{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:50:34Z","timestamp":1791287434091,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Hand-held percussive vibration therapy (PVT) is widely used in musculoskeletal rehabilitation, yet its incremental benefit beyond an active physiotherapy program for chronic non-specific low back pain (CNLBP) is unclear. We investigated whether PVT added to conventional physiotherapy (CPT) improves disability, sleep quality, and pain. Methods: This single-center, parallel-group, assessor-blinded randomized trial enrolled 50 adults aged 18\u201365 years with CNLBP and baseline visual analogue scale (VAS) pain \u22654\/10. Participants were allocated equally to PVT + CPT or CPT alone and attended three sessions weekly for eight weeks. The Oswestry Disability Index (ODI) was the primary outcome; Pittsburgh Sleep Quality Index (PSQI) and VAS scores were secondary outcomes. Week-8 scores were analyzed with baseline-adjusted ANCOVA using HC3 robust standard errors. Results: Follow-up data were complete for all participants. The adjusted ODI score at week 8 was 2.59 points higher with PVT + CPT than with CPT (95% confidence interval [CI], 0.47 to 4.71; p = 0.017), a statistically significant difference in favor of CPT. PSQI scores did not differ between groups (adjusted difference, 0.25; 95% CI, \u22120.40 to 0.90; p = 0.451). VAS scores were lower with PVT + CPT (adjusted difference, \u22121.15; 95% CI, \u22121.45 to \u22120.85; p &lt; 0.001). Conclusions: PVT did not provide an additional benefit for disability and did not improve sleep quality when added to CPT. The pain difference was a secondary, exploratory finding of uncertain clinical relevance.<\/jats:p>","DOI":"10.3390\/jcm15197711","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:46:29Z","timestamp":1791283589000},"page":"7711","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Percussive Vibration Therapy as an Adjunct to Conventional Physiotherapy in Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9918-5604","authenticated-orcid":false,"given":"Elif Esma","family":"Bayraktar","sequence":"first","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Kerem Aydinlar Campus, Kayisdagi No. 32, 34752 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-5939","authenticated-orcid":false,"given":"\u00d6mer","family":"\u015eevgin","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, \u00dcsk\u00fcdar University, NP Health Campus, Saray, Ahmet Tevfik \u0130leri No. 5, 34774 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Ainaz","family":"Vahedi","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Graduate School of Health Sciences, \u00dcsk\u00fcdar University, Mimar Sinan District, Selman-\u0131 Pak, 34664 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6835-5428","authenticated-orcid":false,"given":"Ertu\u011frul","family":"Safran","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Geli\u015fim University, Cihangir, Avc\u0131lar, 34310 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"ref_1","unstructured":"(2023). GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol., 5, e316\u2013e329."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","article-title":"What low back pain is and why we need to pay attention","volume":"391","author":"Hartvigsen","year":"2018","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S0140-6736(21)00733-9","article-title":"Low back pain","volume":"398","author":"Knezevic","year":"2021","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/AJP.0b013e3181f3bdd5","article-title":"The association between chronic low back pain and sleep: A systematic review","volume":"27","author":"Kelly","year":"2011","journal-title":"Clin. J. Pain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2791","DOI":"10.1007\/s00586-018-5673-2","article-title":"Clinical practice guidelines for the management of non-specific low back pain in primary care: An updated overview","volume":"27","author":"Oliveira","year":"2018","journal-title":"Eur. Spine J."},{"key":"ref_7","first-page":"CD009790","article-title":"Exercise therapy for chronic low back pain","volume":"9","author":"Hayden","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.26603\/001c.73795","article-title":"The effect of percussive therapy on musculoskeletal performance and experiences of pain: A systematic literature review","volume":"18","author":"Sams","year":"2023","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1186\/s13018-023-04217-2","article-title":"Vibration therapy to improve pain and function in patients with chronic low back pain: A systematic review and meta-analysis","volume":"18","author":"Li","year":"2023","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s10354-023-01026-4","article-title":"Effects of whole-body vibration therapy on pain, functionality, postural stability, and proprioception in patients with subacute and chronic non-specific low back pain: A systematic review","volume":"175","author":"Remer","year":"2025","journal-title":"Wien. Med. Wochenschr."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Yang, C., Li, Y., Sucharit, W., Eungpinichpong, W., and Huang, X. (2024). Effects of percussive massage therapy on fascia echo intensity and fascia thickness in firefighters with chronic non-specific low back pain: A randomized controlled trial. BMC Complement. Med. Ther., 24.","DOI":"10.1186\/s12906-024-04687-9"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"61","DOI":"10.5455\/annalsmedres.2024.08.177","article-title":"Investigating the effects of percussion massage therapy on pain, functionality, kinesiophobia, and quality of life in individuals with non-specific low back pain","volume":"32","author":"Gorguluer","year":"2025","journal-title":"Ann. Med. