{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:51:46Z","timestamp":1791532306775,"version":"4.3.4"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Massage Therapy Research Fund","award":["MTRF 2019-2020"],"award-info":[{"award-number":["MTRF 2019-2020"]}]},{"DOI":"10.13039\/100008240","name":"Fonds de Recherche du Qu\u00e9bec-Soci\u00e9t\u00e9 et Culture","doi-asserted-by":"publisher","award":["Audace program#284121"],"award-info":[{"award-number":["Audace program#284121"]}],"id":[{"id":"10.13039\/100008240","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec \u2013 Sant\u00e9","doi-asserted-by":"publisher","award":["#266408"],"award-info":[{"award-number":["#266408"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003151","name":"Fonds de recherche du Qu\u00e9bec \u2013 Nature et technologies","doi-asserted-by":"publisher","award":["#316861"],"award-info":[{"award-number":["#316861"]}],"id":[{"id":"10.13039\/501100003151","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Insights Imaging"],"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n To compare thoracolumbar fascia (TLF) shear strain between individuals with and without nonspecific low back pain (NSLBP), investigate its correlation with symptoms, and assess a standardized massage technique\u2019s impact on TLF shear strain.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Participants were prospectively enrolled between February 2021 and June 2022. Pre- and post-intervention TLF ultrasound and pain\/disability questionnaires were conducted. Cumulated (C|ShS|\n L<\/jats:sub>\n ) and maximum (Max|ShS|\n L<\/jats:sub>\n ) shear strain parameters were computed from radiofrequency data, and TLF thickness was measured on reconstructed B-mode images. Statistical analysis included linear mixed-effects regression.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Thirty-two NSLBP participants (mean age, 57\u2009\u00b1\u20099 years [standard deviation]; 21 women) and 32 controls (51\u2009\u00b1\u200910 years; 22 women) (\n p<\/jats:italic>\n \u2009=\u20090.02) were enrolled. The mean shear strain was higher in NSLBP participants (C|ShS|\n L<\/jats:sub>\n : 327.1%\u2009\u00b1\u2009106.0 vs 290.2%\u2009\u00b1\u200999.8,\n p<\/jats:italic>\n \u2009<\u20090.0001; Max|ShS|\n L<\/jats:sub>\n : 8.1%\u2009\u00b1\u20092.8 vs 7.0%\u2009\u00b1\u20092.4,\n p<\/jats:italic>\n \u2009<\u20090.0001) than controls, while mean TLF thickness (1.6\u2009mm\u2009\u00b1\u20091.0 vs 1.5\u2009mm\u2009\u00b1\u20090.9;\n p<\/jats:italic>\n \u2009=\u20090.43) was comparable. Elastography parameters correlated with pain [C|ShS|\n L<\/jats:sub>\n estimate [\u03b2], 0.01 [95% CI: 0.002, 0.02];\n p<\/jats:italic>\n \u2009=\u20090.02); Max|ShS|\n L<\/jats:sub>\n [\u03b2]\n ,<\/jats:sub>\n 0.003 [95% CI: 0.001, 0.005];\n p<\/jats:italic>\n \u2009<\u20090.001)] and disability [C|ShS|\n L<\/jats:sub>\n [\u03b2] 0.02 [95% CI: 0.005, 0.03];\n p<\/jats:italic>\n \u2009=\u20090.009); Max|ShS|\n L<\/jats:sub>\n [\u03b2] 0.003 [95% CI: 0.001, 0.006];\n p<\/jats:italic>\n \u2009=\u20090.002)] scores. Neither C|ShS|\n L<\/jats:sub>\n (\u03b2, 0.13 [\u22120.27, 0.53];\n p<\/jats:italic>\n \u2009=\u20090.53) nor Max|ShS|\n L<\/jats:sub>\n (\u03b2, \u22120.02 [\u22120.10, 0.05];\n p<\/jats:italic>\n \u2009=\u20090.59) changed post-intervention.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Individuals with NSLBP demonstrated elevated TLF shear strain compared to controls, with similar TLF thickness. The shear strain correlated with pain and disability scores, yet a brief massage did not influence shear strain.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n Clinicaltrials.gov, NCT04716101. Registered 14 January 2021,\n https:\/\/clinicaltrials.gov\/study\/NCT04716101<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Critical relevance statement<\/jats:title>\n Ultrasound shows elevated TLF shear strain in lower back pain sufferers compared to controls. This correlates with symptoms, suggesting a role as a pain generator. Further investigation into its anatomy, mechanical characteristics, and pathophysiology is crucial for better understanding.