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MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
March, 2013, Vol. 13, Issue 03
Testing the Treatment Dose of Massage for Chronic Neck Pain
By Massage Therapy Foundation Contributor
Contributed By April V. Neufeld, BS, LMT, NCTMB; Jolie Haun, PhD, LMT; MK Brennan, MS, LMBT, RN, ACM
Researchers at the Group Health Research Institute in Seattle are improving the quality of research studies on massage therapy.This month's Massage Therapy Foundation's review is the Institute's latest project published in a recent BMC Complementary and Alternative Medicine publication, "Dosing study of massage for chronic neck pain: protocol for the dose response evaluation and analysis of massage [DREAM] trial."
"As with back pain, a plethora of options are available for treating neck pain, yet the most commonly used treatments lack consistent evidence of the effectiveness, especially for persons with chronic neck pain," write Sherman, et al. Although there have been a number of studies examining the benefits of massage for neck disorders, a review of the literature indicate the need for Sherman's study. "A major deficiency of previous studies [on massage therapy] has been their use of low ‘doses' of massage that massage therapists consider inadequate," in addition to the lack of massage as the primary treatment, treatment schedule, or descriptions of the type of massage used. And considering the lack of a standard protocol for evaluating massage therapy, it is not surprising that the benefits of massage therapy remain unspecific.
This study was designed to provide a foundation for rigorous research by evaluating three components of optimal dosing: 1) frequency of treatments per week; 2) length of each treatment session; and 3) total treatment period using a massage protocol that includes typically used techniques. Such research will determine the optimal minimal dose of massage for chronic neck pain. Unlike many of the research studies reviewed in this column, this study has not been completed; however it outlines the ideal methods for determining the optimal dose of massage therapy on chronic neck pain, providing details about protocol and treatment regimen not often published in massage related research. This addition to the massage therapy literature will contribute to advancing this area of research.
To start, the authors ran a small, randomized pilot trial to determine if clinical significance was seen among massage recipients by four weeks when receiving one 60 minute massage per week. In this subsequent research, the research team will recruit 228 participants with neck pain to receive different weekly doses of massage for four weeks to determine the optimal dose. The study was set up so the research team could evaluate five doses over several frequencies/week ( two or three 30-min treatments or one, two, or three 60-min treatments). Using the five dosing combinations, participants will be randomized to a wait-list control or treatment group to implement the study protocol. A second treatment period of six weeks with a weekly 60 minute massage or no treatment will follow the initial four weeks of study. This was chosen because, in the authors' previous trial, up to 10 treatments were given over a period of 10 weeks, allowing for evaluation of benefits of an additional six week treatment protocol.
Participants will include the general Seattle area population, of mixed race and gender, ages 20 to 64, who have had at least one primary care visit for neck pain within the previous 3 to 12 months and has a diagnosis of non-specific, uncomplicated neck pain. Exclusions include, but are not limited to, receiving massage for neck pain within the past year, or any massage in the last three months, mild neck (lasting less than three months) or complicated neck problems related to cervical radiculopathy, previous neck surgery, MVA within the past three months. Treatments will be performed by licensed massage practitioners at Group Health Research Institute, who have at least five years experience treating musculoskeletal pain, have practiced and are comfortable with the massage protocol.
A specific massage therapy protocol was written for both 30 min and 60 min sessions and includes: a Cervical ROM assessment; hands-on tissue warming; lymph drainage; neck work; LMP can address compensatory patterns found in upper body, upper and lower extremities, pelvis, etc. using supine, prone and/or side-lying positions; integration which may include cranio sacral techniques, stretching, rocking and other; and completion. Neck work is defined as skull through upper back/chest, C7/T1, clavicles to 2nd/3rd ribs and sternum. Massage strokes may include, in no specified order, friction on base of skull, long strokes down lamina from base of skull, slow friction of the anterior neck, slow friction to scalenes, deeper longitudinal stripping techniques running parallel to muscle fibers to encourage muscle lengthening, treatment of scar tissue along with areas affected by scar tissue, effleurage, petrissage of trapezius, paraspinals, spenius cervicus/capitus, levator scapula and SCM muscles as blending strokes between a-f above for relaxation and transition, stretching to finish and enhance soft tissue manipulation – including PNF, MET and any active assisted stretching.
Sherman, et al, will use the Neck Disability Index, a 10-item questionnaire, to assess neck pain and dysfunction and a pain index that will be provided at five weeks post treatment. Secondary measures will also be used to assess factors such as stress and days of restricted activity. A blinded telephone interview at five, 12 and 26 weeks post-randomization will be performed to determine the primary outcomes of neck-related dysfunction and pain. A further questionnaire on the Internet will be collected at 10, 16, 20 and 39 weeks to supplement the interviews. The study outlines data collection, processing and quality control with details on the protection of human rights, safety monitoring and what will occur should a participant experience adverse effects.
For readers aware of the many limitations of massage therapy research, this trial should be of great interest. Namely, the sample size is appropriately powered to provide a rigorous data set which will allow for interpreting findings in a conclusive manner. Further, the protocol and methods are clearly delineated, which will allow for subsequent replication of findings and be key for validating these study findings.
The publication of this rigorous research has several implications for the field of massage therapy research, the practice of massage and practitioners alike. First, a study of this caliber will advance the science of research in massage therapy by providing valid, reliable and ultimately conclusive findings. Second, using methods to demonstrate the mechanisms and dosages required to produce optimal benefits of massage therapy for conditions such as chronic neck pain will advance the practice in non-clinical and clinical settings as an integral part of integrative health care. Third, and maybe most critical for you the reader, this research provides a valid and reliable source for you to demonstrate evidence based practice for your clients, your students, health care providers and others who want to know how and why what you do works.
We look forward to the results of this trial being released and will report the findings in subsequent reviews sponsored by the Massage Therapy Foundation. Janet Kahn, PhD, LMT, one of the researchers who performed this study, will be presenting the keynote address on day three of the International Massage Therapy Research Conference – Presented by the Massage Therapy Foundation (IMTRC). Join us in Boston April 25-27, 2013, to hear Dr. Kahn present "Massage in 21st Century Healthcare: Let's Seize the Moment." Registration is now open.
Editor's Note: Want to hear more great research all in one place? Attend the International Massage Therapy Research Conference – Presented by the Massage Therapy Foundation April 25-27, 2013, in Boston, Massachusetts. Registration is now open. Learn more at www.imtrc.org.
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