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News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
September, 2011, Vol. 11, Issue 09
Massage for Symptoms of Multiple Sclerosis
A brief review of an article published in the Multiple Sclerosis Journal
By Massage Therapy Foundation Contributor
This month's Massage Therapy Foundation article review addresses a common issue, constipation, or difficulty having a bowel movement, among people with multiple sclerosis (MS).Constipation affects many people; however, this is commonly a chronic issue for people with multiple sclerosis. Constipation can involve discomfort, distress and can negatively affect the quality of life for people with MS. However, research suggests the use of abdominal (stomach) massage can improve bowel movements. McClurg and colleagues conducted a study to determine the feasibility of using abdominal massage to alleviate constipation in people with MS.
Of 41 volunteers, 30 patients with MS and constipation were recruited and met the requirements to be included in the study. Several outcome measures were used, including several self-report questionnaires, including the Constipation Scoring System (CSS), the Neurogenic Bowel Dysfunction Score (NBDS), and a bowel diary. Participants were randomly assigned to a massage group or a control group (no massage). Both groups received bowel management advice. In addition to advice, the massage group participants, or their caregivers, were taught abdominal massage techniques. Four primary techniques were provided – stroking, effleurage, kneading and vibration. Participants and their caregivers were provided with instruction, practice and opportunities to ask questions regarding the techniques. Each participant in the massage group was advised to perform on themselves or receive from their caretakers abdominal massage daily for the 4-week intervention period. An instructional DVD was provided to participants in the massage group. Outcomes were measured at baseline (Week 0), post treatment (Week 4), and at Week 8; and were administered by telephone by a third party data collector who was blinded to participants' group assignment (massage versus control).
Findings indicated participants in the massage and control groups reported a decrease in CSS score (Week 0 to Week 4), suggesting improved bowel function; however, the massage group improved significantly more than the control group. The massage group also reported improvement on the NBDS, but the control group reported worse scores (Week 0 to Week 8); these data indicated the massage group reports were significantly improved over those participants in the control group. The bowel diary also provided telling evidence, such that the frequency of bowel movements increased (improved) for both groups, but participants in the massage group reported significantly more bowel movements than those in the control group (Week 0 to Week 4). Further, participant reports suggest time spent defecating reduced for both groups from Week 0 to Week 4, in the massage group it was reduced from 10 minutes at baseline to 6 minutes per day; and in the control group from 12 minutes to 10 minutes, per day.
The authors reported several limitations in this study, namely the small sample size and the potential lack of sensitivity of the NBDS to detect changes in the study population. As with many similar studies, a convenient sampling strategy was used, in that patients self-selected to participate in the study and thus may have different characteristics than those individuals who do not self-select to participate in research. As with most massage research, it was not possible to blind the participants or clinicians. The duration of the intervention was short compared to other published research; authors suggest the effects may have continued to increase if the intervention had been for a longer duration. Furthermore, some participants felt applying self-massage was tiring, and they were unable to apply the same pressure as the therapist. It is noted that the inability to provide adequate pressure for a sustained period could reduce massage treatment effects.
What is the take home message of this publication? McClurg and colleagues' findings support the feasibility of a randomized control trial (RCT) of abdominal massage to manage symptoms of constipation in people with MS. These study findings provide support for using abdominal massage with clients and patients who report symptoms related to constipation. Notably, study participants reported finding the bowel diary useful; bowel diaries may be a useful tool for monitoring and managing constipation in tandem with other modalities such as massage. Furthermore, as massage becomes recognized as a viable treatment for diverse populations, the use of instructional DVDs continues to gain popularity. Instructional DVDs that provide informal caregivers with massage techniques opens up new opportunities to receive the benefits of massage for people who may not otherwise have the financial resources to access massage.
In closing, McClurg and colleagues provided data in an area where empirical data is needed and demonstrated the feasibility of using abdominal massage "as part of an integrated bowel management program." As more conclusive research findings are published, we will gain more insight into the effects of massage on constipation symptoms in patients with MS and other patient populations who struggle with bowel management.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
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