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

Abstract

Massage therapy is increasingly used in palliative settings to improve quality of life and symptom burden; however, the optimal massage "dosage" remains unclear. To compare three massage dosing strategies among inpatients receiving palliative care consultation. 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 quality of life and symptoms among hospitalized adult patients receiving palliative care consultation for any indication (Arm I: 10-min massage daily x 3 days; Arm II: 20-min massage daily x 3 days; Arm III: single 20-min massage). Primary outcome measure was single-item McGill Quality of Life question. Secondary outcomes measured pain/symptoms, rating of peacefulness, and satisfaction with intervention. Data were collected at baseline, pre- and post-treatment, and 1-day post-last treatment (follow-up). Repeated measure analysis of variance and paired t-test were used to determine significant differences. 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 quality of life (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. 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.