Effects of the combination of traditional Thai massage, scapular stabilization exercise, and chest mobilization in subjects with forward head posture: a single-blinded randomized clinical trial

BACKGROUND

Forward head posture (FHP) is  a common condition where the head appears to be positioned in front of the vertical midline of the body. FHP is associated with shortening of the neck extensors and pectoral muscles, and the deep neck flexors and shoulder retractors are weakened. FHP is also found to cause decreases in respiratory function. Few clinical trials have investigated the effects of combination treatments to alleviate these problems. The aim of this study was to examine the effects of combination of traditional Thai massage, scapular stabilization exercise, and chest mobilization on forward head angle (FHA), forced vital capacity (FVC), and cervical flexion in subjects with FHP.

METHODS

Forty-eight subjects with FHP were randomly allocated to a treatment group receiving a Combination of Traditional Thai massage, Scapular stabilization exercise, and Chest mobilization (CTSC group) (n = 24) and a control group (relaxed by lying supine) (n = 24). FHA, FVC, and cervical flexion were measured before and after the four-week intervention (Week 4) and one month after the intervention period (Week 8).

RESULTS

The CTSC group showed statistically significantly greater improvement in FHA and cervical flexion than the control group at Week 4 (FHA, mean difference - 6.05; 95% CI - 8.03, - 4.07; cervical flexion, mean difference 6.84; 95% CI 3.14, 10.55) and Week 8 (FHA, mean difference - 4.64; 95% CI ( - 6.71, - 2.58); cervical flexion, mean difference 5.21; 95% CI 0.84, 9.58). There were no significant between-group differences in FVC at week 4 (mean difference 0.09; 95% CI - 0.06, 0.23) and week 8 (mean difference 0.04; 95% CI - 0.11, 0.19).

CONCLUSION

This study showed that CTSC had a positive effect on FHA and cervical flexion in subjects with FHP.

TRIAL REGISTRATION

Thai Clinical Trials Registry (TCTR) (Identification number: TCTR20211119001), registered 19 November 2021; https://www.thaiclinicaltrials.org/show/TCTR20211119001 .

Preliminary Study: Short-term Beneficial Effects of Thai Tok Sen Massage on Pain, Pressure Pain Threshold, and Upper Trapezius Muscle Thickness Among People with Shoulder Pain

Background

Shoulder muscle pain and spasm is the most common problem in people after prolonged working, similar to that resulting from office syndrome. Various medicinal treatments with analgesic drugs, hot packs, therapeutic ultrasound, or deep friction techniques can be clinically applied. Alternatively, traditional Thai massage (TM) with deep compression gentle technique also can help to release that problem. In addition, an traditional Thai treatment with Tok Sen (TS) massage has been generally performed in the Northern part of Thailand without any scientific evidence support. Thus, the aim of this preliminary study was to reveal the scientific value of Tok Sen massage on shoulder muscle pain and upper trapezius muscle thickness among people with shoulder pain.

Materials & Methods

Twenty participants (6 males and 14 females) who suffered from shoulder pain were randomized into TS (n =10, aged 34.2 ± 7.34 yrs) or TM (n=10, aged 32.8 ± 7.24 yrs). Each group received two times 5-10 minutes of treatment, one week apart. At the baseline and after completing two times of each intervention, pain score, pain pressure threshold (PPT), and specific trapezius muscle thickness were evaluated.

Results

Before both TM and TS interventions, pain score, PPT, and muscle thickness were not statistically different between groups. After two times of intervention, pain scores significantly reduced in TM (3.1 ± 0.56; p = .02, 2.3 ± 0.48; p < .001), as same as in TS (2.3 ± 0.67; p = .01, 1.3 ± 0.45; p < .001) when compared to baseline. This was the same as the results of PPT in TM (4.02 ± 0.34; p = .012, 4.55 ± 0.42; p = .001) and TS (5.67 ± 0.56; p = .001, 6.8 ± 0.72; p < .001). However, the trapezius muscle thickness reduced significantly after two interventions by TS (10.42 ± 1.04; p = 0.002 & 9.73 ± 0.94 mm, p < .001), but did not change in TM (p > .05). Moreover, when compared between intereventions at the first and second periods, TS showed a significant difference in pain score (p = .01 & p <.001), muscle thickness (p = .008 & p = .001) as well as PPT (p < .001 & p < .001) when compared to TM.

Conclusion

Tok Sen massage improves upper trapezius thickness from muscle spasms and reduces pain perception and increases the pressure threshold pain among participants who suffer from shoulder pain similar to that of office syndrome.

