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Massage reduced severity of pain during labour: a randomised trial [with consumer summary] |
Silva Gallo RB, Santana LS, Jorge Ferreira CH, Marcolin AC, Polineto OB, Duarte G, Quintana SM |
Journal of Physiotherapy 2013 Jun;59(2):109-116 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
QUESTION: Does massage relieve pain in the active phase of labour? DESIGN: Randomised trial with concealed allocation, assessor blinding for some outcomes, and intention-to-treat analysis. PARTICIPANTS: 46 women pregnant at >= 37 weeks gestation with a single fetus, with spontaneous onset of labour, 4 to 5 cm of cervical dilation, intact ovular membranes, and no use of medication after admission to hospital. INTERVENTION: Experimental group participants received a 30-min lumbar massage by a physiotherapist during the active phase of labour. A physiotherapist attended control group participants for the same period but only answered questions. Both groups received routine perinatal care. OUTCOME MEASURES: The primary outcome was pain severity measured on a 100mm visual analogue scale. Secondary outcomes included the Short Form McGill Pain Questionnaire, pain location, and time to analgesic medication use. After labour, a blinded researcher also recorded duration of labour, route of delivery, neonatal outcomes, and the participant's satisfaction with the physiotherapist during labour. RESULTS: At the end of the intervention, pain severity was 52 mm (SD 20) in the experimental group and 72 mm (SD 15) in control group, which was significantly different with a mean difference of 20 mm (95% CI 10 to 31). The groups did not differ significantly on the other pain-related outcome measures. Obstetric outcomes were also similar between the groups except the duration of labour, which was 6.8 hr (SD 1.6) in the experimental group and 5.7 hr (SD 1.5) in the control group, mean difference 1.1 hr (95% CI 0.2 to 2.0). Patients in both groups were satisfied with the care provided by the physiotherapist. CONCLUSION: Massage reduced the severity of pain in labour, despite not changing its characteristics and location. TRIAL REGISTRATION: NCT01392053.
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