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Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
September, 2009, Vol. 9, Issue 09
Knowledge Translation in Massage Therapy
By Whitney Lowe, LMT
I recently received an e-mail from a practitioner concerned about a study he had read about massage. The study reported that massage did not aid the removal of lactic acid from the body nor did it increase circulation, both commonly reported effects of massage.He was concerned that what he had learned in school wasn't true and perhaps his work was not that helpful after all.
Are these issues true, and do they mean that massage isn't all it's cracked up to be? Well, yes and no. Research has established for some time that massage does not speed the removal of lactic acid from the body. Does that mean massage isn't useful in reducing soft-tissue pain and disability? Certainly not. On the contrary, this finding actually helps us better understand the physiological effects of massage.
What about massage not helping increase circulation? This one is a little trickier. Most of the studies investigating the effect of massage on increased circulation have focused on blood flow increases through major vessels. Massage does not increase blood circulation through these larger vessels. However, rarely do these studies investigate circulation through small capillaries in muscle tissue and skin. Increases in small capillary blood flow bring fresh oxygenated blood to muscle tissue and produce hyperemia (the characteristic redness) in the skin.
What this story illustrates is a need we currently have in all health care professions, including massage. This need is addressed by a discipline known as knowledge translation. Knowledge translation (KT) is the process of integrating research findings into clinical practice. A recent study investigating knowledge translation in medical practice noted that it takes about 20 years for advances in medical knowledge to be incorporated into clinical practice.1 This lag time is one reason that myths persist, such as the role of massage in removing lactic acid from the blood.
How Does KT Fit with Massage
There is increasing emphasis on the importance of research in the massage profession. New findings allow massage professionals to refine clinical treatments so effective care can be provided. An example of how integrating science is relevant for massage comes from recent research into the pathology of overuse tendon disorders. It is now recognized that most overuse tendon disorders involve degeneration of the collagen matrix within the tendon structure (tendinosis) and not an inflammatory condition resulting from torn tendon fibers (tendinitis).
For years, the primary massage treatment strategy for overuse tendon disorders has been deep transverse friction. Treatment protocols emphasized friction applied in a transverse direction to re-align the scar tissue from torn tendon fibers. Today, we know that the primary benefit of friction massage is actually the combination of pressure and movement in stimulating fibroblast production, thereby enhancing the tendon's healing process.
This finding has important implications for treating problems such as bicipital tendinosis in the shoulder. Deep transverse friction treatments applied to the bicipital tendon run the risk of popping the muscle's tendon out of the bicipital groove. It is now understood that tendinosis is effectively treated with longitudinal friction since pressure and movement, not pressure direction, are the key.
Challenges to Implementing Research
There are reasons why research is not more quickly integrated into health care fields, including the massage profession. The volume of information currently being published is simply overwhelming. One study suggested that for physicians to keep abreast of current findings, they would have to read 19 original articles each day.2
Another issue is the sheer complexity of the research; interpreting information from a study can be difficult. In other cases, such as the massage article mentioned above, the findings can be misinterpreted if the study's design and methodology are not more closely analyzed.
Another challenge for integrating research into practice is long-held beliefs or practices. This challenge is captured by a wonderful quote from the Canadian researcher Serge Gracovetsky. At a fascinating presentation at the 2007 Fascia Congress in Boston, he stated, "Medicine is perhaps the only discipline in which an attractive idea can survive experimental annihilation." In order to advance the health care professions, there needs to be adaptability and willingness to change practice patterns in response to new research findings.
Research Integration Barriers
The problem of integrating scientific research into massage therapy centers on several key issues. The first is access. Knowing how and where to access primary source Web sites and journal articles remains a barrier for many clinicians. It is also very difficult for full-time professionals to find the time required to look up and read material.
A second barrier is the material itself, often written in difficult medical jargon, with methodologies unfamiliar to the massage professional. The answer to this problem lies with both the source and the recipient. First, the massage professional needs to develop clinical reasoning (see my MT column March 2009) and research literacy skills. Being capable of interpreting and evaluating research, as well as analyzing methodology, is critical. An individual must be able to read an article or research study, evaluate and critique aspects of it, and then conceive how its findings may relate to clinical practice.
On the other side of the equation, those scientists producing published materials must be able to write clearly and well (which is why many choose to use technical writers). They also need to find ways to get their materials out to relevant communities. The gap between scientist and clinician is fundamentally both a communication problem and a mechanism issue. What mechanism is being used to get material to the clinician? What format and how accessible? Answering this dilemma is what KT is about.
Knowledge Translation as a Solution
The increasing complexity of our health care system and the volume of published literature require an increased emphasis on KT strategies. Finding ways to make research more accessible and improving research literacy among clinicians is critical to the profession.
Massage therapists have a wonderful resource in the Massage Therapy Foundation, which is dedicated to improving access to and expanding resources for massage professionals. There are now two peer-reviewed publications available, the Journal of Bodywork & Movement Therapies and the International Journal of Therapeutic Massage & Bodywork (an open access online journal from the Massage Therapy Foundation).
In addition, massage educators - both basic training and continuing-education providers - have important roles in KT. Many CE educators already make current research an integral part of their programs, but many more could improve this aspect of their teachings. There is an increasing movement to make research literacy part of the initial training programs for massage students. As more people within the field develop research literacy, the move to bring research into clinical practice will grow.
The more clinicians incorporate the latest findings from quality clinical research, the more effective and successful they become in their practice. With that, the more the profession can continue to develop as a legitimate and critical part of the health care industry.
Click here for more information about Whitney Lowe, LMT.
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