Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial

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.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.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.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.ClinicalTrials.gov NCT00970008

Effects of sugar-sweetened and sugar-free cocoa on endothelial function in overweight adults

Studies of cocoa suggest an array of cardiovascular benefits; however, the effects of daily intake of sugar-free and sugar-sweetened cocoa beverages on endothelial function (EF) have yet to be established

30- and 60-Minute Massage Protocols.

<p>*Accounting for time spent in transition including the welcome, transition to the massage room, taking off jewelry, and other preparatory activities.</p

Changes in outcomes at 24-weeks post-baseline.

<p>Values are mean with 95% confidence intervals; negative values indicate improvement.</p

Demographic Characteristics and Baseline Values.

<p>Values are mean ± SD except otherwise stated.</p

Mean change (95% CI) in outcomes at 8-weeks post-baseline (primary endpoint).

<p>Values are mean with 95% confidence intervals; negative values indicate improvement;</p>†<p>Significant (non-overlap) compared to Usual Care;</p>‡<p>Significant (non-overlap) compared to Group 1.</p

Improvement in WOMAC-Global Scores at Assigned Doses of Massage.

<p>Improvement in WOMAC-Global Scores at Assigned Doses of Massage.</p