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It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
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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