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A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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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