Effect of Connective Tissue Massage in Low Back Pain

Roland-Morris Disability Questionnaire: The Roland-Morris Disability Questionnaire (RMDQ) is one of the most widely used tools developed to assess the functional status of patients with low back pain. This questionnaire is a self-administered scale used to measure disability in individuals with low back pain, and it is based on selected statements from the Sickness Impact Profile.

Hamstring flexibility: The participant will be asked to raise one leg upwards without bending the knee while lying on their back. At the final point, the distance between the lateral malleolus and the bed will be measured.

Finger-to-Floor Distance (FFD) Test: The finger-to-ground lateral flexion test will be administered to assess the participant's range of motion and flexibility in spinal lateral flexion. The participant will be asked to stand with their hands flat at their sides, their heels, gluteal region, and shoulders resting against a wall. They will then be asked to bend to the side as far as possible without creating flexion or rotation movements in their torso. The distance between the distal tip of the third finger and the ground will be measured with a tape measure and recorded in centimeters.

Lumbar lateral flexion assessment: The participant will be asked to lean to the right and left while standing, without creating flexion or rotation in the torso. The distance between the tip of the middle finger and the ground will be measured.

Core muscle static endurance will be assessed using the McGill Static Endurance Test Battery. This test will be evaluated using trunk flexion, extension, and right and left lateral bridge tests. A stopwatch will be used for measurements. Results will be recorded in seconds. The test ends when the position is compromised or the participant states they cannot continue.

Trunk Flexion Test Trunk Extension Test Lateral Bridge Test

Single-Leg Balance Test (Static Assessment): The participant is instructed to stand on one leg with their arms crossed over their chest, lifting one leg with the knee flexed at approximately a 45° angle, closing their eyes, and maintaining their balance in this position without opening their eyes. Once the correct position is achieved, a stopwatch is started, and the test is performed for a maximum of 30 seconds. If the participant uses their leg or arm for support, or opens their eyes, the stopwatch is stopped, and the time is recorded in seconds.

Functional Reach Test (Dynamic Assessment): Participants are asked to stand sideways next to a wall. Then, without touching the wall, they are instructed to raise their arm to a 90-degree shoulder flexion angle with the elbow extended and the fist closed. To determine the starting point of the test, the point where the distal end of the third metacarpal bone meets the wall is marked. The subject is then asked to reach as far as they can without lifting their heels from the ground. The new point reached by the third metacarpal bone is then marked.

The Modified Schober Test will be administered to assess participants' lumbar spine flexibility. The test is administered by standing the patient with their feet 30 centimeters apart. The midpoint of the posterior superior iliac spine, corresponding to the S2 vertebra, is located. Marks are made 10 centimeters upwards and 5 centimeters downwards from this point. The participant is asked to bend forward as far as possible, keeping their arms at their sides and their knees straight. After reaching the maximum bending position, the distances between the previously marked points are measured. The resulting value is then subtracted from the previous distance of 15 centimeters between the two marked points, and the resulting value is recorded.

Pittsburgh Sleep Quality Index: The PUKI (Personal Sleep Quality Assessment) is a 19-item self-report scale that assesses sleep disturbance and quality over the past month. It consists of 24 questions in total. 19 of these are self-report questions answered by the patient themselves. The remaining 5 questions are answered by the patient's spouse or roommate and are used for clinical information only; they are not included in the scoring. The self-report questions cover various factors related to sleep quality. The total score ranges from 0 to 21. A total score above 5 indicates that the individual is experiencing significant sleep disturbance or mild to moderate disturbance in multiple areas.

Fatigue Severity Scale: The minimum score is 9 and the maximum is 63. A total score of 36 or higher indicates severe fatigue.

Nottingham Health Profile: The NHP assesses perceived social, emotional, and physical health issues. It consists of six sections: physical activity (eight items), pain (eight items), energy level (three items), emotional reactions (nine items), sleep (five items), and social isolation (five items). The scale contains a total of 38 questions. Each question is answered with a yes or no response. Each section is scored from 0 to 100, with 0 representing the best health status and 100 representing the worst.

Visual Analog Scale: A numerical pain scale will be used to assess pain during activity, rest, and night. This scale is an 11-point scale scored from 0 to 10: "0" = no pain, "10" = the most severe pain imaginable. Participants verbally choose the value that best reflects the severity of pain they experienced in the past 24 hours.