International Journal of Therapeutic Massage & Bodywork (IJTMB)
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Massage Therapy for Ankle Mobility and Spasticity in an Adult with Cerebral Palsy: A Case Report
No full textBackground: Cerebral palsy (CP) refers to a group of permanent neurologic disorders associated with injury to the brain during its development. The most common type of CP is spastic CP. Individuals with spastic CP commonly present with increased deep tendon reflexes, tremors, muscular hypertonicity, and weakness. Treatment aims to manage primary and secondary symptoms of CP and improve quality of life. Massage therapy has been shown to improve function and decrease spasticity in individuals with CP.
Objective: The objective of this study was to determine the effectiveness of massage therapy in increasing ankle mobility and decreasing spasticity in an adult with spastic CP.
Method: A student massage therapist at MacEwan University administered five massage therapy treatments over 6 weeks on a 55-year-old female with spastic diplegic CP who presented with no active ankle movement and her ankles rigid in plantarflexion. The treatment goals were to obtain some ankle mobility and decrease spasticity in the knee extensors, which negatively impacted her ability to don socks and shoes. Progress was monitored using goniometry pre- and post-treatment to assess ankle mobility, and by administering the Modified Ashworth Scale prior to the third, fourth, fifth, and final sessions to assess spasticity. Techniques included static contact, effleurage, broad compressions, petrissage, muscle stripping, Golgi tendon organ release, muscle approximation, joint mobilizations, and passive range of motion.
Results: Ankle mobility increased, and slight active ankle dorsiflexion and plantarflexion were possible. Spasticity in the knee extensors decreased, but the change was not clinically significant.
Conclusion: The results of this study suggest that massage therapy may improve ankle mobility and decrease spasticity in an adult with spastic CP
Research as a Pathway to Advancing Interprofessional Integration
No full textInterprofessional collaboration enhances health care by fostering communication, improving patient outcomes, and integrating diverse expertise. For therapeutic massage and bodywork (TMB) practitioners, engaging in interprofessional practice remains a challenge due to professional silos, limited research engagement, and other barriers to integration within health-care teams. This article explores the potential of research as a mechanism for strengthening interprofessional collaboration, positioning TMB practitioners as active contributors to evidence-informed health care. By fostering a stronger research culture, TMB can enhance its role within health-care systems, create new opportunities for integration, and contribute meaningfully to interdisciplinary patient care
Reframing Massage Therapy: The Somato-Relational Framework for Mental Health and Healing
No full textMassage therapy, often regarded as a tool for physical relief, has untapped potential in addressing mental health challenges such as anxiety, depression, and substance abuse. The somato- relational framework (SRF) offers a structured model to bridge manual therapies with modern mental health care by focusing on three interdependent pillars: embodiment, relational dynamics, and integration. By emphasizing body awareness, therapeutic connection, and the integration of healing experiences, SRF positions massage therapy as a bio-psychosocial approach to holistic mental health care. This paper explores the applications of SRF in practice, education, and research, highlighting its potential to position massage therapy as a cornerstone of integrative care. Addressing current limitations and emphasizing interdisciplinary collaboration, the SRF invites innovation and sets the stage for transformative advancements in both massage therapy and mental health
Deep Front Line Myofascial Release Versus Novel Soft Tissue Kinetic Chain Activation Technique (K-CAT) on Pain, Radiological Patellar Position and Dynamic Knee Valgus in Knee Osteoarthritis: A Randomized Clinical Trial
No full textBackground: Knee osteoarthritis (OA) is the most common degenerative condition, afflicting large number of people globally. Fascia is a three-dimensional network of connective tissue that helps in force transmission along the myofascial chains to bone level causing malalignments and movement dysfunctions. Myofascial dysfunctions have been identified in osteoarthritis of knee as a pain-causing component. Recently, clinicians have aimed a variety of therapeutic techniques at fascia. There is a lack of literature to determine the effect of kinetic chain activation technique (K-CAT) as well as deep front line (DFL) release technique in OA knee.
