a well-trained, certified massage therapist. Massage points
included in this method are located along four lines on each
side of the body (Fig. 1). The pressing technique employed
in TTM uses the body weight of the massage therapist to
apply gentle, gradually increasing, pressure through the
therapist’s thumb, fingers, or palm. Pressure is applied until
the patient starts to feel slight discomfort after which this
pressure is maintained for 5e10 s at a time. This sequence
can be repeated several times for each massage point
(Chatchawan et al., 2005). The final step of TTM applied in
this study included three specific stretching techniques for
the patients with SCS. These techniques were performed
according to the techniques of Eungpinichpong (2008) (Figs.
2 and 3).
Physical therapy modalities (comparison group)
The PT group received a 30-min session of a hot pack and
ultrasound therapy for 9 sessions over a period of 3 weeks in
the same environment as the TTM group. The physical
therapy modalities included continuous ultrasound treatment
(Sonostat 833; CAmed Medical Systems GmbH,
Elbeallee 17, D-50765 Koln, Germany) with 1 MHz frequency
and 1 W/cm2 intensity around the scapular region for
10 min. In addition, the patients were treated with a hot
pack (60 C) for 20 min. The same pre- and post-treatment
assessments were conducted on both groups. At the end of
the study (after the 2 week follow-up), all participants in
both groups were given the opportunity for instruction in
a series of scapular exercises to practice at home.
Outcome measures
The outcome measures in this study were measured by
a research assistant who has documented clinical practice
as a licensed physical therapist. The reliability of outcome
measures (such as pain intensity, PPT, feeling of muscle
tension and state anxiety inventory) was tested on 10
patients with SCS prior to data collection. All outcome
Figure 1
a well-trained, certified massage therapist. Massage points
included in this method are located along four lines on each
side of the body (Fig. 1). The pressing technique employed
in TTM uses the body weight of the massage therapist to
apply gentle, gradually increasing, pressure through the
therapist’s thumb, fingers, or palm. Pressure is applied until
the patient starts to feel slight discomfort after which this
pressure is maintained for 5e10 s at a time. This sequence
can be repeated several times for each massage point
(Chatchawan et al., 2005). The final step of TTM applied in
this study included three specific stretching techniques for
the patients with SCS. These techniques were performed
according to the techniques of Eungpinichpong (2008) (Figs.
2 and 3).
Physical therapy modalities (comparison group)
The PT group received a 30-min session of a hot pack and
ultrasound therapy for 9 sessions over a period of 3 weeks in
the same environment as the TTM group. The physical
therapy modalities included continuous ultrasound treatment
(Sonostat 833; CAmed Medical Systems GmbH,
Elbeallee 17, D-50765 Koln, Germany) with 1 MHz frequency
and 1 W/cm2 intensity around the scapular region for
10 min. In addition, the patients were treated with a hot
pack (60 C) for 20 min. The same pre- and post-treatment
assessments were conducted on both groups. At the end of
the study (after the 2 week follow-up), all participants in
both groups were given the opportunity for instruction in
a series of scapular exercises to practice at home.
Outcome measures
The outcome measures in this study were measured by
a research assistant who has documented clinical practice
as a licensed physical therapist. The reliability of outcome
measures (such as pain intensity, PPT, feeling of muscle
tension and state anxiety inventory) was tested on 10
patients with SCS prior to data collection. All outcome
Figure 1
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