A randomized controlled trial on clinical efficacy of massage therapy in a multisensory environment for residents with severe and profound intellectual disabilities

Abstract

Abstract: Institutional care is the major service provision for persons with severe and profound intellectual disabilities because of their high dependence on daily living activities and physical illness. The daily schedule is usually non-stimulating and monotonous, which can be the contributing factors of their challenging behaviours. Recent literature has suggested that relaxation activities could reduce their challenging behaviours due to the counteractive effect of muscle relaxation on psychological distress. Despite having inconclusive evidence, multisensory environment and massage therapy have been increasingly used to manage challenging behaviours. Methods: A clinical trial was conducted in a long-term care facility in Hong Kong to evaluate the effects of multisensory environment, massage therapy and their combined use on reducing the challenging behaviours and improving positive behaviours of residents with severe and profound intellectual disabilities. All eligible residents were recruited and then randomly assigned to wither one of three treatment groups, or usual care only (n=31-34/group) for 10-week intervention after a one-month washout period. Outcome measures, including a few behavioural measures and physiological data, were assessed at recruitment and immediately and 2 weeks after completed the 10-week intervention. Results: A total of 129 participants (63 male and 66 female) completed the study. There were significant improvements in respiration rate, adaptive behaviours and sleepy state in all study groups. Participants in massage therapy had significantly greater increases in their number and duration of adaptive behaviours over 2-week follow-up than those in usual care; and they also showed greater reduction in sleepiness during and after the intervention. Conclusion: Short-lived positive effect of massage therapy and/or multisensory environment on challenging behaviours was found during and immediately after interventions. However, this positive effect could not be sustained when observed in the residential unit over the 2-week follow-up. Hence, there is a need for additional intervention strategies in promoting these residents’ positive and adaptive behaviours to enhance longer-term effects of massage therapy and multisensory environment and thus reduced their challenging behaviours in the units.