resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
Dr. Frank Nicchi Receives Award at ACC-RAC; Sherman College Expands International Influence.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Applauding a Legacy of Leadership
Founding Palmer West President, John Miller, DC, HCD (Hon.), FICA (Hon.), a 1954 graduate of Palmer College of Chiropractic, passed away March 8, 2015 at age 83.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Trouble in the Wellness Waters?
Call me old-fashioned, paranoid or just old, but I do remember graduating from chiropractic college in the late '70s in the midst of the Wilk v AMA lawsuit.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Make Every Day Mother's Day
May is a special month for many reasons. After a long, harsh winter, spring is at last in full swing. Memorial Day helps us honor those who have fought and fallen in the name of freedom.
Functional Impingement of the Hip (Part 2): Rehab Exercises
I find functionally impinged hips that don't move properly on so many of my patients. (See part 1 of this article for a description of the condition.)
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
If Your Pro-Chiropractic Governor Resigned, Would You Be Prepared?
John Kitzhaber, MD, recently re-elected to a historic fourth term as Oregon governor, has resigned among alleged ethics violations by his fiancée' and first lady, Cylvia Hayes. I developed a personal friendship with John and consider him a good friend.
Apple Takes a Bite Out of Research
The more than 700 million iPhone users have just been given the opportunity to "do their part to advance medical research."
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Talking to Patients About Medial Branch Neurotomy (Part 2)
Even when lumbar facet denervation (medial branch neurotomy) is successful, relief is rarely complete or permanent. Smuck, et al., reviewed 16 articles and found the average duration of >50 percent pain relief for an initial procedure was nine months.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Teach Your Patients About External Healing Applications
Since the skin is the body's largest organ, and is able to respond to both internal and external stimulations, communicate sensations to the brain, protect the body, breathe and even excrete toxins, it can be an excellent source of healing.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
May, 2006, Vol. 06, Issue 05
A Study on Massage and Symptom Relief
By Tracy Walton, LMT, MS
This column is devoted largely to the rewards and challenges of working with people who have been diagnosed with cancer. To that end, I will discuss clinical practice, research and education, all of which are important to this work.In particular, because people have a keen interest in the research on massage and cancer, I've compiled research on the topic and made it available in a bibliography at http://tracywalton.com/id8.html.
The number of studies on this topic is growing, but the quality of research varies, as it does in any discipline. Some studies show good, solid research methods, and others suffer flaws that compromise the integrity of the investigators' findings. In this column, I'd like to share one of my favorites. The work by Janice Post-White and her colleagues, based at the University of Minnesota in Minneapolis and the United Hospital in Saint Paul, is wonderfully designed.1
The investigators studied 230 people in chemotherapy. They looked at immediate symptom relief just after a session, and at overall effects from a course of four weekly treatments. They compared massage therapy to three other types of care: Healing Touch (HT), a specific type of energy therapy derived from therapeutic touch, including both off- and on-body components;2 Caring Presence (P), in which a provider was present in the treatment room with the patient, but with no touch involved; and a control condition of Usual Care (UC), consisting of standard medical care provided to patients, but with no special intervention.
To best describe the design of the project, I ask you to imagine you were a patient recruited for it. After consenting to the study, you were randomized to one of three groups - MT, HT, or P - receiving a 45-minute session of the intervention each week over four weeks. Although you had free choice to join up with the study, and were free at any time to leave it, you did not get to choose your group assignment - it was chosen for you randomly. Your vital signs were taken before and after each session, and you were asked questions about your symptoms at those time points to determine the immediate effects of the intervention. At the beginning of the first session and the beginning of the fourth session in the series, researchers asked you additional questions about pain, nausea and mood, and questions about your use of other complementary therapies. You were asked to keep a log of your medication use, and it was collected from you at each weekly session.
One interesting feature of this study is that investigators used a "crossover design," meaning each research subject served as his or her own control. You went through two, four-week periods in this study - one week getting an intervention such as MT, HT or P, and one week as a "control subject," in which you completed the same kinds of measurements but received no intervention, just your usual medical care (UC). The order in which you spent time in the control and treatment conditions was random: some of you had the four weeks of treatment first; some of you had the control period first. A several-day "washout period" took place in between, to be sure the first period didn't influence the second one.
One thing I admire about this study is how researchers timed the sessions. Because the patients were in chemotherapy, they were subject to the ups and downs of strong medical treatment, which can follow a cyclical pattern after the drug is delivered. Symptoms such as nausea, anxiety, profound fatigue and pain can ebb and flow during chemotherapy, depending on how the patient responds to it. How someone feels depends a lot on when you ask. Unfortunately, this variability can significantly "confound" or muddy the outcomes of a research study. What if fatigue is measured at a particularly bad point in one chemotherapy cycle, but at a better point in another? It would make it hard to assess the true effects of massage on fatigue.
The authors anticipated this and made sure that the two sets of measurements, one over a four-week control period and one over a four-week treatment period, occurred at the same time point in identical chemotherapy cycles. Their care with this timing is one key to the solid design of this study.
After all this, what were their findings? Some highlights: They found that MT and HT reduced pain, improved mood and increased relaxation more than presence or the usual care control. These modalities also lowered respiration rate, heart rate and blood pressure. These were immediate effects of the sessions, but they were consistent across all four sessions. Only massage significantly lowered anxiety, and only HT significantly reduced fatigue. No intervention lowered nausea, but investigators found that the timing of the weekly sessions was such that the patients' nausea scores were already low, and it's difficult to significantly reduce a symptom that is low in the first place. This is called a "floor effect," and since nausea typically is worse in the few days following chemotherapy and then resolves, higher nausea scores didn't get picked up in the weekly sessions (the first massage right before the first infusion; the second a whole week later). Finally, over a four-week course of massage therapy, patients used less pain medication than those in the other groups, and less than they did during their control group experience.
Does this study "prove" that massage helps? In general, it's good to steer clear of that term until we have enough additional well-designed studies to provide convincing numbers. The field needs a large body of evidence for such a strong statement. Certainly, the findings suggest benefit and the authors cite other studies that corroborate their findings. The most consistent finding among studies on massage and cancer is its effect on anxiety, which is supported by this paper. In my own promotion of massage, whether speaking or teaching, I'm finally starting to feel the support of those numbers. And, if you're an individual in chemotherapy, finding symptom relief with massage, you feel supported no matter what the numbers show. You're not likely to stop what you're doing to wait for the data to catch up with your experience.
This is a wonderful study, worth reading closely. In the growing body of research on massage therapy, this is one of the largest, strongest works to date. I'm planning a research update, including this study, at the Atlanta AMTA convention this fall. I appreciate the dialogue that flows from this work.
Click here for more information about Tracy Walton, LMT, MS.
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