Care ally-assisted massage for Veterans with chronic neck pain: TOMCATT results.

Munk N, Daggy JK, Slaven JE, Evans E, Foote T, Laws BV, Matthias MS, Bair MJ. Care ally-assisted massage for Veterans with chronic neck pain: TOMCATT results. Contemporary clinical trials. 2024 Jul 1; 142:107561.

Related HSR&D Project(s)

• IIR 15-333 – Trial Outcomes for Massage: Caregiver-Assisted vs. Therapist-Treated (TOMCATT)

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Abstract:

PURPOSE: Chronic neck pain (CNP) is prevalent and challenging to treat. Despite evidence of massage''s effectiveness for CNP, multiple accessibility barriers exist. The Trial Outcomes for Massage: Care Ally-Assisted vs. Therapist Treated (TOMCATT) study examined a care ally-assisted massage (CA-M) approach compared to a waitlist control prior to a study design modification (WL-C). METHODS: CA-M consisted of in-person training for veteran/care-ally dyads to learn a standardized 30-minue massage routine, instructional DVD, and printed treatment manual. Participants were to complete three care ally-assisted massage sessions weekly for 12-weeks. Outcomes collected at baseline, 1-, 3-, and 6-months included validated measures of neck pain severity and associated disability. Linear mixed-model approaches were used for analysis with 3-months as the primary outcome timepoint. RESULTS: Participants (N  =  203) were 56.7 ± 14 years old, 75% White, 15% female, and 75% married/partnered. Among 102 CA-M participants, 45% did not attend the in-person training and subsequently withdrew from the study and were more likely to be younger (p  =  .016) and employed (p  =  .004). Compared to WL-C, CA-M participants had statistically significant reductions in pain-related disability at 3-months (-3.4, 95%CI  =  [-5.8, -1.0]; p  =  .006) and 6-months (-4.6, 95%CI  =  [-7.0, -2.1]; p  <  .001) and pain severity at 3-months (-1.3, 95%CI  =  [-1.9, -0.8]; p  <  .001) and 6-months (-1.0, 95%CI  =  [-1.6, -0.4]; p  =  .007), respectively. CONCLUSION: In this analysis, CA-M led to greater reductions in CNP with disability and pain severity compared to WL-C, despite treatment engagement and retention challenges. Future work is needed to determine how to better engage Veterans and their care-allies to attend CA-M training.