resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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?
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
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.
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
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!
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?
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
December, 2010, Vol. 10, Issue 12
Pediatric Massage Study Finds Surprising Results
By Tracy Walton, LMT, MS
I had the great pleasure of attending the American Massage Therapy Association National Convention in Minneapolis this year, and hearing a panel discuss pediatric massage research. Among the presenters was Dr. Sean Phipps, a psychologist and researcher at St. Jude Children's Research Hospital in Memphis.He presented a large study of massage and humor therapy in children undergoing stem cell transplant (SCT).1 Stem cell transplant is typically used to treat certain types of cancer and blood diseases. It is a rigorous procedure, with multiple medical risks to the patient.
This is an important and useful study for a number of reasons:
I'll leave the explanation and importance of the first two points to the various resources in massage research literacy.2 Instead, I want to focus here on the last point, that the study observed NO effect from massage or humor therapy in pediatric SCT patients. The audience was understandably surprised, and some of us were stunned. What happened?
The study staff recruited 178 pediatric SCT patients. Because stem cell transplant is notoriously strong treatment, associated with high degrees of distress for patients and families, the study looked at both patient- and parent-targeted interventions. This was not the first time the group attempted research in this area; Previous, smaller studies had documented the feasibility and appeal of massage and humor therapy,3 and had even suggested some benefit to warrant this further study, which was a larger scale, NIH-funded controlled trial.
The patients, aged 6-18, were randomized into three arms. One was a child-targeted intervention composed of massage and humor therapy. Another group received the child-targeted intervention in addition to a parent-targeted intervention that involved massage and relaxation/imagery. The third group, the control group, received only standard medical care.
A standard massage routine was provided by professional massage therapists, with the intended dose set at three half-hour sessions per week for 4 weeks, beginning at 1 week before transplant. The actual average massage dose turned out to be 8.8 sessions over the course of the study, as timing and other logistics often affect the actual amount delivered. The researchers measured somatic distress, mood disturbance, length of hospitalization, the time to engraftment (for the transplant to "take") and the use of opioid pain relievers and antiemetics (antinausea drugs).
As stated above, the investigators found that massage therapy and humor therapy made no difference in any of the outcomes. The patients' experiences of SCT appeared to be unchanged by these two complementary therapies. Even the addition of the parent-targeted therapy, in which the designated parent received massage on the same schedule as the child, along with relaxation therapy, seemed to make no difference. In fact, Dr. Phipps showed graphs of the three groups that were almost identical. Changes in mood and distress measures did occur in all three groups over the course of 4 weeks, but they were typical ups and downs over the course of the procedure. During SCT, the mood and distress measures get worse before they get better, and the patterns were the same in all three groups.
There were no differences in the medical outcomes, either. The time to engraftment, length of hospital stay, and use of pain relievers and antiemetics were surprisingly similar across the three groups.
What Do We Make Of This?
The study authors admitted being surprised by the results, and even disappointed. One important quality in a research paper is humility, and the authors were quick to point out possible limitations in the study design: perhaps they weren't measuring exactly the right outcomes, or the timing of the measurements was not perfect. The age range of 6-18 years in their patient may have been too broad to fully standardize the treatments. They also report that the results of a single study--theirs--is not sufficient for firm conclusions. More studies, from additional researchers, are needed before we can determine whether to advise massage for this population.
One of the most potent observations in this paper, and in the talk that I heard, was that the standard medical care during SCT has improved much in the past years, and that patient distress is so well-managed that it is difficult to improve upon it with massage. In fact, levels of distress in the study sample were quite low to begin with, and throughout the study. While SCT-related distress still exists, it may be that standard medical care is already reducing it to the lowest levels possible, and massage cannot be expected to take it any further.
I was impressed by the care taken in this project, by the findings, and by the reflections of the investigator. I have a few of my own thoughts to add to discussion:
First, it is important for researchers to publish work like this, when the outcomes do not meet the researcher's hypothesis. If we reported only the "good" or "bad" news in massage research (a problem called publication bias), then it would hold back the science of massage, and take longer to learn its true impact. I hope that other massage therapy trade publications also report on these findings, as disappointing as they are, so that the news is balanced.
Second, as much as I might wish for massage to have an effect in this population, the science and my own wishful thinking are two separate things. Massage is powerful therapy, but it is unlikely to be a cure-all. If it really is true that massage has no significant effect on a given population, we need to know that. As a profession, it's important to know if massage is less effective in some populations than in others. If it is, we can direct our study and practice where we know it is effective. Perhaps other patient populations are more responsive to massage, or there are places where the medical management of a condition falls short, and massage could play a larger role. If so, perhaps we should focus our efforts there. This would not mean denying massage to people undergoing SCT. Instead, it would mean that we continue to study the impact of massage, learn where it's most effective, and make sure we act on that information.
Finally, I am interested in the massage design and dose. I have to ask, in this and other studies, whether the massage dose is sufficient to bring about a change? Do we need to schedule daily massage in some populations, so that after logistics have taken their toll, the participants end up receiving 4-5 sessions per week? If so, would 4-5 sessions per week be sufficient, or too much? Does scheduling massage at certain points compromise its effectiveness, and, instead, it should be provided on demand the way some pain medications are administered? Are certain massage strokes, or body areas of focus essential for massage to be effective?
As disappointing as these results were, the study offers an important contribution to the body of research. I am not ready to abandon massage of SCT patients, nor do the investigators suggest that we should. But the study asks good questions. I am grateful to the investigators for their care, expertise, and clear reporting. As good research, this study invites further reflection, discussion, and, of course, more research.
Click here for more information about Tracy Walton, LMT, MS.
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