title: Massage therapy and exercise therapy in patients with multiple sclerosis: a randomized controlled pilot study.
abstract: OBJECTIVE
  The primary aim was to investigate the comparative effects of massage therapy and exercise therapy on patients with multiple sclerosis. The secondary aim was to investigate whether combination of both massage and exercise has an additive effect.
  
  
  METHODS
  Randomized controlled pilot trial with repeated measurements and blinded assessments.
  
  
  METHODS
  Local Multiple Sclerosis Society.
  
  
  METHODS
  A total of 48 patients with multiple sclerosis were randomly assigned to four equal subgroups labelled as massage therapy, exercise therapy, combined massage-exercise therapy and control group.
  
  
  METHODS
  The treatment group received 15 sessions of supervised intervention for five weeks. The massage therapy group received a standard Swedish massage. The exercise therapy group was given a combined set of strength, stretch, endurance and balance exercises. Patients in the massage-exercise therapy received a combined set of massage and exercise treatments. Patients in the control group were asked to continue their standard medical care.
  
  
  METHODS
  Pain, fatigue, spasticity, balance, gait and quality of life were assessed before and after intervention.
  
  
  RESULTS
  Massage therapy resulted in significantly larger improvement in pain reduction (mean change 2.75 points, P = 0.001), dynamic balance (mean change, 3.69 seconds, P = 0.009) and walking speed (mean change, 7.84 seconds, P = 0.007) than exercise therapy. Patients involved in the combined massage-exercise therapy showed significantly larger improvement in pain reduction than those in the exercise therapy (mean change, 1.67 points, P = 0.001).
  
  
  CONCLUSIONS
  Massage therapy could be more effective than exercise therapy. Moreover, the combination of massage and exercise therapy may be a little more effective than exercise therapy alone.
authors.affiliation: Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Negahban
authors.forename: Solmaz
authors.initials: S
authors.lastname: Rezaie
authors.forename: Shahin
authors.initials: S
authors.lastname: Goharpey
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D035002:Lower Extremity / Q000502:physiology / Q000503:physiopathology*; D008405:Massage / Q000379:methods*; D009103:Multiple Sclerosis / Q000150:complications / Q000534:rehabilitation*; D009128:Muscle Spasticity / Q000209:etiology / Q000534:rehabilitation; D010043:Outcome and Process Assessment, Health Care; D059408:Pain Management / Q000379:methods; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology; D011788:Quality of Life; D016138:Walking / Q000502:physiology
keywords: Massage therapy; exercise therapy; multiple sclerosis; outcome