Massage Therapy for Hospitalized Patients Receiving Palliative Care: A Randomized Clinical Trial

Hunter Groninger; Donya Nemati; Cal Cates; Kerry Jordan; Anne Kelemen; Gianna Shipp; Niki Munk

doi:10.1016/j.jpainsymman.2023.01.011

Massage Therapy for Hospitalized Patients Receiving Palliative Care: A Randomized Clinical Trial

J Pain Symptom Manage. 2023 May;65(5):428-441. doi: 10.1016/j.jpainsymman.2023.01.011. Epub 2023 Jan 31.

Authors

Hunter Groninger¹, Donya Nemati², Cal Cates³, Kerry Jordan³, Anne Kelemen⁴, Gianna Shipp⁵, Niki Munk⁶

Affiliations

¹ Georgetown University Medical Center/MedStar Health (H.G., A.K.) Washington, District of Columbia, USA. Electronic address: hunter.groninger@medstar.net.
² Indiana University School of Health and Human Sciences (D.N., N.M.) Indianapolis, Indiana, USA; Department of Health Sciences (D.N., N.M.) Indianapolis, Indiana, USA.
³ Healwell (C.C., K.J.) Arlington, Virginia, USA.
⁴ Georgetown University Medical Center/MedStar Health (H.G., A.K.) Washington, District of Columbia, USA.
⁵ Virginia Commonwealth University School of Medicine (G.S.) Richmond, Virginia, USA.
⁶ Indiana University School of Health and Human Sciences (D.N., N.M.) Indianapolis, Indiana, USA; Department of Health Sciences (D.N., N.M.) Indianapolis, Indiana, USA; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Massage & Myotherapy Australia Fellow and Visiting Faculty of Health, University of Technology Sydney (N.M.) Sydney, New South Wales, Australia; National Centre for Naturopathic Medicine, Southern Cross University (N.M.) East Lismore, New South Wales, Australia.

PMID: 36731805
DOI: 10.1016/j.jpainsymman.2023.01.011

Abstract

Context: Massage therapy is increasingly used in palliative settings to improve quality of life (QoL) and symptom burden; however, the optimal massage "dosage" remains unclear.

Objectives: To compare three massage dosing strategies among inpatients receiving palliative care consultation.

Methods: At an urban academic hospital, we conducted a three-armed randomized trial examining three different doses of therapist-applied massage to test change in overall QoL and symptoms among hospitalized adult patients receiving palliative care consultation for any indication (Arm I: 10-min massage daily × 3 days; Arm II: 20-min massage daily × 3 days; Arm III: single 20-min massage). Primary outcome measure was single-item McGill QoL question. Secondary outcomes measured pain/symptoms, rating of peacefulness, and satisfaction with intervention. Data were collected at baseline, pre- and post-treatment, and one-day postlast treatment (follow-up). Repeated measure analysis of variance and paired t-test were used to determine significant differences.

Results: Total n = 387 patients were 55.7 (±15.49) years old, mostly women (61.2%) and African-American (65.6%). All three arms demonstrated within-group improvement at follow-up for McGill QoL (all P < 0.05). No significant between-group differences were found. Finally, repeated measure analyses demonstrated time to predict immediate improvement in distress (P ≤ 0.003) and pain (P ≤ 0.02) for all study arms; however, only improvement in distress sustained at follow-up measurement in arms with three consecutive daily massages of 10 or 20 minutes.

Conclusion: Massage therapy in complex patients with advanced illness was beneficial beyond dosage. Findings support session length (10 or 20 minutes) was predictive of short-term improvements while treatment frequency (once or three consecutive days) predicted sustained improvement at follow-up.

Keywords: Palliative care; integrative medicine; massage; pain; quality of life; symptoms.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Female
Humans
Inpatients
Male
Massage
Middle Aged
Pain
Palliative Care*
Quality of Life*