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Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
June, 2013, Vol. 13, Issue 06
Help in Understanding Parkinson's, Part 2
By Ann Catlin, LMT, NCTMB, OTR
In part one of this series from the April issue, I presented an understanding of Parkinson's disease (PD), its symptoms and current medical treatment.Now we'll take a look at how massage and other bodywork may play an important role in managing symptoms and offering those with PD a better quality of life.
I'd like to challenge you to ponder what it means for a person living with PD to have "quality of life." Most massage therapists immediately think of tremors and muscle stiffness when asked to name a symptom of Parkinson's disease (PD). What about symptoms that can't be seen but only experienced by the people living with this progressive neurological disease? The Parkinson's Outcomes Project reports that negative mood and depression have the greatest impact on health status and that 40% of people with PD experience depression and/or anxiety disorder.
These symptoms seem to have even greater impact on quality of life than motor symptoms. There's constant frustration from struggling to get through daily activities. But I've observed another invisible symptom – feeling isolated. One symptom of PD is a mask-like expression that comes from poor motor control of facial muscles. The subtleties we rely on for communication and social connection are gone. Imagine a man with PD at a social gathering, say a neighborhood picnic. Here's a man who can't move or walk well so will stay in one place and has a blank and staring expression on his face. Is this a person who will likely be approached by others? I suspect not. Strangers will misread the expression as boredom and withdrawal. Acquaintances may feel uneasy about what to say as they notice the changes that have occurred and avoid him. Closer friends may overcompensate for their uneasiness and dote or be overly helpful. Children may even be a little frightened of him. The end result is that few people will treat this man as they would have before PD. Satisfying social relationships must be hard to come by for many people living with the symptoms of PD.
I have a client who has, for many years, been an active board member of a community music guild. In his early seventies, he developed PD, however he continued to be involved on the board. During a recent session, he told me about the board meeting he attended last week. He said that hardly anyone spoke to him directly and he felt ignored. "I'm the same person," he told me. "Do I smell? I'll never go back." The more I think about this, the more I realize the full impact of his statements. He's been cut out of a community and he knows it. Now, he's left to wrestle with the loss and anger along with feelings of low self-worth. I don't think his situation is unique at all. So how can we, as massage therapists, make a positive difference?
Which modalities are most effective?
It's reported that up to 40% of individuals who have PD use at least one type of complementary therapy with herbal supplements, vitamins, massage and acupuncture most commonly used. I was curious about which bodywork modalities have proven most effective. The following is a survey of the literature along with my personal experience.
Alexander Technique: This educational method teaches the client how to change faulty postural habits to improve mobility, performance and alertness along with relief of chronic stiffness, tension and stress. Main benefits are coordination of the musculoskeletal system, improved breathing, vocal production and speed and accuracy of movement. One study demonstrated that following 24 lessons in Alexander Technique, people with PD had less depression and greater self-concept. These results were sustained for six months. Alexander Technique may have the greatest impact on these PD symptoms: bradykinesia, which means slow, deliberate movements and difficulty performing rapid alternating movements such as combing one's hair or clapping. Because Alexander Technique uses a cognitive approach to re-learning movement patterns it may also help develop new neural pathways in the brain to compensate for those no longer functioning properly. The client may also feel empowered by being actively involved in learning new movement patterns resulting in improved mood and feelings of confidence and self-worth.
Neuromuscular Therapy: This approach is described as soft tissue manipulation techniques including myofascial release, positional release and trigger point techniques. One study examined the effects of neuromuscular therapy on motor and non-motor symptoms of PD. Following treatments twice a week for four weeks, clients had significant decreased tremor and improved rapid alternating movements (finger tapping). However, clients did not have substantial changes in mood. It appears that neuromuscular therapy may be most beneficial for motor symptoms of PD, which would contribute to improved ability to perform activities of daily living.
Swedish Massage: In my experience, rocking broad compression and moderate pressure effleurage seem especially effective for PD symptoms. Rocking stimulates the vestibular system as well as the proprioceptor nerves in the skin, joints and muscles which may improve postural tone while promoting an overall relaxation response. Gentle, sustained compression applied to muscles that are rigid or hypertonic encourages "letting go" or relaxation of the muscle and increases range of motion at least temporarily allowing greater postural comfort for those who have advanced PD. Broad, slow-stroke effleurage on the full back seems especially helpful. Studies have shown that three minutes of slow-stroke back massage decreases blood pressure and heart rate while skin temperature increases. Slow-stroke back massage has been used as a common nursing intervention to help patients sleep. We've long understood the link between massage and improved mood. One study showed that Swedish massage increased serotonin and dopamine levels by 28% and 31% respectively while decreasing cortisol levels by 31%. This is important in understanding that massage changes the biochemistry of the body and decreasing stress reactions.
It's clear that touch therapies can be effective in easing the physical symptoms of PD which goes a long way in improving function and alleviating physical discomfort. But I'd like to go back to those hidden symptoms I described earlier, the frustration, isolation and feelings of low self-worth. Let's look beyond bodywork to the power of compassionate human touch to heal in ways we are only beginning to fully understand. The man I described who felt shunned by his peers looks forward to our sessions which take place in his home. Following the massage, he reports decreased pain and appears physically comfortable and is able to move his arms a little smoother. But what shines through the physical benefit is a shift in his demeanor. The other day he told me how much our sessions mean to him. "You treat me like I still matter." I believe his statement had nothing to do with bodywork but rather by reaching past the disease to serve the human being inside of the body impacted by PD.
Acceptance and compassionate presence comes through caring human touch. I'll close with a quote from one of the sources for this article, "While complementary treatment modalities are used widely by patients with PD, only use of various massage techniques seems to improve subjective well-being and quality of life," from Rehabilitation Interventions in Parkinson Disease by Alex Moroz, MD, et.al.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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