Massage & Bodywork

January | February 2014

Issue link: https://www.massageandbodyworkdigital.com/i/230373

Contents of this Issue

Navigation

Page 59 of 141

SOMATIC RESEARCH It is rare to have double blinding in massage clinical trials because both the subjects and the clinician are aware of the type of treatment being rendered. But these types of trials frequently have single blinding by including a research clinician who does not know the treatment allocation and who takes all measurements. This person does not know which group the patients are in, and measures all subjects in the same manner. treated with a placebo improves, was the placebo really a placebo, or was it a different form of treatment that we don't fully understand or know how to measure? Another important topic with placebo treatment is that in some studies the subjects find it easy to determine if they are in the placebo group or not. This is a problem because it will affect the overall results. If a person believes he is in the placebo group, he will not score as well on the outcome measures because he does not think he should be doing better. Vice versa, if the subjects in the active treatment group know they are getting the active treatment, they will be more likely to show an improvement on the outcome measures because they think they should be doing better. All studies that include a placebo group should ask their subjects which group they think they are in, so the amount of potential bias can be determined. In some studies, a placebo treatment is not possible. For example, if we were going to do a study comparing massage with a placebo, what would our placebo look like? Would the therapist touch the subject at all? Would the therapist do massage but not on the areas that need treatment? A placebo for massage does not make sense; therefore, placebo is not usually utilized in massage clinical trials. DOUBLE BLINDING The final major factor found in clinical trials is double blinding. This means that neither the subject nor the clinician who provides the treatment or measures the outcomes knows which treatment the subject received. A positive aspect of double blinding is that if the clinician doesn't know the subject's group assignment, he or she will not be biased when measuring the outcomes. All clinicians come with inherent bias, meaning they believe one group will outperform the other. This bias can lead to subconscious decisions when measuring outcomes. However, double blinding can remove those biases because the clinician does not know to which group each subject belongs. DOWNSIDE TO CLINICAL TRIALS While all of this consistency and rigor allows researchers the ability to describe outcomes based on a specific treatment for a specific condition in a specific population, the results generated from clinical trials are not necessarily true to life. Most clinicians would not treat every patient the same, using the same treatment protocols over the same amount of time. But researchers need to start somewhere and will typically continue doing research with modified populations and treatments to determine what treatment is beneficial for what type of condition. HOW DOES THIS AFFECT YOU? The bottom line is clinical trials are considered the strongest study design because of their rigor. They can include structured treatments and outcome measures, randomization to treatment groups, placebo control groups, and double blinding. All of this structure helps the reader better understand the specifics of what treatment led to what outcome, but they can also be seen as being too far from real clinical practice. What does this mean to you? First, when you are searching in PubMed for articles, try to find clinical trials. They carry the most weight in terms of evidence, and they are considered the most important when discussing them with other health-care professionals. Second, when reading research articles, pay attention to the way the study was designed. Was there randomization, blinding, or a placebo group? All research is important to the growth of the literature. However, clinical trials carry the most weight. Jerrilyn Cambron, DC, PhD, MPH, LMT, is an educator at the National University of Health Sciences and president-elect of the Massage Therapy Foundation. Contact her at jcambron@nuhs.edu. It pays to be ABMP Certified: www.abmp.com/go/certifiedcentral 57

Articles in this issue

Links on this page

Archives of this issue

view archives of Massage & Bodywork - January | February 2014