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Överskrift Massage for mechanical neck disorders
Upplaga Issue 3
Sidor CD004871.pub3
Överskrift Massage for mechanical neck disorders
Beskrivning BACKGROUND: Mechanical neck disorders (MND) are common, disabling and costly. Massage is a commonly used modality for the treatment of neck pain. OBJECTIVES: . To assess the effects of massage on pain, function, patient satisfaction and cost of care in adults with neck pain. . To document adverse effects of treatment. SEARCH STRATEGY: Cochrane CENTRAL, MEDLINE, EMBASE, MANTIS, CINAHL, and ICL databases were electronically searched, without language restriction, from their inception to September 2004 SELECTION CRITERIA: Studies using random or quasi-random assignment were included. DATA COLLECTION AND ANALYSIS: Two reviewers independently conducted citation identification, study selection, data abstraction and methodological quality assessment. Using a random-effects model, we calculated the relative risk and standardized mean difference. MAIN RESULTS: Nineteen trials met the inclusion criteria. Overall, the methodological quality was low, with 12/19 assessed as low-quality studies. Trials could not be statistically pooled because of heterogeneity in treatment and control groups. Therefore, a levels-of-evidence approach was used to synthesize results. Assessment of the clinical applicability of the trials showed that the participant characteristics were well reported, but neither the descriptions of the massage intervention nor the credentials or experience of the massage professionals were well reported.Six trials examined massage as a stand-alone treatment. The results were inconsistent. Of the 14 trials that used massage as part of a multimodal intervention, none were designed such that the relative contribution of massage could be ascertained. Therefore, the role of massage in multimodal treatments remains unclear. AUTHORS' CONCLUSIONS: No recommendations for practice can be made at this time because the effectiveness of massage for neck pain remains uncertain.Pilot studies are needed to characterize massage treatment (frequency, duration, number of sessions, and massage technique) and establish the optimal treatment to be used in subsequent larger trials that examine the effect of massage as either a stand-alone treatment or part of a multimodal intervention. For multimodal interventions, factorial designs are needed to determine the relative contribution of massage.Future reports of trials should improve reporting of the concealment of allocation, blinding of outcome assessor, adverse events and massage characteristics. Standards of reporting for massage interventions, similar to CONSORT, are needed. Both short- and long-term follow-up are needed. PLAIN LANGUAGE SUMMARY: Massage for mechanical neck painNeck pain is common and can limit a person's ability to participate in normal daily activities. Massage is a widely used treatment for neck pain. In this review, it was defined as touching or manipulating the soft tissues surrounding the neck with the hand, foot, arm or elbow. There are a number of different types of massage. This review included studies that looked at Traditional Chinese massage, ischemic compression, self-administered ischemic pressure using a J-knob cane, conventional Western massage and occipital release, among other techniques. It did not include studies that examined techniques such as Reiki or Polarity.We included 19 trials (1395 participants) in this review that assessed whether massage alone or in combination with other treatments could help reduce neck pain and improve function. Results showed that massage is safe and any side effects were temporary and benign. However, neither massage alone nor massage combined with other treatments showed a significant advantage over other comparison groups. Alone, or in combination with other treatments, it was compared to no treatment, hot packs, active range-of-movement exercises, interferential current, acupuncture, exercises, sham laser, TENS, manual traction, mobilization, education and pain medication.There were a number of challenges with this review. Overall, the quality of the studies was poor and the number of participants in most trials was small. Most studies lacked a definition, description, or rationale for massage, the massage technique or both. In some cases, it was questionable whether the massage in the study would be considered effective massage under any circumstance. Details on the credentials or experience of the person giving the massage were often missing, and only 11/19 trials reported enough detail to determine who actually was giving the massage. There was such a range of massage techniques and comparison treatments in the studies that we could not combine the results to get an overall picture of the effectiveness of massage. Therefore, no firm conclusions could be drawn and the effectiveness of massage for improving neck pain and function remains unclear.
Källa Cochrane Database of Systematic Reviews
Publicerad 2006
Författare Bronfort G, Cervical Overview Group, Ezzo JM, Goldsmith C, Gross AR, Haraldsson BG, Morien A, Myers CD, Peloso PM

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