resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
September, 2009, Vol. 9, Issue 09
Massage and Alzheimer’s Disease, Part 2
What does the literature say?
By Ann Catlin, LMT, NCTMB, OTR
Mary, an 81-year-old female, has resided in a nursing home for seven months. Her medical history reveals that she has Alzheimer's disease; anxiety (state unspecified); dementia with behavior disorder; insomnia; osteoarthritis; osteoporosis; and recurrent urinary tract infections. She requires a wheelchair because she no longer is able to safely ambulate and has fallen several times; she has increasing difficulty communicating her needs because she cannot find the appropriate words to express herself; she has recently begun to yell out and, at times, bangs on her wheelchair for long periods of time. She relies on staff to assist her with activities of daily living; she is incontinent of urine; she attends group activities, but the yelling and banging is upsetting to the others and she is removed from the group. She spends much of her time in her room or in the hallway. She has difficulty sleeping and is often anxious at night, which increases her yelling behavior. This concerns staff because they have difficulty calming her and other residents are awakened.
Following a referral for massage therapy, I arranged for sessions twice a week and it was agreed the need for continued session would be determined after six weeks. I saw Mary in her room while she was sitting in her wheelchair. Each session lasted 20 to 30 minutes and typically took place in the morning before lunch. Mary was receptive to having massage lotion applied to her hands in the form of a hand massage and she seemed to enjoy the one-to-one attention.
Following three weeks of sessions, the activity director reported that Mary was able to remain in more group activities without disruptive yelling and only occasional banging on her wheelchair. This resulted in less isolation and opportunities for social interaction for Mary. After six weeks, I demonstrated a simple hand massage technique that the staff could use in addition to continued weekly massage therapy sessions. The nurse assistant reported that Mary was more cooperative during self care activities and that she had decreased restlessness and agitation at night. The overall impact of massage therapy was an increase in the quality of life for Mary and decreased job stress along with increased feelings of satisfaction for the staff.
This scenario illustrates that, indeed, massage appears to have a positive impact on the care and quality of life of an elder living with the effects of Alzheimer's disease. I'm not alone in witnessing these effects -- many of my colleagues share similar stories that point to the efficacy of massage in Alzheimer's care. But our stories may not be enough to substantiate what we experience during our sessions. As massage therapy becomes more recognized as a health care profession we are expected to back up our stories with data. Like it or not it is the world we live in. Fortunately there is a long-standing and growing body of evidence that substantiates the value of massage and touch in Alzheimer's care. While there is need for further research, studies indicate that the use of some forms of massage are effective in managing challenging behavior often exhibited by elders living with Alzheimer's disease and other forms of dementia. What follows is a brief report on a few such studies and articles. While this is surely not an exhaustive collection of articles, it will give you some interesting data on which to hang your hat (or your holster!). I've included Web links so you can access the full text of each article.
Studies in Dementia
Editor's note: The following abstracts were taken from various Internet sources; author, title, publication and Web links of each abstract are cited.
Hicks-Moore S, Robinson B. "Favorite Music and Hand Massage: Two Interventions to Decrease Agitation in Residents with Dementia." Dementia, 2008;7(1):95-108. http://dem.sagepub.com/cgi/content/abstract/7/1/95
Agitation in individuals with dementia living in the nursing home environment affects care and quality of life. Relaxation techniques such as music and massage are showing promise to decrease agitation and improve quality of life in individuals with dementia. Using an experimental 3 x 3 repeated measures design, 41 residents with mild to moderate dementia participated in a study to test the effectiveness of favorite music (FM) and hand massage (HM) in reducing agitated behaviors. Agitated residents were randomly assigned to either the treatment or control groups. Residents in the treatment group received each of three treatments, HM, FM, and HMFM, with each treatment lasting 10 minutes. Residents in the control group received no treatment. Agitation was measured using the Cohen-Mansfield Agitation Inventory (CMAI) at three different intervals. The results suggest that FM and HM individually and combined are effective in significantly decreasing agitation immediately following the intervention and also one hour post intervention.
