Evaluation of Comparative Efficacy of Levothyroxine Versus Kshar Basti and Kanchanar Guggul in the Treatment of Hypothyroidism: Protocol for a Randomized Controlled Trial.

BACKGROUND: The thyroid gland is an endocrine gland that has an impact on the body's general metabolism. Thus, the secretions of the thyroid gland can modify the overall metabolism of the entire body. The prevalence of hypothyroidism is increasing quickly, with rates of 2%-5% in affluent countries and 11% in India. Individuals diagnosed with hypothyroidism need to take medication for the rest of their lives, resulting in significant stress. Therefore, conducting a study in this area is imperative. OBJECTIVE: This study aims to assess the effectiveness of the therapeutic enema (Kshar Basti) and oral Kanchanar Guggul in the treatment of hypothyroidism. METHODS: The trial group (n=45) will receive a therapeutic enema (Kshar Basti) followed by oral Ayurvedic drugs for 180 days. The control group (n=45) will be given levothyroxine tablets at a dosage of 1.6 µg/kg/day for the same duration. The objective is to examine the alterations in thyroid stimulating hormone (TSH) levels before and after the treatment. RESULTS: Any deviation of the serum TSH by more than 20% from the initial values, while keeping triiodothyronine (T3), and thyroxine (T4) levels within the normal range, will be deemed statistically significant. Consequently, we anticipate a statistically significant variation in serum TSH levels between the therapeutic enema and Kanchanar Guggul treatments. Presently, the drug preparation operations are in progress. We expect to start enrolling patients in June 2024, do data analysis in December 2025, and acquire results by early 2026, marking the end of this trial. CONCLUSIONS: This study will evaluate the efficacy of the therapeutic enema, specifically Kshar Basti, in treating hypothyroidism. Furthermore, more research can determine the efficacy of a therapeutic enema (Kshar Basti) in treating overt hypothyroidism and hypothyroidism during pregnancy. TRIAL REGISTRATION: Clinical Trials Registry India CTRI/2023/05/052389; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=Nzk1NjY=&Enc=&userName=052389. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/57287.

Effect of Single Session of Swedish Massage on Circulating Levels of Interleukin-6 and Insulin-like Growth Factor 1.

Massage therapy increases muscle blood flow and heat, relieving pain, improving immune function, and increasing vagal activity. The mechanisms are unclear. Muscles release cytokines and other peptides called myokines. These myokines exert their effects on different tissues and organs in para-, auto-, and endocrine fashion. The aim of this intervention study was to investigate if massage therapy affects circulating myokine levels. A total of 46 healthy, normal-weight subjects (15 men) aged 18-35 were recruited. Forty-five minutes of massage Swedish therapy was applied to the back and hamstrings. Blood samples via cannula were taken at the baseline, during the massage (30 min), end of the massage (45 min), and 30 min and 1 h after the massage. Interleukin 6 (IL-6) and insulin-like growth factor 1 (IGF-1) were measured as surrogate markers by ELISAs. There was a significant increase in IL-6 from 1.09 pg/mL to 1.85 pg/mL over time (Wilks' Lambda Value 0.545, p < 0.000; repeated measures ANOVA). Pair-wise comparisons showed a significant increase after 1 h of massage. No significant increase was observed in IGF-1 levels. The change in myokine levels was not correlated with muscle mass (p = 0.16, 0.74). The increase in IL-6 suggests that there might be anti-inflammatory effects, affecting glucose and lipid metabolism pathways via IL-6 signaling to muscles, fat tissue, and the liver.

Efficacy of traditional Thai massage as adjunctive therapy in patients with major depressive disorder.

