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Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Research: Know What You're Talking About
Have you ever seen a patient in your office with multiple serious health problems you weren't sure exactly how to address?
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Looking Back: Abstracts From Chiropractic History (Summer 2015 Issue)
The following abstracts are reprinted with permission from Chiropractic History, the official journal of the Association for the History of Chiropractic. Chiropractic History is the leading scholarly journal of the chiropractic profession dedicated to the preservation and dissemination of the profession's credible history.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Are You Making the Wrong Impression?
Taking a page from Stacy and Clinton of The Learning Channel's hit television program, "What Not to Wear," we recently published an article in the summer issue of Chiropractic History: The Archives and Journal of the Association for the History of Chiropractic, that explores the evolution of physician attire from prehistoric times to the present.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
The Winter of Life: A Personal and Chiropractic Practice Perspective
Last November, my wife and I invited an elderly relative, Uncle Josh, to spend the winter with us. He was 82 years old at the time and turned 83 during his stay. As soon as he accepted our invitation, we began preparing.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
7 Reasons You Want a Beacon in Your Office
Have you heard about how "beacons" are transforming the way businesses interact with their customers? Beacons are low-energy Bluetooth devices that have the ability to send information to a smartphone app.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Reverse Digit Span: A Useful Assessment Tool for Patients With and Without Concussion
Reverse digit span is an easily administered test of attention span. It is a component of the SCAT3 test, which is frequently used to assess concussion. It has been part of the armamentarium of cognitive assessment for many years.
Chiropractic Care and Risk of Stroke: The Shoe Moves to the Other Foot
For decades, numerous papers have linked upper cervical chiropractic care to the incidence of vertebral artery dissections and stroke.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Does Massage Therapy Lower Blood Pressure? A Literature Review
Contributed by Derek R. Austin, PT, DPT, MS, BCTMB, CSCS, Renee Stenbjorn, BS, MPA, LMT, April Neufeld BS, LMP
If you did not already have enough reasons to get a stress-busting, mood-lifting, pain-relieving massage, this month's Massage Therapy Foundation research review details another great benefit of massage therapy. Promising research suggests that massage therapy can lower blood pressure. The study of the month explores the following questions: Is massage as effective as antihypertensive drugs to lower blood pressure? Does adding massage to antihypertensive drugs lower blood pressure further? The answer to these questions may be yes.
A rigorous analysis of research articles published on the topic of massage and hypertension was published in the Journal of Human Hypertension during 2014. Dr. Xing Jiang Xiong and his colleagues published the article with the title, "Massage therapy for essential hypertension: a systematic review." A systematic review aims to provide an exhaustive summary of current literature relevant to a research question. The question under study is how effective and safe is massage therapy for essential hypertension, meaning hypertension that has no known cause. The authors note that hypertension is the leading risk factor for mortality worldwide. Preliminary research has shown that complementary medicine approaches such as yoga, qigong, Tai Chi, acupuncture, and moxibustion may lower blood pressure. The researchers performed the first systematic review of randomized clinical trials to determine whether massage can combat hypertension.
The authors searched a large number of databases for randomized controlled trials published in English or Chinese. To be included, a study had to involve massage as an intervention for participants diagnosed with essential hypertension. The massage intervention had to be compared to a control group not receiving massage. Treatment duration of the analyzed studies ranged from a minimum of 10 days up to 1 year. Studies were excluded if the patients involved had a history of heart attack, kidney failure, liver failure, arrhythmia, or heart failure.
A total of 24 articles were selected and then analyzed for their risk of bias. The studies included a total of 1,962 patients with essential hypertension. Treatment groups included either massage alone or massage combined with antihypertensive drugs. Massage interventions were widely variable between studies, ranging from 1 hour per week to 45 minutes each day. Control groups received no intervention or antihypertensive drugs. Most studies were determined to be of generally poor methodological quality; for example, only 3 of the 24 studies included follow-up. The authors developed four categories of research, each compiled and analyzed using the process called meta-analysis. This statistical process comprises contrasting and combining results from different studies in the hope of identifying patterns among study results. Due to the statistical nature of this approach, only trials with quantitative data of blood pressure measurements could be included in the analysis.
The first group, of five studies, compared massage with no intervention. Only three of these studies provided blood pressure data in numerical terms. The researchers combined the results of these three trials and performed a meta-analysis to determine significance. The meta-analysis indicated no significant for massage in lowering blood pressure compared to no intervention.
The second group, of nine trials, compared massage to antihypertensive drugs, and six of these provided figures appropriate for meta-analysis. The meta-analysis showed that massage lowers systolic blood pressure better than antihypertensive drugs by an average of 3.5 mm Hg (p=0.0004). There was no significant effect on lowering diastolic blood pressure (p=0.14).
The third group, of eleven trials, compared antihypertensive drugs to massage combined with antihypertensive drugs, and six provided numerical values appropriate for meta-analysis. The meta-analysis indicated that massage plus antihypertensive drugs was superior compared to the antihypertensive drugs alone. Adding massage to antihypertensive drugs reduced systolic blood pressure by an average of 6.9 mm Hg (p=0.0001) and diastolic blood pressure by an average of 3.6 mm Hg (p=0.005). A meta-analysis of four of the other trials, which summarized the effect of massage based on grades of efficacy, also indicated that massage combined with antihypertensive drugs lowered blood pressure better than antihypertensive drugs alone (p=0.0002).
The final group, of five trials, reported adverse effects, and the authors' analysis showed that massage was potentially safer than antihypertensive drugs. While this conclusion is limited by the small number of trials reporting adverse events, massage may provide an effective alternative for those who suffer serious side effects from antihypertensive drugs.
The authors conclude that combining massage with antihypertensive drugs may be more effective than using just antihypertensive drugs to lower blood pressure. They also conclude that massage alone appears beneficial for reducing systolic blood pressure when compared with antihypertensive drugs.
One of the main strengths of this article is the thoroughness of its search for research articles and its inclusion of research articles published in either Chinese or English. Including Chinese language articles greatly expanded the number of articles included in the review, as massage is frequently studied in China. Other strengths include the rigorous assessment of methodological quality and the use of meta-analysis to combine published research data.
The authors report that the primary weakness of their review is the poor quality of the original studies. They note that many of the included trials did not report randomization procedures, concealment of allocated groups, whether individuals dropped out, pre-trial estimation of sample size. The most important weakness of the included studies was the lack of follow-up; it remains unclear whether massage would continue to have any effects on blood pressure beyond the end of the treatment period.
Due to the wide use and acceptance of massage therapy in general, massage could be an important adjunct therapy for treating hypertension in the primary care setting. Further research can help determine exactly how effective massage is in lowering blood pressure. A cost-efficacy analysis would also be useful, since essential hypertension is tremendously common, and yet many effective antihypertensive drugs are quite expensive. Future research will also help determine the most effective dose of massage and how massage interacts with different classes of antihypertensive drugs.
Not sure you understand the difference between a confidence interval, p-value, t-test, and ANOVA? MTF offers a course on the Basics of Research Literacy that teaches massage therapists and educators how to incorporate principles of research literacy into your practice and teaching. In this online, 8-hour, NCBTMB-approved workshop, you will be introduced to basic research vocabulary and concepts. Once you understand the terminology, you will learn how to use databases to look up research, evaluate the validity of published research articles, and apply research findings to improve massage outcomes. Your massage therapy practice can be improved by becoming more research literate.
To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation review article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.