4. Discussion
low back pain, tachycardia, faintness, palpitations, pain, CM, disability, strokes
CHRONIC LOW BACK PAIN, HEART, DISEASES, STROKES
A wide variety of treatment methods have been used for CMLBP over the years.There are several factors that negatively affect the results of this study. Precautions were taken when planning the study to avoid negatively affecting results.First, the “minimization” method used for randomization ensured that the participants were assigned to the groups equally by considering many parameters (age, gender, occupation). We maintained the laboratory environment under the same conditions during the evaluation and treatment to prevent negative effects that may arise from the environment. The laboratory was kept between 21°C to 25°C, not directly sun light, and the participants rested before the procedures. Finally, participants who had adapting problems to the procedures were excluded from the study.In general, CM is used more often than CTM for the pain treatment. The mechanisms of the 2 massages are similar. Touching and pulling strokes activate subcutaneous mechanoreceptors and reveal the therapeutic effects. This results in decrease pain, regulation of autonomic response, and increase relaxation. When we look at the pain decreasing mechanisms, CTM and CM uses presynaptic and postsynaptic pathways to decrease pain.The autonomic response regulating mechanism of CTM was explained as stimulation of cutaneo-visceral reflexes with pulling strokes,Previous studies found that CTM and CM were successful in treating low back pain and other diseases.In another study, patients with chronic low back pain were divided into 3 groups as CTM, placebo CTM, and control.In a different study, the researchers compared the effectiveness of CM and routine treatment in subacute and chronic low back pain.Thai massage and CM were compared in a study.In autonomic responses, this study’s scientific results provided information to reflect on from a clinical perspective. CTM and CM produce a measurable physiological response and avoid the unwanted autonomic side effects of faintness, palpitations, and tachycardia. It was also an indication that the effects of CTM and CM lasted for a long time. There are studies that support the results of the current study and those that had different results. Similar studies reported that massage created changes in autonomic functions.In a study, a single-session CTM was applied to healthy women with different physical activity levels.In a different study, Holey et alIn a different study, Gholami-Motlagh et alThere are several studies that used massage therapy in disability due to CMLBP. In a study examining the effects of CTM and sham CTM on disability,In a study comparing CM and Thai massage, disability was measured using the ODI.CMLBP decreases health-related quality of life. From the study, it was seen that CTM was more effective in improving quality of life. In a similar study, individuals with chronic low back pain were divided into CTM, sham CTM, and control groups.It was found that 50% of individuals with chronic low back pain suffer from sleep problems.This study has several strengths. Firstly, pain intensity was measured every 5 sessions to identify which massage reduced pain better. In this way, the change in pain intensity could be observed each week.There are expensive and complex techniques to assess the autonomic changes. Heart rate variability, galvanic skin response, and thermal camera systems are among these techniques. Heart rate, blood pressure, and skin temperature were measured in this study. These measurements are low-cost and easy-to-use, which was the second strength side of this study.This study also had a limitation. The study was planned as 5 sessions per week. In this design, some individuals were short of time. Setting the number of sessions to 3 or 4 per week would have made it easier to continue treatments.