Massage & Bodywork

MARCH | APRIL 2016

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SOMATIC RESE ARCH C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 51 or stretched, using physical contact with the hand or mechanical device." Forms of massage that focused on acupuncture points were excluded. Because articles were only focusing on upper and lower extremities, and because there were many exclusion criteria for this review, only six articles were included. All six had a low risk of bias, demonstrating strong study designs. The six articles focused on lateral epicondylitis (2 articles), shoulder impingement syndrome (1), carpal tunnel syndrome (1), and plantar fasciitis (2). The results demonstrated that myofascial release therapy was beneficial for lateral epicondylitis and plantar fasciitis. Movement reeducation was also beneficial for lateral epicondylitis. Localized relaxation massage combined with other forms of care provided short- term benefit for carpal tunnel syndrome. The main limitation of this review was that the authors were searching for articles on a variety of conditions being treated with a variety of soft-tissue techniques, while using very narrow acceptance criteria, such as the stipulation that articles must be in English with a strong study design. Only six articles were chosen, and they were very different in content, making it difficult to come to any conclusion. CONCLUSIONS Overall, the two systematic review articles demonstrated that massage therapy appears to reduce pain and improve function in some musculoskeletal conditions. Because the articles included in the reviews were so divergent, we do not have strong conclusions on what treatment is most effective for what massage was compared to acupuncture, joint mobilization, manipulation, or relaxation therapy, there were no clear outcomes for which one treatment type was more beneficial than another. As in all review articles, there are limitations to the results. For example, the majority of clinical trials (16 out of 26) had a high risk of bias based on the GRADE analysis, leading to weakened overall results. Also, the type of massage, diagnosis, sample size, outcome measures utilized, data collection time points, and comparative group differed from study to study, making it difficult to combine the data. A similar review article was also recently published on the effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities of adults and children. 4 Six scientific databases were searched and the articles were critically appraised using the Scottish Intercollegiate Guidelines Network (SIGN) criteria rather than the GRADE analysis, but with similar study characteristic assessments. To be included in this review article, studies had to be in English; published after 1989; be a clinical trial, cohort, or case-control design; and have a minimum of 30 subjects per treatment arm. In this review, musculoskeletal disorders and injuries were based on the US Centers for Disease Control and Prevention definition and defined as "grade I–II sprains or strains; nonspecific shoulder, elbow, wrist, hip, knee, ankle, and/or foot pain; tendonitis; tendinopathy; tendinosis; and other musculoskeletal disorders and injuries (including nerve injuries/neuropathies)." Studies were excluded if subjects had pathologies such as dislocations, fractures, infections, neoplasms, or systemic disease. The definition of soft-tissue therapy used in this study was "a mechanical form of therapy where soft-tissue structures are passively pressed, kneaded, specific condition. However, we do have a better understanding that more high-quality research is needed on specific conditions using consistent treatment methods. Once that occurs, future review articles may elicit stronger conclusions. The results found in these review articles may not translate to your clients, so be sure to discuss your proposed treatment plan with your clients and their health-care teams. Notes 1. The Lancet, "Global Burden of Disease Study 2010," accessed February 2016, www.thelancet.com/global- burden-of-disease. 2. Ibid. 3. D. C. Bervoets et al., "Massage Therapy Has Short-Term Benefits for People With Common Musculoskeletal Disorders Compared to No Treatment: A Systematic Review," Journal of Physiotherapy 61, no. 3 (July 2015): 106–16, doi: 10.1016/j.jphys.2015.05.018. 4. S. Piper et al., "The Effectiveness of Soft-Tissue Therapy for the Management of Musculoskeletal Disorders and Injuries of the Upper and Lower Extremities: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration," Manual Therapy 21 (February 2016): 18–34, doi: 10.1016/j.math.2015.08.011. Jerrilyn Cambron, DC, PhD, MPH, LMT, is an educator at the National University of Health Sciences and president of the Massage Therapy Foundation. Contact her at jcambron@nuhs.edu. More high-quality research is needed on specific conditions using consistent treatment methods.

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