resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
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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