resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What is a Discipline in Medicine?
In my now prolonged dialogue with physicians, one question emerges with enough regularity to deserve mention and naming: what is a discipline?
Why DCs Need to Understand the Principles of "Inclusive Design"
In the past few columns, I've written about the negative effects of prolonged sitting at work. I've attempted to make the point that prolonged sitting (or prolonged standing) takes a toll on workers. Now let's discuss a related issue: the concept of "inclusive design."
Are You Guilty of Paternalism in Your Approach to Patient Care?
Einstein is purported to have said, "When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity." In some way, everything is relative to one's point of view.
Green Tea Catechins Lower PSA, Other Biomarkers in Men With Localized Prostate Cancer
A 2006 study (Cancer Research) was the first human investigation to show that green tea catechins (GTC) are highly effective in reversing premalignant prostate lesions (high-grade prostate intra-epithelial neoplasia), an established precursor to prostate cancer.
Monoculture of the Mind: Part II
Cases are built within boundaries. Such bounds may be a program, event, activity or individuals. In this instance, a medical case has boundaries that include clinical interactions that are comprised of history, signs, symptoms, diagnoses, treatment plans and treatments.
AAAOM – The Beginning of the End (Part II)
In 2012, the AAAOM board members met in Chicago for their annual meeting. The goal was to come to a consensus on a long list of issues the AAAOM needed to work on including a functional board and budget.
Resilience is the New Longevity
Sometimes we must enter a room through one door and not another, even though they both lead into the same space. I am talking now of the recent cachet with the concept of "resilience" regarding health, chronic pain and longevity.
Flexion-Intolerant Lower Back Pain (Pt. 3): Mobilization & Soft-Tissue Treatment
What is the biggest challenge to the chiropractor in treating discogenic pain? You have to completely reframe the purpose of your manipulation. It is rarely about unlocking a stuck segment at the disc involvement level; it is not about putting a joint back in alignment.
Stress in the Modern Age: Impact on Homeostasis and What You Can Do (Part 1)
In 1926, Hans Selye first used the word stress in a biological context, referring to the nonspecific response of the body to any demand placed upon it.
Epigenetics: The Western Science Supporting Essence
Since the days of Darwin, western medicine has touted that our genes were set in stone, that our genetics were our destiny. We were told that the diseases that ran in our family were likely coming to us as well.
Get That Shoulder to Move: Restoring Internal Rotation
How many times have you mobilized, performed ART, Graston, FAKTR and PIR, and stripped a patient's posterior capsule, yet on re-exam, discovered it was still blocked?
Creating Child-Friendly Clinics with ABT
The Zurich Dojo was scattered with toy ducks, dolls, trains, exercise balls and teddy bears during my recent pediatric workshop.
Successful Strategies in Integrating Acupuncture and Shiatsu in a Hospital Oncology Program
Colleagues from the Network of Researchers in Public Health in CAM recently published an article of interest to our Traditional Asian Medicine community.
Risk Factors for Heel Problems
Heel pain and gait disability are common occurrences in adults, often the result of thinning heel pads and a lifetime of exposure to heel-strike shock. One condition experienced by many people is plantar fasciitis.
AAAOM – Making Promises They Can't Keep
When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy. The first years of the organization were filled with promise and hope.
Collaboration for a Cause
The Patient Protection and Affordable Care Act strongly encourages the formation of multidisciplinary practitioner teams called Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs).
One and Done: Keeping Patients From Vanishing After Just One Appointment
What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel. I tried to get her to reschedule, but she refused." 2) "She no-showed.
Leaving a Lasting Legacy: Donna Liewer
For the past 31 years, Donna Liewer has been on a personal mission "to comfort the afflicted and afflict the comfortable." In her role as executive director of the Federation of Chiropractic Licensing Boards, Liewer has accomplished that and much, much more.
News in Brief
Hamm Elected New President of the ACA; WFC / ACC 2014 Education Conference: Call for Papers; F4CP Recognizes Standard Process as $1 Million Supporter; Texas Chiro. College Begins Search for New President; League of Chiropractic Women Hosts Women's Success Summit.
Steven Rosenblatt: Birthing A Cross-Cultural Acupuncture Profession
The existence of a cross-cultural acupuncture profession in the United States, one that is legalized, licensed, supported by formalized, academic training and inclusive of non-Asian practitioners, is an important part of the medical landscape in this country and is responsible for improving the lives of hundreds of thousands of Americans.
The Healing Properties of Light: An Interview With Researcher Anna Cocliovo
This interview is with Anna Cocliovo, a light researcher and Acupuncturist in Arizona. During my own research in light, I came across the article she published for the American Journal of Acupuncture and sought her out as a result.
