Kalevala traditional manual therapy as an independent therapy and integrated into health coaching compared with physiotherapy‑based care in the management of chronic low back pain: a randomized controlled trial
Chronic low back pain
This study is a randomized, controlled, three‑arm intervention trial with an 8‑week treatment period and a 6‑month follow‑up. Participants are randomized into three groups (n = 35 per group). Randomization will be performed using a computer-assisted block method to ensure balance (age, sex) after the first study visit. 1. Physiotherapy (FT) The physiotherapy program consists of three supervised physiotherapy sessions delivered during study weeks 1 (45–60 minutes), 3 (30 minutes), and 6 (30 minutes). During the remaining weeks, participants continue the exercises at home according to the physiotherapist’s instructions. The program includes therapeutic exercises such as mobility, motor‑control, core‑stabilization, and strength‑training exercises, which are individually selected to support lumbar spine function. In addition, the home‑exercise program includes aerobic activity, such as walking, which is progressively increased over the course of the program. The physiotherapy intervention is progressive, meaning that the volume and difficulty of the exercises are gradually increased while taking into account functional capacity and safety. 2. Kalevala Traditional Manual Therapy (KTMT) Participants receive three KTMT treatment sessions over the 8‑week period. The manual therapy applied in the study is a gentle, non‑invasive soft‑tissue approach designed to support the body’s natural mobility and balance. The treatment proceeds from the lower body toward the upper body in the following sequence: feet and ankles, lower legs, knees, thighs and hips, sacral and back region, upper limbs, and the head and cervical spine. The techniques consist of soft, slow, tissue‑responsive manual strokes intended to facilitate normal tissue movement, fluid circulation, and functional balance. The treatment does not include manipulations or high‑force techniques. Each session lasts approximately 90 minutes. 3. Kalevala Traditional Manual Therapy + Health Coaching (KTMT+HC) Participants re
1. Aged over 18 years 2. Chronic low back pain (>12 weeks) 3. Start Back Screening Tool score >3 4. Ability to participate in the treatment and follow‑up period
1. Pregnancy 2. Cardiac pacemaker or metallic prosthesis 3. Rheumatic diseases 4. Severe structural deformity 5. Previous spinal surgery 6. Acute disc herniation or severe sciatica