DoH Natural Health Review – A Catalyst For Cooperation On Research Methodologies

DoH Natural Health Review – A Catalyst For Cooperation On Research Methodologies

General, Government, Industry

The Australian Association of Massage Therapists (AAMT) welcomes the finalization of the Department of Health’s (DoH) Review of natural therapies, calling on the Federal government to prioritize a program of research funding in areas where the evidence suggests therapies are of likely benefit, and where more research would be beneficial.

Tricia Hughes, CEO for the AAMT, said ‘We are encouraged by the researchers who state that it is also more likely that further research may identify clinical conditions for which particular therapies are effective such as massage therapy.’

‘Like the vast majority of research into medical treatments, of the thousands of positive studies into the benefits of massage only a limited number meet the ‘gold standard’ applied in the DoH Review.

However, massage is in very high demand. Massage therapists deliver around 13 million massages per year with the sector growing at a rate of 62.3% over the past 10 years, and creating an additional 3,300 jobs in the past five years[1].

‘The AAMT supports evidence-based treatment and efforts to weed out false or misleading health claims. Given the high and growing demand for massage therapy, the findings of this study highlight the need for a collaborative approach to developing appropriate research methodologies for massage therapy.

‘Gaining acknowledgement and collaboration with the National Health and Medical Research Council (NHMRC) on developing appropriate and reliable mixed methods of studies for particular modalities, as an alternative to simply applying a rarely obtainable ‘gold plated’ research standard, is essential for the growth of a professional and skilled massage sector in Australia.

‘As the leading government body supporting and funding medical research in Australia, the NHMRC now has the opportunity to progress its Strategic Plan which detailed a program to ‘examine alternative therapy claims’ as a major health issue for consideration, including the provision of research funding,’ Ms Hughes said.

The DoH Report also states that the absence of evidence does not mean that the therapy does not work. Importantly, to improve the understanding of the effectiveness of massage the researchers concluded that developments in research are required:

  • more rigorous, multicentre, and well-designed clinical studies assessing the effectiveness of massage for a particular patient population
  • a combined treatment approach that properly reflects the way that massage is applied in practice
  • optimal treatment parameters such as number of sessions or duration of sessions, combined with longer-term follow-up of patients

Ms Hughes said, The challenge is to develop a suitable research methodology. For example, it is impossible to implement a double blind placebo massage, which involves the researcher, massage therapists and patient not knowing which massage is a placebo or the real thing in order to establish and a clear cause and effect link with a minimal chance of outside influences.’

Importantly, not all massage therapists are the same. Some massage therapists are highly qualified health professionals that deliver higher level and technically skilled services in hospitals, palliative care, clinical practices, and elite sports settings; while others offer wellbeing and relaxation massage.’

It is important to note the breadth and diversity of the application of massage as an intervention. In the Australian context, two authoritative examples are worth noting for their use of massage in dedicated cancer patient care: 1) The Olivia Newton John Foundation now employs massage therapists at the Austin Hospital; 2) Solaris Care delivers massage therapy for cancer patients at the Sir Charles Gairdner Hospital in Perth.

Ms Hughes said, ‘As a leading area of demand and growth in the natural medicine and health sector, a greater allocation of health research funding towards furthering our understanding of higher level and technically skilled areas of massage and Myotherapy seems reasonable if we are to ensure patients receive the best and most appropriate form of massage therapy,’

Ms Hughes said that despite limited funding the AAMT has funded similar reviews o the DoH review. A 2008 RMIT study which reviewed 740 studies into massage conducted prior to 2008, found that a growing body of research supports massage therapy as being an evidence-based therapeutic modality.

Another AAMT commissioned study conducted during 2012 by the University of South Australia’s International Centre for Allied Health Evidence, which looked at the effectiveness of massage therapy for the treatment of non-specific low back pain reported the following challenges and limitations when undertaking, and interpreting findings of research evidence for massage therapy:

  • in massage therapy research the conflict between replicating what occurs in clinical practice while adhering to strict research criteria presents a challenge
  • in a clinical practice context, massage therapy is often offered as a ‘package of care’ in addition to advice, education and using a combination of modalities, however, in a research context, a ‘package of care’ is rarely offered
  • the primary research undertaken may not truly capture and replicate what occurs in a clinical practice context.

Until recently, few clinical trials examined or measured the biological effects of massage, focusing on subjective reporting by the patients in the areas of pain, stress, sleep, anxiety, and general wellbeing.

‘The 2008 RMIT study also found that there are many opportunities for further research into the benefits of massage therapy for infants, depression and post-natal depression, labour pain, fibromyalgia, premenstrual syndrome, urinary symptoms in multiple sclerosis, myofascial pain, and osteoarthritis of the knee.

AAMT also supports a world-first researcher development program—the International Complementary Medicine (CM) Leadership and Capacity Building program with the Sydney’s University of Technology. Recently, AAMT also hosted a symposium of key national and international researchers to address the methodology and paucity of Cochrane level studies,’ Ms Hughes said.

‘Higher levels of collaboration and research will contribute to Australia’s high standard of health care, and develop our knowledge base as a leading exporter of health education.

The allocation of Federal funding towards initiatives that enhance research capabilities in the areas of massage that promise significant benefits for patients will continue to build confidence in the benefits and value of massage,’ Ms Hughes said.

Local accredited massage therapists can be sourced through AAMT’s online massage directory:

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