Issue link: https://www.massageandbodyworkdigital.com/i/68178
SOMATIC RESEARCH Our PICO Their PICO Patient An older male with osteoarthritis (OA) pain 68 OA patients, average age in the intervention group 70.4 +/- 11.3 years, and average age in the control group 66.2 +/- 11.3 years, 15 males and 53 females, 58 white and 10 of other ethnic groups; comparable scores on pain, stiffness, functionality, range of motion, and time it took them to walk 50 feet. Intervention Massage therapy One-hour long massage sessions administered by na- tionally-certified licensed massage therapists. Sessions consisted of standard Swedish full-body therapeutic massage, including petrissage, effleurage, and tapote- ment as the therapists judged appropriate. Treatments were carried out twice per week in the first four weeks of the study, and weekly in the last four weeks. Comparison Standard care Usual care: pain medications, exercises, hot and cold therapy. The experiment utilized a crossover design, so the control group also received treatment later in the study. • Daily medication usage diary to track how much pain and other medication was needed during the study. • Pain, as assessed by the Western Ontario and McMaster Universities (WOMAC) questionnaire. Outcome Reduced pain • Pain, as assessed by Visual Analog Scale (VAS). • Time in seconds to walk a 50-foot straight path. • Range of motion in degrees as assessed by goniometry. • Stiffness, as assessed by the WOMAC questionnaire. • Physical functional disability in patients with knee and hip OA as assessed by the WOMAC questionnaire. STUDY, FINDINGS, RESULTS HOW DID THE RESEARCHERS STUDY THEIR DESIGN QUESTION? Here, they used a randomized controlled trial (RCT) design, considered the gold standard of research methodology because of its ability to minimize bias in distinguishing among treatments. There were two groups: the control group and the massage group. In addition, the control group crossed over to receive massage treatment after the first part of the study was completed. Although control groups sometimes receive absolutely no treatment, that was not true here. It is unethical to make subjects suffer by participating in a study, and since there is a standard of care for OA patients (pain medication, exercise, hot and cold therapy), massage is compared against that standard of care rather than against no treatment at all. It represents a common standard and a humane ethical compromise. The difference between the standard care group and the massage group reflects another methodological issue. If the massage group showed an improvement over the standard care group, we would assume massage is what made the difference. But—as the fundamental question of science insists—how would we know if we were wrong? Perhaps simply having a caring human around for 20 minutes, whether providing massage or not, is enough to encourage healing. To sort this out, researchers often include a third group who get a visit—but no massage—from the massage therapist. If the researchers find a difference in outcomes between the individual attention group and the massage group, we would assume the difference was due to the massage itself, not just the presence of another caring person. Here, the researchers' description of how they carried out their study sounds reasonably good. The sufficiently large research population connect with your colleagues on massageprofessionals.com 129