Moderate to severe adverse events in paediatric massage therapy (n=27)
| First author (year), location Study design | Indication for treatment | AE Severity | n event/N population | Age | Time of AE | Gender | Type of MT | MT practitioner | Outcome (grade) | Notes from study authors |
| Rudnicki et al (2012),54 Poland CCT | Assessing the physiological effects* of MT in preterm infants | Arterial oxygen desaturation <85% Moderate | 4/39 | 39 preterm infants, 22 <32 weeks GA and 17 ≥32 weeks GA | 18 days (n=17), 24 days (n=22) | 5 F | Shantal (stroking and rubbing whole body) | Therapist/mother | Withdrawn from the study (grade 2) | No other information was given by the authors about management or resolution of this AE |
| Masoodi et al (2014),55 India Case series | Breast hypertrophy (12 mastitis and 20 abscess) | Mastitis and breast abscesses Moderate | 15/32 received MT to express secretions for breast hypertrophy | 6–48 days | NS | NS | Repeated breast massage | NS | Resolved after antibiotic therapy/drainage of abscess (grade 3) | Massage for neonatal breast hypertrophy should not be performed |
| Razafimahandry et al (2007),44 Madagascar Case series | Upper arm osteomyelitis (Staphylococcus aureus) | Severe infection due to delayed diagnosis (20–60 days) Moderate | 4/4 | 5–11 years | NS | 2 F 2 M | Traditional massage | NS | 3 cases resolved after hospitalisation and antibiotic therapy (grade 3) | One case was a severely cachectic 11-year-old boy diagnosed with pulmonary tuberculosis and died of septic shock 5 days later; no other details regarding his death was described |
| Guilbert et al (2007),53 France Case series | Flatulence | Status epilepticus Severe | 1/1 | 4 months | 72 h | 1 F | Abdominal massage with camphor-containing lotion | Caregiver | Hospitalised, intubated, treated for status epilepticus (grade 4) | Other investigations were normal; the infant was extubated after 3 days and later discharged home with a normal neurological examination |
| Kalinga et al (1996),33 Singapore Case report | Swelling of right thigh due to osteochondroma | Popliteal artery pseudoaneurysm Moderate | 1/1 | 16 years | 3rd session of massage | M | MT with herbal medicine (5 sessions) | Traditional Chinese medicine practitioner | Resolved after hospitalisation and surgery (grade 3) | Diagnosis was right popliteal artery pseudoaneurysm after the 5th session of MT. At surgery, femoral artery defect was found adjacent to the osteochondroma |
| Medvedev (1994),57 Russia Case report | Autonomic nervous system dysfunction | Acute unilateral neurosensory hearing loss Moderate | 1/1 | 14 years | During treatment | M | Tonic MT of the neck including trapezius muscle | NS | Recovered with hospitalisation; medications plus ‘5 sessions of TENS for 8th cranial nerve’ (grade 3) | The boy with ANS dysfunction received MT and developed acute unilateral neurosensory hearing loss with noise. MT stimulated the ANS and caused vascular spasm leading to decreased blood flow to the cochlea and subsequent hearing impairment |
| Ram et al (1994),32 Malaysia Case report | Hydrocele | Scrotal haematoma Moderate | 1/1 | 1 day | 1st day | M | Traditional MT to testes with warm sand bag | NS | Resolved after surgery (grade 3) | None |
AE, adverse event; ANS, autonomic nervous system; CCT, controlled clinical trial (non-randomised controlled trial); F, female; GA, gestational age; M, male; MT, massage therapy; NS, not stated; TENS, transcutaneous electrical nerve stimulation.