resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
June, 2011, Vol. 11, Issue 06
Models and Evidence-Bases
By Keith Eric Grant, PhD, NCTMB
The techniques we use as massage therapists are increasingly coming under scrutiny and review. To an extent, this is part of a general movement in health care to review both the effectiveness of interventions and to compare what is actually done in practice with what accumulated evidence suggests would be the "best course".Two reports from the Institute of Medicine out this year underline this review: "Clinical Practice Guidelines We Can Trust" and "Finding What Works in Health Care: Standards for Systematic Reviews". The motivation from this introspection was noted by Joseph Padula in his blog "Managed Care Matters" — even many medical guidelines have had little or no solid evidence behind them, often resulting in less than optimal treatment.
In part also, the scrutiny of massage techniques and conceptual models behind the techniques stems from a cohort of massage educators looking to frame a more sound basis for massage therapy as a component of health care and to bring what's being taught into agreement with modern knowledge of anatomy and physiology. This has turned into an ongoing, international discussion across multiple social media: Facebook, Twitter, and ABMP's "Massage Professionals" forums, in particular.
Looking at evidence requires asking two types of questions; questions that I believe are separable. First, are there specific conditions for which we have evidence that massage techniques provide an effective treatment or co-treatment? If so, what can we say about the reliability of the evidence? Is it supported by research in addition to anecdotal (narrative) observations? In the best of possible worlds, we would like research and anecdote to reinforce each other and add to our insights. Enkin and Jadad provide a context for this delicate process of integrating experience and research.
Those who really follow the principles of evidence-based health care, "the conscientious and judicious use of current best evidence from clinical care research to guide health care decisions," understand that conscientious and judicious use does not mean blind adherence. They are making efforts to integrate research evidence with other types of information, values, preferences, resources and circumstances. Enkin and Jadad also caution about the interplay of belief with anecdotal "evidence," especially when anecdotes and research disagree, leaving the clinical practitioner to face a paradox.
Despite its low ranking in the evidence hierarchy, anecdotal information exerts a disproportionately powerful influence on clinical thinking and behavior. The paradox was well described by William Asher: "If you can believe fervently in your treatment, even though controlled tests show that it is quite useless, then your results are much better, your patients are much better, and your income is much better too... It is an almost insoluble problem, and the majority of worth-while doctors are driven to a compromise in which they muster enough genuine belief in their treatment to keep their patients happy and maintain their own respect, while preserving enough doubt to admit their inadequacy during transient bouts of uncomfortable honesty."
It's in trying to resolve the interplay between research and clinical anecdotes that we find the second kind of question. Do we have an explanation for the effectiveness of our techniques that doesn't violate laws of physics and is in accord with modern knowledge of anatomy, physiology and neurology? I explicitly add neurology because our body is not just physical. Our brain does an amazing computational feat in taking the myriad of sensory signals as input and providing us with a body sense as output. This second type of question brings us into the realm of conceptual models or maps for the actions of our techniques. Any such model is an approximation of reality. We can further subdivide questions about such a map into: "Is it useful?" and "Is it a correct approximation?"
Gregory Bateson, in "Form, Substance and Difference," from Steps to an Ecology of Mind (1972), elucidates the essential impossibility of knowing what the territory is, as any understanding of it is based on some representation: "We say the map is different from the territory. But what is the territory? Operationally, somebody went out with a retina or a measuring stick and made representations which were then put on paper. What is on the paper map is a representation of what was in the retinal representation of the man who made the map; and as you push the question back, what you find is an infinite regress, an infinite series of maps. The territory never gets in at all. [...] Always, the process of representation will filter it out so that the mental world is only maps of maps, ad infinitum."
Elsewhere in that same volume, Bateson points out that the usefulness of a map (a representation of reality) is not necessarily a matter of its literal truthfulness, but its having a structure analogous, for the purpose at hand, to the territory. Bateson argues this case at some length in the essay "The Theology of Alcoholics Anonymous."
To paraphrase Bateson's argument, a culture that believes that common colds are transmitted by evil spirits, that those spirits fly out of you when you sneeze, can pass from one person to another when they are inhaled or when both handle the same objects, etc., could have just as effective a "map" for public health as one that substituted microbes for spirits. While treatments of the individual would differ between the two models, actions such as isolation and quarantining would not.
Our challenge as a health care profession in the modern world comes in the way we address these questions, identifying areas needing research, filtering out disproved myths and ensuring the transfer of knowledge into practice.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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