Development and application of a newly designed massage instrument for deep cross-friction massage in chronic non-specific low back pain

Abstract

Objective: To introduce a newly designed massage instrument, the Hand Grip T-bar (HT-bar) and use it to relieve chronic non-specific low back pain (nLBP) through deep cross-friction massage (roptrotherapy).

Method: 22 subjects (9 males and 13 females, aged 51.6±6.7) with chronic nLBP were allocated randomly to a Roptrotherapy group (n=12) and a Transcutaneous Electrical Nerve Stimulation (TENS) group (n=10). The Roptrotherapy group received deep cross-friction massage with the HT-bar, which was made of metal and had a cylinder for increasing weight and grooves for an easy grip. It was applied across the middle and lower back for 20 minutes a day, 3 days a week for 2 weeks. The TENS group received TENS for 20 minutes a day, 5 days a week for 2 weeks. The outcome was measured on the pain numeric rating scale (PNRS), by the Oswestry disability index (ODI), and by the Roland & Morris Disability Questionnaire (RMDQ) at pre-treatment, at immediate post-treatment and 2 weeks later. The application of the HT-bar was assessed by a questionnaire to 19 therapists.

Results: At post-treatment, immediately and 2 weeks later, both groups showed significant improvement in PNRS, ODI and RMDQ. During the two weeks after post-treatment, however, the Roptrotherapy group improved in PNRS, ODI and RMDQ, but the TENS group did not. Over 80% of the therapists responded that the HT-bar was useful and comfortable.

Conclusion: This study suggests that deep cross-friction massage can be a beneficial therapeutic technique and that the HT-bar can be a useful instrument in deep cross-friction massage for chronic nLBP patients.

Keywords: Instrumentation; Low back pain; Massage.

Fig. 1

Hand grip T-bar (HT-bar) was made of metal and had a metal cylinder (diameter=2.7 cm, height=3 cm) and grooves in middle of vertical bar, just below the cylinder. Both side of the horizontal bar was wrapped by polyethylene rubber pipe and blue sponge in 3 mm was placed above it; then the whole area of the horizontal bar and top of the cylinder which is in contact with the palm were overlapped in leather. Anterior (A), Superior (B), Lateral (C) view of HT-bar.

Fig. 2

Flow chart of the study.

Fig. 3

The post-treatment immediately and 2 weeks later, scores of PNRS, RMDQ and ODI were decreased significantly in both groups. Comparing post-treatment immediately and 2 weeks later, there were significant changes of PNRS, ODI, RMDQ scores in the Roptrotherapy group, but no significant change in the TENS group. PNRS: Pain numeric rating scale, ODI: Oswestry disability index, RMDQ:Roland & Morris Disability Questionnaire. ^*p<0.05.

Fig. 4

Post-treatment 2 weeks later, the percentage of patients with scores of good or excellent in the Roptrotherapy group was higher than in the TENS group according to all evaluation tools. Values shown in the bar graph are the number of cases. R: Roptrotherapy group, T: TENS group, PNRS: Pain numeric rating scale, ODI: Oswestry disability index, RMDQ: Roland & Morris Disability Questionnaire.