A Critique on the Article: Knowledge and Perception of Athletes on Sport Massage Therapy
(SMT)Mignon Schilz, BA (Hons), Lloyd Leach, PhD Department of Sport Recreation and Exercise Science, Faculty of Community and HealthSciences, University of the Western Cape (UWC), Bellville, South Africa
The article, Knowledge and Perception of Athletes in Sport Massage Therapy (SMT) by Mignon Schiltz, BA and Lloyd Leach, PhD is an article from a peer reviewed journal which seeks to determine athletes’ comprehension about Sports Massage Therapy (SMT) and whether or not athletes perceive a benefit with this treatment modality. The authors claim that despite an increased interest in Sports Massage Therapy, there is still a lack of knowledge and beliefs about the benefits of Sports Massage among athletes. With a sample of 100 male and female athletes, aged 18 years and older from various mountain biking and trail running events, the authors’ goal with this article is to find out the level of knowledge athletes have of SMT, as well as their perceptions of the practice. The authors used a researcher-generated and self-administered demographic questionnaire distributed to the participants either as a hard copy or completed online via Google Forms. The questionnaire consisted of 10 knowledge and 17 perception questions based on validated questionnaires. Data was analyzed descriptively using frequencies or percentages. Their findings showed that athletes who made use of SMT were quite knowledgeable about this modality and that they found SMT to be beneficial for sports performance and post exercise recovery.
The authors supported their findings by adding up the responses of the participants in the questionnaire and expressed the results as percentages. The questionnaire was previously validated and responses were recorded by tick boxes for each questions. The responses were in the form of tick box that allowed a “yes” or “no” response, as well as rating scale questions that allowed the respondent to make one answer choice from the scale range. The percentages were shown as column and pie charts. In the results portion, some questions were thoroughly discussed together with the corresponding percentage and others were not.
The study objective was not presented in a way that the authors intended it to be. As the title suggested, their purpose was to determine the knowledge and perception of athletes about SMT. The reader would assume from the title that this includes athletes across all sport disciplines. Despite this, though, the participants in the study only included those in the trail running and mountain biking discipline, and may not be relevant to patients outside of these disciplines. The title and the purpose was generalized such that the reader would be unable to determine whose knowledge and perception would benefit most with SMT. The circumstances that form the setting for the article would be appropriate if a more detailed or focused journal title and objective was made.
The sample was described as 100 male and female athletes, aged 18 years and older from various mountain biking and trail running events. The classification, distance and difficulty of these events were not specified. The method of randomization was not described. Randomization would be important to exclude bias as this is a sporting event where participants are assumed to have an urgent need for a massage treatment. Also, because the participants are all athletes, most of them would have received a massage treatment in the past. The participants were selected based on their age, as well as prior experience with SMT. There is a noted overlap with the exclusion and inclusion criteria with regards to age. The inclusion and exclusion criterion both mentioned 18 years old. Determining the midpoint at which they were either included or excluded was not indicated. The sample was not well described since it did not include several important questions or factors in the demographics that would influence the outcome or results, such as the athlete’s experience level, their age category, the intensity of their training, involvement in other sports, or previous injuries and other relevant medical history. No blinding procedures were used in the study and no comparison or placebo groups used. The article clearly described the methodology and study procedure, and the results were straightforward. However, the questionnaire in the appendix only showed 26 questions (10 knowledge, 16 perception) contrary to the initial claim of having 27 questions (10 knowledge, 17 perception). In addition, Question # 15 (Sport Massage can improve flexibility?) in the questionnaire was labelled under Perception, but was labelled under Knowledge in Table 1.
The article presented the results graphically by showing figures of column and pie charts which made it easier for the reader to interpret. Column and pie charts were used to show patient’s responses, and tables and graphs were clearly labeled. All 100 participants were accounted for. There was no clear indication in the article as to how many 18 year olds were men and how many were women. Descriptive statistics were used to analyze the data through IBM SPSS statistics program (version 25). All athlete responses were reported but only some of the responses were properly investigated. The questions did not seem to have equal bearing or weight with each other as some questions were directly related to the objective and some did not. The discussion covered several claims which were very subjective and difficult to prove without proper patient assessment and follow up. In essence, it is hard to affirm that author’s comments justified the results and if they follow logically from the results.
The authors pointed out several weakness or limitations in the study design and statistical analysis. By not using a random sampling, they admit to limitations of the external validity of the findings. The limited demographic information describing the subjects did not include the fitness or health background of the athletes which may have a greater influence on how they perceive sport massage. Some athletes may have pre-existing conditions that generally require regular massage which would considerably influence the bias towards massage in general.
In the conclusion section, the authors admit to the deficiency of quantifying the participants knowledge about SMT. In spite of this, they claim that the participants had overwhelmingly positive perceptions and attitudes about SMT. The participants also see the use of SMT in addressing a variety of muscular issues. In addition, they responded that they enjoyed receiving SMT and felt relaxed afterwards. In the last paragraph, the authors added that there is a potential benefit for athletes in other sports disciplines. This statement however should be examined carefully as not all sports disciplines use the same set of muscles as trail runners and mountain bikers do, for example, swimmers.
The clinical significance of the study is expressed in terms of the benefits of sports massage in general. The authors cited other articles that prove this point ranging from relieving muscle fatigue during and after sport training, promoting muscle recovery, injury prevention, relaxation and enhancing sports performance. Benefits would also extend to athletes with physical disabilities and even non-athletes. Recommendations would be to extend the sample size to other sporting disciplines and to include randomization to avoid sampling bias.
Lastly, references were adequate for the authors to be able to examine related articles, but the study designs were not similar. The references dealt more with general benefits of massage therapy rather than focusing on the the principles of knowledge and perception of sport massage.
Reference:
Schilz M, Leach L. Knowledge and Perception of Athletes on Sport Massage Therapy (SMT). Int J Ther Massage Bodywork. 2020 Feb 26;13(1):13-21. PMID: 32133041; PMCID: PMC7043719.
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