103 Randomized Controlled Trial of the Immediate and Long-term Effect of Massage on Adult Postburn Scar
Bibliographic record
Abstract
One objective of massage applied to hypertrophic scar (HSc), is to improve the structural properties so skin possesses the strength and elasticity required for normal mobility. However, research supporting this effect is lacking. We therefore conducted a prospective, randomized, single-blinded clinical trial evaluating the impact of a 12 week course of massage. The aim was to characterize the changes in scar elasticity, erythema, melanin, and thickness immediately after massage and after an extended course of treatment compared to matched control scars. Seventy burn survivors consented to participate and 60 completed the study. Two homogeneous, intra-individual scars were randomized to standard of care control (CS) or massage (MS). OTs or PTs provided massage treatment (Tx) 3 x/week for 12 weeks. Scar sites were evaluated weekly immediately before and after massage Tx. The Cutometer, Mexameter, and high-frequency ultrasound were used to evaluate elasticity, erythema, melanin, and thickness respectively. Paired t-tests were used to investigate the immediate changes within each group at each time point. ANCOVAs were performed to test for the immediate and long-term difference between groups. A mixed-model approach was used to account for the intra-individual scars. Tests were two-sided at a significance level of 0.05. There were immediate changes for all scar characteristics except thickness: MS elasticity increased for the first 4 weeks, reaching significance at week 4; MS erythema increased for the first 7 weeks, reaching significance at week 1, 2 & 6 and CS increased for the final 3 weeks, reaching significance at week 10 & 12; MS melanin reduced at each time point, reaching significance at week 1, 2, 5–8, 10 & 11. There was a significant increase in elasticity, and a reduction in thickness, during the 12 week Tx period for both the CS and MS. The increase in elasticity reached significance by week 8 and the reduction in thickness by week 5. There was no significant long-term difference for either erythema or melanin. There was no immediate or long-term group effect of massage for any of the scar characteristics except melanin. The immediate impact of forces applied during massage may mobilize the interstitial fluid associated with the glycosaminoglycans, increase the scar circulation, and exfoliate the scar thereby reducing melanin. However, once baseline measures, the control, and time were incorporated in the analysis there was no immediate or long-term benefit. Ostensible immediate HSc changes after massage do not culminate in long-term improvements in elasticity, erythema, melanin or thickness. Massage applied with the aim to have a long-term impact on these scar characteristics should be reconsidered.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".