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Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
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.
Click here for more information about Massage Therapy Foundation Contributor.
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