Browsing by Author "Elder, William"

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    Massage Effectiveness for Primary Care Patients with Chronic Low Back Pain and Below Normal SF-36v2 Mental Health Scores: Secondary Analysis
    (2014-05) Munk, Niki; Elder, William; Love, Margaret
    Purpose: The challenging condition of chronic low back pain (CLBP) is often complicated by negative mental health factors. Non-pharmacological approaches to address CLBP alone and in combination with mental health issues are needed. A recently completed NIH funded study examined the effectiveness of clinical massage therapy (CMT) on functional health outcomes for CLBP patients referred to CMT by their PCP regardless of mental health status save psychosis. CMT was found to have significant and clinically meaningful effectiveness for patients (N=85) in the primary outcomes: Oswestry Disability Index, SF-36v2 mental and physical components and pain domain (in review). The purpose this study's secondary analysis is to determine the extent to which participants that began the study below normal in the SF-36v2 mental health component had clinically meaningful change. Methods: CLBP patients referred by their PCP were assigned to community massage practitioners (CMPs) to receive up to ten, 1-hour CMT sessions over 12-weeks. Individual treatment plans were formulated by study CMPs. Secondary data analyses were conducted examining a subpopulation (n=41) of those beginning the study at below normal (<45) for the SF-36v2 mental health component score. Results: Mean change for those
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    A Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) Examination of a Recent Study of Massage and Relaxation Therapy Effectiveness
    (2014-05) Elder, William; Munk, Niki
    Purpose: This presentation will discuss the pragmatic methodological approach of a recently completed NIH sponsored study of clinical massage therapy (CMT) and progressive muscle relaxation (PMR). While CMT and PMR have demonstrated efficacy for chronic low back pain (CLBP), their effectiveness in the real world of health care practice is only now being evaluated. Pragmatic studies have been recommended by NIH and the Institute of Medicine to address effectiveness questions. Methods: Critical discussion among 2 key study team members and 2 outside reviewers analyzed the study protocol for accordance with pragmatic vs. explanatory characteristics developed in the PRECIS tool by Thorpe et al. (2009). Scores for each of 10 domains were used to create an overall visual representation of the extent to which this study reflects a pragmatic research approach. Results: The visual wagon wheel reflecting the current study's “standing” on the Thorpe model will be presented. The study most strongly reflected a pragmatic approach in the following domains: Eligibility Criteria, Flexibility of Experimental Intervention, Practitioner Expertise, Outcomes, and Participant Compliance. Areas that the current study neutrally reflected a pragmatic approach or reflects more of an explanatory approach included Follow-up Intensity, Analysis of the Primary Outcome, and Practitioner Adherence. Conclusion: To our knowledge, this is the first CAM related research trail that has retrospectively critiqued its study design utilizing the PRECIS tool. CAM investigators may utilize this self-critique and the PRECIS tool to develop study designs and prospectively critique the extent to which pragmatic approaches apply. Audience participants will gain understanding of methodologies and techniques of pragmatic studies.