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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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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 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.
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.
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.
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.
January, 2012, Vol. 12, Issue 01
Massage Therapy Reduces Pain for Patients in a Postoperative Thoracic Surgery Care Setting
By Massage Therapy Foundation Contributor
What's new in research? We at the Massage Therapy Foundation always want to know! This month's review sponsored by the Foundation is an informative study examining the efficacy and feasibility of using massage therapy within a postoperative thoracic surgery setting at Mayo Clinic in Rochester, Minnesota.
General thoracic surgery is provided to patients for a spectrum of diseases and conditions, "varying from malignancies of the lungs, esophagus, mediastinum, and chest wall to benign conditions of these same anatomical areas. The surgical procedures encompass either resection-type procedures, such as pulmonary lobectomy or esophagectomy, or reconstructive operations, such as bronchoplasty or antireflux procedures." Patients face considerable challenges with pain and discomfort after undergoing thoracic surgery. This pain is often long-term if it is not managed effectively in the postoperative stage.
Massage therapy has gained support as an effective intervention to improve patient experiences during hospitalization, particularly for pain reduction. While previous studies have identified benefits of massage, none have evaluated its use in reducing pain for thoracic surgery patients. According to Bauer and his colleagues, certain medical strategies have been developed to reduce pain and discomfort for patients undergoing thoracic surgery, however, many patients still suffer from pain and discomfort in the postoperative setting. These authors hypothesized that the patients who received massage therapy would benefit by having their post-surgical pain and discomfort managed. To test this hypothesis, they evaluated patients' reports of pain before and after massage treatments received in a thoracic surgery practice.
Bauer and colleagues used a descriptive pre-post measure evaluation design with a standard numeric pain rating scale. Patients who received massage reported pain scores on a scale of zero to 10; zero being no pain, and 10 being the worst possible pain. These scores were recorded before and after massage and throughout recovery. Descriptive comments provided by patients and staff also were recorded and analyzed.
Two massage therapists provided treatments. Each massage included 20 minutes of hands-on massage on the areas requested by the patient, typically the back, neck and shoulders, and sometimes the hands and feet. Patients were positioned to comfort; positioning depended on patient's comfort level and mobility. Therapists did not massage near surgical wounds. The two therapists in the study used several techniques and modalities including Swedish massage, craniosacral therapy, myofascial release, reflexology and diaphragmatic breathing. Depth and pressure of massage was light to moderate.
This study included a sample of 194 patients, with 160 completing the study. Patient characteristics were similar among the patients who provided responses, with an average age of 61 years and an equal number of males and females. Most patients received one individualized massage during their hospital stay (mean 1.2 massages), but 19 patients had two massages, and eight patients received three massages.
Study findings suggest "patients receiving massage therapy had significantly decreased pain scores after massage (p <= .001), and patients' comments were very favorable. Patients and staff were highly satisfied with having massage therapy available, and no major barriers to implementing massage therapy were identified." Only one patient out of the 160 receiving the massage reported a subjective negative experience. Patient responses after receiving a massage included: "I feel I can breathe again;" "That was wonderful, I can move my neck;" and "Before massage treatment pain was radiating, after treatment pain has completely stopped radiating." Staff comments related to massage therapy included: "The patients love it! They want another one;" "Once they try a massage they can't believe the difference. The pain is still there but they feel they can work with it;" and "Massage calms them."
The compelling findings of this pilot study indicate massage therapy is an effective intervention for helping patients deal with pain. Bauer and colleagues provide both subjective descriptions and objective measures of the benefits of massage therapy for thoracic surgical patients for pain management. Pain scores improved, and patient and staff comments were positive. Further, this study demonstrated the feasibility of integrating massage therapy into a high-volume thoracic surgical practice. Authors suggest, "Massage therapy in the hospital setting needs to be focused on individual patient symptoms, and then the therapy is individualized based on these symptoms, medical status, and positioning tolerance." Bauer and colleagues also suggest their findings warrant further research, particularly to determine optimal frequency, duration, and timing of treatment.
So, what do these findings mean for the massage profession and massage therapists? Postoperative massage therapy might have a significant role in pain management and the healing experience for patients recovering from thoracic surgery. Further, massage treatments can be integrated into hospital settings to facilitate pain symptom management. This research, and the growing knowledge base about the use of massage therapy in the clinical setting, is steadily growing. This work and others like it, published in the International Journal of Therapeutic Massage and Bodywork provide excellent references for the evidence-based practice of massage therapy in clinical and non-clinical settings.
Original research study source: www.ijtmb.org/index.php/ijtmb/article/view/100/168.
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