Issue link: https://www.massageandbodyworkdigital.com/i/943527
A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 53 protocol so that study participants get the same treatment as other participants every time they get a treatment. This sort of thing is much easier in pharmaceutical or substance research when precise measures of active ingredient dosage and consumption can be made. For research in applied disciplines like massage therapy, the items manualized in this study are the places where additional parameters need to be set to ensure consistent intervention application throughout the study: massage timing, technique usage and sequencing, areas addressed and sequencing, duration, therapist/participant interaction, and others. These parameters are meant to reduce the variability of treatments within and between study participants, which ultimately allows researchers to point with confidence and validity to the intervention as the cause of study outcomes. It is important to note as well that while manualized, the briefly described massage protocol delivered in this study is reasonably one that any one of us would do for a similar client, considering it addressed the full body, used Swedish massage techniques typical in practice, and followed a logical progression and flow. Ultimately, this study demonstrates that massage for CRF has efficacy and can work for breast cancer survivors. Results from this study do not imply that only a manualized treatment delivered exactly like those in this study will produce beneficial results in practice. On the contrary, this study provides an evidence base to which massage therapists can point as explanation for results they see related to CRF. A LARGER DISCUSSION There are so many other great discussion topics this article could spark, but time and space do not allow for further exploration this issue. Perhaps in later columns I'll be able to discuss some of the potentially lingering questions you may have, such as: • Why is "blinding" important in research, and if blinding is so important, why were only the principal investigator, statistician, and physicians blinded in this study?* • What made a study participant's data evaluable, and why were only 57 of the 66 participants in this study used in the evaluation?* • Do research participant expectations and preferences influence research, and do research designs account for these potential biases? (As an aside, researchers in this study did collect and consider these variables in the analysis plan.) • How do collaborations between research and massage therapy- related institutions work? • What were the roles and duties of the massage therapists engaged in research efforts? *The answers to these questions do not diminish this study's integrity or value. I leave you for now to consider these questions and develop more as you access and consider this and other research articles in depth on your own. The research highlighted here is still in the early-trial phase, and I am confident the field can expect future related work from this research program. I encourage those interested in providing massage for individuals with CRF and other cancer- related challenges to consider taking continuing education courses specific to this work. As with research in the massage-for- cancer field, there is a lot of great practice work to be done in this regard. Notes 1. American Cancer Society, "Cancer Facts & Figures 2017," 2017, accessed January 2018, www.cancer. org/content/dam/cancer-org/research/cancer- facts-and-statistics/annual-cancer-facts-and- figures/2017/cancer-facts-and-figures-2017.pdf. 2. "Cancer Facts & Figures." 3. Network NNCCN NCCN. Cancer-Related Fatigue. In: Network N, ed. NCCN clinical practice guidelines in oncology (NCCN guidelines). Version 1. 2016 ed: NCCN National Comprehensive Cancer Network, 2016: 1–56. SOMATIC RESE ARCH 4. J. M. Jones et al., "Cancer-Related Fatigue and Associated Disability in Post-Treatment Cancer Survivors," Journal of Cancer Survivorship 10, no. 1 (2016): 51–61, http:// dx.doi.org/10.1007/s11764-015-0450-2. 5. K. M. Mustian et al., "Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue: A Meta-Analysis," JAMA Oncology 3, no. 7 (2017): 961–68, https:// doi.org/10.1001/jamaoncol.2016.6914. 6. ClinicalTrials.gov, "Efficacy of Swedish Massage Therapy on Cancer-Related Fatigue in Cancer Survivors," NCT01926678, https://clinicaltrials.gov/ct2/show/ NCT01926678?cond=cancer+related+fatigue&rank=3. 7. J. B. Kinkead et al., "Massage Therapy Decreases Cancer-Related Fatigue: Results from a Randomized Early Phase Trial," Cancer 124, no. 3 (October 2017), 546–54, https://doi.org/10.1002/cncr.31064. 8. E. M. Smets et al., "Application of the Multidimensional Fatigue Inventory (MFI-20) in Cancer Patients Receiving Radiotherapy," British Journal of Cancer 73, no. 2 (January 1996): 241–45. 9. A. Purcell et al., "Determining the Minimal Clinically Important Difference Criteria for the Multidimensional Fatigue Inventory in a Radiotherapy Population," Supportive Care in Cancer 18, no. 3 (March 2010): 307–15. 10. R. C. Gershon et al., "The use of PROMIS and Assessment Center to Deliver Patient-Reported Outcome Measures in Clinical Research," Journal of Applied Measurement 11, no. 3 (2010): 304–14; J. Endicott et al., "Quality of Life Enjoyment and Satisfaction Questionnaire: A New Measure," Psychopharmacology Bulletin 29, no. 2 (1993): 321–26. Niki Munk, PhD, LMT, is an assistant professor of health sciences at Indiana University, a Kentucky-licensed massage therapist, a visiting fellow with the Australian Research Centre in Complementary and Integrative Medicine, and mother of two young daughter-scientists. Munk's research explores real-world massage therapy for chronic pain, trigger point self-care, massage for amputation-related sequelae, and the reporting and impact of massage-related case reports. Contact her at nmunk@iu.edu.