Effects of percussive massage therapy on fascia echo intensity and fascia thickness in firefighters with chronic non-specific low back pain: a randomized controlled trial.

IF 3.3 2区 医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE BMC Complementary Medicine and Therapies Pub Date : 2024-11-08 DOI:10.1186/s12906-024-04687-9
Chao Yang, Ying Li, Wiraphong Sucharit, Wichai Eungpinichpong, Xingyu Huang
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Abstract

Background: Chronic non-specific low back pain (CNSLBP) is prevalent among firefighters and may negatively affect their job performance. Alterations in the thoracolumbar fascia (TLF) structure are associated with CNSLBP. Percussive massage therapy (PT) has demonstrated potential in modifying fascial properties and alleviating pain. However, its effects on TLF structure in CNSLBP patients have not been thoroughly investigated. This study evaluates the effects of 6 weeks of PT on TLF echo intensity, thickness, pain, and disability in firefighters with CNSLBP, utilizing ultrasound imaging as a primary assessment tool.

Methods: This six-week randomized controlled trial involved 38 firefighters with CNSLBP. Participants were randomly assigned 1:1 to either the PT group (receiving PT and core stability exercise) or the control group (receiving only core stability exercise). TLF echo intensity and thickness were measured using ultrasound imaging, and disability was assessed using the Roland-Morris Disability Questionnaire (RMQ) at baseline and post-intervention. Pain was measured using the Visual Analog Scale (VAS) at baseline, immediately after the first intervention, three weeks post-intervention, and post-intervention. Paired t-tests were conducted to analyze within-group changes in RMQ and ultrasound data, while ANCOVA was used to assess between-group differences, and repeated measures ANOVA for VAS scores.

Results: Participants in the PT and control groups were aged 26.6±4.1 and 23.6±1.7 years, respectively, with BMI of 23.1±1.8 and 21.8±1.2 kg/m². The PT group showed significant reductions in bilateral TLF echo intensity post-intervention (left side: mean difference -6.4, 95% CI -9.7 to -3.1, p < 0.001, effect size 0.67; right side: mean difference  -7.6, 95% CI -11.8 to -3.3, p < 0.01, effect size 0.60). Changes in TLF thickness were not statistically significant (p > 0.05). The PT group demonstrated significantly lower VAS scores than the control group (mean difference - 0.626, 95% CI -1.087 to -0.165, p = 0.009, effect size 0.63). RMQ scores decreased by -1.3 (95% CI -2.1 to -0.4, p < 0.01, effect size 0.5).

Conclusion: Six weeks of percussive massage therapy significantly reduced thoracolumbar fascia echo intensity, alleviated pain, and improved functional disability in firefighters with chronic non-specific low back pain, but was not effective in altering fascia thickness. Percussive massage therapy emerges as an effective and safe strategy for managing chronic non-specific low back pain in firefighters.

Trial registration: Retrospectively registered in Thai Clinical Trials Registry (TCTR20221223001) on December 22, 2022.

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冲击性按摩疗法对患有慢性非特异性腰痛的消防员筋膜回声强度和筋膜厚度的影响:随机对照试验。
背景:慢性非特异性腰痛(CNSLBP)在消防员中很普遍,可能会对他们的工作表现产生负面影响。胸腰筋膜(TLF)结构的改变与 CNSLBP 有关。冲击性按摩疗法(PT)在改变筋膜特性和减轻疼痛方面具有潜力。然而,该疗法对 CNSLBP 患者 TLF 结构的影响尚未得到深入研究。本研究利用超声波成像作为主要评估工具,评估了 6 周按摩疗法对患有 CNSLBP 的消防员的 TLF 回声强度、厚度、疼痛和残疾的影响:这项为期六周的随机对照试验涉及 38 名患有 CNSLBP 的消防员。参与者按 1:1 随机分配到 PT 组(接受 PT 和核心稳定性锻炼)或对照组(仅接受核心稳定性锻炼)。使用超声波成像测量 TLF 回声强度和厚度,并在基线和干预后使用罗兰-莫里斯残疾问卷 (RMQ) 评估残疾情况。在基线、首次干预后立即、干预后三周和干预后使用视觉模拟量表(VAS)测量疼痛。采用配对 t 检验分析 RMQ 和超声波数据的组内变化,采用方差分析评估组间差异,采用重复测量方差分析评估 VAS 评分:运动疗法组和对照组患者的年龄分别为 26.6±4.1 岁和 23.6±1.7 岁,体重指数分别为 23.1±1.8 公斤/平方米和 21.8±1.2 公斤/平方米。干预后,PT 组的双侧 TLF 回声强度明显降低(左侧:平均差异 -6.4,95% CI -9.7 至 -3.1,P 0.05)。PT 组的 VAS 评分明显低于对照组(平均差 -0.626,95% CI -1.087 至 -0.165,P = 0.009,效应大小 0.63)。RMQ 分数下降了-1.3(95% CI -2.1至-0.4,p 结论:叩击式按摩疗法是一种有效的治疗方法:对患有慢性非特异性腰痛的消防员来说,为期六周的冲击性按摩疗法可明显降低胸腰部筋膜回声强度、减轻疼痛并改善功能障碍,但对改变筋膜厚度无效。冲击性按摩疗法是治疗消防员慢性非特异性腰背痛的一种有效而安全的策略:该试验于2022年12月22日在泰国临床试验注册中心进行了回顾性注册(TCTR20221223001)。
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来源期刊
BMC Complementary Medicine and Therapies
BMC Complementary Medicine and Therapies INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
6.10
自引率
2.60%
发文量
300
审稿时长
19 weeks
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