Forbes D et al. "Nonpharmacological Management of Agitated Behaviours Associated with Dementia." Geriatrics & Aging, 2005;8(4):26-30. http://www.medscape.com/viewarticle/503816
Abstract: Strategies such as simulated presence therapy, pet therapy, light therapy, validation therapy, music, massage, therapeutic touch, aromatherapy, and multisensory stimulation have shown promising results in decreasing physical aggression, physical nonaggression, verbal aggression, and verbal nonaggression in older adults with dementia. Further research is needed to identify which strategies are most effective in managing symptoms of agitation associated with the different types of dementia and at different levels of cognitive impairment.
Nonpharmacological approaches have several advantages. They address the psychosocial and/or environmental reason(s) for the agitation, and compared to pharmaceutical interventions they avoid potential side effects, drug-drug interactions, and masking of behaviour that may serve as a signal for a need. The purpose of this review is, therefore, to assess and summarize research evidence on the efficacy of nonpharmacological strategies in managing agitated behaviour associated with Alzheimer's disease and related dementias.
Cohen-Mansfield J. "Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia: A Review, Summary, and Critique." American Journal of Geriatric Psychiatry, 2001;9:361-81. http://focus.psychiatryonline.org/cgi/reprint/2/2/288
Abstract: Inappropriate behaviors are very common in dementia and impose an enormous toll both emotionally and financially. Three main psychosocial theoretical models have generally been utilized to explain inappropriate behaviors in dementia: the "unmet needs" model, a behavioral/learning model, and an environmental vulnerability/reduced stress-threshold model. A literature search yielded 83 nonpharmacological intervention studies, which utilized the following categories of interventions: sensory, social contact (real or simulated), behavior therapy, staff training, structured activities, environmental interventions, medical/nursing care interventions, and combination therapies. The majority are reported to have a positive, albeit not always significant, impact. Better matching of the available interventions to patients' needs and capabilities may result in greater benefits to patients and their caregivers.
Massage/Touch. Six articles report studies of massage or therapeutic touch. Usually, the procedure took about five minutes and was performed once or twice per day. One study reported unequivocal success (using a combination of massage and verbalizations). The other studies reported either a positive trend, partial effects (on physical and verbal behaviors) or no effect of the intervention (on aggression).
Snyder M et al. "Efficacy of Hand Massage in Decreasing Agitation Behaviors Associated with Care Activities in Persons with Dementia." Geriatric Nursing, March/April 1995:60-3. http://www.ncbi.nlm.nih.gov/pubmed/7774819
Summary: The purpose of this study was to explore if administering hand massage before care activities that were often associated with agitation behaviors would reduce the frequency and intensity of these behaviors during these care activities. Both aggressive and non-aggressive forms of agitation were studied. A hand massage protocol that took five minutes to give was chosen as the intervention. Hand massage was performed in the morning and afternoon for ten days. Results showed that hand massage decreased the frequency and intensity of agitated behavior during morning care routines, although not during evening care. Staff reported that reducing the intensity of the behavior made it easier to care for the elders.
Kilstoff K et al. "New Approaches to Health and Well-Being for Dementia Day-Care Clients, Family Carers, and Day-care Staff." International Journal of Nursing Practice, June 1998;4(2):70-83. http://www.ncbi.nlm.nih.gov/pubmed/9748936
Abstract: This study was conducted in one multicultural dementia day-care centre over a period of 18 months. It introduced a gentle hand treatment for clients using three essential oils. The study evolved out of the process of action research where the family carers and day-care staff participated with the researchers to choose, design, develop and evaluate a hand treatment program. Data was collected through in-depth interviews pre-and post-treatment, focus group discussions, client observation logbooks and a disability scale. The findings indicate a positive strengthening of the relationship between the person with dementia and their family carer, and an improvement in feelings of health and well-being for both. The specific improvements for clients include increased alertness, self-hygiene, contentment, initiation of toileting, sleeping at night and reduced levels of agitation, withdrawal and wandering. Family carers have reported less distress, improved sleeping patterns and feelings of calm. They also found the treatment useful in helping them manage the difficult behaviors exhibited by their relative with dementia. The benefits of this treatment for nursing practice are that it is safe, effective and easily administered by staff in any setting.
Want to learn more?
I invite you to explore this topic further. Who knows; maybe the next study will be conducted by YOU! Additional online resources that I have found helpful are:
I leave you with this quote: "If you have knowledge, let others light their candles at it." Margaret Fuller
Read Ann's previous article "Massage and Alzheimer's Disease, Part 1 What would Maslow say?"
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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