resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
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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