Evidence on effectiveness of massage and stretching in animals limited, review finds

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"The scientific evidence is not strong enough to define the clinical efficacy and effectiveness of massage and stretching in sport and companion animals," researchers say.
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The scientific documentation on massage and stretching is not good enough to draw clear conclusions about their clinical effect in horses, dogs, and cats, the authors of a fresh review have concluded.

Researchers in Sweden and Finland examined the scientific literature on massage and stretching in the three species.

Anna Bergh and her collaborators, writing in the journal Animals, noted that soft tissue mobilization is frequently used in the treatment of sport and companion animals. It can be conducted by trained professionals, but is also performed by laypeople and animal owners.

Research has shown its popularity. For example, a study on Swiss Warmbloods reported that massage was used in 8% of the horses treated for lameness and back problems. A New Zealand study showed that 26% of dressage riders used different types of massage for their horses. The main reason for using allied health personnel to treat their horse was back problems.

“There is, however, uncertainty regarding the efficacy and effectiveness of these methods,” the review team said.

To learn more, they assessed studies that provided evidence for clinical effects in the three species. Relevant articles from three scientific databases were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects.

Of 1189 unique publications screened, only 11 were eligible for inclusion. The risk of bias was assessed as high in eight of the studies, and moderate in three of the studies, with two of the latter indicating a decreased heart rate after massage.

There was considerable variability in reported treatment effects, they found.

Discussing their findings, the authors said it is clear that the amount of evidence is very limited. “A larger number of articles is available on massage than on stretching. However, the studies mostly concern general physiological effects rather than the effects on specific clinical indications.

“However, based on studies of low to moderate quality, the results of the present review suggest that different massage techniques induce a reduction in heart rate and an increase in behavioral signs related to relaxation.” These results correspond to studies on humans and in animal models, they said.

Interestingly, none of the studies examined the effect on muscle perfusion, often used as an explanatory model for the positive effects, they said.

“As for stretching, the limited number of studies and the diverse results do not enable any conclusions regarding the efficacy of the method.”

Several details complicate any conclusions on the included soft tissue mobilization methods. One is the limited number of studies. In addition, the quality of the studies varied considerably, and they again pointed to a high average risk of bias.

“Across the board, the outcome variables used in the studies are not equal, and thus the results are not comparable, making their interpretation and use in clinical context challenging.”

The authors said that, regardless of the soft tissue mobilization technique, it is important to remember that touch in itself might be pleasant and that it offers the potential to discover abnormalities that may otherwise have gone unnoticed. “However, when treating illness or injury, the benefits of a treatment must be demonstrated with rigor.”

Randomized controlled and blinded trials with sufficient statistical power are needed to gain more understanding of the effects of the techniques on healthy sport and companion animals as well as on animals with pathologies, they said.

They concluded: “The scientific evidence is not strong enough to define the clinical efficacy and effectiveness of massage and stretching in sport and companion animals.”

The study team comprised Bergh, with the Swedish University of Agricultural Sciences; Kjell Asplund, with Umeå University in Sweden; Iréne Lund, with the Karolinska Institute in Sweden; and Anna Boström and Heli Hyytiäinen, with the University of Helsinki in Finland.

Bergh, A.; Asplund, K.; Lund, I.; Boström, A.; Hyytiäinen, H. A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Soft Tissue Mobilization. Animals 2022, 12, 1440. https://doi.org/10.3390/ani12111440

The review, published under a Creative Commons License, can be read here

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