resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
May, 2005, Vol. 05, Issue 05
Spotlight on Research: Trager Approach Shows Promise in Treating Chronic Headaches
By Michael Devitt
This periodic column keeps you abreast of the latest research documenting the benefits of massage and bodywork. Published research is summarized, with references to the full study text provided; abstracts of research are reproduced with minimal edits.If you would like your research abstract or summary published in Spotlight on Research, please contact us at .
Named after an Illinois medical doctor, the Trager approach is one of several mind-body techniques used frequently by massage therapists in the course of care. A combination of massage, mobilization and relaxation, the Trager approach relies on gentle, rhythmic rocking motions and stretching techniques that promote easy and free movement and sensations throughout the body. A typical Trager session can last from between 60 and 90 minutes, and includes not only stretching and movements, but also a form of mental exercise called "Mentastics" that helps clients remember and recreate the experiences felt during the actual Trager session.
The Trager approach is usually employed to treat musculoskeletal conditions such as low back pain. In a study published in a recent issue of Alternative Therapies in Health and Medicine, however, scientists looked at the role Trager could play in the treatment of another debilitating condition: chronic headaches. The study found that the Trager approach reduced both the frequency and duration of headaches, with the added benefit of helping people cut back on the amount of drugs they needed to treat headache pain.
In the trial, 29 men and women were randomly assigned to either a medication/Trager group, a medication/attention-control group, or a medication-only control group. All of the subjects had been diagnosed with some form of chronic headache, and all were taking some type of headache medication to relieve the condition.
Patients in the Trager group were treated by a Trager practitioner once a week for six weeks. A typical Trager session lasted approximately one hour and consisted of three parts: 1) a brief, current patient history; 2) a series of movements performed by the practitioner with the patient lying on a padded table, on joint and soft-tissue areas of the patient such as (but not limited to) the head, neck, upper back and shoulders, designed to increase range of motion, ease tension, and encourage both site-specific and general relaxation; 3) teaching the client simple movements designed to help recall and recreate the movements achieved while the practitioner worked on the client, and encouraging the client to practice these movements between treatment sessions.
In the attention control group, subjects met with a physician once a week for approximately 20 minutes, during which time the physician examined the person's head and neck and recorded any pertinent findings or changes. The physician also discussed any headaches the subject experienced in the past week, and asked about medication intake, headache changes and overall well-being. Patients in the medication-only group had no scheduled visits with a health care provider during the six-week treatment period.
For two weeks prior to the start of the study and throughout the six-week treatment period, participants were required to keep a headache diary that documented the frequency, duration and intensity of headaches, and use of headache-related medications. Each participant also completed a modified headache quality of life (HQOL) questionnaire.
Compared to the attention and medication-only groups, patients in the Trager group experienced significant mean decreases in the number of headache episodes per week. Trager patients reported a 27.5 percent reduction in weekly headache frequency, while attention patients experienced only a moderate (3.7 percent) reduction in headache episodes. In the medication-only group, however, the frequency of headaches actually increased by 13.5 percent.
Significant differences were also seen in the area of headache duration. In Trager patients, the length of headaches decreased an average of 0.6 hours; in attention patients, average headache duration decreased 0.3 hours. As with headache frequency, headache duration for patients in the medication-only group increased by an average of 1.3 hours per week.
Perhaps most strikingly, "statistically significant differences" in medication use were seen between groups. In the Trager group, biweekly medication usage decreased an average of 44 percent per patient from baseline through the treatment phase of the study. Medication use among patients in the attention group decreased an average of 19 percent. Patients in the medication-only group, on the other hand, showed an average 25 percent increase in biweekly medication use.
Each of these factors appeared to have an impact on the participants' quality of life. Not surprisingly, patients allocated to the Trager group "showed a significant improvement in HQOL," a result the researchers deemed "encouraging." Interestingly, improvements in headache quality of life scores were similar between patients in the attention and Trager groups. While these scores were not significantly different, the authors noted, "[the] improvements for each of these groups were significantly better than the control group."
The investigators admitted some limitations to their study design, most notably the small number of participants (33 randomized subjects, including four people who withdrew prior to completing the treatment phase). They also observed that while the attrition rate for their study was relatively low, dropout rates of other headache trials have approached 50 percent, a situation that must be taken into account when planning future studies. Finally, the authors noted that different participants took different types of headache remedies. "In the ideal situation," they wrote, "the medication used by all participants would be the same pharmaceutical preparation, and a clearly defined increase or decrease of specific drug type would be measured."
Limitations notwithstanding, the scientists suggested that the improvements seen in headache patients given the Trager approach "support the potential efficacy of Trager in treating chronic headache."
They also recommended that the results of the current trial be used as the framework for a larger, more ambitious study. As the scientists wrote in their conclusion: "In this first randomized trial evaluating the efficacy of Trager in treating chronic headache, we have demonstrated that the Trager approach decreased both headache frequency and medication usage, and that both Trager and physician attention improved the HQOL measurements in chronic headache patients ... the patient improvement in frequency, HQOL, and medication usage while under the care of the Trager practitioner implies that properly focused attention, combined with Trager's manual approaches, is an effective and promising treatment for chronic headache.
"... Demonstration of equivalence between the Trager method and the attention control group in a randomized, controlled, pilot study such as this, is the first step in scientifically assessing the efficacy of alternative treatments. Thus, this pilot study has provided data for the design feasibility of a larger, phase III multi-site trial."
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