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The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
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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