We analyzed a total of 9 studies in this literature review. These studies came from four countries, namely Turkey (n=3), Egypt (n=3), Iran (n=2), and Thailand (n=1). The majority of the studies were published in 2019. The research designs reviewed were experimental with RCT design (n=4), and Quasi Experiment (n=5). There were intervention and control groups in the reviewed studies. The intervention group received massage intervention, while the control group received standard care. The majority of instruments used to measure fatigue are the Visual Analog Scale (VAS) and Brief Fatigue Inventory (BFI). Most of the results showed that massage therapy reduced fatigue in cancer patients undergoing chemotherapy. More details can be seen in
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Research Characteristics
| Author (Year), country | Massage Method | Design | Instrument | Responden t | Results |
|---|---|---|---|---|---|
| Acupressure | Random ized Clinical Trial | Visual Analog Scale (VAS) | 90 cancer patients undergoing chemothera py. | The results indicated that following chemotherapy, the average visual analog scale for fatigue in the intervention group was notably lower compared to the control group (p = 0.028). | |
| Reflexology | Experim ental | Rhoses index of nausea, vomiting, and retching (INVR), Brief Fatigue Inventory (BFI) | 60 patients diagnosed with Stage I-III breast cancer undergoing chemothera py. | The findings revealed a progressive decline in the mean score of BFI in an experimental group across the first, second, and third measurements (P < 0.05). | |
| Thai Massage | Random ized Controll ed Trial | Numeric rating scale | 66 patients with colorectal cancer. | Following the post- assessment, the level of fatigue in the intervention group was notably lower than that of the control group when compared to the pre- assessment results (P = 0.001). | |
| Back Massage | Quasi experim ent | The State Anxiety part of Spielberger State-Trait Anxiety Inventory (STAI), Brief Fatigue Inventory (BFI) | 40 cancer patients undergoing chemothera py in 1 day. | There was a statistically significant reduction in fatigue levels observed in the intervention group on the day following chemotherapy (p = 0.020; effect size = 0.84).. | |
| Foot massage | Quasi experim ent | Visual Analague Scale of Vatigue (VAS-F) | 88 gastrointest inal cancer patients. | A notable distinction in average fatigue scores emerged between the two groups following | |
| Therapeutic massage | Quasi experim ent | PedsQL Multidimensional Fatigue Scale | 66 children with leukemia aged 4-16 years. | Results showed that children in the intervention group had significantly lower fatigue (p=0.000) than children in the control group. | |
| Reflexology | Quasi experim ent | Rhoses index of nausea, vomiting, and retching (INVR), The brief fatigue inventory self report assessment tool (BFI) | 50 respondent s were breast cancer patients who are scheduled for chemothera py | A remarkably substantial statistical distinction was observed between the intervention and control groups following the 2nd and 3rd foot reflexology interventions. difference pertained to the total experience score, occurrence and discomfort associated with nausea, vomiting, and retching, as well as the degree of fatigue and its impact on daily activities (P<0.001). | |
| Back massage | Quasi experim ent | Rhodes Index of Nausea and Vomiting (RINV), Beck Anxiety Inventory (BAI), The Brief Fatigue Inventory (BFI) | 98 respondent s were breast cancer patients undergoing | Following the massage, a statistically noteworthy reduction in BFI scores was observed in the intervention | |
| Reflexology | Random ized controll ed trial | Brief Pain Inventory (BPI), Brief Fatigue Inventory (BFI), Multi dimensional Quality of Life Scale Cancer (MQOLS-CA) | 80 patient respondent s diagnosed with uterine, ovarian and cervical cancer in grades I-III and treated with second or third cycle chemothera py | In the reflexology and reflexology + Progressive Muscle Relaxation groups, a significant reduction in pain severity and fatigue was found and an increase in QoL (p < 0.05). |
The review results show that there are many types of massage therapy that can be performed on cancer patients undergoing chemotherapy. There are reflexology (n=4), back massage (n=2), acupressure (n=1), Thai massage (n=1), and therapeutic massage (n=1). Based on the results, the average massage therapy can be done once or twice a visit for 30-60 minutes. More details can be seen in
Types of massage therapy for chemotherapy patients
| Type intervention | time | Prosedur time |
|---|---|---|
| Acupressure | 2 minutes/point | In the study, the investigator opted for three acupuncture points: hegu (located at the midpoint between the first and second metacarpals), zusanli (positioned one finger laterally below the tibial tuberosity and four fingers below the knee joint), and sanyigjiao (located four fingers above the medial ankle and behind the tibia). Pressure was administered at the commencement and conclusion of chemotherapy sessions. The technique involved delicately applying pressure to each designated acupoint using the finger, with the intensity gradually heightened until a pain sensation was perceived. |
| Reflexology/ foot massage | 30-40 minutes | A reflexology session typically lasts for approximately 30-40 minutes, beginning with the right foot and then proceeding to the left foot. To facilitate a smooth experience, unscented baby oil at room temperature is employed. The session commences with the right foot, employing techniques such as effleurage, shaking, rotation, and stretching to relax the foot. Throughout the procedure, the researcher supports the patient's foot with one hand while using the fingers of the other hand, with a predominant use of the thumb technique. |
| 25-30 minutes/leg | Before initiating the reflexology session, the feet undergo relaxation through the application of effleurage, shaking, rotation, and stretching techniques. To trigger the release of endorphins and send messages throughout the body, pressure is applied to the "solar plexus" point. This involves the method of pressing and lifting the thumb three times. | |
| 30 minutes 20 minutes | Foot hygiene was performed on all patients, and no creams or lotions were applied to their feet. All reflexology sessions began with applying controlled pressure using the thumb or index finger on the patient's foot. Then the reflex points on the right foot, such as the brain (frontal lobe), thyroid, upper lymph, and diaphragm, followed by the patient's left foot. In a PMR exercise session, the patient takes a deep breath as the muscle is tightened and exhales as it relaxes, progressing from the leg to the facial muscles (i.e., from bottom to top). | |
| 56 minutes for 3 hours of chemotherapy | Foot massage is performed using superfcial efeurage techniques with gentle pressure, deep efeurage with relatively harder pressure, petrissage techniques (movements from the soles of the feet to the shins using both palms of the therapist), friction techniques in the form of penetrating pressure with fingertips, and finally superficial efeurage massage. The massage starts from the right foot first and then continues with the left foot. | |
| Thai Massage | 45 minutes | The same experienced therapist conducted standardized massages on the head, neck, face, back, shoulders, arms, hands, lower legs, and feet using coconut oil infused with 0.05 ml of ginger oil. These massages were administered during three sessions for one week. |
| Back Massage | 60 minutes for 2 hours chemotherapy 75 minutes for 3 hours chemotherapy | The massage begins with warming the hands by rubbing and applying Vaseline to make them slippery. The massage starts from the waist with a long effleurage and continues to the neck in a circular motion. Effleurage is the application of uninterrupted gliding movements that are repeated and follow the contours of the client's body. In the subsequent step, the researcher proceeded with the back massage using petrissage, involving the gripping of subcutaneous tissue and muscles using the thumb and other fingers. Following petrissage, the back massage transitioned to friction movements. The massage commenced from the sacroiliac junction, with the tips of the thumbs stacked, and circular friction movements were then applied with the fingertips along the spine towards the occipital region. |
| Therapeutic Massage | 20 minutes | The massage therapy employed consisted of effleurage, petrissage, friction, and tapotement techniques, applying light to medium pressure and utilizing unscented olive oil. For children, the massage covered the back, legs, arms, and neck, administered in three sessions—two before chemotherapy and one following chemotherapy. |