Background: Major depressive disorder (MDD) is the most common mental ailment. Moreover, it is one of the most incapacitating medical conditions. Although antidepressant medication has traditionally been the mainstay of treatment, adjunctive therapy may provide therapeutic advantages that reduce the severity of depression. Methods: An experiment using randomization and control groups was undertaken. A total of forty-eight individuals diagnosed with severe depressive illness and undergoing antidepressant medication were selected and randomly assigned to either get traditional Thai massage (TTM) treatment, consisting of 90-minute sessions twice a week for eight weeks, or to be part of the control group, which continued with their regular daily activities. The main assessment tools used were the Hamilton Depression Rating Scale (HAM-D), the Clinical Global Impression-Severity (CGI-S), and the Khon Kaen University Depression Inventory 14 (KKU-DI-14). Secondary outcomes, such as blood pressure (BP) and quality of life measured by The EuroQol-5D-5L (EQ-5D-5L), were assessed both before and after the first therapy, as well as at the last session at the 8th week. Results: The TTM group showed a statistically significant decrease in the HAM-D score within the eighth week of therapy compared to the control group (5.14 points, 95% confidence interval=2.92 to 7.37 points, P<0.001). Conclusion: These findings suggest that combining TTM with antidepressant medication may effectively reduce depression scores and improve quality of life scores.

Effectiveness of Medical Massage in Reducing Neck Pain Among Multiple Occupational Groups: A Longitudinal Study.

Background: Neck pain is a common complaint affecting people across various professions, especially those involving prolonged sedentary activities. Purpose: This study aimed to evaluate the efficacy of medical massage in reducing neck pain among diverse occupational groups in North Macedonia over a 3-year period (2019-2022). Methods: A total of 127 participants from various professions such as information technology professionals, bank accountants, textile workers, business sector employees, and secretaries were subjected to one or two massages per month. Pain intensity was measured using a numerical rating scale at the start and throughout the study. The statistical methods in this research study included descriptive statistics for summarizing demographic data, comparative analyses to assess the effectiveness of massage therapy on pain reduction, and inferential statistics to determine significance levels and correlations within the data. Results: At the beginning of the study, participants reported an average pain intensity level of 7 on a numerical rating scale from 1 to 10. Over the study period, consistent massage therapy led to a significant reduction in neck pain, with participants reporting an average pain level of 2 in the final months. Crucially, the research revealed that discontinuation of massage sessions, as observed in a subset of respondents who abstained for approximately 4 months, resulted in an escalation of pain intensity. This finding draws attention to the importance of regular massage therapy in sustaining pain relief benefits. Conclusion: The study's outcomes focus on the effectiveness of medical massage in managing neck pain across various occupational backgrounds. This research provides valuable perception in the potential long-term benefits of massage therapy, accenting the need for continued treatment to maintain pain relief among people exposed to neck and back pain. These findings offer essential guidance to healthcare professionals and individuals seeking non-pharmacological interventions for chronic neck pain management.

Ergonomic Considerations for Practicing Massage Therapists.

The physical demands and repetitive movements performed by massage therapists during a treatment increase the risk for work-related musculoskeletal disorders. While massage therapy meets the level of heavy physical demand, the ergonomic risk of performing a massage was previously unknown. The Massage Therapy Foundation undertook a job task analysis to be used by educators, employers, and clinicians to create an optimal work environment. Data collected via survey were used to create the protocol for an onsite data collection where massage therapists were evaluated on the ergonomic risk factors by trained ergonomists. The results of the job task analysis found the highest variability in movement when the massage therapist was treating the neck prone, neck supine, and leg prone. When the massage therapists did not change positions during a stroke, there was increased forward flexion of the trunk which increased postural stress on the extensors of the back and neck. Strokes such as effleurage which can span the entire length of the body part had the highest cumulative load, requiring postures that put mild biomechanical stress on the shoulders (90% of the time), neck (70% of the time), and trunk (60% of the time). The forward-bending posture of the massage therapist increases the eccentric demands of the therapist's neck and back musculature, thereby increasing fatigue and leading to an increase in the chance of overuse injury. The job task analysis recommends the massage therapist monitor the duration of application in an unsupported position, take more time between sessions, work in an optimum environment, including correct table height, and have a healthy, active lifestyle to maintain career longevity.

The Pillars of the IJTMB-Exploring TMB Education.

This editorial is the final in a three-part series discussing the pillars of the International Journal of Therapeutic Massage a nd Bodywork: research, practice, and education. Highlighting the need for scholarly discourse, this piece aims to inspire therapeutic massage and bodywork (TMB) educators to share their creative approaches to educational matters. The author advocates for a united effort to share knowledge and practices that will enrich TMB education and, ultimately, professional practice.

