Purpose and Overview
Overview
This protocol provides standardized clinical guidance for Zeel massage therapists participating in the Department of Defense–funded study evaluating Zeel’s Medical Massage Therapy (MMT) plus the standard of care (SOC), as compared to the current standard of care alone, for sub-acute low back pain in active military personnel.
Objective
Demonstrate the efficacy of medical massage as an adjunct to standard care (SOC) in improving pain, mobility, function, and mood and readiness.
Duration and Structure
Randomized Controlled Trial (RCT)
100 control (SOC only) and 100 treatment (SOC + MMT)
12 MMT sessions per participant, ideally 1×/week (minimum 5 days apart; all 12 sessions must be completed within ≤15 weeks)
Partners
Funded by the Department of War (DoW, formerly Department of Defense [DoD], and will be referred to as such) and conducted in collaboration with Geneva Health.
Location
All treatments will be performed in the patient’s home, which can be either on or off base.
For all on-base treatments, you are required to have car insurance and either a passport or Real ID.
Measurement Tools
All outcome data are collected by Geneva Health (prior to each visit) using clinically validated instruments.
Measurement | Description | Frequency |
|---|---|---|
Global Pain Scale (GPS) | 20-item comprehensive pain and function questionnaire | Visit 1, midpoint, final |
Defense & Veterans Pain Rating Scale (DVPRS) | 5-question pain intensity/interference scale | Each session |
Definition of Medical Massage Therapy (MMT)
MMT in this study consists of three integrated components that will be delivered on every session based on Zeel’s protocol.
A) Soft Tissue Work (Massage)
Techniques limited to Swedish and Deep Tissue massage only.
Target spinal stabilizers (multifidi, erector spinae, quadratus lumborum), hip musculature, and compensatory regions.
Maintain patient comfort and clear communication throughout. Effective communication is the key to safe and effective treatment.
B) Patient Education
Explain injury mechanisms and recovery principles.
Protocol: Teach posture, body mechanics, hydration, self-care, and breathing techniques, mobility, and core strength.
Reinforce that massage is one part of a holistic recovery program, along with guided movement and education—medical massage therapy.
C) Remedial / Active Exercises (Based on Pain Score)
Introduce graded movement and mobility exercises.
Select based on pain score and functional tolerance.
Follow Zeel’s exercise progression chart (pain-scale based).