Table 1.40Low Back Pain - Massage - Mixed - Non-Specific Pain

Author ID CountryStudy CharacteristicsPopulation CharacteristicsPain CharacteristicsIntervention DetailOutcome results: Pain, DisabilityOutcome results: Other Outcomes/Harms
Chatchawan U (2005)183

Country: Thailand

Quality score: 6/13

Initial of reviewer: SG
Trial Design-RCT

Tx duration: 3-4 wks
Final assessments: 3 wks and 1 mo post tx

N screened: 214
N randomized: 180
N completed tx: 177
N attended last fu: 172

Inclusion: 21-50 yrs; persistent LBP; >/= one TP was present in the upper and/or lower torso region (TP = presence of focal tenderness at a palpable nodule in a taut band + pain recognition)

Exclusion: menstruation; pregnancy; fever; a hx of acute trauma, back surgery, spinal fracture, other significant disorders of musckuloskeletal or nerveous system
Mean age (SD/range): IG = 37.3 (8.8) vs. CG = 35.5 (8.8) yrs

% of male: 36%

Racial composition: NR

Work status: 95% Light workers

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: IG = 6.7 (8.1) wks; CG = 5.2 (5) wks

Prior CAM intervention: NR

Prior surgery related to current complaint: None
Cause of Pain: Myofacial pain syndrome

Duration of Pain: Sub-acute/chronic, IG = 36.6 (38.8) mo; CG = 34.8 (35.6) mo

Severity of pain (Grading): NR

Co-interventions: NR
Groups
IG (n = 90)– Traditional Thai massage (TTM); 6 sessions over a 3-4 wks, generally 2 sessions/wk for 3 wks
Drop outs: A = 1, B = 0, C = 4

CG (n = 90) – Swedish Massage (SM): performed using body-oil for lubrication for the skin; Same as IG
Drop outs: A = 1, B = 1, C = 1
Outcomes:
Pain: VAS (10 cm) N based on ITT

Disability: ODQ

Results-Baseline: Pain: IG = 5.5 (1.5), CG = 5.2 (1.7)
Disability: IG = 20.7 (8.9), CG = 20.7 (8.3)

Immediate post tx:
Pain: IG = 2.2 (1.9), CG = 2 (1.7)
Disability: IG = 13.8 (8.8), CG = 15.4 (9.1)

Short term: VAS: IG = 2.4 (1.9), CG = 2.5 (2) ODQ: IG = 13.4 (10.1), CG = 13.9 (8.9)

Intermediate: NR

Long term: NR
Outcome instruments:
QoL/ well being: NR

Other: Back performance (data not shown)

Results:
Baseline: NA

Immediate post tx: NA

Short term: NR

Intermediate: NR

Long term: NR

Harms: one Pt in IG droped out due to car accident
Hoehler F (1981)134

Country: US

Quality score: 3/13

Initial of reviewer: SG
Trial Design-RCT

Tx duration: NR
Final assessments: immediately post tx; and long term (as stated in the study)

N screened: 1880
N randomized: 95
N completed tx: NR
N attended last fu: NR

Inclusion: presence of palpatory cues indicating that SM might be successful

Exclusion: Spinal manipulation contraindicated or alternative tx strongly indicated; pregnancy; previous experience with manipulation; disability income; pending litigation; previous back surgery; obesity; drug or alcohol abuse
Mean age (SD/range): IG = 30.1 (8.4) vs. CG = 32.1 (9.8) yrs

% of male: 59% total

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Cause of Pain: N-S

Duration of Pain: 50% Acute, 23% Chronic

Severity of pain (Grading): NR

Co-interventions: NR
Groups
IG (n = 58)– Manipulation: rotal manipulations of the lumbosacral spine; # of tx varied
Drop outs: NR

CG (n = 39) – Soft-tissue massage: soft-tissue massage of the lumbosacral areas, with the rotal thrust omitted; same as IG
Drop outs: NR
Outcome instruments:
Pain: improvement in amout of pain

Disability: NR

Results:

Immediate post tx: % of Pts with improved pain: 84% vs. 68%

Disability: NR

Short term: NR

Intermediate: NR

Long term:
Pts reporting tx as effective: 88% vs. 86%)
Outcome instruments:
QoL/ well being: NR

Improvement in SLR, degrees:

Results:
Immediate post tx: To pelvic rot 1.6 (6.3) vs. 1.0 (6.3) To pain: 3.3 (6.2) vs. – 0.5 (5.9)

Short term: NR

Intermediate: NR

Long term: SLR to pelvic rot 8.0 (9.3) vs. 4.1 (8.6); to pain: 7.8 (7.4) vs. 8.6 (8.4) Improvement in forward flextion (cm): 11.4 (15.9) vs. 10.7 (14.2)

Harms: NR
Zhang, J (2004)182

Country: China

Quality score: 6/13

Initial of reviewer: SG
Trial Design-RCT

Tx duration: 3-6 wks?
Final assessments: immediately post tx

N screened: 165
N randomized: 165
N completed tx: 165
N attended last fu: NR

Inclusion: diagnosed as Shanghai Chinese Medical Diagnostic and therapeutic Effective Standard, score between 0-23 based on Lumbar Function Assessment (ref[5]), 20-60 yr, no other tx before, volunteer participation

Exclusion: pregnant, brest feeding, with fracture, tumor, low bone density, skin damage, tubercal
Mean age (SD/range): IG = 40.9 (10.5), CG1 = 41.2 (10.8), CG2 = 42.1 (10.5) yrs

% of male: 57%

Racial composition: Most likely Asian

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Cause of Pain: Disc/joint disease: lumbar disc herniation

Duration of Pain: Acute, Sub-acute and chronic, IG = 6.8 (2.3), CG1 = 6.9 (2.3), CG2 = 6.8 (2.4) mo

Severity of pain (Grading): NR

Co-interventions: NR
Groups
IG (n = 55)– Traction: traction table, 0.5 weight-weight, 20 min/tx; 1 tx/d, 20 tx total
Drop outs: A = NR, B = 0

CG1 (n = 55) – Massage: NR; 20 min/ tx; 3 tx/wk, 20 tx total
Drop outs: A = NR, B = 0

CG2 (n = 55) – Massage + EX: Massage: 20 min/tx, 3 tx/wk 20 tx total. Exercise: 20-30 min/tx, 3 tx/wk
Drop outs: A = NR, B = 0
Outcomes:
Pain: Score based on Shanghai Chinese Mediccal diagnosis and treament Standard Procedure

Results:
Baseline:
Pain: IG = 12.78 (1.68), CG1 = 12.75 (1.65), CG2 = 12.79 (1.67)

Immediate post tx:
Pain: IG = 17.87 (7.51), CG1 = 25.71 (4.95), CG2 = 25.83 (5.02)

Short term: NR

Intermediate: NR

Long term: NR
Outcome instruments:
QoL/ well being:

Results:

Immediate post tx: NA

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR

From: Appendix C, Evidence Tables

Cover of Complementary and Alternative Therapies for Back Pain II
Complementary and Alternative Therapies for Back Pain II.
Evidence Reports/Technology Assessments, No. 194.
Furlan AD, Yazdi F, Tsertsvadze A, et al.

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