Purpose: The current study aimed to determine and compare the effectiveness of DFL release and K-CAT in knee OA.
Methods: The study was a randomized clinical trial conducted in an outpatient department of a tertiary care hospital. Thirty-two (n = 32) participants between 45 and 60 years of age with knee osteo-arthritis (grades 2 and 3) were included and randomized into two groups based on selection criteria. Group A received DFL myofascial release and Group B received K-CAT, along with common conventional therapy (modality + exercises), three sesions per week for 2 weeks. Pain intensity using Numeric Pain Rating Scale, skyline view of knee radiographic parameters including lateral patellar tilt angle (LPTA) and bisect offset (BO), dynamic knee valgus (DKV) by single leg squat using Kinovea software and quality of life using Knee Injury and Osteoarthritis Outcome Score on day 1 and day 14 of intervention were assessed.Results: Within-group analyses showed significant improvements in both the groups for pain, BO on x-ray, DKV, and Knee Injury and Osteoarthritis Outcome Score (p < 0.05). LPTA showed statistical significance only in the DFL group. However, between-group comparisons showed no statistical difference in all the outcomes (p > 0.05).
Conclusion: Both DFL myofascial release and K-CAT were found to be equally effective in alleviating pain, improving quality of life and knee malalignments.
Trial registered under Clinical Trial Registry of India (CTRI/2023/11/059388)
Understanding Australian Massage Therapist’s Awareness of and Knowledge to Recognize Domestic and Family Violence: Findings from a Community Survey
No full textThe objective of this study is to investigate massage therapists’ knowledge, confidence, and awareness of domestic and family violence (DFV) in clinical practice. An online questionnaire methodology was used to collect data from Australian massage therapists who were 18 years or over. The study was open for participation for 6 months. The authors developed the questionnaire based on a previous massage therapy profession questionnaire; it included 64 questions in three sections. Two hundred and seventeen respondents formed the dataset. This study found respondents with prior experience of DFV were significantly more likely to have undertaken DFV training than respondents with no prior experience of DFV (p = 0.004). Almost two-thirds of respondents either strongly agreed or agreed that they would like some training to better understand DFV (n = 142, 65.4%) and to better understand their responsibilities around DFV (n = 149, 68.7%). Over half of the respondents were somewhat or very confident they would recognize the signs and symptoms of DFV (n = 126, 58.3%). Over half of respondents (n = 119, 54.8%) felt somewhat knowledgeable about DFV. The main theme from the qualitative analysis was absent resources. The subthemes were (i) without training I cannot help, (ii) prepare me, train me early, and (iii) support me with resources. This study concluded that there is a lack of resources and a deficiency in skills and knowledge among massage therapists to recognize and respond appropriately to domestic violence in clinic. Respondents indicated a desire to learn more about DFV in their practices as they deemed that without training, education, and resources they cannot provide the best of care for their clients
The Prevalence of Massage Therapy Utilization for Musculoskeletal Conditions: A Systematic Review
No full textBackground: Massage therapy is a popular treatment for musculoskeletal conditions globally. As the efficacy for massage therapy grows over time, it is becoming a more acceptable form of therapy alongside conventional medicine. The aim of this systematic review is to highlight the prevalence of massage therapy utilization specifically for the treatment of musculoskeletal conditions.
Methods: A comprehensive search of health databases using keywords mapped to massage and musculoskeletal conditions identified 38 studies. An assessment of the quality of these studies was undertaken using a validated quality appraisal instrument.
Results: Overall, the prevalence of mas-sage use ranged from 2% to 81.2%. The range narrowed marginally from 2.2% to 56% in larger studies (n ≥ 1,000). Prevalence was higher among younger individuals, ranging from 12% to 56%. The prevalence of use among women ranged from 7.7% to 56%. The highest prevalence for conditions was for lower back pain/back pain, ranging from 10.5% to 68.1%, and for patients with chronic pain, ranging from 17.6% to 56%. The lowest prevalence was reported in Australia, ranging from 2% to 56%, and the highest in North America, from 2.2% to 81.2%.
