Issue link: https://www.massageandbodyworkdigital.com/i/918051
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 47 progressive in nature (e.g., osteoarthritis, scoliosis, degenerative disc disease, etc.) and are not actually curable, at least not from massage therapy. Other people may be in situations where their chronic pain is perpetuated by physical demands placed on them by their jobs or other meaningful life experiences that also can't or won't change. These situations are also not curable by massage therapy, but massage can help manage the extent to which pain is experienced from these necessary and continued activities. More often than not, these management-type situations are those that massage therapists work with in their daily clinical experiences and are the next needed step in massage therapy research. This study determined that for most real-world primary-care patients with CLBP, a course of 10 one- hour real-world massage treatments over 12 weeks provided meaningful improvement in pain with disability. The next question research should tackle is how often does real-world massage need to be provided in order for people with CLBP to maintain and/or continue improving after an initial course of massage therapy is complete? Studies designed to answer questions like this could help to turn research toward the more massage practice-reflective approach to chronic pain conditions: management. Keep your eyes peeled to future research. Hopefully we will see these types of developments in the coming years. 2. OSWESTRY DISABILITY INDEX (ODI) This study used the ODI to measure pain- related disability for people with CLBP. The ODI is a valid and reliable measure specific to back pain that is easy to use in research and practice settings. 3 The ODI consists of 10 sections, each focused on a specific aspect of meaningful function: personal care, lifting, walking, sitting, standing, sleeping, sex, social, traveling, and general pain intensity. Each section contains six statements related to its topic in order of severity progression. People taking the ODI are asked to select which one statement under each section best applies to them. Initial statements for each section are scored at zero and indicate no issue or pain related to the section topic. After four additional progressive statements scored 1–4, final statements for each section are scored 5 and indicate extreme limit and/or disability and pain. By way of example, below are the progressing statements for the "sitting" section of the ODI: 4 I can sit in any chair as long as I like. I can only sit in my favorite chair as long as I like. Pain prevents me from sitting more than 1 hour. Pain prevents me from sitting more than 30 minutes. Pain prevents me from sitting more than 10 minutes. Pain prevents me from sitting at all. Simple scoring instructions applied to a completed ODI produce a disability percentage, with those scoring 12 percent or higher considered experiencing back-related pain with disability. 5 A change of 6 percentage points or more is considered clinically meaningful and the ODI's use is not proprietary (in other words, use and access of the ODI is free). 6 While primary analysis for the study considered group ODI mean scores and their changes at the study's three data-collection time points, a descriptive consideration of individual ODI scores and changes from baseline to 12 weeks provides a more practice- relevant picture of this study's participant outcomes. The below tables display ODI section responses at baseline (left column) and 12 weeks (right column) for two study participants. EXAMPLE 1 Baseline: ODI=40% Disabled 12 Weeks: ODI=10% Normal but painful personal care Normal personal care, no pain No sitting > 1 hour Sit in any chair as long as I like No standing > 1 hour Standing as long as I like with no pain < 6 hours of sleep Sleep never disturbed by pain No sex life at all due to pain Normal sex life with no extra pain Normal but painful social life Normal social life with no pain Limited travels due to pain Can travel anywhere with some pain EXAMPLE 2 Baseline: ODI=54% Disabled 12 Weeks: ODI=40% Severe pain intensity Mild pain intensity Only able to lift light to medium weights Able to lift heavy weights if conveniently placed Only able to walk 100 yards Can walk up to ¼ mile Severely restricted sex life Nearly normal but painful sex life Travel no more than 1 hour due to pain Can travel anywhere with some extra pain These two participant examples provide two different ways in which people in the study experienced improved back-related pain with disability. The first table depicts a participant who began the study with moderate disability (40 percent) and after a 30 percent point reduction in ODI from baseline to 12 weeks, concluded the intervention window of the study below the ODI threshold for pain with disability (12 percent). This particular participant had a 75 percent improvement in ODI score from baseline to post-intervention and several meaningful life functions such as personal care, sitting, standing, sleep, and sex dramatically improved. The second participant example began the study with more severe disability and experienced a less pronounced but still clinically meaningful change of 14 percentage points. Although this participant was still moderately disabled at the massage