The Relationships Between Psychosocial Factors and Short-Term Treatment Outcomes of Massage Therapy in Patients with Myogenic Temporomandibular Disorders: A Single-Arm Preliminary Study.

Background: Massage therapy is included as part of a comprehensive treatment plan for patients with temporomandibular disorders (TMDs). However, it displayed varying degrees of success. Preexisting psychosocial impairments may be one of the possible factors affecting the treatment response. This preliminary study aimed to investigate the relationships between psychological factors and treatment outcomes of massage therapy in myogenous TMD patients. Methods: Twenty-two myogenous TMD patients were enrolled in this single-arm preliminary study. Baseline psychosocial assessment was done using self-report measures associated with chronic pain severity, depression, anxiety, and non-specific physical symptoms. Massage therapy including the intraoral and extraoral massage of the face and neck muscles was performed twice a week for 4 weeks. Pain intensity and quality of life related to oral health were evaluated as treatment outcomes before and immediately after eight sessions of massage therapy. Results: Regression analyses showed a significant effect of depression on changes in the quality of life after massage (ß = 0.35, p-value = 0.026). In addition, results showed a significant effect of chronic pain severity on changes in the pain intensity following massage (ß = 1.50, p-value = 0.027). Conclusion: Our findings suggested that psychosocial characteristics of myogenous TMD patients should be considered as important factors that may adversely affect pain intensity reduction and quality-of-life improvement after short-term massage therapy.

Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont.

Background/Objective: Pain is one of the most common chronic conditions in the US, estimated to affect 20.9% of the population (51.6 million people). We evaluated the Partners Aligned in Transformative Healing (PATH) program at University Medical Center's Comprehensive Pain Program clinic. Feasibility, initial clinical and financial results were assessed to inform payers' support for PATH, an integrative transdisciplinary program within a bundled payment format. Methods: Participants completed a multi-week program including integrative therapies, with empirically validated assessment surveys administered at the beginning and end of the program. Insurance claims data were analyzed 12 months pre- and post-program. Statistical significance of pre-post differences was assessed by paired T-tests with P < 0.05. Results: Between June 2019 and August 2022, 170 individuals enrolled in PATH, 151 (88.8%) completed the program, and 121 participants completed outcome surveys. Participants were predominately White, non-Hispanic (98%), female (76%), with an average age of 49.8. All participant-reported clinical outcomes (PROs) showed statistically significant improvement from baseline to final assessment, and some but not all were clinically significant. PEG subscale of average pain interference, enjoyment of life, and interference with general activity each decreased. The T-scores for the following domains of PROMIS-29 decreased: Pain interference; fatigue; sleep disturbance; anxiety, and depression. The PROMIS-29 domains of overall physical function and social roles and activities mean T-scores increased. Per Member Per Month (PMPM) total cost of care decreased by $462 (18%). Emergency room utilization for all diagnoses decreased by 457 visits/1000 patients (65%), and for pain-related diagnoses by 194 visits/1000 patients (67%) during the observation period. Conclusions: Results suggest that the PATH Program is a feasible and acceptable model that shows initial effectiveness relative to short-term patient-reported clinical outcomes and shows signs of durability in both utilization and financial outcomes at 1 year. The results support continued study including a multi-site RCT.

Potential of Massage Therapy for Improved Growth and Development Among Infants Under 9 Months: A Systematic Scoping Review of Intervention Type, Technique, and Outcome.

