post-randomization. To better characterize the trajectory of treatment effects, these interview data will be supplemented with outcomes data collected by internet questionnaire at 10, 16, 20 and 39 weeks. Comparisons of outcomes for the 6 groups during the primary treatment period will identify the optimal weekly dose, while comparisons of outcomes during the secondary treatment period will determine if 10 weeks of treatment is superior to 4 weeks. DISCUSSION A broad dosing schedule was included in this trial. If adherence to any of these doses is poor, those doses will be discontinued. TRIAL REGISTRATION This trial is registered in ClinicalTrials.gov, with the ID number of NCT01122836
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Affiliation(s)
- Karen J Sherman
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Andrea J Cook
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Janet R Kahn
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA
| | - Rene J Hawkes
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, USA
| | - Robert D Wellman
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, USA
| | - Daniel C Cherkin
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, USA
- Departments of Family Medicine and Health Services, University of Washington, Seattle, WA, USA
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Patel KC, Gross A, Graham N, Goldsmith CH, Ezzo J, Morien A, Peloso PMJ. Massage for mechanical neck disorders. Cochrane Database Syst Rev 2012:CD004871. [PMID: 22972078 DOI: 10.1002/14651858.cd004871.pub4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The prevalence of mechanical neck disorders (MND) is known to be both a hindrance to individuals and costly to society. As such, massage is widely used as a form of treatment for MND. OBJECTIVES To assess the effects of massage on pain, function, patient satisfaction, global perceived effect, adverse effects and cost of care in adults with neck pain versus any comparison at immediate post-treatment to long-term follow-up. SEARCH METHODS We searched The Cochrane Library (CENTRAL), MEDLINE, EMBASE, MANTIS, CINAHL, and ICL databases from date of inception to 4 Feburary 2012. SELECTION CRITERIA Studies using random assignment were included. DATA COLLECTION AND ANALYSIS Two review authors independently conducted citation identification, study selection, data abstraction and methodological quality assessment. Using a random-effects model, we calculated the risk ratio and standardised mean difference. MAIN RESULTS Fifteen trials met the inclusion criteria. The overall methodology of all the trials assessed was either low or very low GRADE level. None of the trials were of strong to moderate GRADE level. The results showed very low level evidence that certain massage techniques (traditional Chinese massage, classical and modified strain/counter strain technique) may have been more effective than control or placebo treatment in improving function and tenderness. There was very low level evidence that massage may have been more beneficial than education in the short term for pain bothersomeness. Along with that, there was low level evidence that ischaemic compression and passive stretch may have been more effective in combination rather than individually for pain reduction. The clinical applicability assessment showed that only 4/15 trials adequately described the massage technique. The majority of the trials assessed outcomes at immediate post-treatment, which is not an adequate time to assess clinical change. Due to the limitations in the quality of existing studies, we were unable to make any firm statement to guide clinical practice. We noted that only four of the 15 studies reported side effects. All four studies reported post-treatment pain as a side effect and one study (Irnich 2001) showed that 22% of the participants experienced low blood pressure following treatment. AUTHORS' CONCLUSIONS No recommendations for practice can be made at this time because the effectiveness of massage for neck pain remains uncertain.As a stand-alone treatment, massage for MND was found to provide an immediate or short-term effectiveness or both in pain and tenderness. Additionally, future research is needed in order to assess the long-term effects of treatment and treatments provided on more than one occasion.
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Affiliation(s)
- Kinjal C Patel
- Advantage Health Castleridge, 2210-4818B Westwinds Drive NE, Calgary, Alberta, Canada
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