Is massage therapy effective in relieving pain and fatigue among Ironman triathlon athletes?
Date of publication of randomized controlled trial: April 2016
Design
Randomized controlled trial (RCT).
Participants
74 triathlon athletes who completed the entire Ironman triathlon race with complaint of pain in the anterior portion of the thigh (mean age range: 37 to 39 years, male %: 94.6%).
Intervention
Massage therapy was performed on quadriceps by a therapist. It included superficial effleurage, deep effleurage, petrissage and tapotement. Duration of massage was 7 minutes.
Comparator
Comparison: Massage therapy versus waitlist control.
Major Outcomes
Outcome 1: Change in level of pain score as measured by Visual Analog Scale (VAS) at the end of the intervention. The VAS ranged from 0 to 100 mm, with 0 mm indicating no pain and 100 mm indicating the worst possible pain.
Outcome 2: Change in level of perceived local fatigue as measured by VAS at the end of the intervention. The VAS ranged from 0 to 100 mm, with 0 mm indicating no fatigue and 100 mm indicating extreme exhaustion.
Settings
The authors did not state whether the trials were conducted in inpatient or outpatient settings.
Comparison    Massage therapy versus waitlist control
Main Results
Compared to waitlist control, massage therapy on quadriceps significantly reduced local pain (mean differences (MD): -7, 95% CI: -13 to -1) and perceived fatigue (MD: -15, 95% CI: -21 to -9) among Ironman triathlon athletes.
Comparison: Massage therapy versus waitlist control among Ironman triathlon athletes
Outcomes No. of studies (Total number of participants) Mean (SD)/ No. of participants Heterogeneity test (I2) MD (95% CI) Overall quality of evidence*
Intervention Comparator
1 (mm) 1(73) 48 (24)/36 59 (23)/37 Not applicable as there is only 1 trial -7 (-13 to -1) Moderate
2 (mm) 1(73) 69 (24)/36 79 (19)/16 Not applicable as there is only 1 trial -15 (-21 to -9) Moderate
Keys: SD= standard deviation; MD: mean difference; CI: confidence interval.
Comparison    Massage therapy versus waitlist control
Main Results
Compared to waitlist control, massage therapy on quadriceps significantly reduced local pain (mean differences (MD): -7, 95% CI: -13 to -1) and perceived fatigue (MD: -15, 95% CI: -21 to -9) among Ironman triathlon athletes.
Comparison: Massage therapy versus waitlist control among Ironman triathlon athletes
Outcomes 1 (mm) 2 (mm)
No. of studies (Total number of participants) 1(73) 1(73)
Mean (SD)/ No. of participants Intervention 48 (24)/36 69 (24)/36
Comparator 59 (23)/37 79 (19)/16
MD (95% CI) -7 (-13 to -1) -15 (-21 to -9)
Overall quality of evidence* Moderate Moderate
Keys: SD= standard deviation; MD: mean difference; CI: confidence interval.
Conclusion
Benefits
Compared to waitlist control, massage therapy on quadriceps significantly relieved local pain and perceived fatigue among Ironman triathlon athletes. For all outcomes, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
Adverse events were not reported in this trial
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/27025688
The synopsis is based on the following article:
Nunes GS, Bender PU, de Menezes FS, Yamashitafuji I, Vargas VZ, Wageck B. Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial. Journal of physiotherapy. 2016 Apr 30;62(2):83-7.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.