Massage therapy in palliative care populations: a narrative review of literature from 2012 to 2022.

BACKGROUND AND OBJECTIVE: Patients living with serious illness are often eligible for palliative care and experience physical symptoms including pain or dyspnea and psychological distress that negatively impacts health-related quality of life and other outcomes. Such patients often benefit from massage therapy to reduce symptom burden and improve quality of life when such treatment is available. At present, no synthesis or review exists exploring massage therapy specifically provided with palliative care patient populations. This review is needed because those with serious illness are a growing and important vulnerable population. Massage therapy is used frequently and in many healthcare delivery contexts, but the body of research has not led to its systematic integration or broad acceptance. METHODS: PubMed search for clinical research focused on massage therapy for palliative care-eligible populations from 2012 and 2022. Search terms included keywords: massage, massage therapy, serious illness, advanced illness, and palliative care. KEY CONTENT AND FINDINGS: Thirteen unique articles were identified through the PubMed database search and from a manual review of references. Study designs of included articles were one pilot, one quasi-experimental single-arm study, one mixed-methods study, two qualitative (both with hospital-based palliative care populations), seven randomized controlled trials, and one retrospective cohort analysis in a major Veterans Health Administration health care facility. CONCLUSIONS: Variability was found in study design, scope, sample size, and outcomes for related articles published in the last ten years. Few eligible interventions reflected real-world massage therapy delivery suggesting more clinical research is needed to examine massage provided by massage therapists trained to work with palliative care populations. Gaps in the current body of existing evidence supports the need for this review and recommendations for the direction of future related research.

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

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