A Commentary on the Role of Randomized Controlled Trials in Massage Therapy

Abstract

Some massage therapists (MTs) view research as a way to demonstrate to other healthcare professionals (OHPs) that massage therapy is safe and effective and should be an integral part of patients’ health care. This desire for credibility through research, however, requires studies that are acceptable to medical professionals. Therefore, researchers have begun to study massage therapy, primarily using randomized controlled trials (RCTs). Many of the RCTs of massage therapy, rather than proving efficacy, have been met with criticism, including their lack of reproducibility and lack of a suitable control. The belief that RCTs will save the profession of MT, or any health care practice, by proving treatments work, is unfounded. Evidence hierarchies suggest that practitioners should accept the results of RCTs, or the systematic review of RCTs, as the gold standard for efficacy research. Privileging one methodology over another does not use the benefits of the multiple approaches to research available. Researchers should consider whether there are other methodologies that allow for rigorous investigation of massage therapy in a way that would be useful for stakeholders of this research. It is only through research that is rigorously and authentically conducted that the credibility of massage therapy will be established.

The Effectiveness of Massage in Managing Pregnant Women with Pelvic Girdle Pain: a Randomised Controlled Crossover Feasibility Study

“…( 30 ) “This type of design combines the best parts of a RCT along with qualitative design, … to enhance the data collected and, subsequently, the results”. ( 30 )…”

“…Participants enrolled in the study during the uncertainly of the COVID-19 pandemic and in between the numerous lockdown measures that took place; therefore, their experience of PPGP and pregnancy may have been influenced by this unusual time. A well-recognised limitation for massage therapy RCT research study designs is the inability to blind participants and therapists; ( 30 ) thus the research results reflect any biases participants had about the interventions.…”

“…Mixed methods studies combine qualitative and quantitative methods and this study design is 'becoming recognized for the potential to investigate complex questions". (30) "This type of design combines the best parts of a RCT along with qualitative design, … to enhance the data collected and, subsequently, the results". (30) Our study found that both massage and exercise were significantly helpful in reducing pain after each treatment.…”

“…(30) "This type of design combines the best parts of a RCT along with qualitative design, … to enhance the data collected and, subsequently, the results". (30) Our study found that both massage and exercise were significantly helpful in reducing pain after each treatment. Participants receiving the massage had significantly improved pain in the health-related quality of life measure and reduced pain intensity as per the pain intensity numerical rating scale.…”

What is Effective in Massage Therapy? Well, “It Depends…”: a Qualitative Study of Experienced Orthopaedic Massage Therapists

“…Whole-person research, mixed-methods, pragmatic effectiveness trials, and n-of-1 studies would potentially provide deeper insights into correlations that may lead to more targeted clinical studies in the future. (79)(80)(81)(82) Studies in which the researcher observes the massage therapist in practice are challenging due to the intimate nature of massage therapy. However, they have been conducted, (22,32) and future studies that encompass the observation of treatments and the ability to ask therapists to explain their processes in real time would potentially have a greater ability to access their tacit knowledge, and to gain a deeper understanding of how they combine techniques, build treatments dynamically, and use clinical reasoning to work through client issues within a session.…”