resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
Climbing the Ladder of Opportunity (Part 1)
President Obama spoke of building "ladders of opportunity" in his State of the Union and Inauguration addresses.
Gallop Confidently Into The New Year
Happy New Year! As you may know, this is the year of the Wooden Horse. I received a wonderful gift for Christmas. It is a beautiful glass sculpture of a horse, by Luili Gong Fong, a Chinese artist.
New Knee, New Pain (Part 2)
The patient presented to the chiropractic clinic with symptoms of genu varum and pain on the medial aspect of the tibiofemoral joint.
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
Putting Public Health Into Action: Thinking Globally, Acting Locally
The Chiropractic Health Care section of the American Public Health Association (APHA) met at the 141st APHA Annual Meeting and Exposition in Boston late last year, and it was another triumph for chiropractic and its public health advocates.
We Get Letters & E-Mail
Let's Restore Integrity to Health Care – Starting With Us; MDs Offer More – So Can We.
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
News in Brief
Parker Announces Executive Director of Parker Professional; Athletic TIPS Program Getting Financial Support; ANJC Award Recipients Named.
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
The Many Faces of Cervical Compression
When evaluating the neck, there are any number of orthopedic tests to be considered.
Why Stretching Doesn't Work
Like most chiropractors, a good part of my day is spent working with sedentary office workers who spend eight to 12 hours a day glued to a desk chair in front of a computer.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
Peer Points: Spreading The Word
Pedram Shojai describes his venture into Traditional Chinese Medicine as a journey led by various "mystical experiences." Shojai decided to change the course of his career when he looked deeper into the basics of TCM.
Increased Breast Cancer Risk: Another Implication of High Cholesterol
In addition to being a known risk factor for heart and cardiovascular disease, recent studies have highlighted the link between high cholesterol and increased risk of breast cancer. Breast cancer is the second most common malignancy in women after skin cancer.
The Importance of Staying Focused
Our world is so full of over stimulation and constant information. We live in a fast paced, ever-changing society. If you seek you will receive.
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
Preserving the Natural Resources and Culture of Chinese Herbal Medicine
As the world experiences unprecedented population growth and ever-increasing ecological pressures, the topic of preserving Chinese medicine's natural resources has attracted steadily increasing attention from practitioners.
An Introduction to Evidence-Based Clinical Practice - Again
One of your patients is in for treatment and catches you off guard by asking you a question about a news article she recently read. It seems that a new intervention for back pain was found to reduce the rate of serious side effects by 50 percent.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
Betraying Patients and the Profession
Imagine flying from New York to Paris on a jumbo 747. Your thoughts are on your vacation and experiencing the City of Lights. Midway over the Atlantic Ocean, you overhear the flight attendants talking in muffled voices.
Ask and You May Receive
A friend of my mother has had a problem with her ears for almost 20 years. Whenever the wind blows, it sends shooting pain through her jaw. She has seen any number of medical specialists over that time, but with no relief.
Look, Listen and Learn to Code
Study of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) coding system can leave a doctor of chiropractic a bit confused. The description of the five new-patient and five established-patient examination codes takes up several pages in most coding books. The degree of detail and charts used to describe the codes can be overwhelming.
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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