Is massage therapy effective in reducing pain and tension among patients who completed abdominal colorectal surgery?
Date of publication of the randomized controlled trial: August 2015
Design
Randomized controlled trial (RCT).
Participants
131 patients who underwent abdominal colorectal surgery and indicated discomfort along the occipital ridge into the upper trapezius and bilateral scalenes, as well as the bilateral rhomboids and mid thoracic region. (mean age: 54.2 years for intervention group, 54.7 years for control group, male%: 39.37%)
Intervention
Massage was provided by a certified massage therapist on postoperative days 2 and 3. Each session consisted of patient care assessment, Swedish massage techniques, and quiet time (with dim lighting, a relaxation channel on the television or soft music). Duration of each session lasted for 20 minutes.
Comparator
Comparison: Massage versus social visit and relaxation session.
Major Outcomes
Outcome 1: Pain as measured by numeric rating scales (NRS) after intervention on postoperative day 3;
Outcome 2: Anxiety as measured by NRS after intervention on postoperative day 3;
Outcome 3: Tension as measured by NRS after intervention on postoperative day 3;
Outcome 4: Relaxation as measured by NRS after intervention on postoperative day 3.
Settings
This study was performed in an inpatient setting.
Comparison    Massage versus social visit and relaxation session
Main Results
Compared to social visit and relaxation session, massage therapy significantly reduced pain (mean difference (MD): -1.39, 95% CI: -1.9 to -0.9), anxiety (MD: -1.5, 95% CI: -2.1 to -0.9) and tension (MD: -1.90, 95% CI: -2.5 to -1.2). Besides, massage significantly promote relaxation (MD: 1.8, 95% CI: 1.2 to 2.4) among patients undergoing abdominal colorectal surgery.
Comparison: Massage versus social visit and relaxation session in patients who completed abdominal colorectal surgery
Outcomes No. of studies (Total number of participants) Mean score (SD) /No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 1 (127) -1.5 (1.6)/61 -0.2 (1.7)/66 Not applicable as there is only 1 study. -1.39 (-1.9 to -0.9) <0.001 Moderate
2 1 (127) -1.6 (1.9)/61 -0.4 (2.4)/66 Not applicable as there is only 1 study. -1.5 (-2.1 to -0.9) <0.001 Moderate
3 1 (127) -2.3 (2.3)/61 -0.2 (2.4)/66 Not applicable as there is only 1 study. -1.90 (-2.5 to -1.2) <0.001 Moderate
4 1 (127) 2.3 (2.2)/61 0.5 (1.7)/66 Not applicable as there is only 1 study. 1.8 (1.2 to 2.4) <0.001 Moderate
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Comparison    Massage versus social visit and relaxation session
Main Results
Compared to social visit and relaxation session, massage therapy significantly reduced pain (mean difference (MD): -1.39, 95% CI: -1.9 to -0.9), anxiety (MD: -1.5, 95% CI: -2.1 to -0.9) and tension (MD: -1.90, 95% CI: -2.5 to -1.2). Besides, massage significantly promote relaxation (MD: 1.8, 95% CI: 1.2 to 2.4) among patients undergoing abdominal colorectal surgery.
Comparison: Massage versus social visit and relaxation session in patients who completed abdominal colorectal surgery
Outcomes 1 2 3 4
No. of studies (Total number of participants) 1 (127) 1 (127) 1 (127) 1 (127)
Mean score (SD) /No. of participants Intervention -1.5 (1.6)/61 -1.6 (1.9)/61 -2.3 (2.3)/61 2.3 (2.2)/61
Comparator -0.2 (1.7)/66 -0.4 (2.4)/66 -0.2 (2.4)/66 0.5 (1.7)/66
MD (95% CI) -1.39 (-1.9 to -0.9) -1.5 (-2.1 to -0.9) -1.90 (-2.5 to -1.2) 1.8 (1.2 to 2.4)
p value <0.001 <0.001 <0.001 <0.001
Overall quality of evidence* Moderate Moderate Moderate Moderate
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to social visit and relaxation session, massage therapy showed significant beneficial effect during postoperative recovery for patients undergoing abdominal colorectal surgery. 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
The authors did not mention adverse events of the intervention.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/26256133
The synopsis is based on the following article:
Dreyer NE, Cutshall SM, Huebner M, Foss DM, Lovely JK, Bauer BA, Cima RR. Effect of massage therapy on pain, anxiety, relaxation, and tension after colorectal surgery: A randomized study. Complement Ther Clin Pract. 2015 Aug;21(3):154-9.


* 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.