非特異的慢性腰痛：リラクセーション・メッセージが有効

A Comparison of the Effects of 2 Types of Massage and Usual Care on Chronic Low Back Pain
A Randomized, Controlled Trial
Ann. Int. Med. July 5, 2011 vol. 155 no. 1 1-9

401名の（20－65歳）の非特異的腰痛に対し、構造化メッセージ(n=132)、リラクセーション・メッセージ(n=136)、通常ケア(n=133)割り付け

症状スコア：oland Disability Questionnaire (RDQ) 、symptom bothersomeness score比較

10週目の機能アウトカムは同等。

26週めで比較
補正平均RDQスコア（事前設定：2ポイント以上を意義ありとする）；通常ケア比較で　
・リラクセーション・メッセージ　2.9点(95%CI, 1.8-4.0点）低下
・構造化メッセージ　2.5点(95%CI, 1.4-3.5点）低下

平均症状（事前設定：1.5点を意義有るとする）
・リラクセーション・メッセージ　1.7点(95%CI, 1.2-2.2点)
・構造化メッセージ　1.4点（95%CI, 0.8-1.9点）　

機能上のリラクセーションメッセージの有益性が52週でも認められた。

---

Relaxation massage

which is intended to induce a generalized sense of relaxation, comprised effleurage, petrissage, circular friction, vibration, rocking and jostling, and holding.
Therapists were given time limits for each body region, including 7 to 20 minutes on the back and buttocks (6). Therapists could provide a compact disk of a 2.5-minute relaxation exercise to be done at home to enhance and prolong treatment benefits.

Structural massage

which is intended to identify andalleviate musculoskeletal contributors to back pain, comprisedmyofascial, neuromuscular, and other soft-tissuetechniques (6). Myofascial techniques are intended to engage and release identified restrictions in myofascial tissues. Neuromuscular techniques are used to resolve soft-tissue abnormalities by mobilizing restricted joints, lengthening constricted muscles and fascia, balancing agonist and antagonist muscles, and reducing hypertonicity. The areas of the body that were treated varied across patients and treatment sessions. Therapists could recommend a home exercise consisting of psoas stretch to enhance and prolong any benefits of structural massage.

---

日本語化して、電子メールなど使って、構造的に指導行えばよいと思う。