Therapist-Delivered Versus Care Ally-Assisted Massage for Veterans With Chronic Neck Pain: Protocol for a Randomized Controlled Trial

Niki Munk; Joanne K Daggy; Erica Evans; Matthew Kline; James E Slaven; Brian Laws; Trevor Foote; Marianne S Matthias; Matthew J Bair

doi:10.2196/38950

Therapist-Delivered Versus Care Ally-Assisted Massage for Veterans With Chronic Neck Pain: Protocol for a Randomized Controlled Trial

JMIR Res Protoc. 2022 Sep 27;11(9):e38950. doi: 10.2196/38950.

Authors

Niki Munk^{1

2}, Joanne K Daggy³, Erica Evans⁴, Matthew Kline⁴, James E Slaven³, Brian Laws⁴, Trevor Foote⁴, Marianne S Matthias^{4

5

6}, Matthew J Bair^{4

5

6}

Affiliations

¹ Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States.
² Australian Research Centre in Complementary and Integrative Medicine, Massage & Myotherapy Australia Fellow and Visiting Faculty of Health, University of Technology Sydney, Sydney, Australia.
³ Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, Indianapolis, IN, United States.
⁴ Richard L. Roudebush Veterans Affairs Medical Center, Center for Health Information and Communication, Indianapolis, IN, United States.
⁵ School of Medicine, Indiana University, Indianapolis, IN, United States.
⁶ Regenstrief Institute, Indianapolis, IN, United States.

PMID: 36166287
PMCID: PMC9555333
DOI: 10.2196/38950

Abstract

Background: Chronic neck pain (CNP) is prevalent, and it reduces functional status and quality of life and is associated with deleterious psychological outcomes in affected individuals. Despite the desirability of massage and its demonstrated effectiveness in CNP treatment, multiple accessibility barriers exist. Caregiver-applied massage has demonstrated feasibility in various populations but has not been examined in Veterans with CNP or compared in parallel to therapist-delivered massage.

Objective: This manuscript described the original study design, lessons learned, and resultant design modifications for the Trial Outcomes for Massage: Care Ally-Assisted Versus Therapist-Treated (TOMCATT) study.

Methods: TOMCATT began as a 3-arm, randomized controlled trial of 2 massage delivery approaches for Veterans with CNP with measures collected at baseline, 1 and 3 months after intervention, and 6 months (follow-up). Arm I, care ally-assisted massage, consisted of an in-person, 3.5-hour training workshop, an instructional DVD, a printed treatment manual, and three 30-minute at-home care ally-assisted massage sessions weekly for 3 months. Arm II, therapist-treated massage, consisted of two 60-minute sessions tailored to individual pain experiences and treatments per week for 3 months. The treatments followed a standardized Swedish massage approach. Arm III consisted of wait-list control.

Results: Retention and engagement challenges in the first 30 months were significant in the care ally-assisted massage study arm (63% attrition between randomization and treatment initiation) and prompted modification to a 2-arm trial, that is, removing arm I.

Conclusions: The modified TOMCATT study successfully launched and exceeded recruitment goals 2.5 months before the necessary COVID-19 pause and is expected to be completed by early 2023.

Trial registration: ClinicalTrials.gov NCT03100539; https://clinicaltrials.gov/ct2/show/NCT03100539.

International registered report identifier (irrid): DERR1-10.2196/38950.

Keywords: TOMCATT; Veterans; chronic neck pain; integrative medicine; modified trial design; therapist-delivered versus care ally–assisted massage for Veterans with chronic neck pain; whole health.

©Niki Munk, Joanne K Daggy, Erica Evans, Matthew Kline, James E Slaven, Brian Laws, Trevor Foote, Marianne S Matthias, Matthew J Bair. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 27.09.2022.

Associated data

ClinicalTrials.gov/NCT03100539