Is massage therapy effective in managing pain and fatigue among patients with spinal cord injury?
Date of publication of the randomized controlled trial: February 2017
Design
Randomized controlled trial (RCT).
Participants
40 patients (mean age: 46.0 years, male %: 85%) who had experienced an acute spinal cord injury at least 12 months before the study.
Intervention
30 minutes Swedish style massage therapy to upper body once a week over 5 consecutive weeks.
Comparator
Comparison: Massage therapy versus guided imagery relaxation.
Major Outcomes
Outcome 1: Pain severity measured by short-form McGill Pain Questionnaire (SF-MPQ). Higher score indicates greater pain severity;
Outcome 2: Fatigue level measured by Chalder Fatigue Scale (CSF). Higher score indicates higher level of fatigue.
Settings
This trial was performed in an outpatient setting.
Comparison    Massage therapy versus guided imagery relaxation.
Main Results
Compared to guided imagery relaxation, the effect of massage therapy on pain severity (p>0.05) and fatigue (p>0.05) is insignificant among patients with spinal cord injury.
Comparison: Massage therapy versus guided imagery relaxation among patients with spinal cord injury.
Outcomes No. of studies (Total number of participants) Mean score (SD)/ No. of participants Heterogeneity test (I2) p value Overall quality of evidence*
Intervention Comparator
1 1 (40) 9.1 (8.1)/ 20 8.6 (8.9)/ 20 Not applicable as there is only 1 study. >0.05 Low
2 1 (40) 14.1 (4.3)/ 20 16.5 (5.9)/ 20 Not applicable as there is only 1 study. >0.05 Low
Keys: SD = standard deviation.
Comparison    Massage therapy versus guided imagery relaxation.
Main Results
Compared to guided imagery relaxation, the effect of massage therapy on pain severity (p>0.05) and fatigue (p>0.05) is insignificant among patients with spinal cord injury.
Comparison: Massage therapy versus guided imagery relaxation among patients with spinal cord injury.
Outcomes 1 2
No. of studies (Total number of participants) 1 (40) 1 (40)
Mean score (SD)/ No. of participants Intervention 9.1 (8.1)/ 20 14.1 (4.3)/ 20
Comparator 8.6 (8.9)/ 20 16.5 (5.9)/ 20
p value >0.05 >0.05
Overall quality of evidence* Low Low
Keys: SD = standard deviation.
Conclusion
Benefits
Compared to guided imagery relaxation, massage therapy is not significantly more effective in managing pain and fatigue among patients with spinal cord injury. For Outcome 1-2, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/27897186
The synopsis is based on the following article:
Lovas J, Tran Y, Middleton J, Bartrop R, Moore N, Craig A. Managing pain and fatigue in people with spinal cord injury: a randomized controlled trial feasibility study examining the efficacy of massage therapy. Spinal Cord. 2017 Feb;55(2):162-166.


* 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.