A pilot feasibility study of massage to reduce pain in people with spinal cord injury during acute rehabilitation.

Abstract

To determine the feasibility of conducting a randomized controlled trial of massage therapy for patients with a new spinal cord injury (SCI) during acute inpatient rehabilitation. A pilot single-center, randomized, single-blind, cross-over clinical trial. Free-standing, not-for-profit, comprehensive rehabilitation center specializing in SCI rehabilitation. Forty adults ages 18 years and older undergoing acute rehabilitation following an SCI reporting any type of pain. Rehabilitation nurses trained to give broad compression massage (BCM) and a control light contact touch (LCT) treatments. Participants were randomized to receive either BCM or LCT first, in six 20-min treatment sessions over 2 weeks, with a 1-week washout between the 2-week treatment periods. Primary outcomes were changes in pain intensity and in fatigue, measured daily. Secondary outcomes included depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9) and an assessment of pain medication usage. Pain intensity was higher at baseline and reduced more in the LCT-first group compared with the BCM-first group in period 1 (P=0.014), although this pattern was not found in period 2 (P=0.58). LCT and BCM groups did not significantly differ on any secondary measures except PHQ-9. This study demonstrates the feasibility of using rehabilitation nurses to provide tactile therapy to patients with an SCI and suggests a model for controlled clinical trials examining the efficacy of massage therapies. Although efficacy was difficult to assess, BCM was safe and well tolerated.