The Effect of Thai Massage on the Severity of Pain in Patients with Unstable Angina: A Randomized Controlled Clinical Trial

Introduction: Chest pain is an unpleasant and the most common symptom in patients suffering from unstable angina. This study was implemented to investigate the effect of Thai massage on severity of pain in patients with unstable angina. Methods: This study was a randomized controlled clinical trial that carried out on 70 patients with unstable angina who had been hospitalized in hospital affiliated to Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran. The participants were allocated randomly to either the intervention (n=35) or control group (n=35) between August 1, 2016 and April 30, 2017. The patients in the intervention group received routine care beside and Thai massage with the duration of 30 minutes in two consecutive days. The patients in the control group received routine care. The intensity of pain was assessed by using the numeric rating scale, five minutes before and immediately, 15, 30 and 60 minutes after the intervention. The independent t-test and repeated measures analysis of variance (ANOVA) were used to analysis data through SPSS 13. Results: After the intervention, the severity of pain was significantly diminished by about four measurement points (P=0.001) with the linear pattern of pain reduction. Nonetheless, in the control group, no statistically significant difference in the intensity of pain was found. Conclusion: This study showed that Thai massage as non-invasive approach, concomitant with standard nursing care, has the potential to decrease chest pain. Nurses should be taught about pain relief methods for improving the quality of patient care.

A comparative study of Thai massage and muscle energy technique for chronic neck pain: A single-blinded randomized clinical trial

BACKGROUND

Myofascial pain syndrome (MPS) is the most common form of muscle disorders. Traditional Thai massage (TM) and muscle energy (ME) technique have been used to treat patients with MPS for long time but head-to-head comparisons of these interventions have not been established.

AIM

The aim of the current study was to compare the effects of TM and the ME technique on pain intensity (PI), pressure pain threshold (PPT), neck disability (ND), and neck flexion range of motion (NFROM) in patients with chronic neck pain associated with myofascial trigger points (MTrPs).

DESIGN

A randomized, single-blinded clinical trial.

SETTING

Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University.

POPULATION

Forty-five patients with chronic neck pain associated with MTrPs were recruited.

METHODS

The patients were randomly allocated to the TM, ME, or control groups, with each having eight treatment sessions over a period of two weeks. PI, PPT, ND, and NFROM were assessed before, immediately after the first treatment session, and one day after the last treatment session.

RESULTS

Based on the results, both TM and the ME technique resulted in a significant improvement in all parameters (p < 0.05) compared to the control group. Additionally, no significant difference was observed between TM and the ME technique in all parameters.

CONCLUSIONS

The application of TM or the ME technique can be a practical alternative approach for the treatment of chronic neck pain associated with MTrPs.

Immediate Effects of Self-Thai Foot Massage on Skin Blood Flow, Skin Temperature, and Range of Motion of the Foot and Ankle in Type 2 Diabetic Patients

Objectives: The purpose of this study was to investigate the immediate effects of self-Thai foot massages (STFMs) on the foot skin blood flow, the foot skin temperature, and range of motion (ROM) of the foot and ankle in type 2 diabetic patients with peripheral neuropathy. Design: A randomized crossover study. Subjects: Twenty five diabetic patients with peripheral neuropathy were recruited. Interventions: Participants were randomly assigned to either STFM or Thai foot massage (TFM) performed by a massage therapist; then, they were switched to the other group after a 1-week washout period. In both groups, the foot massage was performed in a seated position on the dominant lower leg and foot for 25 min. Outcome measures: Before and immediately after treatment, foot skin blood flow, foot skin temperature, and ROM of the foot and ankle were evaluated. Heart rate was measured throughout the treatment. Results: After a single treatment of the massage, foot skin blood flow and ROM of the foot and ankle significantly improved in both groups (p < 0.05). Foot skin temperature did not change in STFM, whereas it significantly increased in TFM. Heart rate significantly increased in STFM, whereas it tended to decrease in TFM. Conclusions: Both STFM and TFM by a massage therapist could improve foot skin blood flow and ROM of the foot and ankle in diabetic patients with peripheral neuropathy. An STFM could be a promising alternative treatment that patients can perform at home.

Possible Role of Court-Type Thai Traditional Massage During Parturition: a Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Court-type Thai traditional Massage (c-TTM) applied during intrapartum may have some benefit other than pain relief. This study aimed to evaluate the effect of c-TTM during the first and second stage of labor, as well as pain alleviation in the first stage.

METHODS

This was a randomized controlled trial study. Eligible participants were singleton pregnant mothers with cervical dilation between 3-5 cm and no medical complications. Both trial groups received the same routine antepartum care except for 1 hour additional c-TTM given to the experimental group when they were in the active phase of labor. The pain score was taken from the participants at the time before labor pains started, at the time of active labor, 1, 2, 3, and 4 hours after the intervention. Pain was recorded by the researcher using a visual analog scale. The primary outcome during the first and second stages of labor was compared between groups. Pain relief during the first stage of labor and analgesic drugs used were compared as a secondary outcome. This trial is registered under the identification number TCTR20171115003.