Background: Infants are in a critical period during which often occur many problems, such as growth, development, and motor delays. One of the interventions that can potentially reduce these problems is by giving a massage therapy. Purpose: This study aims to conduct a systematic scoping review of massage therapy's potential for growth and development among infants under nine months. Methods: This study followed a Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA-ScR). We collected data from three databases, including PubMed, Scopus, and CINAHL with full text, published in 2013-2022, subjects aged less than nine months, full-text articles, and randomized controlled trials. Studies were excluded if they were not in English. Results: Of the 11 studies found, it shows that therapy massage can effectively increase infants' growth and development, including body weight, length, visual-motor coordination and integration, hand-eye, hearing, speech, social, vagal activity, language, locomotion, stationary, and reflexes. The interventions include medium chain triglyceride oil massage, Dabur Lal Tail massage, oil massage, massage by mothers, and massage therapy without additives for 5-45 minutes. In addition, massage therapy has a positive effect on infants with various conditions, including preterm infants, infants with HIV-infected mothers, and infants with Down's syndrome. Conclusion: Our findings highlight that infants receiving massage therapy were significantly more likely to increase growth and development than the population who were not given massage therapy. However, further investigation into preventing the severity of growth and developmental problems is urgently needed.

Evaluation of clinical characters and use of alternative medicines in the management of headache and predictors of treatment satisfaction among Saudi adults - A community-based study in Saudi Arabia.

Background and objective: The use of alternative medicine (AM) is rising globally. Hence this study aimed to assess the Use of and Satisfaction with Alternative Medicine in the management of headache and Related Factors in Individuals, living in Saudi Arabia. Methods: A cross-sectional study was conducted from July to December 2023 using an online questionnaire in Riyadh Saudi Arabia. The data was collected using a series, of prevalidated questionnaires aimed to assess the utilization and satisfaction of AM for the headache. Convenience sampling was applied for data collection. Results: A response rate of 93.1 % (n = 550) was obtained. Among the respondents, 78.7 % reported having headaches, while 69.2 % had a history of using AMs for headaches. However, among the users of AMs, 65.9 % of them were satisfied with the results of AMs, of those who were satisfied, 33.7 % said that AMs helped to prevent headache attacks, and 53.8 % reported that AMs use reduced pain intensity. The regression results demonstrated that there was a significant relationship between the satisfaction of AM for the headache and age (p < 0.004), and Active in sports (p < 0.019) and severity of the headache pain (p < 0.081). Conclusion: The findings reported that relatively high prevalence of AMs used to manage headaches, while 65.9% of the users were satisfied with the outcomes, the satisfaction was found to have a significant relationship with age, activity in sports and severity of pain. To avoid negative effects of AM, it is recommended to use under the qualified healthcare professionals.

The effect of the massage on cramp frequency, cramp severity, and sleep quality of hemodialysis patients: A randomized controlled trial.

INTRODUCTION: Leg muscle cramps and compromised sleep patterns are prevalent issues experienced by individuals undergoing hemodialysis treatment. The aim of this study was to assess the impact of massage therapy on hemodialysis patients experiencing cramping, specifically focusing on the frequency and severity of cramps, as well as the quality of sleep. METHODS: This research involved 36 hemodialysis patients. The intervention group received intradialytic massage targeting the lower extremities, administered three times a week for a total of six sessions over a 2-week period. Data collection utilized a Patient Information Form, the Pittsburgh Sleep Quality Index, the Visual Analog Scale, and a Patient Follow-Up Form. FINDINGS: The study revealed a significant reduction in both the frequency and severity of cramps experienced by patients in the intervention group during hemodialysis sessions and at home, from the end of one session to the beginning of the next, compared to the control group (p < 0.05). This effect was observed over the course of six dialysis sessions. Additionally, there was a notable decrease in the mean total score of the Pittsburgh Sleep Quality Index (PSQI) among participants in the intervention group, declining from 9.00 ± 3.79 prior to massage therapy to 5.94 ± 2.84 post-massage (p < 0.001). Conversely, no significant change was observed in the control group, highlighting a notable disparity between the intervention and control groups in terms of sleep quality improvement. DISCUSSION: The investigation revealed that employing intradialytic massage on the lower extremities led to a reduction in both the frequency and severity of cramps, while also eliciting a positive impact on the sleep quality of patients undergoing hemodialysis.

Prevalence and determinants of massage therapy use in the U.S.: Findings from the 2022 National Health Interview Survey.

