resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
November, 2006, Vol. 06, Issue 11
A Study of Foot Massage and Cancer Symptoms
By Tracy Walton, LMT, MS
In my May 2006 column (www.massagetoday.com/archives/2006/05/13.html), I discussed a wonderful study on massage and healing touch for patients in chemotherapy.1 Here, I'll continue the research theme by describing another solid research paper, this one published in 2000 in a nursing journal.One might not think that an article published six years ago is news, but I find myself repeatedly referring to it in my teaching and practice. It's not just the newer studies that should make a splash; the enduring "solid citizens" of past research bear repeating and celebrating. I introduce the study here not only to acknowledge the work, but also to highlight some things in massage and cancer research: The importance of noting the massage providers and their credentials; the actual massage therapy protocol used in the study; and the results they found.
In "Foot Massage: A Nursing Intervention to Modify the Distressing Symptoms of Pain and Nausea in Patients Hospitalized with Cancer,"2 the investigators studied a sample of 87 inpatients. To bring this study most vividly into the present, I ask you to imagine you were a patient in the study. You were studied over a period of three consecutive nights during your hospital stay. On two of those evenings, you received foot massage; on the other evening, you were asked to stay in bed for a "quiet activity" (usually reading or watching television) only. The sequence of these was random (massage-control-massage or control-massage-massage, and so on). The same measurements - your heart rate and your "zero to 10" reports of your pain, nausea and relaxation levels - were recorded before and after the intervention each night.
A Crossover Study
The fact that you "crossed over" between massage and control conditions makes this a "crossover study" - a nice design when it's done well. You were your own control. Since you effectively served in both groups, the control and experimental groups were comparable. Interventions occurred at roughly the same time each day, because regular medications in the hospital tend to make symptoms follow characteristic patterns each day.
The Massage Provider and Protocol
In the study, you received foot massage from a nurse "experienced in the administration of massage." This sometimes raises eyebrows among massage therapists who ask about credentials and whether this truly reflects massage therapy practice. In this case, the authors wanted to restore massage to nursing care when needed, not try to pass off a nursing intervention as massage therapy. But, their description of the massage, a very detailed, fixed protocol, suggests that the authors clearly understand some of the important essentials of massage. This is the massage session described by Grealish, et al. "The massage was performed using slow, firm or gentle strokes toward the heart, from the base of the toes up the foot and lower leg to the knee ... The fingertips were used to make small circular movements around joints and between deep and superficial muscles, including the ankle, and between the metatarsals. A rhythmic lifting and squeezing of the flesh using both hands was alternated with the other movements. Joints were rotated in a clockwise and counterclockwise direction three times. When doing massage, the nurse's hands were warm. The foot not being massaged was covered with a towel and the massaged foot was held firmly. A non-fragrant vegetable oil was used."
Two things are important to note about the protocol. First, the title of the study depicts "foot massage," yet it included both foot and low leg. In fact, "foot massage" might have been good shorthand for the study, but this discrepancy suggests it's important to read what actually happened in the session. I meet MTs in my trainings who claim to be allergic to reading research, but even they become engaged when flipping through a study to read the actual massage protocol. Second, this massage protocol is very clear. This is one of my favorite massage research protocols because it describes so clearly what actually happened. I can imagine each toe being rotated three times in each direction! The researchers clearly share practices with massage therapists and note them in the study. Cover the nonmassaged area with a towel. Firm touch matters. The kind of oil you use bears mentioning. Moreover, each patient received an "introductory massage" before the study began, so they would know what to expect. These things suggest the researchers understand important elements such as safety, warmth, depth and firm touch. Regardless of whether I agree with their choice of protocol, the description is so clearly written I could easily replicate it in practice, especially if good things seem to come from it!
Measurements and Findings
The authors measured immediate effects of massage, not sustained or long-term effects. They asked questions just prior to the massage, and then 20 minutes after it was over. On the control night, they did the same, but left the patient in a quiet activity, and then measured again 20-30 minutes later.
Three "subjective outcomes" (pain, nausea and relaxation) and one "objective outcome" (heart rate, a function of relaxation) were measured in this study. Patients were asked to complete three "visual analogue scales" before and after each condition. On a 100 mm line, showing "no pain" at 0 mm and "worst possible pain" at 10 mm, patients were asked to mark their symptom level on the scale. Somewhat similar scales were used for relaxation and nausea. While subjective, the VAS is a convenient measurement tool that therapists easily can incorporate into clinical practice, before and after the session.
The study found that immediate self-reports of pain and nausea dropped on the massage nights compared to the control nights. Relaxation appeared to increase after massage, shown in heart rates and self-reports. This was associated with only two short foot massages; perhaps a greater effect would occur with a higher massage therapy dose. In their discussion, the authors note the positive findings. But, instead of making sweeping, grandiose claims of benefit, they list limitations of their own study and directions for further research. (A humble tone is a good sign in a research paper; look for it any time you read the discussion section.) We should follow their lead and not overstate results. This study still is relatively small - 87 in the sample - although it's one of the largest of the small studies. We need a larger body of research evidence before we truly can claim, "The evidence shows massage helps symptoms." For now, we can state that small "controlled trials" (as both Grealish and Post-White provide, with control conditions and good design) are "beginning to suggest a relationship between massage and symptom relief." This study, along with some other solid contributions, is beginning to point the way. Cautious claims aside, let's focus on the individual stories again. If you were a patient whose nausea or pain subsided, would you insist on the data to support your experience? Probably not. You would simply feel better. Perhaps you'd feel grateful for having your feet and low legs massaged with firm, warm hands. Your single story is worth telling, too. Indeed, individual stories are as compelling as the group story here. All should be examined closely and noted, told and retold. Each story contributes something to our understanding of massage and symptom relief.
Click here for more information about Tracy Walton, LMT, MS.
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