<\/jats:p>\n <\/jats:sec>\n \n Key Points<\/jats:title>\n \n \n \n Structural and mechanical alterations of the TLF may contribute to low back pain.<\/jats:p>\n <\/jats:list-item>\n \n Elevated TLF lateral shear strain was found in patients with NSLBP.<\/jats:p>\n <\/jats:list-item>\n \n A brief standardized massage therapy technique did not influence elastography parameters.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Graphical Abstract<\/jats:title>\n <\/jats:sec>","DOI":"10.1186\/s13244-024-01895-2","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T09:25:15Z","timestamp":1736933115000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Thoracolumbar fascia ultrasound shear strain differs between low back pain and asymptomatic individuals: expanding the evidence"],"prefix":"10.1186","volume":"16","author":[{"given":"Norio","family":"Tomita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-H\u00e9l\u00e8ne","family":"Roy-Cardinal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Chayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Daher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameer","family":"Attiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Boulanger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaly","family":"Gaudreault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Cloutier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-9280","authenticated-orcid":false,"given":"Nathalie J.","family":"Bureau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"1895_CR1","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1136\/annrheumdis-2013-204428","volume":"73","author":"D Hoy","year":"2014","unstructured":"Hoy D, March L, Brooks P et al (2014) The global burden of low back pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73:968\u2013974","journal-title":"Ann Rheum Dis"},{"key":"1895_CR2","doi-asserted-by":"publisher","first-page":"2875","DOI":"10.1007\/s00586-018-5742-6","volume":"27","author":"G Olafsson","year":"2018","unstructured":"Olafsson G, Jonsson E, Fritzell P, Hagg O, Borgstrom F (2018) Cost of low back pain: results from a national register study in Sweden. Eur Spine J 27:2875\u20132881","journal-title":"Eur Spine J"},{"key":"1895_CR3","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/S0140-6736(11)60610-7","volume":"379","author":"F Balague","year":"2012","unstructured":"Balague F, Mannion AF, Pellise F, Cedraschi C (2012) Non-specific low back pain. Lancet 379:482\u2013491","journal-title":"Lancet"},{"key":"1895_CR4","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","volume":"389","author":"C Maher","year":"2017","unstructured":"Maher C, Underwood M, Buchbinder R (2017) Non-specific low back pain. Lancet 389:736\u2013747","journal-title":"Lancet"},{"key":"1895_CR5","doi-asserted-by":"publisher","first-page":"350","DOI":"10.2519\/jospt.2020.9971","volume":"50","author":"LM Finucane","year":"2020","unstructured":"Finucane LM, Downie A, Mercer C et al (2020) International framework for red flags for potential serious spinal pathologies. J Orthop Sports Phys Ther 50:350\u2013372","journal-title":"J Orthop Sports Phys Ther"},{"key":"1895_CR6","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1111\/j.1469-7580.2012.01511.x","volume":"221","author":"FH Willard","year":"2012","unstructured":"Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R (2012) The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat 221:507\u2013536","journal-title":"J Anat"},{"key":"1895_CR7","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1007\/s00276-011-0876-9","volume":"33","author":"C Stecco","year":"2011","unstructured":"Stecco C, Stern R, Porzionato A et al (2011) Hyaluronan within fascia