Abstract
Background and Objectives: Gravity Relief Mobilisation is a novel manual therapy treatment for persistent musculoskeletal pain. It involves the facilitation of a non-volitional movement response. In the massage practice of the researcher, GRM appeared to have short–term benefit for musculoskeletal pain after transient increases of pain but its lasting effects were unknown.
Aim: To evaluate if GRM is an effective component of a massage therapy intervention for chronic low back pain (CLBP).
Method: Five individuals with CLBP were recruited into a concurrent series of Single Case Experiments (SCEs). Participants were randomized to a baseline (control) phase of 3-7 weeks then crossed into a 13–14 week intervention phase with 10–13 treatments. Ecological Momentary Assessments (EMA) were completed by the participants using an on line tool called the PainQuILT identifying low back pain (LBP) locations, pain intensity of LBP locations, and pain interference. EMAs were completed at a similar time of day up to three times per week. The 12 week follow up phase involved each participant completing three EMAs during weeks 4, 8, and 12.
Results: Four participants completed the intervention and follow-up phases. One participant withdrew during the intervention due to transient pain increases. EMA compliance rates were high and sufficient data were collected for the final analysis. Participant-1 did not improve. Participant-2 and -5 had reduced LBP intensity and pain interference, with large effect sizes (phi values of >1). Participant-4 experienced small to moderate reduction in LBP intensity and pain interference (phi values of 0.24 (0.16 to 0.58), p=0.2; and 0.7 (0.36 to 0.93), p<0.001).
Conclusions: GRM shows potential as an effective component of a massage therapy intervention for CLBP, with favourable effect on mean pain intensity of LBP locations, and pain interference, but may not be tolerated by all individuals. SCE design with data capture via online tools is a practical approach for evaluation of complex therapeutic interventions.