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5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
January, 2013, Vol. 13, Issue 01
Dosage Affects Immune and Endocrine Response to Massage
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, MS CMT, Jolie Haun, PhD EdS LMT, Sandra K. Anderson, BA, LMT, ABT
If a weekly massage is helpful for stress relief and immune function, then two weekly massages must be twice as beneficial, right? The results might surprise you.The Massage Therapy Foundation's previous monthly research columns have reported research suggesting massage may reduce pain, stress, depression, anxiety and cortisol levels, and enhance certain immune function parameters. However, how massage produces these outcomes remains a largely unanswered question. In a new study published in The Journal of Alternative and Complementary Medicine, Dr. Mark Rapaport and his colleagues investigated the mechanisms of repeated massage.
The authors compared once and twice-weekly Swedish massage to two equivalent doses of light touch. Fifty-three participants were randomized to one of four intervention groups: five weeks of Swedish massage once-weekly or twice-weekly, or control light-touch once-weekly or twice-weekly. Eight of the 53 participants did not complete the five-week protocol for reasons unrelated to the study intervention, leaving 45 participants (22 male and 23 female). Therapy sessions of 45 minutes were performed by licensed massage therapists using a standardized, specified protocol with nonaromatic oils. The light-touch condition followed the same protocol as the Swedish massage except that the therapist used only light touch with the back of the hand. Blood neuroendocrine and immune samples and salivary cortisol samples were collected prior to and following the therapy sessions.
The twice-weekly massage group demonstrated greater changes in oxytocin, arginine vasopressin, ACTH, and cortisol than the twice-weekly touch group. Twice-weekly massage also increased mean pretreatment levels of CD56+ cells, but decreased all other circulating immune markers. Changes in pretreatment levels of cytokines in the once-weekly group were similar to the authors' previous study showing sustained decreases in many pro-inflammatory and other cytokines. Interestingly, these decreases in markers of inflammation were not observed in the twice-weekly intervention groups. The authors note that the weekly massages were separated by 7 to 8 days, while the twice-weekly sessions were separated by 3 to 4 days; therefore, observed differences may represent differences in length of time between sessions. Heart rate variability was also measured, but no differences were found between the groups. This is not surprising, since young, healthy (i.e. relatively unstressed) sample participants were studied.
Overall, the results can be summed up as follows: once-weekly massage demonstrated patterns of change in circulating lymphocyte markers and cytokines similar to what was observed after a single massage session. Once-weekly massage increased immune changes that were identified after a single session of massage, but had minimal effect on neuroendocrine function. By contrast, twice-weekly massage increased neuroendocrine changes with little effect on the immune markers studied.
These results are consistent with the authors' initial hypothesis that the positive effects of massage therapy might be mediated through oxytocin and arginine vasopressin. The authors conclude these may be sustained, cumulative, biologic effects caused by the massage and light touch interventions. As a whole, the current findings suggest that while these effects are sustained for several days, they were not merely additive; they effects are different depending on the dosage of the intervention. Another intriguing finding of this study is that the light touch condition, involving gentle, systematic, and comprehensive stroking of an individual for 45 minutes, does have impact on biologic activity. This finding calls into question the use of a light-touch group as a "placebo" for research.
These findings are compelling, but study limitations should be noted when interpreting results. The most pressing limitation of this study is the small sample size of the groups. However, this is often the nature of pilot studies. What is important is the results of this small sample warrant a larger follow-up study, which may provide findings that are more conclusive. The authors note that further investigation of dosage, length of treatment, and different massage techniques are needed. Another limitation is this study did not report measures of sympathetic and parasympathetic function, which could have been helpful for interpreting the findings.
These findings make a significant contribution to advancing the science of massage therapy research. Most therapists, and people in general, are aware that massage works but how it works and which dosages are optimal are questions that have remained largely unanswered and are continually being debated in the field. However, published data findings such as these are starting to provide some direction for finding answers to these massage therapy mysteries. These data provide a glimpse into the biological mechanisms of massage therapy and an indication of dosage response. Also notable from a research perspective, light touch does have a biological effect and is not the "placebo" it was believed to be in previously reported research. These findings can inform future studies use of biological outcomes measures, dosage protocols and the re-evaluation of what is an appropriate placebo.
So, what's the take home message? In general, these findings provide justification of repeated massage to promote sustained cumulative effects. However, it is important to be aware that different dosages of massage may result in different changes in biologic activity. Because of this, massage dosage may need to be adjusted based on the desired effect. For example, if immune function is a priority, once-weekly massage may be optimal for desired effect whereas, if neuroendocrine function is a priority, twice-weekly massage may be the best option. Massage therapists, and clinical providers who recommend repeated massage to their patients, can refer to research such as this article and other related research, to inform their dosage recommendations.
To learn more about previously reported research on the biological mechanisms and dosage effects of massage therapy, you can review the Massage Therapy Foundation website, read our previous articles in Massage Today, read accepted MTF Research Grant abstracts or search Pub Med for related massage therapy studies.
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