in the etiology of myofascial pain. Surg Radiol Anat 33:891\u2013896","journal-title":"Surg Radiol Anat"},{"key":"1895_CR8","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/j.pain.2013.09.025","volume":"155","author":"A Schilder","year":"2014","unstructured":"Schilder A, Hoheisel U, Magerl W, Benrath J, Klein T, Treede RD (2014) Sensory findings after stimulation of the thoracolumbar fascia with hypertonic saline suggest its contribution to low back pain. Pain 155:222\u2013231","journal-title":"Pain"},{"key":"1895_CR9","doi-asserted-by":"publisher","first-page":"4342","DOI":"10.3390\/jcm10194342","volume":"10","author":"L Sinhorim","year":"2021","unstructured":"Sinhorim L, Amorim MDS, Ortiz ME et al (2021) Potential nociceptive role of the thoracolumbar fascia: a scope review involving in vivo and ex vivo studies. J Clin Med 10:4342","journal-title":"J Clin Med"},{"key":"1895_CR10","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.1007\/s11548-015-1167-4","volume":"10","author":"S Condino","year":"2015","unstructured":"Condino S, Turini G, Parrini S et al (2015) A semiautomatic method for in vivo three-dimensional quantitative analysis of fascial layers mobility based on 3D ultrasound scans. Int J Comput Assist Radiol Surg 10:1721\u20131735","journal-title":"Int J Comput Assist Radiol Surg"},{"key":"1895_CR11","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1016\/j.jbmt.2016.04.007","volume":"20","author":"SJ Tu","year":"2016","unstructured":"Tu SJ, Woledge RC, Morrissey D (2016) Does \u2018Kinesio tape\u2019 alter thoracolumbar fascia movement during lumbar flexion? An observational laboratory study. J Bodyw Mov Ther 20:898\u2013905","journal-title":"J Bodyw Mov Ther"},{"key":"1895_CR12","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.clinbiomech.2016.02.011","volume":"33","author":"S Engell","year":"2016","unstructured":"Engell S, Triano JJ, Fox JR, Langevin HM, Konofagou EE (2016) Differential displacement of soft tissue layers from manual therapy loading. Clin Biomech 33:66\u201372","journal-title":"Clin Biomech"},{"key":"1895_CR13","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.jbmt.2016.05.011","volume":"21","author":"A Griefahn","year":"2017","unstructured":"Griefahn A, Oehlmann J, Zalpour C, von Piekartz H (2017) Do exercises with the foam roller have a short-term impact on the thoracolumbar fascia?\u2014a randomized controlled trial. J Bodyw Mov Ther 21:186\u2013193","journal-title":"J Bodyw Mov Ther"},{"key":"1895_CR14","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-12-203","volume":"12","author":"HM Langevin","year":"2011","unstructured":"Langevin HM, Fox JR, Koptiuch C et al (2011) Reduced thoracolumbar fascia shear strain in human chronic low back pain. BMC Musculoskelet Disord 12:203","journal-title":"BMC Musculoskelet Disord"},{"key":"1895_CR15","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s12998-022-00455-z","volume":"30","author":"R Vining","year":"2022","unstructured":"Vining R, Onifer SM, Twist E, Ziegler AM, Corber L, Long CR (2022) Thoracolumbar fascia mobility and chronic low back pain: phase 2 of a pilot and feasibility study including multimodal chiropractic care. Chiropr Man Therap 30:46","journal-title":"Chiropr Man Therap"},{"key":"1895_CR16","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1080\/09638280400018411","volume":"27","author":"M Tousignant","year":"2005","unstructured":"Tousignant M, Poulin L, Marchand S, Viau A, Place C (2005) The modified-modified schober test for range of motion assessment of lumbar flexion in patients with low back pain: a study of criterion validity, intra- and inter-rater reliability and minimum metrically detectable change. Disabil Rehabil 27:553\u2013559","journal-title":"Disabil Rehabil"},{"key":"1895_CR17","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","volume":"35","author":"CL Craig","year":"2003","unstructured":"Craig CL, Marshall AL, Sjostrom