April, 2013, Vol. 13, Issue 04
Massage Improves Range of Motion for Children with Burn Injuries
By Massage Therapy Foundation Contributor
Contributed By Jolie Haun, PhD, EdS, LMT, Derek R. Austin, MS, CMT, Beth Barberree, BA, RMT
Understanding the effects of massage is critical to advance the field. Yet, understanding the impact for a child with burn injuries is critical to improving the quality of life for someone who has experienced considerable trauma. This month's research review by the Massage Therapy Foundation looks into a pilot study conducted to examine the effect of massage on mood and range of motion (ROM) in eight children post recovery from severe burns.
Many children with burn injuries undergo considerable care in recovery. Treatment options are limited, so often patients with burn injuries pursue alternative therapies such as massage to address issues related to psychological and physical outcomes associated with burns. Little research has examined the effects of massage in children with burn injuries. Those published suggest that massage decreases distress related to change in wound dressing and may decrease severe itching. Now, Morien and colleagues extend current research with children by examining the effect of massage on mood and range of motion (ROM). Based on research conducted with adult burn survivors, the research team predicted massage would increase mood and ROM.
Participants were eight children attending a camp for pediatric burn survivors, with a mean age of 13.5 years (range 10–17 years). Five children participated in the study for 4–5 days and three participated for 3 days. All participants had thermal burns to several body parts, including arms, legs, trunk and face. Massage was provided on healed third degree burns that had previously required skin grafts. The authors defined third degree burns as the loss of skin structures at a depth that reaches the subcutaneous fat and fascia, which includes epidermis, dermis and all skin organs. Areas receiving massage were well-healed, with 2–16 years since the burn.
Four therapists participated in data collection and were blinded to the results until the end of the study. Therapists with advanced training in massage for burn scars offered massage sessions that lasted 20–25 minutes once daily, for up to 5 days. Massage provided on scar tissue consisted of 5 minutes of lengthening using long light strokes (effleurage); 5 minutes of stretching and rolling strokes between hands, fingers or thumbs (petrissage); and 2–5 minutes of small cross fiber movements (friction) to loosen the scar tissue. The last 5 minutes of the massage session included general lengthening and rolling movements. Massage therapists discussed possible needs or concerns regarding the massage before and after the sessions.
Participants reported their mood before the first massage session and after their last massage session. A visual scale using "smiley faces" that corresponded to a numerical scale was used for data collection. This method is common when conducting research with children. ROM of the knee, neck and shoulder joints was measured in degrees using a goniometer. ROM measurements were also taken on non-massaged tissue contralateral to scarred tissue to serve as a control comparison. The authors conducted a statistical analysis to determine differences in ROM and mood from pre- to post-massage.
Findings of the study indicate ROM increased after the massage sessions, in contrast to the contralateral control tissue. An objective scar assessment was not conducted; however, subjective observations by the massage therapists noted that scar tissue was red and firm before massage, while participants' scars post-massage were flesh colored, softer and the skin was more easily stretched. There was no significant difference in mood across time.
Authors concluded massage increased ROM in children with burn scars, which is consistent with studies showing that massage increases ROM in patients with injuries not resulting from burns. The authors were surprised to find no change in mood following massage considering findings of improved mood in previous studies with adult participants. The authors contend mood findings may have resulted from a "ceiling effect" because participants already had an elevated mood upon arrival to the camp.
The authors noted some study limitations including: small sample size; a quick and easy mood instrument that was likely too simple and lacked the sensitivity to measure changes accurately; and because the participants were 2–16 years post burn injury, their emotional coping strategies toward their scars had already occurred. An additional limitation, that the authors failed to note, was their sample size was too small to appropriately apply a t-test statistic; such that the authors cannot make assumptions about the data being normally distributed with equal variances, as assumed when applying parametric statistics. A non-parametric analysis method such as the Mann-Whitney U-test would be a more convincing basis for the authors to conclude significant changes in ROM with such a small sample size.
The authors do suggest more research using larger samples is needed, with measures to include affective states such as anxiety. They also propose that further investigation should address whether massage effects vary depending on stage of recovery (i.e. new versus old burn scars). The authors are planning a follow-up study to address research questions related to attitude, anxiety and self-esteem.
Though the study sample is small, this work provides good information to support the advancement of therapeutic massage for children with severe burn injuries. First, though this area of research is lacking in conclusive findings, this study does support the need for subsequent work to further explore the use of massage therapy for this vulnerable population. Second, massage therapists should use these findings as a basis for recognizing that this vulnerable population can in fact benefit from massage therapy. Finally, this research supports the expansion of scope for the application of massage therapy.
Similar to other serious conditions like cancer, there was a time when massage therapists may have avoided providing massage therapy to severe burn scar tissue for fear of causing more harm than good. However, through evidence-based research such as this reported study, we are learning as a profession when and how to appropriately apply massage therapy for individuals with burn injuries. When considering providing massage treatments for someone with severe burn scarring, it is strongly recommended that massage therapists acquire special training and consult with a physician before providing treatments.
Editor's note: For more information about massage therapy research, visit the Massage Therapy Foundation at www.massagetherapyfoundation.org.
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