Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
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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