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Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Massage Therapy During Childbirth May Reduce Labor Pain
Contributed by Derek R. Austin, PT, DPT, MS, BCTMB, CSCS; MK Brennan, MS, RN, LMBT; Jolie Haun, PhD, EdS, LMT
Labor hurts. Labor is an often painful and sometimes long process causing much distress to women during the birthing process. Recent research published in the International Journal of Therapeutic Massage and Bodywork reports on an evaluation of the effects of massage therapy in managing labor pain. The article titled, "Massage Therapy and Labor Outcomes: a Randomized Controlled Trial" was published in December 2012. This randomized controlled trial (RCT) was conducted with pregnant women at the British Columbia (BC) Women's Hospital in Vancouver. Findings indicate massage therapy appears to be an effective pain management technique during labor.
Previous randomized trials have reported reductions in mothers' pain when massage therapy is provided during childbirth. However, these trials have been limited by small sample sizes and using non-massage therapists for the massages, and not all of the results showing effects have been statistically significant.
This study by Janssen et al. is the first published study on labor pain where massage therapy was provided by a regulated massage therapist. In British Columbia, registered massage therapists have to complete two years of massage training and normally work under insurance.
Seventy-seven women participated in this RCT. Thirty-seven women received massage during labor and 40 women received standard care. The standard care group received routine medical care without the massage intervention. The women in both study arms were also able to use non-invasive pain management techniques. There were no dropouts, meaning that all 77 women who began the study finished the study and responded to research follow-up.
Exclusion criteria included co-morbidities or complications during pregnancy. Inclusion criteria included first time term pregnancy, single gestation with the maternal age between 18 and 35. In the massage group, Swedish massage was administered by a registered massage therapist during active labor for up to 5 hours. Women could choose to pause the massage or have it administered intermittently, and massage was stopped if the participant decided to have epidural analgesia. Five hours was chosen as the maximum time that the massage therapist would work with the participant.
The primary effects were based on the timing of epidural analgesia with respect to cervical dilation. The authors hypothesized that massage therapy would lengthen the time before a woman would choose to use epidural analgesia as measured by greater cervical dilation.
The secondary effects were on measures of labor pain and outcome. The authors looked at many factors, specifically contraction pain, length of stages of labor, need for narcotic or other analgesia, cervical dilation at the time of epidural insertion and mode of delivery. There were no adverse effects or events reported in the study.
The researchers found that women in the massage therapy group received epidural analgesia at higher cervical dilation than the women in the routine care group, although they were admitted on average at a less advanced stage of labor. The analysis of variance showed about a 1cm difference, which was not statistically significant. Similarly, pain levels on the McGill Pain Questionnaire were consistently lower in the massage group, but were not statistically significant. This study did show a trend toward a delay in epidural injections, which may result in a reduction of assisted vaginal deliveries and decreased time between the first two stages of labor.
The authors suggest that continuing massage throughout labor might have stronger effects on pain that could be statistically significant. Perhaps massage therapy can further reduce pain once epidural analgesia is given; in this study, massage was stopped if the patient chose an epidural.
While it is the largest study to date of massage therapy in labor, this study still involved only 77 women, just 1% of the approximately 7500 births that take place annually at BC Women's Hospital. Future research should expand sample sizes, which would help identify significant effects of massage therapy to support conclusive findings of the effects of massage in this context. It would be very interesting to see what the overall effects would be if a hospital were to provide massage therapy during even 10% of annual births.
In the current study, 60% of women asked to participate were willing to receive massage therapy during labor, indicating that massage is well-accepted by women giving birth. There were also no cases of a woman or her support person(s), nursing or the medical staff asking the massage therapist to discontinue treatment.
This research demonstrates that massage therapists can effectively integrate into an obstetrics healthcare team to provide pain relief during childbirth. This research provides implications for the continued growth and application of massage modalities in the role of health care.
If you are interested in performing research like this study on massage and labor pain or on any other topic, check out the Research Grant Contest from the Massage Therapy Foundation. The MTF will be awarding up to $30,000 for a one-year project period. For more information, visit www.massagetherapyfoundation.org/research-grants/. The deadline to apply is March 2, 2015. Research is funded by the Massage Therapy Foundation by help from your donations.
The MTF has ongoing efforts such as this monthly review to support research literacy among massage therapists. Please consider donating to MTF to support these continued efforts to promote research literacy among massage therapists. To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.