BACKGROUND: This study presents findings on the prevalence and determinants of past-year massage therapy use among U.S. adults from the 2022 round of the National Health Interview Survey (NHIS) (total available N = 27,651), an annual national population survey. METHODS: The NHIS uses face-to-face interviews on a representative sample of the civilian, noninstitutionalized U.S. population drawn using a systematic, stratified, single-stage probability design. The analyses consist of logistically modeling the determinants of three outcome (dependent) measures: past year utilization of a practitioner of massage, past year utilization of massage for pain, and past-year utilization of massage to restore overall health. Exposure (independent) variables include numerous sociodemographic, health services, health-related, mental health and well-being, and behavioral indicators. RESULTS: The past-year prevalence rate for visiting a massage therapist in the U.S. is 11.1 %. The past-year rate for massage visits for pain is 6.0 %, and for restoring overall health is 8.5 %. Significantly higher rates are found among females and socioeconomically advantaged individuals, among other categories, and the strongest net determinant of massage therapy utilization is use of complementary or integrative practitioners. CONCLUSION: It is apparent that massage therapy is a commonly utilized therapeutic modality in the U.S. While use of complementary or integrative therapies is a significant determinant of massage utilization, it may not be fitting to consider massage therapy itself as an "alternative" therapy, but rather a widely used and increasingly mainstream therapeutic modality meriting wider integration into the community of healthcare professions.

A Comparison Between the Effectiveness of Tepurak Therapy Versus Deep Tissue Massage Stretching on Low Back Function in Nonspecific Low Back Pain.

Introduction: The research carried out is a large research project that examined two different massage methods on many variables so that they can determine their effect on variables on a wider scale, namely pain, range of movement (ROM), and low back function. Pain and ROM variables have been published in different journals, and their acute effects are only known after treatment and the results are effective. This study examined the low back function variable 24, 48, and 72 hours after treatment. Objective: This study aimed to determine the effectiveness of Tepurak and deep tissue massaging with stretching (DTMS) on low back function in nonspecific low back pain (NSLBP) and conduct a comparison of the effectiveness of Tepurak versus DTMS for low back function in NSLBP. Methods: This research is a quasi-experiment using a pre-test/post-test design to determine the difference in scores before and after treatment. The variable measured involved the low back function using the Oswestry Disability Index. Measurements were carried out four times at pre-test, 24, 48, and 72 hours after the treatments. This study used two different sample groups. The research sample consisted of 42 NSLBP sufferers who were randomly divided into two groups, A and B. Group A received Tepurak treatment, while Group B received DTMS treatment. These treatments were carried out in one treatment session. Results: The results of the different treatments for the low back function variables in the Tepurak treatment have a p-value of 0.000. The results of the low back function variables in the DTMS treatment have a p-value of 0.000. The results of the comparison test of Tepurak versus DTMS therapy for the low back function variable had a p-value of 0.771. Conclusion: Both Tepurak and DTMS are effective in improving low back function in NSLBP cases. In comparison between Tepurak and DTMS, there was no significant difference in the effectiveness in improving low back function in NSLBP cases.

The Pillars of the IJTMB-Looking More Closely at the Practice Section.

This editorial continues the exploration of the three pillars of the International Journal of Therapeutic Massage and Bodywork. We discuss opportunities in TMB practice to share experiences and learnings with the IJTMB community. Several exemplars of manuscripts published in the Practice Sections are shared for inspiration.

Touch medicine: bridging the gap between recent insights from touch research and clinical medicine and its special significance for the treatment of affective disorders.

Interpersonal touch represents the primal sensory experience between humans, fostering social bonding from the cradle to the death bed. In recent decades "affective touch" has been intensely studied, stimulated by the discovery of a population of mechanosensitive unmyelinated C-tactile afferents in mammalian skin. A lack of touch in childhood is associated with negative consequences for psychosocial and physical health and the benefits of professional touch techniques in the prevention and treatment of various diseases have been shown over and over again in clinical studies. However, its application in mainstream clinical applications remains limited. To bridge the gap between recent discoveries in touch research and clinical medicine, we propose the establishment of a new discipline: 'Touch Medicine'. Here, we unfold the potential of Touch Medicine by focusing on the treatment of depression, which in our view is primarily a disorder of the lived body. Controlled studies and systematic reviews have demonstrated the antidepressant, anxiolytic and analgesic effects of specific massage techniques. Underlying mechanisms of action are currently under investigation, ranging from interoceptive, endocrinological, to stress-related or psychological underpinnings. Touch Medicine represents a novel interdisciplinary field connected to various medical specialities such as neonatology, pediatrics, pain medicine, neurology, psychiatry, and geriatrics - but also clinical psychology and psychosomatic medicine might benefit from the integration of these findings into their daily practice.

