A Research Agenda for the Massage Therapy Profession: a Report from the Massage Therapy Foundation

INTRODUCTION

Massage therapists are a part of a broad community of allied health-care providers. Member groups within this community develop and maintain specific research agendas and strategic plans to guide the development of the knowledge base that serves as the foundation of practice for their profession.^(1–3)

The Massage Therapy Foundation (MTF) is a primary steward of massage therapy research, funding studies to advance the science and art of massage therapy over the past 30 years. The first massage therapy research agenda was developed by the MTF in 1991 and outlined five key goals: 1) Build a research infrastructure within the massage therapy profession; 2) Fund research into the safety and efficacy of massage therapy; 3) Fund studies on physiological and other mechanisms by which massage therapy achieves its effects; 4) Fund studies stemming from a wellness paradigm; and 5) Fund studies on the profession of therapeutic massage. This effort, combined with the efforts of international massage organizations⁽²⁾ facilitated the growth and development of the massage therapy profession in each of the goal areas, and greatly expanded the knowledge base that now supports the science-informed practice of therapeutic massage.

The MTF evaluated the extensive progress and remaining knowledge gaps, then put together a team to develop a new research agenda to guide and advance the therapeutic massage knowledge base into the future.

Process Description

The MTF 2020 Massage Therapy Research Agenda was developed by a team of experienced researchers, massage therapists, business owners, administrators, educators, and other allied health-care providers. The agenda was also developed to align with the United States National Institutes of Health’s National Center for Complementary and Integrative Health (NCCIH) Strategic Framework,⁽³⁾ presenting a unified strategy for advancing the profession.

The MTF 2020 Massage Therapy Research Agenda

The MTF 2020 Massage Therapy Research Agenda has four key objectives, each with specific goals (Figure 1). The agenda aspires to support the work of every member of the massage therapy community. Following each objective is a section called “Moving the Agenda Forward”, with a few ideas on how researchers, practitioners, educators, students, and organizations can become involved in progressing the agenda and the profession.

Figure 1.

Summary of the MTF 2020 Massage Therapy Research Agenda.

Objective 1: Advance Fundamental Science and Methods Development

Goals

1. Advance understanding of basic biological mechanisms of action of therapeutic massage and bodywork in the management of chronic and acute conditions.

2. Advance understanding of the mechanisms through which therapeutic massage and bodywork affect health, resiliency, healing, and well-being.

   Note: Special interest in mechanisms of action of therapeutic massage and bodywork for patients on long-term medications, including adverse and beneficial interactions.

3. Develop new and improved research methods and tools for conducting rigorous studies of therapeutic massage and bodywork approaches and their integration into health care as part of comprehensive treatment plans.

4. Facilitate the transition of generated research knowledge into clinical practice.

Moving the MTF 2020 Massage Therapy Research Agenda Forward

• MTF: Prioritize funding for research studies to advance understanding in these key areas. Facilitate understanding of new research for all stakeholders through continued development of guides, informational/ educational materials, webinars and other mediums.

• Researchers: Develop research questions and projects that build new knowledge in these areas of importance to the massage profession.

• Practitioners: Challenge yourself to become a good consumer of research and implement quality new knowledge into your practice.

• Students: Immerse yourself in the massage therapy research literature and bring that new information to the classroom, asking instructors how it relates to your lessons.

• Educators: Integrate new evidence-based knowledge into your teaching. Schools and educators should build relationships and collaborations with researchers and institutions to involve educators and students in the research process. Textbook publishers should find a progressive and innovative way to disseminate current research. Ensure textbooks contain options, such as links to research websites, for up-to-date information.

• Clients/Patients: Search for new information about massage therapy research, determine the best methods to evaluate the quality of the material, and talk to your friends, family, and health-care providers about whatyou discover. Seek out and join research teams that include patients/public involvement in their studies to improve the quality of massage therapy research. Volunteer as a participant in massage therapy research.

• Organizations: Collaborate with massage schools and practitioners to build networks and partnerships to support, advance, and implement massage therapy research.

Objective 2: Improve Care for Health-Related Symptoms and Conditions

Goals

1. Develop, improve, and advance understanding of therapeutic massage and bodywork approaches and treatment strategies alone and as an adjunct therapy.

   Note: Special interest in studies focusing on hard-to-manage and complex health conditions.

2. Develop and advance understanding of therapeutic massage and bodywork’s impact on acute to chronic transition.

3. Develop and advance understanding of therapeutic massage and bodywork’s impact on quality of life during treatment and management of acute and chronic conditions.

4. Conduct studies in “real world” multi-disciplinary clinical settings to test the safety and effectiveness of therapeutic massage and body-work approaches, including integration with health care and health-care systems.

Moving the MTF 2020 Massage Therapy Research Agenda Forward

• MTF: Seek out and fund research studies to discover massage methods that improve health-related care. Support massage practice-based networks conducting “real world” research.

• Researchers: Investigate the validity and effectiveness of current and new massage therapy interventions for specific health-related issues. Collaborate with massage schools and practitioners to determine effective implementation strategies.

• Practitioners: Share successful interventions through case studies, presentations, and collaborations with researchers who can study and advance these methods. Participate in practice-based research networks. Increase collaborations with patients’ medical care teams, consistently utilizing research evidence to support interprofessional communication and clinical decision-making.

