06 June 2023: Articles
Unlocking Pain Relief for Chronic Low Back Pain: The Potential of the 4xT Method – A Dual Case Study Analysis
Unusual setting of medical care
Robbert N. van Amstel A* , Karl Noten DDOI: 10.12659/AJCR.939284
Am J Case Rep 2023; 24:e939284
Table 1. Within-treatment results.
| Assessment | Baseline | Locations | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| L3 | S2 | T12 | T9 | T4 | LD (R) | LD (L) | IL (R) | IL (L) | LS | |||
| PNRS (standing) | 4 | 3 | 1 | 0 | x | 0 | 0 | 0 | – | – | – | |
| PNRS (flexion) | 8 | 5 | 3 | 1 | x | 1 | 0 | 0 | – | – | – | |
| PNRS (extension) | 6 | 6 | 5 | 3 | x | 3 | 2 | 0 | – | – | – | |
| FROM | 57 | 72 | 86 | 92 | x | 96 | 101 | 104 | – | – | – | |
| EROM | 5 | 9 | 14 | 18 | x | 18 | 20 | 21 | – | – | – | |
| FFD | 34 | 28.5 | 16 | 8 | x | 7.5 | 2 | 0 | – | – | – | |
| PNRS (standing) | 3 | 2 | 1 | 0 | 0 | x | x | 0 | 0 | x | 0 | |
| PNRS (flexion) | 6 | 5 | 3 | 2 | 2 | x | x | 2 | 2 | x | 2 | |
| PNRS (extension) | 7 | 6 | 4 | 4 | 3 | x | x | 3 | 1 | x | 1 | |
| FROM | 58 | 68 | 86 | 91 | 93 | x | x | 97 | 99 | x | 101 | |
| EROM | 16 | 17 | 21 | 23 | 23 | x | x | 23 | 24 | x | 25 | |
| FFD | 23.5 | 18 | 14.5 | 8 | 8 | x | x | 5.5 | 6 | x | 4 | |
| This table represents the results evaluated after each step (test, trigger, and tape) per location. Moreover, the end results and post-training results are reported (measured after initial treatment). The relative change is calculated by . The baseline values were obtained during the first treatment session in week 0. The evaluation was performed 1 week after the last session without any intervention or with tape in situ, in week 7. • Pain NRS (0–10 scale): MCID 10% to 20% is minimally important; MCID 30% decrease is moderately important; MCID 50% ≤ decrease is substantially important. • Trunk mobility: FROM MDC of 7° ≤; EROM MDC of 6° ≤; FFD an MDC of 9.8 cm. MCID – minimum clinically important difference; MDC – minimal detectable change; L – lumbar; S – sacrum; T – thoracic spine; LD – latissimus dorsi; IL – Ilium; LS – lumbar spine; R – right; L – left; PNRS – pain numeric rating scale; ROM – range of motion; F – flexion; E – extension; FFD – finger-floor distance; x – no fascia tissue manipulation indicated at this location; ‘–‘ – individual was pain free, no further interventions required. | ||||||||||||
| Assessment | End result | After train | Week 7 | Relative change | ||||||||
| (B-W7) | ||||||||||||
| Case 1 | PNRS (standing) | 0 | 0 | 0 | 100% | |||||||
| PNRS (flexion) | 0 | 0 | 0 | 100% | ||||||||
| PNRS (extension) | 0 | 0 | 0 | 100% | ||||||||
| FROM | 104 | 107 | 101 | 77% | ||||||||
| EROM | 21 | 24 | 23 | 360% | ||||||||
| FFD | 0 | 0 | 0 | 100% | ||||||||
| Case 2 | PNRS (standing) | 0 | 0 | 0 | 100% | |||||||
| PNRS (flexion) | 2 | 0 | 0 | 100% | ||||||||
| PNRS (extension) | 1 | 0 | 0 | 100% | ||||||||
| FROM | 101 | 103 | 105 | 81% | ||||||||
| EROM | 25 | 28 | 27 | 69% | ||||||||
| FFD | 4 | 2 | 3 | 87% | ||||||||
| This table represents the results evaluated after each step (test, trigger, and tape) per location. Moreover, the end results and post-training results are reported (measured after initial treatment). The relative change is calculated by . The baseline values were obtained during the first treatment session in week 0. The evaluation was performed 1 week after the last session without any intervention or with tape in situ, in week 7. • Pain NRS (0–10 scale): MCID 10% to 20% is minimally important; MCID 30% decrease is moderately important; MCID 50% ≤ decrease is substantially important. • Trunk mobility: FROM MDC of 7° ≤; EROM MDC of 6° ≤; FFD an MDC of 9.8 cm. MCID – minimum clinically important difference; MDC – minimal detectable change; L – lumbar; S – sacrum; T – thoracic spine; LD – latissimus dorsi; IL – Ilium; LS – lumbar spine; R – right; L – left; PNRS – pain numeric rating scale; ROM – range of motion; F – flexion; E – extension; FFD – finger-floor distance; x – no fascia tissue manipulation indicated at this location; ‘–‘ – individual was pain free, no further interventions required. | ||||||||||||