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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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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).
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.
Chiropractic Prevents ADHD? Research Shows...
Now that I have your attention, let me tell you what the latest study actually states. As you may have noticed, research over the past few years has begun to reveal that acetaminophen (the primary ingredient in Tylenol) is not as safe as once thought.
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.
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?
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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