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NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
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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