Conclusions: Our findings indicate that 74% of studies in this review relating to prevalence of massage therapy utilization for musculoskeletal conditions are reported within studies focus-ing on complementary medicine more generally. Further studies on massage as an independent treatment modality would be useful to provide improved evidence on prevalence for massage use for musculoskeletal conditions. While the range of prevalence reported here is wide, inpatients and outpatients with specific musculoskeletal conditions including pain are high users of massage therapy. Despite the growing interest in research, there is a gap in the literature around men and their use of massage therapy. Further high-quality research in these areas will better inform the knowledge base around these participant cohorts
Evaluating the Effectiveness of Deep Transverse Frictional Massage Combined with Conventional Physiotherapy for Tendinopathies: A Systematic Review and Meta-analysis
No full textBackground: Tendinopathies are common musculoskeletal disorders characterized by pain and functional impairment, often requiring therapeutic interventions for effective management. This systematic review and meta-analysis aimed to evaluate the effectiveness of deep transverse frictional massage (DTFM) combined with conventional therapy for the treatment of tendinopathies.
Methods: A study search of electronic databases including MEDLINE, Google Scholar, and PubMed databases, was conducted for randomized controlled trials, pilot study, and comparative study design comparing the combined application of DTFM with conventional physiotherapy (e.g., exercise, stretching, or modalities) to conventional therapy alone for the treatment of tendinopathies. Inclusion criteria were studies that reported clinical outcomes such as pain reduction and disability. Data extraction was performed independently by reviewers. A meta-analysis was conducted using random-effects models to estimate the pooled effect size, and heterogeneity was assessed using the I2 statistic. The risk of bias was assessed using the Cochrane risk-of-bias approach.
Results: A total of 13 studies met the inclusion criteria. The combined treatment group (DTFM + conventional therapy) showed significant improvements in pain reduction (standardized mean difference (SMD) = −0.92, 95% confidence interval (CI): −14.50, p < 0.05) and elbow (SMD = −2.67, 95% CI: −3.38 to −1.96, p < 0.05) compared to conventional therapy alone. No significant adverse effects were reported.
Conclusion: The findings suggest that DTFM, when combined with conventional therapy, offers significant benefits over conventional therapy alone in the management of tendinopathies, particularly in reducing pain and improving function. The exact physiological mechanisms through which DTFM works in combination with conventional therapies remain unclear. Research into how DTFM influences tissue healing, collagen remodeling, or pain reduction pathways could provide more insights into its effectiveness and guide its integration into treatment protocols
The Effects of Massage Therapy on Medically Induced Trauma and Touch Aversion: A Case Report
No full textAlmost 1 million US adults are diagnosed annually with post-traumatic stress disorder related to medical trauma. Individuals who experience life-threatening illness or injuries, frequent hospitalizations, and multiple invasive procedures are more likely to develop post-traumatic stress and touch aversion, making it difficult for them to relax and feel safe in health-care settings. Psychological and somatic symptoms can complicate recovery and decrease quality of life. While massage has been shown to offer a variety of physical and psychological benefits, little is known about the benefits of massage for those diagnosed with post-traumatic stress and touch aversion related to medical trauma. A 44-year-old female was referred to massage therapy for muscle pain and generalized weakness, symptoms of a chronic degenerative illness with limited treatment options. Complicated by multiple diagnoses, her long-standing anxiety and depression had worsened, and she suffered from post-traumatic stress and touch aversion due to significant medical trauma. The patient’s goals included relaxation, decreased pain and anxiety, as well as improvements in her aversion to touch when receiving necessary medical care. A wide variety of massage techniques were offered based on the patient’s physical and psychological symptoms, and her receptivity to touch. Over the course of 2 years, the patient’s anxiety and distress decreased as her ability to communicate her needs increased. A trauma-informed approach is essential when providing massage for those with post-traumatic stress and touch aversion from medical trauma. A pre-massage consultation and customization of the massage allowed the patient to provide consent and have control over where and how her body was touched, something that is often not possible with medical procedures. Further research is needed to determine how best to provide massage therapy to these individuals and measure outcomes related to effectiveness and symptom improvement
Mental Health Impact of Massage and Massage Therapy for Survivors of Domestic and Family Violence and/or Sexual Abuse: A Scoping Review
No full textBackground: Sexual abuse (SA) and domestic and family violence (DFV) are a worldwide issue with high incidence rates. While massage therapists are not generally frontline responders, they may see individuals presenting with the lifelong sequelae of DFV/SA.
