Massage therapy more effective in treating knee OA than usual care .
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(9):49 PLoS One. 2012;7(2):e30248. doi: 10.1371/journal.pone.0030248. Epub 2012 Feb 8125 patients were randomized to evaluate the efficacy of massage therapy in treating knee osteoarthritis (OA). Patients received one of four 8-week programs of Swedish massage regimen (30 or 60 min weekly or biweekly) or a Usual Care control. The results at 8 weeks revealed that the 60-minute massage groups displayed significantly better improvements than the control group in the WOMAC subscales of pain and functionality, as well as the VAS pain scale. However, no significant differences were observed in range of motion.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
3/4
Aleatorización
4/4
Medición de resultados
2/4
Inclusión / exclusión
4/4
Descripción de la terapia
4/4
Estadísticas
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
Currently, about 27 million Americans are affected by osteoarthritis (OA), a progressive degenerative disease of the joints. While massage therapy could be an effective option to manage OA pain, there are relatively few studies that examine the efficacy of this treatment. Therefore, this study aimed to identify a dose and treatment regimen of an 8-week Swedish massage therapy for knee OA that would be both optimal (provide greatest effectiveness) and practical (minimize patient cost and inconvenience).
¿Cuál era la pregunta principal de la investigación?
Did a Swedish massage regimen provide better clinical outcomes for the treatment of knee OA than Usual Care control, assessed at 24 weeks?
- WOMAC Global score displayed a significant improvement (24.0 points, 95% CI range: 15.3-32.7) in the 60-minute massage groups compared to Usual Care (6.3 points, 95% CI range: 0.1-12.8) after 8 weeks; no statistically significant differences were observed between massage groups at this time point.
- For the WOMAC pain subscale, all massage groups produced significant improvement (P < 0.05) from baseline at weeks 8, 16, and 24 for the three highest doses of massage (groups 2, 3, and 4), while no improvement was seen in the Usual Care at any time point (P > 0.05).
- According to the VAS scale, pain perception improved significantly (31.2-39.8 points, 95% CI range: 22.9-48.1 points) in both 60-minute dose groups (groups 3 and 4) compared to Usual Care at 8 weeks, although there were no significant differences between groups 3 and 4.
- Decreased pain perception was observed in all treatment groups at all time points compared to baseline.
- While every group (except group 1 at week 8) displayed decreased time to walk 50 feet at all times, there were no significant differences between the groups at any time point (P > 0.05).
- No significant between-group differences were observed in range of motion after 8 weeks; however, all massage groups changed in the positive direction.
¿Qué es lo que más debo recordar?
This study demonstrated that there was more improvement in the WOMAC Global scores with greater total dose (minutes) of massage. At 8 weeks 16 and 24, every massage group displayed significant improvements in WOMAC Global scores compared to baseline, a change unseen in the Usual Care group.
¿Cómo afectará esto al cuidado de mis pacientes?
This study established an optimal dose of 60-minute Swedish massage therapy (once weekly in 8 weeks) regimen for OA of the knee. While this type of intervention is difficult to conclusively prove its efficacy, physicians may be inclined to prescribe massage therapy as a possible conservative treatment for patients with painful OA.
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