resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Study Examines Use of Massage on Those with Spinal Cord Injuries
Contributed by MK Brennan MS, RN, LMBT; Renee Stenbjorn, BS, MPA, LMT and Derek R. Austin, PT, DPT, MS, CMT, BCTMB, CSCS
As massage therapy continues to gain recognition as a valid treatment option, studies that focus on its use with special populations or in mainstream medicine centers are more readily available. We at the Massage Therapy Foundation are always looking for new studies that help bring massage to populations who might not generally receive it. This month's review focuses on a feasibility study by Dr. Theresa Chase, Dr. Amitabh Jha, C.A. Brooks, MA and Amanda Allshouse, MS, published in the November 2013 issue of Spinal Cord that provided massage to patients with new spinal cord injuries (SCI) while they were being treated at a rehabilitation hospital.
This study researched the feasibility of integrating massage into the treatment protocols for these patients to address their pain. As the authors wrote, "Pain is not only a problem in itself, but may contribute to other conditions, such as negative mood states, depression, anxiety, sleeplessness and poor sleep quality and these, in turn, may interfere with participation in rehabilitation therapies and overall general well-being."
Working with a licensed massage therapist, a protocol was developed for the two arms of the study, broad compression massage (BCM) and light contact touch (LCT). These two treatment options provided an opportunity to test the effects of varying the amount of pressure during the massage since BCM used two to five pounds of pressure compared to two to three ounces of pressure with LCT. The treatment sessions were provided by 10 registered nurses who worked in the facility and were trained over an 8-hour course that included hands-on practice to provide the BCM and LCT treatments. The study was conducted over an 11-month period at a single site, the rehabilitation facility. Subjects were randomized to either the BCM-LCT group or the LCT-BCM according to the study's crossover design, which allowed all participants to receive the "active" treatment (BCM).
For inclusion in the study, the SCI patients needed to have pain, be medically stable and have an anticipated five week or greater length of stay at the rehab facility. This study highlighted the fact that patients with SCI suffer from pain due to injuries sustained during their trauma. Even patients with paralyzing accidents may be suffering from high amounts of pain. Additionally, the patients needed to be able to provide consent and answer questions in English. If they were participating in another clinical trial, they were excluded from the study. Prior to the start of the study, Institutional Review Board (IRB) approval was gained and all participates consented to be a part of the study.
The massage sessions were scheduled to last 20 minutes with limited conversation between the nurse and the patient. Treatments were provided three times a week for two weeks, followed by a one week break in between the BCM-LCT and LCT-BCM switch. A total of 40 adults were enrolled in the study, including seven females. A number of tools were used to gather data pre-treatment including an interview with the subjects by a research assistant to assess pain, fatigue and depressive symptoms. Demographic information, as well as injury severity and medication use for pain, was obtained through a medical chart review. During the study period, assessments were conducted the day after the treatments which may not have effectively captured the immediate effects of the BCM or LCT treatment on pain and fatigue.
Pain intensity was both higher at baseline and reduced more in the LCT-BCM group compared to the BCM-LCT group in the first two-week period (p=0.014). However, this pattern was not found in the second two-week period. LCT and BCM groups did not significantly differ on any secondary measures except the Patient Health Questionnaire-9 (PHQ-9), which measures depressive symptoms. Like pain intensity, the PHQ-9 score was reduced more in the LCT-BCM group in the first period (p=0.0085) though this trend was again not repeated in the second period. There was not a significant difference between the two groups when the first treatment period was analyzed in relation to the second treatment period. Both patients and nurses reported high satisfaction that having 20 minutes of uninterrupted time for the treatment provided, relating that this was usually the longest uninterrupted period of patient care during the day. However, the "researchers on this study believe there were beneficial effects and improvements in patient condition regardless of treatment."
One of the limitations of the study was the lack of balance between the two randomized groups at baseline for pain. Since one group started out with higher pain levels, it is likely that the treatment affected the groups differently. Additionally, the crossover design may have been flawed, as there were carry-over effects with a failure to return to baseline during the one week break in between the treatment sessions. This resulted in a difficulty to do a formal analysis of the cross-over design. Rather, changes in pain intensity were compared within each treatment period for the two groups. Since the type of pain wasn't defined, such as being musculoskeletal or neuropathic, an in-depth analysis was not possible.
One very interesting aspect of this study was the training and utilization of nurses to provide the massage therapy to these subjects. While massage provided by nurses used to be a part of routine patient care, that is not true nowadays. Is there a possibility that by using professionals other than massage therapists, the results may be different since the nurses were only given eight hours of training? Also, is there a possibility that the opportunity to participate in some research studies may not include massage therapists? However, this may indicate a great opportunity to form alliances with nurses. Massage therapists and nurses have similar goals for patients, in that both seek interventions that are beneficial, such as massage.
This pilot study showed that it is possible to integrate massage therapy in an acute rehab program for SCI patients using nurses to provide the sessions. For massage therapists, this provides an opportunity to take the results obtained, along with the items to consider for future studies and create proposals for further study with this patient population. As Massage Therapy Awareness Week starts, reaching out and providing massage to those who would not likely receive it may be worth considering with this study as an inspiration. The full text of the article is available online for free at PubMed Central.
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.