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The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
August, 2002, Vol. 02, Issue 08
Working with Clients Who Have Cerebral Palsy
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In my last article, I discussed the special challenges of working with clients who have survived spinal cord injuries. I had been surprised at how little input I got before I prepared that piece, and I have likewise been surprised (happily) at how much feedback I got afterward - from both massage therapists and SCI survivors (and in one case, a person who is both).Here are some examples:
I want to extend my thanks to all the people who responded to my article. It certainly seems clear that many massage therapists feel they need more education on working with clients with a wide variety of CNS dysfunction.
This month, I have chosen to focus on another type of CNS disorder: cerebral palsy. As usual, I will review some of the technical information about what manifests this set of signs and symptoms; then I will discuss some of the special issues this disorder raises in the context of bodywork.
Cerebral Palsy: What Is It?
Cerebral palsy (CP) is a term that refers to many possible injuries to the brain during gestational development, birth, and early infancy. Several different types of CP have been identified, each involving damage to different parts of the brain.
The incidence of CP in the United States is two to four out of every 1,000 live births. Around half a million CP patients live in the U.S. today. In spite of improved prenatal care, the rate of CP in the U.S. has remained unchanged for many years.
Etiology: What Happens?
Cerebral palsy is the result of brain damage, usually to motor areas of the brain, specifically the basal ganglia and/or cerebellum. The damage can be brought about in a number of ways.
Regardless of the cause of brain damage, the child with cerebral palsy will have some impairment of function. The problem could be so minor that only people who know what to look for may see it, or it may be completely debilitating both physically and mentally; it all depends on what part and how much of the brain has been affected.
Types of Cerebral Palsy
CP is classified into four types: spastic, athetoid, ataxic, and mixed.
CP may also be classified by what part of the body is affected. These terms are consistent with those used for other CNS disorders: hemiplegic CP means the left or right side is affected; diplegic CP means either two arms or two legs are affected; and quadriplegic CP means all the extremities are affected to some extent.
Types of CP may come and go, or change entirely from one kind to another, as the child grows. CP is not a progressive disorder, however, and if symptoms seem to be getting significantly worse over time, a different kind of CNS dysfunction must be considered.
Signs and Symptoms
Signs and symptoms of CP vary according to the location and extent of brain injury. Damage to the cerebellum produces different symptoms from damage to the frontal lobe, for instance. But some of the most common features of CP include hypertonicity; hypotonicity; poor coordination and voluntary muscle control; unusually weak muscles; random movements; seizure disorders; early hearing and/or vision problems; and progressive muscle contractures. About half of all CP patients have some level of mental retardation, and many are unable to communicate verbally.
Because infants don't develop voluntary motor skills until they are around six months old, CP may be difficult to diagnose earlier than this point.
CP is incurable and irreversible; as such, it is managed, rather than treated, by providing skills and equipment to live as fully and functionally as possible. For some CP patients this could mean using a brace for one foot that is slightly weaker than the other; for others it could mean intensive occupational, physical, and speech therapy for many years.
Medication for CP is occasionally prescribed to help manage seizures, and to reduce muscle spasm. Some surgical interventions have been developed to lengthen contracted muscles, to realign vertebrae that have become distorted by scoliosis, and to alter nerve pathways in the brain to reduce the severity of tremors.
Physical therapy is recommended for people with CP because the process of developing muscle contractures is slow and can be made even slower when muscles and joints are specifically stretched and manipulated to maintain flexibility. Patients may also be encouraged to use and strengthen their weaker limbs. It is important to note the many uses and benefits physical therapy has to offer CP patients, because massage therapy may also be a valuable adjunct in these cases.
What about Massage?
There is no question that massage therapy can have a valuable role in improving the quality of life of a person with CP. Unlike many CNS disorders, a lot of information about bodywork for CP patients is easily available; I'll list some wonderful sources at the end of this article. Nonetheless, these clients require some special adjustments in the way bodywork is administered, and I've had several letters from massage therapists who would like to feel their work is more effective with this population.
The damage for a person who has CP does not begin in the muscle and connective tissues. Although this is where we feel the tightening of the connective tissue wrappings around muscles, the contractures themselves are simply a symptom-a complication of a problem deep in the brain. Therefore, if all we try to do is lengthen the muscles and stretch the fascia, we will run smack into a brick wall: either no progress will happed at all, or symptoms may even be temporarily exacerbated. Most people with CP get best results if bodywork focuses on indirectly affecting muscle tone through craniosacral work, gentle rocking, slow range of motion exercises, and manipulation of the arms and legs that engages the client in ways he or she doesn't automatically resist-this often means going with the direction of muscle shortening in order to disengage the reflex. Ultimately, the therapist will have to experiment with lots of different approaches, often accompanied by extremely supportive bolstering, in order to find what techniques allow their clients to relax and enjoy their massage.
The benefits of massage to CP patients are undeniable. Parents write of their satisfaction when their child is able to sleep through the night, when postural distortions unbind, when breathing eases, when faces light up with joy because the massage therapist has arrived for a session. Imagine a child who is the object of vast numbers of painful, intrusive, unpleasant, dehumanizing medical procedures (regardless of the supportive intentions behind them). This child is handled rather than touched. Then his massage therapist arrives and arranges him carefully among pillows and bolsters on the table. She cradles his occiput and straightens his neck so he can breathe more easily. She rocks his arms and legs until their tension eases. She plays with his fingers until he realizes he can move them in lots of directions. Nothing she does hurts. What a gift, what a privilege to be invited into such a relationship!
If physical therapy is used to stretch and strengthen skeletal muscles, massage will also be a safe choice. The only caution is that people with very severe CP may not be able to communicate their wants or concerns clearly. If a massage therapist works with a client who cannot speak, other modes of communication, including nonverbal signals, become especially important. It is the responsibility of the massage therapist to make sure that his or her work is welcome and freely accepted at all times.
Our culture harbors a fear of people who look, or sound, or act differently from ourselves. Seeing or being with someone with CP can raise all kinds of fears or judgments that we never realized were there. Maybe this person can't speak, or drools, or walks funny, or doesn't walk at all. Speaking for myself, I will share that it's especially hard for me to deal with disabilities when they occur in children. And yet, here is a population that so needs the work we do! As long as basic common-sense precautions are respected (don't overwork numb areas, be sensitive to nonverbal communications, if anything you do makes symptoms worse then stop and try something else) massage can be a central coping mechanism for a child or adult with CP.
I am hopeful that any readers who have the opportunity to work with clients who have CP will feel more confident to do so. I am especially delighted to share some valuable resources that help me put together the parts of this article about bodywork:
For my next column, I'm going to offer readers a choice. I've had requests for articles on these topics:
So, what do you want to have discussed next in What's On Your Table?
Ruth Werner, LMT, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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