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Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial.

Journal of general internal medicine
March 1, 2019
Adam Perlman et al. (17 authors)
Journal ArticleMulticenter StudyRandomized Controlled TrialResearch Support, N.I.H., ExtramuralHuman StudyClinical
Study Details

Study Goal

The researchers aimed to examine the effects of whole-body massage on knee osteoarthritis compared to light-touch and usual care, focusing on symptom relief and safety.

Results Summary

At 8 weeks, massage significantly improved WOMAC Global scores, pain, stiffness, and physical function compared to light-touch and usual care. By 52 weeks, no significant differences were observed between groups, though massage maintained improvements without additional benefit over usual care.

Population

Adults with knee osteoarthritis (222 enrolled, 175 completed 52-week assessments).

Effective Dosage

60 minutes of full-body massage or light-touch, eight weekly treatments followed by biweekly intervention or usual care.

Duration

52 weeks (initial 8-week intensive phase, followed by maintenance phase).

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
massage
decrease
WOMAC Global scores
adults with knee osteoarthritis
-8.16, 95% CI = -13.50 to -2.81
significantly improved
#1
massage
decrease
WOMAC Global scores
adults with knee osteoarthritis
-9.55, 95% CI = -14.66 to -4.45
significantly improved
#2
massage
decrease
pain WOMAC subscale scores
adults with knee osteoarthritis
p < 0.001
improved
#3
massage
decrease
stiffness WOMAC subscale scores
adults with knee osteoarthritis
p = 0.04
improved
#4
massage
decrease
physical function WOMAC subscale scores
adults with knee osteoarthritis
p = 0.02
improved
#5
massage
decrease
pain WOMAC subscale scores
adults with knee osteoarthritis
p < 0.001
improved
#6
massage
decrease
stiffness WOMAC subscale scores
adults with knee osteoarthritis
p = 0.002
improved
#7
massage
decrease
physical function WOMAC subscale scores
adults with knee osteoarthritis
p = 0.002
improved
#8
massage
no change
WOMAC Global
adults with knee osteoarthritis
p = 0.707, df = 3
no significant difference in change
#9
Abstract

BACKGROUND: Current treatment options for knee osteoarthritis have limited effectiveness and potentially adverse side effects. Massage may offer a safe and effective complement to the management of knee osteoarthritis. OBJECTIVE: Examine effects of whole-body massage on knee osteoarthritis, compared to active control (light-touch) and usual care. DESIGN: Multisite RCT assessing the efficacy of massage compared to light-touch and usual care in adults with knee osteoarthritis, with assessments at baseline and weeks 8, 16, 24, 36, and 52. Subjects in massage or light-touch groups received eight weekly treatments, then were randomized to biweekly intervention or usual care to week 52. The original usual care group continued to week 24. Analysis was performed on an intention-to-treat basis. PARTICIPANTS: Five hundred fifty-one screened for eligibility, 222 adults with knee osteoarthritis enrolled, 200 completed 8-week assessments, and 175 completed 52-week assessments. INTERVENTION: Sixty minutes of protocolized full-body massage or light-touch. MAIN MEASURES: Primary: Western Ontario and McMaster Universities Arthritis Index. Secondary: visual analog pain scale, PROMIS Pain Interference, knee range of motion, and timed 50-ft walk. KEY RESULTS: At 8 weeks, massage significantly improved WOMAC Global scores compared to light-touch (- 8.16, 95% CI = - 13.50 to - 2.81) and usual care (- 9.55, 95% CI = - 14.66 to - 4.45). Additionally, massage improved pain, stiffness, and physical function WOMAC subscale scores compared to light-touch (p < 0.001; p = 0.04; p = 0.02, respectively) and usual care (p < 0.001; p = 0.002; p = 0.002; respectively). At 52 weeks, the omnibus test of any group difference in the change in WOMAC Global from baseline to 52 weeks was not significant (p = 0.707, df = 3), indicating no significant difference in change across groups. Adverse events were minimal. CONCLUSIONS: Efficacy of symptom relief and safety of weekly massage make it an attractive short-term treatment option for knee osteoarthritis. Longer-term biweekly dose maintained improvement, but did not provide additional benefit beyond usual care post 8-week treatment. TRIAL REGISTRATION: clinicaltrials.gov NCT01537484.

Medical Subject Headings (MeSH)
AgedFemaleHumansMaleMassageMiddle AgedOsteoarthritis, KneePain MeasurementTreatment Outcome
Study Links
Quality Scores
Safety90
Efficacy85/10
Quality88/10
Citation Metrics
Total Citations41
Citations/Year6.8
Relative Citation Ratio3.51
NIH Percentile88%
Research Impact Scores
APT Score0.95
Weight Score2.54
Normalized Score0.88
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