• Students: Volunteer to participate in a research study or to research a massage intervention to share with your class.

• Educators: Reach out to researchers and institutions to collaborate on massage-related research projects. Assess massage therapy curricula for up-to-date content, and add research content massage courses at all levels (foundational and continuing education. See the MTF website for a free e-book on incorporating research into your courses.) Textbook publishers should find a progressive and innovative way to disseminate current research. Ensure your textbook contain options, such as links to research websites, for up-to-date information.

• Clients/Patients: NIdentify possible massage interventions for your health care and wellness needs. Ask your health-care provider to include massage into your wellness plan. Seek out and join research teams who include patients/public involvement in their studies to improve the quality of massage therapy research. Volunteer as a participant in massage therapy research.

• Organizations: Add massage therapy care for your patients and partner with researchers to improve knowledge on massage therapy interventions for specific conditions.

Objective 3: Foster Health Promotion, Cultivate Well-Being, and Support Disease Prevention

Goals

1. Investigate safety, efficacy, cost-effectiveness, and mechanisms of action of therapeutic massage and bodywork compared to, and in conjunction with, standard clinical practice, in supporting health resilience and physical and mental well-being across the lifespan.

2. Investigate the effects of inclusion of therapeutic massage and bodywork into interdisciplinary health-care settings on improving health-care resource management and patient outcomes.

3. Study the effectiveness of therapeutic massage and bodywork in promoting health and wellness among diverse populations over the short-term and across the lifespan.

4. Support the enhancement of health equity and access to care in marginalized populations.

5. Engage in studies to assess the effects of regular therapeutic massage and bodywork sessions on a “healthy” population.

6. Explore research opportunities to study and assess the safety, efficacy, and cost-effectiveness of therapeutic massage and bodywork in nonclinical settings such as community and employer-based wellness programs.

7. a. Examine the potential for regular therapeutic massage and bodywork sessions to impact the frequency, duration, and associated cost of injury and illness.

8. b. Examine the impact of therapeutic massage and bodywork on worker satisfaction, mental health, and satisfaction at home.

Moving the MTF 2020 Massage Therapy Research Agenda Forward

• MTF: Prioritize funding for community service projects with strong evaluation plans that enhance health equity and access to massage care for marginalized populations.

• Researchers: Develop longitudinal studies to assess massage for disease prevention and condition management.

• Practitioners: Work to help ensure access to massage therapy to underrepresented populations.

• Students: Volunteer for programs providing massage for diverse populations or promoting wellness for populations under stress (e.g., health-care providers).

• Educators: Ensure that courses include research information on wellness and prevention for all populations. Enhance efforts to recruit students who are underrepresented in massage therapy (e.g., men, individuals who are Black or African American, Native American, and those of Hispanic/ Latinx ethnicity). Develop and assess massage education curricula that includes content areas that address the social determinants in population health, health equity, and cultural humility.

• Clients/Patients: Document the impact of massage therapy treatment over time.

• Organizations: Make massage therapy services available to patients, clients, and employees. Partner with research organizations to improve the massage knowledge base in areas that benefit the organization and advance knowledge about the effectiveness and return on investment for massage therapy interventions. Support large, longitudinal studies on prevention.

Objective 4: Support the Establishment and Continuation of Educational Research Focused on Massage Therapy Pedagogy/ Andragogy

Goals

1. Determine best practices to convey information to learners of diverse cultures and educational backgrounds.

2. Assess best practices for delivery of therapeutic massage and bodywork to support career longevity and wellness.

3. Identify educational approaches from other disciplines applicable to the field of therapeutic massage and bodywork.

4. Develop and evaluate the most effective methods for facilitation and acquisition of information and resources on therapeutic massage and bodywork for evidence-informed practice.

5. Determine the best methods to foster career development and leadership in the field of therapeutic massage and bodywork.

Moving the MTF 2020 Massage Therapy Research Agenda Forward

• MTF: Continue to advance/facilitate research educational materials for educators to help assess, develop, and incorporate new methods for the classroom.

• Researchers: Investigate methods to improve evidence-based education specifically for massage therapy students and massage education.

• Practitioners: Participate in research investigating practitioner health and wellness

• Students: Inform teachers on what works for you and work together to improve massage therapy education and instruction.

• Educators: Welcome new knowledge and curricula into your classrooms and help to develop and test new methods of instruction.

• Clients/Patients: Attend student clinics at massage therapy schools and provide valuable, constructive feed-back to student massage therapists on techniques and communication styles.

• Organizations: Embrace new research-based curricula and insist research knowledge is included in all courses. Partner with researchers to develop and test new methods of improving educational outcomes.

As the primary steward of massage therapy research, the MTF believes that together these four objectives will guide the future development and expansion of the knowledge base needed to move the profession forward and improve patient/ client care, health and well-being of therapists and patients/clients, massage therapy education, and professional practice for the massage therapy profession.

CONCLUSIONS

The MTF 2020 Massage Therapy Research Agenda can serve as a guide to ensure research efforts in the area of massage therapy and bodywork benefit the massage profession. The massage community is called upon to take up this effort and participate in the expansion and sharing of the knowledge base that supports the valuable care massage clinicians provide to patients and clients.