resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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%.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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).
August, 2012, Vol. 12, Issue 08
How Much Massage Therapy is Enough?
By Massage Therapy Foundation Contributor
Contributed by Karen T. Boulanger, PhD, CMT; Jolie Haun, PhD, LMT; Derek R. Austin, MS, CMT
This month's research summary brought to you by the Massage Therapy Foundation features a study completed by Adam Perlman and colleagues entitled, "Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial." There are three things that we really like about this published research.First, it calls attention to a condition that most massage therapists address frequently. Second, it is the first study that looked at dose to inform how much massage is needed to achieve good outcomes for this condition. And third, it resulted in a massage protocol that was respectful of the individualized nature of practice.
Like many degenerative joint diseases, osteoarthritis (OA) of the knee is painful and limits function. Typical drug therapies are not always helpful and have unpleasant side effects. Six years ago, Dr. Perlman and his team reported the results of a pilot study that offered massage therapy as a feasible, safe and potentially effective treatment for the 27 million Americans that suffer from this condition. The purpose of the current study was to define the "optimal dose" of massage therapy for OA. Once determined, the optimal dose can be used in a more sophisticated study to expand on the current findings.
Participants in the study included 125 adults at least 35 years old with radiographically confirmed OA of the knee and pain rated between 4 and 9 on a 10-point visual analog scale. Along with a wait list control group (usual care), participants were randomized to one of four regimens in which time and frequency (dose) of massage varied:
Swedish massage was provided by licensed massage therapists who provided input to develop 30- and 60-minute full body massage protocols specifically for OA of the knee. Although the protocol specified the percentage of time allotted for each body region, the order of the application was flexible to accommodate practitioner and patient preferences. Outcomes were assessed at baseline and at 8, 16 and 24 weeks. Measurements included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), which assesses pain, function and joint stiffness; a visual analog scale (VAS) for pain; range of motion (ROM); and the amount of time needed to walk 50 feet.
After eight weeks of massage, there were significant changes in WOMAC global scores between the usual care group and the groups that received 60 minutes of massage, but there were no significant differences between the massage groups. There were also significant differences in the WOMAC pain and function subscales and VAS scores between usual care and the 60-minute doses. However, there were no significant between-group differences in the WOMAC stiffness subscale and time to walk 50 feet. ROM improved significantly only in the group that received the highest dose of massage (Group 4).
A dose-response curve was constructed using the WOMAC global scores after eight weeks. It demonstrated that as minutes of massage increased, improvement also increased, plateauing at the 480-minute dose. The optimal dose of massage to improve symptoms of OA of the knee was revealed to be 60 minutes once a week. This result is consistent with the results of their previous pilot study. Although massage ended after eight weeks, significant improvements in WOMAC global scores were observed in all massage groups after 16 and 24 weeks compared to baseline. This improvement was not observed in the usual care group. In addition, there were significant improvements in the WOMAC pain and function subscales in the groups receiving the three highest doses of massage after 16 and 24 weeks compared to baseline.
The National Center for Complementary and Alternative Medicine (NCCAM) has awarded Perlman and colleagues additional funds to continue their exploration of the efficacy of massage for osteoarthritis of the knee. Between-group differences after 16 and 24 weeks may be uncovered with larger sample sizes in their next study. Comparisons of massage to light touch, biological mechanisms (biomarkers) and cost effectiveness will also be explored in their next multi-site trial. The results of this study, particularly the optimal dose of massage, 60 minutes once weekly, are relevant to improving treatment for OA of the knee. Massage therapists can use these findings to support the effectiveness of massage to treat OA of the knee, and for making treatment recommendations based on time and frequency.
These findings also support the notion that the time and frequency of massage treatments is of significance, suggesting more studies are needed to inform the dose of massage for other conditions. Because this study was funded by NCCAM, the full text article is available at no cost to the public. This free full text includes the actual massage protocols used for the treatment of OA. If you are curious to see what other projects NCCAM is funding, you can visit http://nccam.nih.gov/research/extramural/awards and type "massage" in the "term search" box.
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