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Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
June, 2013, Vol. 13, Issue 06
Massage Helps Hospital Patients Manage Pain
By Massage Therapy Foundation Contributor
Contributed By Sandra K. Anderson, BA LMT ABT; MK Brennan, MS RN LMBT; Jolie Haun, PhD EdS LMT
The Massage Therapy Foundation is always looking for new research that is helpful for massage therapists.This month we are reporting on "The Effects of Massage Therapy on Pain Management in the Acute Care Setting," published in the March 2010 issue of the International Journal of Therapeutic Massage and Bodywork.
The authors of this publication, Adams and colleagues, suggest pain management within the acute care setting is a focus of empirical study by researchers, healthcare facilities and accreditation organizations throughout the United States. Previous studies have shown that high levels of stress and anxiety increase pain, and delay hospital patients' recovery by limiting movement and self-care activities, while also reducing quality of sleep. In the hospital setting, stress is due to factors such as excessive noise, social isolation and pain from procedures. In fact, in the acute care setting, clinical procedures are often the only time patients receive touch.
Literature indicates massage therapy is the complementary and integrative medicine (CIM) treatment most often prescribed by physicians that is beneficial without adverse effects. Because massage therapy may be effective in reducing pain through the gate control theory, as well as the relaxation response, it may also play a role in psychological healing along with physical healing. Adams and colleagues conducted this study in the acute healthcare setting to examine the impact of massage therapy on pain and well-being. To account for both psychological and physical effects, the authors included quantitative and qualitative methods.
The study recruited 65 inpatients in various hospital units, admitted between October 1, 2006 and March 31, 2007, at a hospital in a large rural area in the southwest United States. Study inclusion requirements included a physician order for massage, as well as the ability of the patient or a family member to provide consent. Additionally, feedback about the massage and return of a qualitative survey after hospital discharge were collected.
Three licensed massage therapists employed by the hospital provided massage. Each was trained in working with hospitalized or medically frail patients. The massage sessions were 15 to 45 minute sessions given to patients at bedside. The session length varied depending on the patient's energy level and availability. Techniques used included effleurage, petrissage, acupressure, craniosacral therapy, cross-fiber friction and pressure point therapy. The head, neck, shoulders, back and feet were areas most commonly massaged depending on the patient's needs, with patients either supine or in side-lying position. Contraindication for massage sites included areas of injury, surgery or intravenous lines.
Patients indicated their levels of pain before and after receiving massage using a visual analog scale (VAS). The VAS consists of a horizontal line with "0" at 1 end and "10" at the other, with 0 indicating no pain and 10 indicating severe pain. At the completion of the patient's last session, a survey was given asking about length of hospital stay, number of massages received and the impact of the massage on overall pain levels, emotional well-being, ability to move, ability to participate in therapies, relaxation, ability to sleep and recovery. Additionally, participants were asked if they thought massage therapy had an effect on their need for pain medication, how long the effects of the massage had lasted and whether they planned to continue using massage therapy as part of their healing process. An open-ended inquiry at the end of the survey encouraged participants to comment freely about massage. These results, along with demographic data, number of massage sessions and nursing comments were also analyzed.
Of the initial 65 participants, 53 completed the research project. Most participants received one massage, many received two to three massages, and a few received more than three massages. Sessions lasted between 15 and 45 minutes with most being about 30 minutes. The pre-massage pain levels had a mean score of 5.18 on the VAS and the post-massage mean score was 2.33, indicating that the pain level decreased by more than half. The effects of the massage lasted one to four hours for most participants. Some felt they lasted four to eight hours and a few felt they lasted anywhere from eight to over 24 hours. No negative effects from the massage were reported by the participants. The results of the survey included significant reduction in overall pain and need for pain medication as well as an increase in emotional well-being, relaxation and ability to sleep. Over two-thirds of the participants said they planned to continue using massage therapy as part of their healing process.
The results of the study are promising. According to the article, "The fact that patients throughout the various hospital units, with a wide variety of pre-massage pain levels, experienced relaxation through massage therapy indicates the true potential for massage to support healing for hospitalized patients." Additionally, massage therapy relieved the sense of isolation the patients felt. Because so many participants reported increased emotional well-being, the authors suggest it is possible it could be due to the need for compassionate human touch.
Study limitations included only participation by those adults with health status that allowed them to receive massage and to complete the study paperwork. Patients whose energy or pain levels prevented them from participating may have provided information indicating other results. Another limitation is that physiological indicators of pain such as heart rate, blood pressure and oxygen levels were not collected. Finally, a minimal sample size was used with no control group; mainly due to the additional cost this would have incurred.
As researchers in the field continue to pursue understanding the role of massage in pain management, massage therapists can leverage these research findings to promote the need for skilled touch in hospitals to help patients heal. Adams and colleagues suggest, "The further integration of CIM therapies such as massage into the hospital offers the possibility to improve the experience for patients who face physical, psychological, and social challenges in an unfamiliar environment."
As health care systems continue to transform, it is possible that massage therapy will be more widely recognized as essential for patients in the acute care setting. Moving forward massage therapists can reference this work and other research on pain management in the healthcare setting to support the use of massage in the clinical care environment. To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant summaries, or search PubMed for massage therapy studies.
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