AUTHOR=Kang Zhiran , Xing Hua , Lin Qiang , Meng Fanchao , Gong Li 

TITLE=Effectiveness of therapeutic massage for improving motor symptoms in Parkinson's disease: A systematic review and meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.915232

DOI=10.3389/fneur.2022.915232

ISSN=1664-2295

ABSTRACT=Background: Parkinson's disease (PD) causes movement disorder which we call motor symptoms (MS). Motor dysfunction brings great barrier to quality of life. Pharmacological therapy like levodopa can relieve the symptoms but also cause complications such as psychosis nauseas and dyskinesia. A less side-effect therapy is needed for PD. Therapeutic massage, are the commonest used forms of complementary and alternative medicine (CAM), but there is no systematic review and meta-analysis focusing on the efficacy of massage on PD.
Objective: To evaluate the quality of evidence and efficacy on therapeutic massage for improving MS of PD.
Methods: We independently searched 4 electronic databases including Chinese National Knowledge Infrastructure (CNKI), MEDLINE/PubMed, Embase and Cochrane Library for identifying randomized controlled trials (RCTs) about therapeutic massage and other available manual therapies improving MS of PD from January 1, 2012 to December 31, 2021 (recent 10 years). The main outcome measures were total effectiveness and the Unified Parkinson's Disease Rating scale (UPDRS), including UPDRS total, II, III. For the statistical analysis, the risk ratio, standard mean difference, and 95% confidence interval were used to calculate effect sizes between groups. To determine heterogeneity, statistical index I² was used.
Results: A total 363 PD participants in seven RCTs and one randomized pilot-control study were included in this meta-analysis. The total effectiveness showed therapeutic massage was more effective than intervention of control group for improving MS [RR:1.33, 95%CI (1.14-1.55), P=0.0002]. The UPDRS-III scores showed massage improves more motor function than the control group [SMD=-0.46, 95%CI (-0.67, -0.24), P<0.00001]. But we found massage performed no better than the control group in improving activities of daily life [SMD=-0.15, 95%CI (-0.40, 0.10), P=0.23].
Conclusions: Therapeutic massage was effective for improving MS of PD. It is suggested to be an appropriate CAM in treating PD.