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Massage Today
February, 2003, Vol. 03, Issue 02

Spotlight on Research

By Editorial Staff

Welcome to the world of massage research! This periodic column will keep you abreast of the latest research documenting the benefits of massage and bodywork. Published research will be summarized, with references to the full study text provided; abstracts of research projects planned or in progress will be reproduced verbatim whenever possible.

Developing a massage protocol for research on temporomandibular joint disorders.
Marian Wolfe Dixon, MA, LMT

Purpose: A massage protocol for temporomandibular joint disorders (TMD) was developed and pretested for use in a TMD research project. Massage therapy has never been incorporated into a TMD research design.

Methods: Four potential TMD protocols were identified, based on a literature search (MEDLINE and Bodywork Knowledge Base) and follow up interviews with massage therapists who reported experience with TMD or experience developing massage protocols for research. Techniques across the protocols were consolidated into a list of TMD-specific massage techniques. Expert review helped generate a core TMD-specific massage protocol that was pretested using eight TMD patients. Feedback from the patients, the licensed massage therapists, and the supervising massage therapists was used to select two massage therapists to deliver the protocol in clinical studies. The protocol specified setting; forms and record keeping; session length; treatment duration; and specific massage techniques. The protocol was evaluated by patients along five dimensions: effectiveness, responsiveness and overall satisfaction (1=worst, 5=best), as well as pressure and communication (3=just right).

Results: TMD patients found the bodywork protocol to be acceptable, including intraoral work. Mean values for the five variables were: effectiveness, 3.9; responsiveness, 4.2; overall satisfaction, 4.3; pressure, 2.7; and communication, 2.8.

Conclusions: A flexible, yet repeatable, TMD-specific massage protocol was developed in accordance with the best practice in the massage profession. The final protocol incorporated Swedish, myofascial, craniosacral, neuromuscular therapy and structural integration styles, and combined intraoral work with external massage focusing on the trunk, neck and face. Although the protocol was developed specifically to study the effect of massage on TMD, the development process could be adapted to generate syndrome- or condition-specific massage protocols for research with other complex, chronic disorders, such as migraines or fibromyalgia.

Massage therapy for chronic low back pain in low-income patients.
Lucy Candib, MD, The Family Health and Social Service Center, Worcester, Massachusetts

This ongoing study examines the effects of whole-body massage therapy in reducing pain and improving health among low-income Hispanic and Caucasian women who suffer from chronic pain. In many cases, chronic pain is part of more complex mental health problems, such as depression and anxiety. Whole-body massage therapy, which is not readily available in poorer communities, offers a complementary approach to standard treatments of chronic pain. Each patient in this study receives eight hour long massage treatments from experienced massage therapists.

The working hypothesis is that massage therapy will be useful in reducing pain, improving functional health, and curbing excess medical utilization in these patients, for at least eight weeks after the program. To test this hypothesis, researchers will compare health care utilization (office visits, urgent care, and emergency care) from three periods: the year before the study; during the six months of the study; and one year after the study.

Dr. Candib has begun massage treatments on 54 patients, and has collected detailed information about them. This information is awaiting analysis by a statistician. Dr. Candib has also secured funding from the Department of Family Medicine and Community Health at the University of Massachusetts Medical School, to hire a translator to conduct interviews with Spanish-speaking participants in the program.

The primary challenge so far has been frequent cancellation of appointments, often due to problems with transportation and child care responsibilities. Another difficulty has been a low rate of participation in follow up testing. Although these obstacles have slowed down the study, it is still in motion.

Editor's note: Both of the above abstracts were funded by the AMTA Foundation ( and presented at the 2002 AMTA National Convention; they appear in Massage Today with permission from the respective authors.


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