1. Assess and address relevant imbalances in posture
2. In general, seek to establish symmetry
3. Strengthen muscles around knee joint
4. Compensate weak muscles
5. Disperse stress to bring balance
6. Decrease sympathetic activity
7. Diffuse inflammation
8. Reduce inhibition in anti-gravity muscles
Each study therapist was trained in the protocol, and
signed a form attesting to adherence to the manualized
massage protocol after each massage session. No deviations
from the protocol were reported for the duration
of the dose-finding trial at either site.
The manualization team agreed that the knee must be
regarded as a functional unit. Thus, the protocol explicitly
does not specify the percent of time to be spent directly
on structures of the knee. Rather, time variables
included the upper and lower leg, both including the
knee (see Table 1).
The manualized 30- and 60-min protocols were implemented
in a 24-week randomized dose-finding trial of
massage therapy for osteoarthritis of the knee [39]. Subjects
(n=125) were randomized to one of four regimens of
the manualized massage intervention (30 min or 60 min
weekly or biweekly) or to a usual care control. Outcomes
were assessed at baseline, 8, 16, and 24 weeks and
included the WOMAC, visual analog pain scale, range
of motion, and time to walk 50 feet.
1. Assess and address relevant imbalances in posture2. In general, seek to establish symmetry3. Strengthen muscles around knee joint4. Compensate weak muscles5. Disperse stress to bring balance6. Decrease sympathetic activity7. Diffuse inflammation8. Reduce inhibition in anti-gravity musclesEach study therapist was trained in the protocol, andsigned a form attesting to adherence to the manualizedmassage protocol after each massage session. No deviationsfrom the protocol were reported for the durationof the dose-finding trial at either site.The manualization team agreed that the knee must beregarded as a functional unit. Thus, the protocol explicitlydoes not specify the percent of time to be spent directlyon structures of the knee. Rather, time variablesincluded the upper and lower leg, both including theknee (see Table 1).The manualized 30- and 60-min protocols were implementedin a 24-week randomized dose-finding trial ofmassage therapy for osteoarthritis of the knee [39]. Subjects(n=125) were randomized to one of four regimens ofthe manualized massage intervention (30 min or 60 minweekly or biweekly) or to a usual care control. Outcomeswere assessed at baseline, 8, 16, and 24 weeks andincluded the WOMAC, visual analog pain scale, rangeof motion, and time to walk 50 feet.
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