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Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
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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