This is 4 of 5 in our 2015 House of Delegates Blog Series. Our Delegates and Alternate Delegate convened to review each of the 2 Position Statements and 3 Recommendations (Human Trafficking, Media Education, Online CE). We've provided a pros and cons section for each. Please read and offer your thoughts on this year's Recommendations and Position Statements by commenting at the end of each of the blogs. You can earn FREE MA Chapter education! Get to know more about the House of Delegates and this year's Recommendations and Position Statements by clicking here.
Position Statement
It is the position of the American Massage Therapy Association (AMTA) that massage therapy may assist in the rehabilitation of burn scars.
Rationale
Research has indicated not just psychological (10,12) benefits from massage but reduction in pruritus (4,5,7,10,12,13), improvement in scar characteristics (3,5–8), reduction in scar formation (3–7), and reduction in pain (5,10,12). Massage can be used to help prevent or contain the negative evolution of scars (3–8). There is a clear and consistent relationship between the effects of massage therapy and burn rehabilitation.
A major key to acceptance of the effectiveness of a given treatment in the medical and research community is using evidenced based research that clearly demonstrates the efficacy of the procedure and/or intervention. The importance of touch to recovering burn survivors cannot be overestimated.
As the repository of high quality research on burn treatment grows, and training based on this research develops, massage therapists will be able to learn new techniques to assist clients in recovery. “It is essential that the burn care practitioner is skilled and knowledgeable in all aspects of rehabilitation care to ensure the patient can achieve the best physical, emotional and psychosocial outcomes”(4).
Relevant Changes from last year
The first and most obvious change from last years position statement on burn scars is the change from “It is the position of the AMTA that massage therapy can assist to may assist in the rehabilitation of burn scars.” “Can” denotes more confidence than “may” which means you cannot form a strong conclusion. This change in wording shows that the author is showing less confidence in the ability of the research to show that massage therapy is beneficial in the rehabilitation of burn scars.
It is also quite noticeable that the author dropped the number of references from 40 in the 2014 proposal to 13 in the 2015 proposal. There were some extraneous references that were easily removed. Next, all references older than 2009 were removed. There were 4 references added. This left 13 references, 7 were studies, 6 were for informational purposes only.
A number of studies were removed that were studies that showed the effectiveness of massage therapy on the burn scars:
1) The 2000 study by Tiffany Field et. al. showed that in 20 patients, after 30 min. massage twice a week for 5 weeks,the massage therapy group reported reduced itching, pain & anxiety and improved mood.
2) The 1998 study also by Tiffany Field et. al. showed that in 28 patients that received massage therapy vs. a standard treatment before debridement, state anxiety & cortisol levels decreased, and behavior ratings of state, activity, vocalizations and anxiety improved after the massage therapy sessions. Longer term effects including decreases in depression & anger and pain were significantly better in the massage therapy group.
3) In the 2010 study by Li et. al. “Effectiveness of Pain Management Following Electrical Burn Injury”, hospital charts of 55 electrically injured patients were reviewed retrospectively. They found that before rehabilitation massage therapy was the second most common nonpharmacological modality (heat treatment was first) and relieved pain in 75% of patients. During the rehabilitation program, massage therapy was the most common nonpharmacological modality alleviating pain in 75.8% of patients.
4) The 2007 study by Roh et. al. “Effects of skin rehabilitation massage therapy (SRMT) on pruritis, skin status, and depression in burn survivors,” showed that in 18 burn survivors, those receiving the SRMT showed reduced pruritis, improved skin status & reduced depression. The remaining scar showed improvement in skin pigmentation, pliability, vascularity & height.
The authors would like the position statement to pass based on the research relevant to the effect of massage therapy on the burn scars themselves, not on the sequelae of symptoms that result from a burn injury such as pain, itching, anger, depression, anxiety, etc.
Pros
1) Passing this Position Statement sends the message to medical professionals that massage should continue to be included as part of burn treatment. It also sends the message to burn survivors that massage may be effective in improving how their burns feel and look.
2) This Position Statement raises awareness of another applicability of massage therapy.
Cons
1) Passing this position statement gets it off the table, end of discussion, its done. It does not show the depth of help that massage can have on the whole burn survivor, not just their skin. And isn’t that the difference between massage and much of traditional medicine? We look at the person as a whole with all of their symptoms & concerns and not focus on just their skin & how it looks & feels.
2) The change from "can" to "may" waters down the message. Position Statements declare what we as an organization know to be true. We could say massage therapy "may" do just about anything. Its no longer a position.
Thoughts? Comments? Ideas? Please post in our comments section below. You can earn FREE education just by doing so!
Please continue to visit the AMTA-MA's blog as our 2015 HOD Blog Series will cover each Recommendation and Position Statement. Each blog post will have a pros and cons section created by our AMTA-MA Chapter-elected delegates. We invite you to share your thoughts in the comments section of our blogs. Check your inbox the week of JULY 26TH. We'll be sending out a brief survey to enlist your feedback on these recommendations and position statements. Anyone who comments on any of our blogs, on HOD-related social media posts on Facebook or Twitter, or by completing our survey will be entered into a raffle for a $75 chapter education credit! That is equal to one full day of education! Make sure you can receive our emails by signing up here.