Issue link: https://www.massageandbodyworkdigital.com/i/943527
52 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 8 to their CRF and quality of life. Touch, presence, and attention are powerful, important, and beneficial elements of general care and support for emotional well- being, and are key to facilitating the healing process. They are also elements inherent to massage therapy application. Without a way to account for these nonspecific, yet very real, treatment effects, the effects related to the actual massage component of a practitioner-provided therapeutic massage intervention cannot be isolated, specified, or hypothesized. Without the light-touch comparison group, the great results found in this study for CRF and quality of life for breast cancer survivors could simply have been attributed to the 45 minutes of weekly attention provided to them by people who happened to be trained in massage therapy. Because the benefits experienced by those in the Swedish massage group were significantly better than those in the light touch group, this study points to the significant benefit massage therapy specifically has for those with postcancer treatment CRF. Providing the exact same treatment to every client isn't how massage is practiced or how therapists work with clients. How can research findings about a manualized massage "routine" apply to practice? Studies seeking to determine if an intervention can work (efficacy) are different from those seeking whether an intervention does work when applied in practice settings (effectiveness). Establishing the efficacy of an intervention is rather important when considering how much research costs, and this study's researchers point to the purpose of this work as a proof-of-concept that massage is beneficial for CRF. To determine if an intervention can work, studies have to examine said intervention in as controlled a way as possible to have confidence that outcomes truly were caused by the intervention under study. Just like the importance of having a comparison group to account for nonspecific effects (discussed earlier), researchers for efficacy research have to design the intervention application This study provides an evidence base to which massage therapists can point as explanation for results they see related to cancer- related fatigue. who received the course of Swedish massage treatments had significantly better outcomes than those who received light touch or (obviously) no treatment. More importantly, those randomized to the Swedish massage treatments reported clinically meaning ful improvement in their CRF by having their MFI scores improve 16.5 points on average. (Refer to the January/February 2018 Somatic Research column "4 Points Arising from Low-Back Pain Study: For MTs and Their Practices," page 46," for an in-depth discussion on the differences between statistical and clinically meaningful differences.) ADDRESSING QUESTIONS Let's take a look at some questions that arise from the study, starting with some about the effectiveness of massage versus simple light touch. Why does this research include a light touch comparison arm? Do the positive results experienced from massage therapists just touching people diminish the beneficial results found in the massage group? Does this research minimize the massage therapist's significance or that of massage specifically for CRF? The short answer to that final question is absolutely not! The importance of having the light-touch comparison group in addition to the no-treatment control group in this study should not be unacknowledged or understated. Statistical comparison between an intervention group and nonintervention group is standard for research and is enough when a definite effect mechanism can be isolated (for example, in pharmaceutical or medical device research). However, when the intervention in question can be influenced/affected by various internal (e.g., human related) and external (e.g., environmental) factors, and has all manner of understood and nonunderstood direct and indirect variables, a "simple" treatment versus no treatment group research design is not enough. It is no surprise that those who received the light touch intervention had benefit with regard