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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.
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.
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.
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?
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
November, 2012, Vol. 12, Issue 11
Another Look at Massage and Substance Abuse Treatment
By Massage Therapy Foundation Contributor
Contributed By April Neufeld, BS, LMT, NCTMB and Derek R. Austin, MS, CMT, LMT
As readers will recall from reading the previous research review article, "A Mind-Body Intervention that Includes Massage Helps in Treatment of Substance Abuse," (Massage Today, October 2012) Sandy Anderson described the details in Cynthia Price and colleagues' research study on the use of Mindful Awareness in Body-oriented Therapy (MABT) in treatment of women's substance use disorders (SUD)."MABT combines massage and mind-body approaches to develop introception.and self-emotional care tools," wrote Anderson. In this second publication of the study, Cynthia Price and colleagues reported in the Journal of Alternative and Complementary Medicine (2012) the issues around acceptability and implementation of MABT within a women's substance use disorder clinic.
The article "highlights a number of issues, including negotiating perceived conflicts between the most internally valid study design and patient treatment needs, the importance of clinical staff perspectives and buy-in, changes in program structure or organization that are necessitated by a particular research design, and the importance of participant satisfaction with treatment," wrote Price and colleagues in the introduction. But what may be of greatest interest to Massage Today readers, the study authors emphasize that "massage is one of the primary MABT elements and is thought to be clinically useful for increasing awareness of tension, cueing individuals to physical symptoms of stress and habitual patterns of responding to stress that may be important for relapse prevention." To gauge the individual effectiveness of the MABT treatment, the study participants filled out a written questionnaire that specifically asked about the helpfulness of MABT components (including check-in, massage body awareness exercises, mindful practice, session review, and homework).
I had the pleasure of interviewing Dr. Price and she said, "[This article] highlights how [the participants] felt about their experience, and in their own words were able to describe how the intervention was helpful for them." She went on in great detail about her experience with the women's clinic where the study took place. (This clinic was independent from the University of Washington, which sponsored the researchers). Although future studies should include men, the women's only clinic was chosen because it had been involved with previous research studies and, therefore, the staff was very comfortable accommodating the researchers, could help with setup, and could facilitate the study.
The clinic studied already offered alternative medicine options for the inpatients including yoga and massage therapy. Dr. Price emphasized that it was important for a clinic to already have a holistic focus integrated into the treatment protocol. "The success of a holistic study has more to do with the staff values and willingness to work with outsiders," Dr. Price said, "and [touch based therapies are] less common among community substance abuse clinics." Substance abuse clinics that include alternative medicine options typically are only available at high-end clinics, but Dr. Price indicated that directors of low-income clinics are aware and interested in including these types of treatments. However, funding is limited for all treatment options, so the cost-effectiveness of MABT should be included in future studies.
Dr. Price's article outlines the treatment satisfaction of the participants. A general satisfaction survey was part of the research methods. "Participants were asked to indicate level of satisfaction with the number of sessions received; 21 (84%) of the respondents were satisfied with the total number of sessions. The four participants who were dissatisfied (16% of respondents) indicated that this was due to wanting more sessions (three ended early due to early discharge from outpatient treatment and one due to time conflicts)," wrote Price and colleagues. Participants also indicated how helpful they found the primary MABT elements (check-in, massage with body literacy, inner body awareness exercises, Mindful Body Awareness Practice, session review, and homework), and the majority (84%) indicated that all components were very helpful. The participants were also able to leave comments. When asked about the most important MABT experience, one participant said, "Connecting emotions with sensations – It is difficult for me to identify emotions sometimes but I can now look to my body for cues." Dr. Price told me that the participants' responses gave a clear picture about why paying attention and body therapy were so important in preventing relapse and how it changed the lives of the women involved.
When looking at the implementation feasibility, the researchers wrote, "it was possible to effectively deliver MABT as an adjunct to SUD treatment in the community-based treatment program." The clinic staff gave positive reviews for the study inclusion, which was indicated in their "willingness to suggest alternatives to help accommodate the implementation of MABT and its participants."
LMTs sometimes ask how they can get involved in working with special populations such as people with substance use or addiction issues. When I asked Dr. Price about the massage therapists who participated in her study, she said that the LMTs involved had a background in mental health disorder training or had practices that involved addiction and bodywork.
For additional education, Dr. Price recommended, "LMTs interested in further training specific to body awareness to promote emotional well-being might consider training in the Hakomi method: www.hakomiinstitute.com. MABT protocol training is available for individual therapists, and for treatment facilities interested in implementing MABT as part of their patient's recovery (substance use, eating disorders and trauma) program: www.mindfulbodyawareness.org."
Editor's Note: If you are interested in learning more about the evidence supporting the use and integration of massage therapy in clinical and medical practice with different patient populations, visit The Massage Therapy Foundation at: www.massagetherapyfoundation.org/ and tap into the Foundation's Research Resources.
Click here for more information about Massage Therapy Foundation Contributor.
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