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News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
March, 2005, Vol. 05, Issue 03
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Author's note: There is a movement in the health sciences away from using the possessive form of a disease name. This makes some sense, since it's not really Parkinson's disease; it's the disease of those who live with it.Sometimes this change takes the form of turning a descriptive term into a noun (e.g., from Parkinson's to parkinsonism) and sometimes the apostrophe simply disappears (e.g., Alzheimer disease). Since my column "What's on Your Table" always strives to stay on the cutting edge of both grammar and science, I will do my best to incorporate this new adjustment to the language.
The consensus is clear: Parkinson's disease, also called parkinsonism, is the issue on the table for today. Parkinsonism is a fairly common progressive degenerative central nervous system (CNS) disorder that leads to dysfunction at the motor centers in the basal ganglia. It affects about one in 1,000 people in the U.S., and the majority of people with parkinsonism are mature. It is unusual to see diagnoses in persons under 50 years of age - Michael J. Fox is a famous exception to this rule.
Etiology: What happens? Understanding the etiology of this disorder is a little like playing "The House that Jack Built" because the sequence of events is so specific and predictable.
So the sequence goes like this: A voluntary impulse to stand on one foot begins in the cerebral cortex. It is sent through the basal ganglia where, because adequate dopamine is supplied by substantia nigra cells, this impulse travels to the prime movers and antagonists of the lower extremity and postural muscles in order to bend the knee (go ahead, try it).
Parkinsonism occurs when the cells in the substantia nigra unexpectedly and prematurely die. Consequently, dopamine is in short supply in the basal ganglia; it becomes difficult to initiate voluntary movement (this is called bradykinesia - the person often reports feeling "rooted to the floor"), and/or the balance between prime movers and antagonists is disrupted, leading to rigidity or tremor. Several other symptoms may develop as well; they will be discussed shortly.
Causes: Most of the time, it is unclear exactly why the substantia nigra cells die off. Genetics and environmental exposure (or the combination of both) are often thought to be contributing factors. Excessive exposure to carbon monoxide, heavy metals, pesticides or agricultural chemicals is sometimes suspected. Repeated head trauma causes a variation called pugilistic parkinsonism; this is the case with former boxer Muhammad Ali. Most cases of parkinsonism, however, are considered to be idiopathic (of unknown origin).
Signs and Symptoms: Parkinsonism presents very differently in different people, but most primary symptoms have to do with movement problems. A short list of primary and secondary symptoms includes the following:
Treatment: Chemical imbalances in the CNS are often difficult to treat because the blood-brain barrier (a layer of cells that wrap around blood vessels in the brain) blocks the introduction of many substances into this precious environment. Some drugs must be administered in high amounts to overcome this obstacle.
Treatment for parkinsonism often begins with a dopamine precursor, or dopamine agonists. These substances essentially try to replace what the damaged substantia nigra cells should be producing; however, remember that dopamine in the basal ganglia helps create coordinated movement, but too much dopamine in the frontal lobe can cause hallucinations - a significant side-effect! Furthermore, most patients eventually develop tolerance to these drugs, and they lose their efficacy.
Other drugs work to change dopamine metabolism and other brain activity, but at this time no permanent solution or cure for parkinsonism exists. Other options include surgery to affect the globus pallidus or thalamus (this helps to control very extreme tremor), deep-brain stimulation, and eventually the possibility of stem cell implantation with the goal of re-growing the damaged substantia nigra cells.
Massage? Parkinson's patients experience progressive stiffness and rigidity of voluntary muscles. Rigidity is safe for massage, especially when sensation is present, but it is important to remember that this comes about because of a CNS dysfunction, and won't be completely resolved, even with the most brilliantly applied bodywork.
Several different modalities have been quantifiably researched in the context of parkinsonism, including Trager, Alexander Technique and Swedish massage with specific muscle exercises. All modalities report improvement in function, from the reduction of rigidity and improvement of sleep, to the reduction of tremor and increase of daily activity stamina.
It is important to work in cooperation with a client's primary physician, because massage may impact the need for antidepressants and other medication. Be aware, however, that clients with Parkinson's disease do not have the freedom of movement that most other people do, and they may have great difficulty in getting on and off tables safely. Some massage therapists address this by working with these clients on chairs or floor mats.
On a final note, I'd like to recognize two people for their contributions to my preparation of this article. One is a reader named David Ponsonby, who has done an enormous amount of research on this topic and generously shared his information - this article barely scratches the surface of what he has collected on this topic. David has allowed me to put interested readers in touch with him for more information.
The other person is a massage therapist named Jan Mueller who, years ago, published a fascinating and lovely article on working with clients who have Parkinson's disease in the Massage Therapy Journal [Winter 1996, (35): 1]. I made mention of her wonderful work at a class I taught in Kentucky one time, and it turned out by chance that she was one of the participants! Thanks, Jan, for your pioneering work.
And now, loyal readers, a familiar plea: What will it be for next time? At the moment I'm on a progressive degenerative CNS disorder roll, and could easily continue with amyotrophic lateral sclerosis (a.k.a., Lou Gehrig's disease). If you have experience with clients who live with this disease, I invite you to share your wisdom with the rest of our readership. If you have other ideas about what you'd like to read about, let me know that, too. Please let me know: What's on your table?
Many thanks and many blessings,
Ruth Werner, LMP, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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