resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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?
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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
May, 2011, Vol. 11, Issue 05
Research Provides Evidence of Physiological Mechanism For Stress Reduction Resulting From Touch Massage
By Massage Therapy Foundation Contributor
As massage therapy gains popularity as one of the most commonly, used modalities among those offered in complementary and alternative medicine, more research is addressing the physiological effects and mechanisms of massage.This month's Massage Therapy Foundation research synopsis reviews an intriguing study out of Umea University, in Sweden, that evaluated the physiological effects of touch massage and was published in the journal, Autonomic Neuroscience: Basic and Clinical.
Like other massage modalities, touch massage is provided to decrease stress, anxiety and pain. Often massage therapists observe decreases in blood pressure, heart rate, and respiration. These observations suggest massage modalities influence the autonomic nervous system and alter an individual's stress response. The autonomic nervous system is comprised of sympathetic and parasympathetic activity. It controls involuntary bodily functions, such as breathing and the heartbeat. Simply put these two synergistic components act as internal stress (sympathetic) and relaxation (parasympathetic) response systems, which work to maintain autonomic balance. The autonomic nervous system and stress response mechanisms have received considerable attention for explaining a physiological mechanism of massage. Lindgren and colleagues tackled the arduous task of evaluating the physiological effects of touch massage on stress responses in 22 healthy volunteers using a battery of bio-markers to identify autonomic nervous system responses.
Lindgren and colleagues used a crossover design method to conduct this study. In a crossover design, each participant is in both groups (treatment and control). At two separate occasions, each individual either receives the treatment of touch massage or rests in the supine position as a control. Using this method, participants can function as their own comparison with and without the treatment. Though crossover design has many advantages, like requiring smaller sample sizes, the disadvantage of crossover design methods is the carryover effect, where the treatment has lingering effects. If there were a strong carryover effect, we would expect to see the participants who receive treatment first having a different baseline when they return for the control session. However, there were no significant differences between massage first and rest first in the baseline measures taken immediately before the second session, so carryover effects should not influence these results.
Participants received touch massage on their hands and feet, which "consisted of stroking movements on the ventral and dorsal side of hands and feet along with circular movements on each finger and toe. Touch massage was performed for 80 min in the following order: 20 min each on the left hand, the right hand, the right foot, and the left foot." Participants in the control group rested in the same setting. Outcomes measures included heart rate and heart rate variability (the variation in time between heart beats), cortisol stress hormone levels from saliva, blood glucose, and serum insulin. Data were collected before, during, and after touch massage or rest session.
The main finding in this study for Lindgren and colleagues was, "After 5 minutes of touch massage there was a significant decrease in heart rate lasting for 65 min, indicating reduced stress response." Though findings suggested significant changes across several measures, "the only significant differences between the groups were the decreases in heart rate after 45 minutes and in the HF component [high frequency domain of heart rate variability] after 5 minutes." Group differences between treatment and control groups are typically the focus of studies such as this one, because these differences measure the effect resulting from the treatment. Though there were no significant differences between groups in levels of cortisol, glucose, and insulin, "Saliva cortisol and insulin levels decreased significantly after intervention, while the serum glucose level remained stable. A similar pattern, although less prominent was observed in the control group." The findings from this study suggest, "Touch massage reduces the heart rate by decreasing sympathetic nervous activity and evoking a compensatory decreased parasympathetic nervous activity in order to maintain autonomic balance." These findings suggest that after receiving touch massage the participants experienced a biological relaxation response - producing the experience of stress reduction.
As with all research, this study identified limitations to interpreting the findings of this study. First, "calm music" was played during the sessions, which could have had an effect; however, music was used in both groups, therefore touch massage served as the single outcome. Second, as with most massage studies the interpersonal interaction between the therapist and recipient could have affected the treatment. We cannot eliminate the effects of this interaction especially since there was no "sham massage" or "therapeutic touch" group included as a level in between treatment and control. One other potential limitation of the study is that the authors reported that five participants' heart rate and heart rate variability data were excluded due to arrhythmias. Given the already small sample size of less than two dozen individuals, decreasing the sample size by almost 25% for these data points could impact the ability to interpret and generalize these data findings. Further, it is possible that the trend observed of a greater decrease in cortisol following touch massage than following quiet rest and insulin level in this study could prove to be significant with larger sample sizes in future studies. Larger randomized clinical trials will provide evidence for generalizable findings to inform consumers about the effects and physiological mechanisms of touch massage.
This study provides evidence that supports one of the most popular theories for explaining the relaxing effects of massage therapy. Specifically, Lindgren and colleagues found that touch massage significantly reduces cortisol, although not significantly more so than quiet rest, and that massage significantly lowers heart rate. The findings of this study warrant future research to evaluate these physiological mechanisms in larger controlled clinical trials and with more diverse populations. But what does this mean for providers and touch massage recipients? Whether in a non-clinical or clinical setting touch massage can reduce stress for clients and patients. Though this is not likely new information to many providers, as observations of stress reduction are commonplace in the massage setting, Lindgren and colleagues have provided evidence to substantiate these observations, which support incorporating touch massage in individuals' wellness and healthcare plans to facilitate stress reduction and promote personal health.
Source: Lindgren L, Rundgren S, Winsö O, Lehtipalo S, Wiklund U, Karlsson M, Stenlund H, Jacobsson C, Brulin C. Physiological responses to touch massage in healthy volunteers. Autonomic Neuroscience: Basic and Clinical. 2010; 158: 105-110.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
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