RESULTS

Fifty-nine participants were enrolled and randomly assigned with 1:1 allocation to groups. The duration of first and second stage labor was significantly shorter in the experimental c-TTM than in the conventional control group (mean ± SD: 198.37 ± 62.80 minutes: 268.52 ± 137.81 minutes, p value =.02 and 17.54 ± 9.49 minutes: 23.35 ± 15.01 minutes, p value =.03, respectively). There was no difference of pain score between the groups.

CONCLUSION

One hour of c-TTM can significantly decrease the duration of the first and second stages of labor. The pain score recorded is not statistically different between the groups.

The Effectiveness of Thai Massage and Joint Mobilization

BACKGROUND

Non-specific low back pain (LBP) is a common health problem resulting from many risk factors and human behaviors. Some of these may interact synergistically and have been implicated in the cause of low back pain. Massage both traditional Thai massage and joint mobilization as a common practice has been shown to be effective for some subgroup of nonspecific LBP patients.

PURPOSE AND SETTING

The trial compared the effectiveness between traditional Thai massage and joint mobilization for treating nonspecific LBP. Some associated factors were included. The study was conducted at the orthopedic outpatient department, Lerdsin General Hospital, Bangkok, Thailand.

METHODS

Prospective, randomized study was developed without control group. The required sample size was estimated based on previous comparative studies for effectiveness between techniques. Two primary outcome measures were a 0 to 10 visual analog scale (VAS) of pain and Oswestry Disability Index (ODI). Secondary outcome measures were satisfaction of patients and adverse effects of the treatment. The "intention to treat" (ITT) and per protocol approach were used to compare the significance of the difference between treatment groups.

PARTICIPANTS

One hundred and twenty hospital outpatients, 20 (16.7%) male and 100 (83.3%) female, were randomized into traditional Thai massage and joint mobilization therapy. The average age of traditional Thai massage and joint mobilization was 50.7 years and 48.3 years, respectively. Both groups received each treatment for approximately 30 minutes twice per week over a four-week period. Total course did not exceed eight sessions.

RESULT

With ITT, the mean VAS of traditional Thai massage group before treatment was 5.3 (SD = 1.7) and ODI was 24.9 (SD = 14.7), while in joint mobilization groups, the mean VAS was 5.0 (SD = 1.6) and ODI was 24.6 (SD = 15). After treatment, the mean VAS and ODI were significantly reduced (VAS = 0.51 (SD = 0.89) and ODI = 8.1 (SD = 10.7) for traditional Thai massage, VAS = 0.86 (SD = 1.49) and ODI = 8.26 (SD = 12.97) for joint mobilization). Constipation was found in 34 patients (28.3%).

CONCLUSION

The traditional Thai massage and joint mobilization used in this study were equally effective for short-term reduction of pain and disability in patients with chronic nonspecific LBP. Both techniques were safe with short term effect in a chosen group of patients.

Effects of Thai massage on physical fitness in soccer players

[Purpose] The aim of this study was to determine the effects of Thai massage on physical fitness in soccer players. [Subjects and Methods] Thirty-four soccer players were randomly assigned to receive either rest (the control group) or three 30-minute sessions of Thai massage over a period of 10 days. Seven physical fitness tests consisting of sit and reach, hand grip strength, 40 yards technical agility, 50-meter sprint, sit-ups, push-ups, and VO_{2, max} were measured before and after Thai massage or rest. [Results] All the physical fitness tests were significantly improved after a single session of Thai massage, whereas only the sit and reach, and the sit-ups tests were improved in the control group. [Conclusion] Thai massage could provide an improvement in physical performance in soccer players.

Thai traditional massage: efficiency-assessment of three traditional massage methods on office workers: an explorative study

Thai Traditional Massage (TTM) is popular and widely spread in Thailand. This project is aimed at studying the physiological efficiency of three popular TTM methods based on acupressure Meridian basal lines: the Sen Sib(SS) ten lines, Ratchsamnak (RS), Royal style; and Chaloeysak (CS), Folk style. Thirty healthy female administrative employees participated as patients. All were treated for 30 min with the 3 types of massage with a two-week interval between each treatment. Muscle strain was objectified by measuring strength and endurance with surface electromyography of muscle put under stress during office work: the M. Trapezius (static postural load) and the wrist muscles (M. flexors & extensors Carpi-Radialis) (dynamic contractions) as well as measuring the subjective Visual Analogue Scale (VAS) before and after the sessions. An ANOVA-statistical analysis showed that strength in shoulders was not significantly different, but some forearm fatigue was decreased significantly among the three massage techniques.