Purpose: The aim of this scoping review is to characterize the nature, scope, quality, and potential reach of publications within the massage therapy and research fields that focus on massage and massage therapy treatment for those who have or are currently experiencing DFV and/or SA. Additional objectives for this review are the intent to compile a summary of practice- and evidence-based recommendations and completion of an appraisal of included publications.
Methods: A scoping review was conducted following Arksey and O’Malley’s six-step scoping review framework and the PRISMA-ScR guidelines. The electronic databases PubMed, ProQuest, CENTRAL, CINHAL, Web of Science, and MEDLINE as well as Google Scholar were searched to identify publications. Summaries of the publications were undertaken as the included publications did not yield enough rich qualitative data to undertake a thematic analysis.
Results: Twenty-six publications were included from five countries with the most papers coming from the United States. The review demonstrated multiple psychological benefits of massage with the majority of publications presenting mental health improvements as the predominant impact of massage therapy on individuals who had experienced DFV/SA; however, the majority of the interventional benefits came from SA research.
Conclusion: The review highlighted a void in the interventional research on massage and DFV with no interventional study focusing on DFV and massage solely despite anecdotal evidence of benefit. There was also a lack of evidence of impact of massage in clinical practice for individuals with any history of DFV/SA. There is potential that massage therapy may be a useful tool in aiding survivors’ recovery, if administered by trained individuals
MET to Levator Scapulae Versus MET to Anterior Scalene: Comparative Effects on Craniovertebral Angle and Cervical Joint Position in Forward Head Posture
No full textBackground: Forward head posture (FHP) results in an accentuated posterior curve in the higher thoracic vertebrae and an accentuated anterior curve in the lower cervical vertebrae. Dysfunction leads to muscle imbalance, where one side of the neck and scapula muscles become weak and the opposite group of muscles become tight. Strategies to correct this imbalance by treating flexibility and improving strength are the need of the hour.
Purpose: The aim of this study is to assess the effectiveness of muscle energy technique (MET) to levator scapulae versus MET to anterior scalene in improving craniovertebral angle (CVA) and joint position sense.
Setting: This study was conducted at the outpatient department of Dr. D. Y. Patil College of Physiotherapy, Pune, India.
Participants: Both males and females aged between 18 and 30 years with a CVA <48° were included.
Research design: This was an experimental study.
Intervention: A comparative experimental study was done on subjects aged between 18 and 30 years with CVA<48°. Group A (n = 15) received MET to levator scapulae muscles with conventional treatment and group B (n = 15) received MET to anterior scalene muscles with conventional treatment for 4 weeks, three sessions per week. The outcome measures assessed were CVA and cervical joint position error, pre- and post-intervention.
Main outcome measures: CVA and cervical joint position sense.
Results: MET to levator scapulae and anterior scalene significantly improved the FHP (p = 0.001 for both the groups) and cervical proprioception (p = 0.001 for both the groups) using the Wilcoxon signed rank test for pre–post comparison. However, on comparison between groups using the Mann–Whitney U test, MET to levator scapulae was better in improving the FHP (p = 0.002). No significant difference was found in the cervical joint position sense between both the groups.
Conclusion: Levator scapulae and anterior scalene flexibility should also be considered in FHP. Applying MET to these two muscles is not only beneficial in realigning the FHP but also in improving the cervical joint position sense