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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
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.
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.
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.
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.
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.
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.
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
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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