Efficacy of massage versus massage with post isometric relaxation in temporomandibular disorders: a randomized controlled trial.

BACKGROUND: Temporomandibular joint disorder (TMD) is a common condition affecting the masticatory muscles and joint mobility. OBJECTIVES: The primary objective was to compare the effects of massage therapy alone and massage therapy combined with post-isometric relaxation exercises in patients with TMD for pain and maximal mouth opening. DESIGN: Assessor-blinded randomized controlled trial. SETTING: Sir Ganga Ram Hospital, Chaudhry Muhammad Akram Dental Hospital, Lahore Medical and Dental Hospital. SUBJECTS: Temporomandibular joint disorder patients. INTERVENTION: Group A (n = 23) received conventional treatment including massage and therapeutic exercises consecutively for 2 weeks. Group B (n = 23) received post-isometric relaxation technique along with conventional treatment for consecutive 2 weeks. MAIN MEASURES: The main outcome measures were pain and maximal mouth opening. Pain was measured using the Visual Analogue Scale (VAS) and maximal mouth opening (MMO) was measured using the TheraBite Scale. RESULTS: Both groups demonstrated significant improvements in pain and MMO scores post-treatment. However, Group B (massage with post-isometric relaxation exercises) showed significantly better outcomes compared to Group A (massage alone). There was a statistically significant difference in post-treatment pain scores (P = 0.000) and MMO scores (P = 0.000) between the two groups. CONCLUSION: The results suggest that massage therapy combined with post-isometric relaxation is more effective than massage therapy alone in managing pain and improving mouth opening in TMD patients. The study provides evidence supporting the use of these therapies in TMD management. TRIAL REGISTRY NUMBER: NCT05810831. Date of registration/First submission: 15 March 2023.

The Effects of Massage Therapy in Decreasing Pain and Anxiety in Post-Surgical Patients With Breast Cancer: A Systematic Review and Meta-Analysis.

Background: Massage therapy is an effective non-pharmacological intervention in treating pain and anxiety of patients with cancer. Prior studies have reviewed the benefits of massage therapy in patients with breast cancer undergoing chemotherapy, radiation, and other patient-specific cancer treatments. What has yet to be examined is the effects of massage therapy on the pain and anxiety of patients with breast cancer after surgery. Objective: : The purpose of this systematic review and meta-analysis was to examine the effect of massage therapy on post-surgical pain and anxiety in patients with breast cancer. Methods: Systematic searches were performed using databases PubMed, CINAHL, and Medline (EBSCO), with no date constraint through September 30, 2023, to identify randomized control trials, randomized pilot, and quasi-experimental studies. The database searches retrieved 1205 titles, and after screening, 7 studies were chosen for full analysis using Cohen's d, 95% Confidence Interval (CI), and effect size. The heterogeneity of the studies was calculated in the meta-analysis using Cochran's Q equation. Results: Massage therapy techniques reported were massage therapy, classic massage, reflexology, myofascial release, and myofascial therapy, and were performed at day 0 up to 16 weeks post-surgery. Massage therapy decreased pain and anxiety for patients in the massage group. Analyses showed a positive effect size using massage therapy as an intervention for pain and anxiety in women with breast cancer post-surgery. Overall effect size for pain was 1.057 with a P-value of <.0001, and overall effect size for anxiety was .673 with a P-value of <.0001. Conclusion: The current evidence in this study reflects that massage therapy is effective as a non-pharmacological tool in decreasing post-surgical pain and anxiety in women with breast cancer.

Effects of different treatments on pain, functional disability, position sense and range of motion in elite bodybuilders with chronic low back pain.

