Issue link: https://www.massageandbodyworkdigital.com/i/68178
SOMATIC RESEARCH combined with the three-group RCT design makes this seem like a well-designed, robust, solid study. WHAT DID THE RESEARCHERS FIND OUT? The similarity of the numbers in Perlman's Table 1 indicates the groups were similar to each other in age, socioeconomic status, and other demographic variables—meaning any differences in outcomes are unlikely to have been caused by personal differences among the groups. As Perlman's Table 2 shows, the groups experienced similar levels of symptoms before the massage intervention, so each treatment presumably had about the same therapeutic work to do—meaning any differences in outcomes are unlikely to have been caused by different "starting points" among the groups. Table 3 displays those differences in outcomes, demonstrating that the massage group outperformed the other groups in a statistically significant manner (and at 16 weeks, demonstrating that the improvements lasted for a relatively long time after the interventions stopped), except for the measurement of range of motion in degrees. WHAT DO THE RESULTS MEAN? In the last article, I asked: what do the researchers say their results mean (from the Discussion, which the researchers call "Comment" in this article)? What do you think of their interpretation? The researchers judge their results to mean that "massage therapy using the Swedish technique is safe and effective for reducing pain and improving function in patients with symptomatic OA of the knee." Their effect sizes are large, indicating a strong treatment effect, A general principle of scientific and medical research articles is that the author should give the reader information to replicate the work. and they provide a technical reason why they think their results may be conservative, actually underestimating the effects of massage. They place their results in the context of studies on massage for musculoskeletal conditions, asserting consistency with results demonstrated elsewhere. As the researchers mention in their Introduction and reiterate in their Discussion, they consider their study to be extremely important. They cite statistics on the incidence and prevalence of OA, and the associated decline of quality of life, serious side effects ("cardiovascular, gastrointestinal, renal, and hepatotic toxic effects" associated with medications used to treat OA pain), and economic and other costs which result. The size of the study, and the confirmation of large and lasting effects of massage on OA pain and loss of function are factors that Perlman et al. consider very important in making their case. All these aspects made the study seem solid. APPLY THE KNOWLEDGE In our scenario, would this article have provided any useful information for you to give your client? If so, what? These questions may lead to very individualized responses. I approve of the way Perlman et al. dealt with their massage treatment protocol, and how they balanced the need for standardization with the inherently individualized nature of massage. By providing a basic protocol, and checking to ensure that protocol was adhered to, yet permitting individual therapists to make judgments in a session about which strokes to use, and in which order, I consider this article to be more practical and useful than those that do not provide information about their treatment. Many research articles describe their treatment only in vague, 130 massage & bodywork september/october 2009