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A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 45 The study is important for the massage therapy field because unlike earlier large- scale research studies, this one used community practicing massage therapists who developed individualized treatment plans for study participants assigned to them. The whole study was set up to reflect the way real chronic low-back pain patients would access massage therapy in most parts of the country. Several Central Kentucky family and internal medicine primary care providers participated in the research and their referrals were how patients entered the study. Primary care providers referred patients with chronic low-back pain to the study if they thought massage would be beneficial. Once enrolled, patients were matched with community massage therapists who practiced close to either where they lived or worked. Patients were allowed to access up to 10 complimentary one-hour massage sessions over 12 weeks (massage therapists were compensated by the study team). All aspects of the massage sessions occurred as typical in the massage field after the initial patient-to-therapist match by study personnel. Patients scheduled with the massage therapist per their availability and the treatment plan, and they attended sessions in their therapist's clinic. Therapists documented each treatment session with a study-provided SOAP notes template that they submitted to study personnel. Details of the community practicing massage therapists were reported prior to the publication of the study results in the open-access International Journal of Therapeutic Massage and Bodywork. 3 I sat down with Niki Munk, PhD, LMT, co-lead author on the study, at the Alliance for Massage Therapy Education conference back in July to talk about the study, its importance to the field, and the various ways massage therapists can contribute to, or be involved in, massage research. JERRILYN CAMBRON: The buzz word for this study is real world. What does "real world" mean and why is this study considered real world? NIKI MUNK: Real world essentially means what it implies: as it happens or occurs in the real world, in real applications. The words pragmatic and effectiveness are related research terms that indicate, along with real world, that the research does not seek to examine interventions or make observations in controlled settings. Our study design was real world from several perspectives. We had a very open inclusion criteria, which allowed for medically complex participants who are often excluded from research or controlled studies. For example, we did not have an upper age limit for participants, which allowed us to include much older participants who, up to that point, had been excluded from large clinical trials examining massage for back pain. We also allowed chronic low-back pain patients with co- morbidities such as diabetes, hypertension, depression, and obesity to participate, as well as patients who were on scheduled medications such as opioids. Essentially, the participants in this study reflect the real world: complex individuals who massage therapists work with every day in a variety of practice settings, all across the country. JC: And the treatments provided by the community massage therapists were real world too? NM: Yes. Therapists were allowed to develop and apply individualized treatment plans within their scope of practice and skill set to meet the needs of each study participant within the study parameters of 10 one-hour sessions within 12 weeks. There were two non-real-world study aspects related to the massage therapists, though. First, only those who were decision- makers for their practice environment could be study therapists, and second, therapists had to be at least five years out of their foundation massage training program. JC: Why were these non-real- world study parameters needed? NM: The decision-maker parameter simply became a necessity for logistical reasons. The study budget was only able to compensate massage therapists $25 for each completed massage session. Because study therapists were asked to provide all the needed massage materials, schedule the appointments, and provide study-related treatment documentation that became study data (study treatment notes did not remain with the therapist at the end of the study), these were individual decisions that the therapist had to weigh with regard to their client load, the study parameters and compensation policy, their schedule, and what they were willing to do. Environments in which therapists are paid on a percentage split of the charged amount would have

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