M et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381\u20131395","journal-title":"Med Sci Sports Exerc"},{"key":"1895_CR18","first-page":"129","volume":"23","author":"CS Cleeland","year":"1994","unstructured":"Cleeland CS, Ryan KM (1994) Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap 23:129\u2013138","journal-title":"Ann Acad Med Singap"},{"key":"1895_CR19","doi-asserted-by":"publisher","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","volume":"25","author":"JC Fairbank","year":"2000","unstructured":"Fairbank JC, Pynsent PB (2000) The Oswestry disability index. Spine (Phila Pa 1976) 25:2940\u20132952","journal-title":"Spine (Phila Pa 1976)"},{"key":"1895_CR20","doi-asserted-by":"publisher","first-page":"3116","DOI":"10.1118\/1.2936771","volume":"35","author":"E Mercure","year":"2008","unstructured":"Mercure E, Cloutier G, Schmitt C, Maurice RL (2008) Performance evaluation of different implementations of the Lagrangian speckle model estimator for non-invasive vascular ultrasound elastography. Med Phys 35:3116\u20133126","journal-title":"Med Phys"},{"key":"1895_CR21","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1016\/j.ultrasmedbio.2007.01.018","volume":"33","author":"RL Maurice","year":"2007","unstructured":"Maurice RL, Fromageau J, Brusseau E, Finet G, Rioufol G, Cloutier G (2007) On the potential of the lagrangian estimator for endovascular ultrasound elastography: in vivo human coronary artery study. Ultrasound Med Biol 33:1199\u20131205","journal-title":"Ultrasound Med Biol"},{"key":"1895_CR22","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.1016\/j.ultrasmedbio.2007.05.020","volume":"33","author":"C Schmitt","year":"2007","unstructured":"Schmitt C, Soulez G, Maurice RL, Giroux MF, Cloutier G (2007) Noninvasive vascular elastography: toward a complementary characterization tool of atherosclerosis in carotid arteries. Ultrasound Med Biol 33:1841\u20131858","journal-title":"Ultrasound Med Biol"},{"key":"1895_CR23","doi-asserted-by":"publisher","first-page":"3178","DOI":"10.1007\/s00330-020-06660-9","volume":"30","author":"MH Roy Cardinal","year":"2020","unstructured":"Roy Cardinal MH, Durand M, Chartrand-Lefebvre C et al (2020) Increased carotid artery wall stiffness and plaque prevalence in HIV infected patients measured with ultrasound elastography. Eur Radiol 30:3178\u20133187","journal-title":"Eur Radiol"},{"key":"1895_CR24","doi-asserted-by":"publisher","first-page":"935482","DOI":"10.3389\/fmed.2022.935482","volume":"9","author":"M Girard","year":"2022","unstructured":"Girard M, Roy Cardinal MH, Chasse M et al (2022) Regional pleural strain measurements during mechanical ventilation using ultrasound elastography: a randomized, crossover, proof of concept physiologic study. Front Med 9:935482","journal-title":"Front Med"},{"key":"1895_CR25","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1073\/pnas.1713395115","volume":"115","author":"P Grasland-Mongrain","year":"2018","unstructured":"Grasland-Mongrain P, Zorgani A, Nakagawa S et al (2018) Ultrafast imaging of cell elasticity with optical microelastography. Proc Natl Acad Sci U S A 115:861\u2013866","journal-title":"Proc Natl Acad Sci U S A"},{"key":"1895_CR26","doi-asserted-by":"publisher","first-page":"847","DOI":"10.2214\/AJR.17.19211","volume":"211","author":"G Cloutier","year":"2018","unstructured":"Cloutier G, Cardinal MR, Ju Y, Giroux MF, Lanthier S, Soulez G (2018) Carotid plaque vulnerability assessment using ultrasound elastography and echogenicity analysis. AJR Am J Roentgenol 211:847\u2013855","journal-title":"AJR Am J Roentgenol"},{"key":"1895_CR27","unstructured":"FOMTRAC (2012) Inter-jurisdictional practice competencies and performance indicators for massage therapists at entry-to-practice. Federation of Massage Therapy Regulatory Authorities of Canada Web site. Available via https:\/\/www.fomtrac.ca\/resources\/. Accessed Accessed 5 Dec 