Back pain is one of the major global challenges and is one of the most prevalent musculoskeletal disorders occurring in 80% of people at least once in their lifetime. Therefore, the need to find appropriate treatment methods for this issue is very important. The objective is to examine the short-term and acute effects of a treatment session with dry needling, massage therapy, stretching exercises and Kinesio tape on pain, functional disability, position sense and range of motion in elite bodybuilders with non-specific chronic low back pain. The sample of this quasi-experimental study consisted of 48 bodybuilders with non-specific chronic low back pain (all male, mean age = 25.96 ± 2.18 years; mean weight = 74.45 ± 4.51 kg; mean height = 173.88 ± 3.74 cm; mean BMI = 24.60 ± 0.74 kg/m2) who randomly were placed in 4 dry needling, massage therapy, stretching exercises and Kinesio tape groups. The duration of each intervention was 30 min. The dependent variables in this study included the massage range of motion, position sense tests and visual pain scale that were taken separately from each subject in pretest, posttest (acute effect) and follow-up test (72 h after posttest; short-term effect). The results of a 4 (groups) × 3 (time) the mixed ANOVAs showed that pain in the short-term phase was significantly lower in the dry needling group than in the stretching and massage groups (P < 0.05). Also in the acute effect phase, the flexion range of motion was significantly lower in the dry needling group than in the massage group (P < 0.05). Furthermore, the two groups of stretching and massage exercises showed significantly greater range of motion (P < 0.05). Other comparisons were not significant (P > 0.05). The findings of the study showed that both massage and stretching treatment have higher acute effects, while dry needling treatment was more effective in follow up. On the other hand, these findings show that these treatment methods can have immediate and lasting positive effects in improving the performance in elite bodybuilders with non-specific chronic low back pain.

What is Effective in Massage Therapy? Well, "It Depends ": a Qualitative Study of Experienced Orthopaedic Massage Therapists.

Background: Massage has been used as a treatment for musculoskeletal pain throughout history and across cultures, and yet most meta-analyses have only shown weak support for the efficacy of massage. There is a recognised need for more research in foundational questions including: how massage treatments are constructed; what therapists actually do within a treatment, including their clinical reasoning; and what role therapists play in determining the effectiveness of a massage treatment. Purpose: The aim of this study was to explore what experienced orthopaedic massage therapists consider to be the aspects of their work that contribute to effectiveness. Setting and Participants: Semi-structured interviews were conducted via Zoom with six experienced orthopaedic massage therapists in Australia. Research Design: The interviews were analysed using inductive thematic analysis, seeking insights that might be practically applied, rather than theory-driven interpretations. Results: The participants focused on the underlying differences between clients, between therapists, and between treatments, and clearly indicated that this concept of "difference" was foundational to their view of their work and was the underlying context for the comments they made. Within that frame of "difference", three key themes were interpreted from the data: (1) "Everyone is different so every treatment is different": how they individualised treatment based on these differences; (2) "How therapists cope with difference": how they managed the challenges of working in this context; and (3) "What makes a difference": the problem-solving processes they used to target each treatment to meeting the client's needs. Conclusions: Participants did not identify specific techniques or modalities as "effective" or not. Rather, a therapist's ability to provide effective treatment was based on an iterative process of treatment and assessment that allowed them to focus on the individual needs of the client. In this case "effectiveness" could be considered a process rather than a specific massage technique.

The Pillars of the IJTMB-a Focus on Research.

The International Journal of Therapeutic Massage and Bodywork (IJTMB) serves as a dedicated platform for advancing the therapeutic massage and bodywork profession through research, practice, and education. In this article, the focus is on the critical aspect of research, exploring various methodologies and methods to unveil the complexities within therapeutic massage and bodywork research. The IJTMB emphasizes the importance of diversifying research types, considering carefully the methods used, and placing all decisions for research study design and methods within relevant ethical considerations. The necessity of knowledge translation, pushing researchers to disseminate their findings widely, and bridging the gap between research and practice for the betterment of the profession and the broader community are emphasized. The IJTMB remains committed to inspiring and facilitating this vibrant exchange of knowledge within the TMB community, thereby advancing the field.