Efficacy and safety of massage for postoperative stress in colorectal cancer patients: a randomized, controlled, three-arm trial.

Purpose: The purpose of this study was to investigate the effect of rhythmic embrocation (RE), a massage technique, on postoperative stress levels (measured by heart rate variability) in colorectal cancer surgery patients compared to empathic conversation. Methods: The study included 68 patients who were randomized into three groups: one received RE from professionals, another from students, and the third received empathic conversations. Stress was quantified using heart rate variability before and after the interventions. Results: The standard deviation of the heartbeat intervals (SDNN) increased more in the professional RE group 9.12 ms (IQR 3.59-12.3 ms) than in the other groups: student RE group 5.68 ms (-0.66-7.5 ms), empathic conversation group 6.64 ms (-1.49-7.38 ms); hence stress decreased more in the professional RE group, although not statistically significant (p= 0.21). Other factors like sleep quality, nausea, pain, and mood did not differ significantly between the groups. No complications were associated with the interventions. Conclusion: RE was safe and a statistically significant superiority of RE on postoperative stress compared to empathic conversations could not be found. Due to high inter- and intraindividual variability a clear pattern of response of the secondary outcomes to RE in comparison to empathic conversations could not be found. The study was limited by a small sample size, high patient variability, effective co-interventions for sleep, pain and nausea, and by an imbalance between groups. The study indicates that future research on RE should focus on a more narrowly defined patient population, increase the sample size, and select comparison groups that are clearly distinct from each other as well as a clinical context with fewer confounding factors. Furthermore, the patient's preferences and previous experiences with massage therapy should be considered. Clinical trial registration: German Clinical Trials Register (www.drks.de), identifier DRKS00023407.