2023"},{"key":"1895_CR28","doi-asserted-by":"publisher","first-page":"4527","DOI":"10.3390\/ijms24054527","volume":"24","author":"A Stecco","year":"2023","unstructured":"Stecco A, Giordani F, Fede C, Pirri C, De Caro R, Stecco C (2023) From muscle to the myofascial unit: current evidence and future perspectives. Int J Mol Sci 24:4527","journal-title":"Int J Mol Sci"},{"key":"1895_CR29","doi-asserted-by":"publisher","first-page":"5349620","DOI":"10.1155\/2017\/5349620","volume":"2017","author":"J Wilke","year":"2017","unstructured":"Wilke J, Schleip R, Klingler W, Stecco C (2017) The lumbodorsal fascia as a potential source of low back pain: a narrative review. Biomed Res Int 2017:5349620","journal-title":"Biomed Res Int"},{"key":"1895_CR30","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.3390\/life12111735","volume":"12","author":"A Brandl","year":"2022","unstructured":"Brandl A, Egner C, Reer R, Schmidt T, Schleip R (2022) Associations between deformation of the thoracolumbar fascia and activation of the erector spinae and multifidus muscle in patients with acute low back pain and healthy controls: a matched pair case-control study. Life 12:1735","journal-title":"Life"},{"key":"1895_CR31","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.jbmt.2017.01.005","volume":"21","author":"G Parravicini","year":"2017","unstructured":"Parravicini G, Bergna A (2017) Biological effects of direct and indirect manipulation of the fascial system. Narrative review. J Bodyw Mov Ther 21:435\u2013445","journal-title":"J Bodyw Mov Ther"},{"key":"1895_CR32","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1007\/s00276-018-2087-0","volume":"40","author":"M Creze","year":"2018","unstructured":"Creze M, Soubeyrand M, Nyangoh Timoh K, Gagey O (2018) Organization of the fascia and aponeurosis in the lumbar paraspinal compartment. Surg Radiol Anat 40:1231\u20131242","journal-title":"Surg Radiol Anat"},{"key":"1895_CR33","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1111\/joa.12902","volume":"234","author":"J Wilke","year":"2019","unstructured":"Wilke J, Macchi V, De Caro R, Stecco C (2019) Fascia thickness, aging and flexibility: is there an association? J Anat 234:43\u201349","journal-title":"J Anat"},{"key":"1895_CR34","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s00276-013-1185-2","volume":"36","author":"A Stecco","year":"2014","unstructured":"Stecco A, Meneghini A, Stern R, Stecco C, Imamura M (2014) Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up. Surg Radiol Anat 36:243\u2013253","journal-title":"Surg Radiol Anat"}],"container-title":["Insights into Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13244-024-01895-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13244-024-01895-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13244-024-01895-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T09:25:21Z","timestamp":1736933121000},"score":1,"resource":{"primary":{"URL":"https:\/\/insightsimaging.springeropen.com\/articles\/10.1186\/s13244-024-01895-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1895"],"URL":"https:\/\/doi.org\/10.1186\/s13244-024-01895-2","relation":{},"ISSN":["1869-4101"],"issn-type":[{"value":"1869-4101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]},"assertion":[{"value":"22 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al Ethics Committee approved the study (CE 19.358), and all participants signed informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Each participant provided informed consent, which included permission to use anonymized personal data for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"N.T. is a massage therapist certified by the F\u00e9d\u00e9ration qu\u00e9b\u00e9coise des massoth\u00e9rapeutes agr\u00e9\u00e9s (FQM) and the CEO and Chief Therapist of Atelier Tomita Inc., which provides therapeutic massage services in Quebec. The other authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18"}}