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Randomized Controlled Trial
. 2012;7(2):e30248.
doi: 10.1371/journal.pone.0030248. Epub 2012 Feb 8.

Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial

Adam I Perlman  1 , Ather Ali, Valentine Yanchou Njike, David Hom, Anna Davidi, Susan Gould-Fogerite, Carl Milak, David L Katz
Affiliations
Randomized Controlled Trial

Massage therapy for osteoarthritis of the knee: a randomized dose-finding trial

Adam I Perlman et al. PLoS One. 2012.

Abstract

Background: In a previous trial of massage for osteoarthritis (OA) of the knee, we demonstrated feasibility, safety and possible efficacy, with benefits that persisted at least 8 weeks beyond treatment termination.

Methods: We performed a RCT to identify the optimal dose of massage within an 8-week treatment regimen and to further examine durability of response. Participants were 125 adults with OA of the knee, randomized to one of four 8-week regimens of a standardized Swedish massage regimen (30 or 60 min weekly or biweekly) or to a Usual Care control. Outcomes included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog pain scale, range of motion, and time to walk 50 feet, assessed at baseline, 8-, 16-, and 24-weeks.

Results: WOMAC Global scores improved significantly (24.0 points, 95% CI ranged from 15.3-32.7) in the 60-minute massage groups compared to Usual Care (6.3 points, 95% CI 0.1-12.8) at the primary endpoint of 8-weeks. WOMAC subscales of pain and functionality, as well as the visual analog pain scale also demonstrated significant improvements in the 60-minute doses compared to usual care. No significant differences were seen in range of motion at 8-weeks, and no significant effects were seen in any outcome measure at 24-weeks compared to usual care. A dose-response curve based on WOMAC Global scores shows increasing effect with greater total time of massage, but with a plateau at the 60-minute/week dose.

Conclusion: Given the superior convenience of a once-weekly protocol, cost savings, and consistency with a typical real-world massage protocol, the 60-minute once weekly dose was determined to be optimal, establishing a standard for future trials.

Trial registration: ClinicalTrials.gov NCT00970008.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Participant Flow Diagram.
Figure 2
Figure 2. Dose-Response Curve.
Dose-response curve plotting dose (total minutes over the course of 8-weeks of massage) (x-axis) vs. improvement (change in WOMAC Global scores after 8-weeks). Dose-response effects plateaued at 480-minutes (Group 3), with no significant improvements noted in the 720-minute (Group 4) dose.
Figure 3
Figure 3. Improvement in WOMAC-Global Scores at Assigned Doses of Massage.
See this image and copyright information in PMC

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