resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
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.
Click here for more information about Massage Therapy Foundation Contributor.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.