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Massage Therapy and Quality of Life in Osteoarthritis of the Knee

Massage therapy has a direct association with the quality of life. Previous studies show that people with regular access to massage are likely to have positive moods and a healthy mental and emotional status. Besides, some studies reveal that older adults who receive periodic massage therapies have fewer body pains, hence a high-quality life. Nevertheless, a significant number of individuals suggest that massage therapies are expensive despite their positive impacts on the Osteoarthritis of the Knee. In the article, “Massage Therapy and Quality of Life in Osteoarthritis of the Knee: A Qualitative Study,” Ali et al. aimed to examine the impact of Swedish massage therapy on individuals’ quality of life and stress reduction. [1] While the study produced significant results showing improvement in quality of life and stress reduction after receiving therapeutic massage, the findings were not significant due to limitations, including small sample size and the employment of interviewing as the data collection method.

Ali et al. conducted a randomized clinical trial among 18 adults who participated in the Exploring Massage Benefits for Arthritis of the Knee (EMBARK) study in Sweden. The participants were subjected to a four-dose standardized Swedish massage for eight weeks. The inclusion criteria involved patients familiar with the study procedures and willing to share their experiences and feelings of the massage. The participants’ demographic variables included age, gender, weight, height, and ethnicity. Next, three investigators conducted one-on-one, semi-structured interviews to obtain participants’ feelings, perceptions, and experiences of osteoarthritis and massage. Ali et al. analyzed the participants’ perception, feelings and experience using the between-method triangulation. The most significant findings were as follows: The 18 subjects comprised ten and eight participants from the new-jersey and Connecticut sites respectively. Most of the subjects were females and white, and their mean age was 65 years. Besides, there were three main salient themes from the experiment; relaxation effects, improved life quality due to the massage, and massage accessibility during osteoarthritis treatment. In the first theme, 44% of the participants indicated that they felt relaxed after the massage therapy. Regarding the second theme, 44% of the participants indicated an improved emotional and mental status. Concerning participants’ access to massage therapies, some suggested that the therapy was expensive and should be included in the health insurance. In contrast, others suggested that regular massage was vital for improving the immune system and reducing osteoarthritis.

Nonetheless, Ali et al.’s study had two critical limitations. Firstly, the researchers used a small sample, thus limiting the overall conclusion of the findings. For instance, only 18 adults were involved in the study. Additionally, all the participants were selected from a therapeutic clinic and were previously involved in a trial massage therapy for knee osteoarthritis. Considering the two factors makes it difficult to generalize results for the entire population. According to Faber et al., the sample size is crucial for the researcher’s decision-making; thus, it should not be too small or excessive for precise interpretation of findings. [2] Although the research did an excellent job in demonstrating the relationship between Swedish massage and pain-relieving, the study did not consider other pain-causing factors due to the small sample size, which might have led to unreliable findings. Other pain-causing factors may mean the employment of other treatment methods. Secondly, the researchers used one-on-one interviews to obtain that massage therapies are associated with improving patients’ quality of life and relaxation. However, the interview methodology could not provide transparent findings because the participants were likely to forget some important information or provide erroneous information, affecting the overall conclusion. Besides, the poor investigators’ skill to ask questions might have led to probing questions, interfering with data collection. As argued by Hubrich and Wittwer, interviews have low response rates, thus resulting in adverse effects on the quality of the data gathered. [3] Of course, some researchers may have a different view on this study’s sample and data collection methods. For instance, Oliveira et al. may claim that despite the small sample and use of interviews as the primary data collection tool, Ali et al.’s study established similar results like theirs, conducted using a large sample. [4] However, another research conducted by de Paula et al. involving 78 participants concluded massage needs to be used with a parallel method such as an occlusal splint to be effective. [5] Therefore the inconsistencies in findings limited the reliability of findings.

In conclusion, the study achieved its objective by outlining the positive impact of Swedish massage on patients. However, the study was limited by the small sample size and usage of the interview method. Although many participants revealed that massage has physical and emotional benefits, others claimed that the massage therapies were expensive, limiting the number of people who can afford them. Ali et al.’s study employed 18 participants only, thus limiting the generalization of findings. In addition, the reliance on interviews as the only study method undermined the reliability and accuracy of findings since interviews are prone to biased reports. Further research with a large sample and proper assessment tools should be conducted to examine whether the Swedish massage therapies can improve life’s quality by enhancing a healthy mind and body.


  1. Ali A, Rosenberger L, Weiss TR, Milak C, Perlman AI. Massage therapy and quality of life in osteoarthritis of the knee: A qualitative study. Pain Medicine. 2017 Jun 1;18(6):1168-75. Available at:
  2. Faber J, Fonseca LM. How sample size influences research outcomes. Dental press journal of orthodontics. 2014 Aug;19(4):27-9. Available at: 94512014000400027&script=sci_arttext&tlng=es
  3. Hubrich S, Wittwer R. Household or individual–Advantages and disadvantages of different interview selection strategies. Procedia-Social and Behavioral Sciences. 2014 Dec 19;162:439-48. Available at:
  4. Oliveira FR, Gonçalves LC, Borghi F, da Silva LG, Gomes AE, Trevisan G, de Souza AL, Grassi-Kassisse DM, de Oliveira Crege DR. Massage therapy in cortisol circadian rhythm, pain intensity, perceived stress index and quality of life of fibromyalgia syndrome patients. Complementary therapies in clinical practice. 2018 Feb 1;30:85-90. Available at:
  5. Paula Gomes, C.A.F., El-Hage, Y., Amaral, A.P., Herpich, C.M., Politti, F., KalilBussadori, S., de Oliveira Gonzalez, T. and Biasotto-Gonzalez, D.A., 2015. Effects of massage therapy and occlusal splint usage on quality of life and pain in individuals with sleep bruxism: a randomized controlled trial. Journal of the Japanese Physical Therapy Association, 18(1), pp.1-6. Available at: article/jjpta/18/1/18_Vol18_001/_article/-char/ja/


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