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e081123","DOI":"10.1136\/bmj-2024-081123","article-title":"CONSORT 2025 statement: Updated guideline for reporting randomised trials","volume":"389","author":"Hopewell","year":"2025","journal-title":"BMJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"295","DOI":"10.7326\/0003-4819-148-4-200802190-00008","article-title":"Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: Explanation and elaboration","volume":"148","author":"Boutron","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"g1687","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"Hoffmann","year":"2014","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"World Medical Association (2025). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human participants. JAMA, 333, 71\u201374.","DOI":"10.1001\/jama.2024.21972"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"201","DOI":"10.5606\/tftrd.2020.4192","article-title":"A comparison of application frequency of physical therapy modalities in patients with chronic mechanical low back pain","volume":"66","author":"Murat","year":"2020","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_18","first-page":"52","article-title":"Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: A randomized-controlled trial","volume":"64","author":"Karahan","year":"2018","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","article-title":"The Oswestry Disability Index","volume":"25","author":"Fairbank","year":"2000","journal-title":"Spine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1097\/01.BRS.0000113869.13209.03","article-title":"Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain","volume":"29","author":"Yakut","year":"2004","journal-title":"Spine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"ref_22","first-page":"107","article-title":"Pittsburgh Uyku Kalitesi \u0130ndeksi\u2019nin ge\u00e7erli\u011fi ve g\u00fcvenirli\u011fi","volume":"7","author":"Kara","year":"1996","journal-title":"T\u00fcrk Psikiyatr. Derg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1017\/S0033291700009934","article-title":"Clinical applications of visual analogue scales: A critical review","volume":"18","author":"McCormack","year":"1988","journal-title":"Psychol. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1111\/j.1365-2044.1976.tb11971.x","article-title":"The reliability of a linear analogue for evaluating pain","volume":"31","author":"Revill","year":"1976","journal-title":"Anaesthesia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1097\/BRS.0b013e31815b75ae","article-title":"Minimal clinically important change for pain intensity and disability in patients with nonspecific low back pain","volume":"32","author":"Kovacs","year":"2007","journal-title":"Spine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/BRS.0b013e31815e3a10","article-title":"Interpreting change scores for pain and functional status in low back pain: Towards international consensus regarding minimal important change","volume":"33","author":"Ostelo","year":"2008","journal-title":"Spine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.jclinepi.2007.02.006","article-title":"A simple sample size formula for analysis of covariance in randomized clinical trials","volume":"60","author":"Borm","year":"2007","journal-title":"J. Clin. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1186\/s13063-019-3671-2","article-title":"Sample size estimation for randomised controlled trials with repeated assessment of patient-reported outcomes: What correlation between baseline and follow-up outcomes should we assume?","volume":"20","author":"Walters","year":"2019","journal-title":"Trials"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1136\/bmj.323.7321.1123","article-title":"Analysing controlled trials with baseline and follow-up measurements","volume":"323","author":"Vickers","year":"2001","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103029","DOI":"10.1016\/j.explore.2024.103029","article-title":"The effects of connective tissue massage and classical massage on pain, lumbar mobility, function, disability, and well-being in chronic low back pain: A three-arm randomized controlled trial","volume":"20","author":"Dal","year":"2024","journal-title":"Explore"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jbmt.2025.05.036","article-title":"Short-term effects of classical massage added to a conventional physiotherapy on non-specific chronic low back pain: A randomized, placebo-controlled study","volume":"44","author":"Ucurum","year":"2025","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101761","DOI":"10.1016\/j.smrv.2023.101761","article-title":"Effects of non-pharmacological interventions on sleep in chronic low back pain: A systematic review and meta-analysis of randomised controlled trials","volume":"68","author":"Craige","year":"2023","journal-title":"Sleep Med. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"zsae023","DOI":"10.1093\/sleep\/zsae023","article-title":"Sleep as a prognostic factor in low back pain: A systematic review of prospective cohort studies and secondary analyses of randomized controlled trials","volume":"47","author":"Silva","year":"2024","journal-title":"Sleep"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1002\/ejp.2222","article-title":"The importance of context (placebo effects) in conservative interventions for musculoskeletal pain: A systematic review and meta-analysis of randomized controlled trials","volume":"28","author":"Saueressig","year":"2024","journal-title":"Eur. J. Pain"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7711\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:52:52Z","timestamp":1791283972000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":34,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197711"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197711","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]}}}