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Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
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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