resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Make Low-Level Laser Therapy Part of Your Evidence-Based Practice
Low-level laser therapy (LLLT), also referred to as photobiomodulation, has been increasingly utilized in the clinical setting over the past decade.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
Step by Step: Long-Term Treatment of Soft-Tissue Injuries Combines Skill and Care
Treating soft-tissue injuries with long-lasting results starts the moment an individual enters the office. When it comes to pain, the only thing that matters to the patient is relief.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
November, 2013, Vol. 13, Issue 11
Lymphatic Pump Techniques Improve Immune Function
By Massage Therapy Foundation Contributor
Contributed by Derek R. Austin, MS, CMT, Jolie Haun, PhD, EdS, LMT, and M.K. Brennan, MS, RN, LMBT
Do you know that lymphatic pump techniques (LPT) can enhance your massage practice? Immune response is central to maintaining health.However, health can be compromised when there is any delay in the immune response to a pathogen. Lymphatic flow is a key component in facilitating the immune response. Techniques that focus on lymphatic flow are effective adjunctive therapy in acute infection, as well as immune support.
Exercise, passive movement and manipulative techniques have been shown to increase lymph flow. Osteopaths have historically used osteopathic lymphatic pump techniques (LPT) to improve lymphatic circulation, reduce edema and combat infectious disease. However, until recently, there was no scientific evidence that LPT enhances function of the lymphatic and immune systems.
Lymphatic pump techniques may be familiar to readers, as these techniques are commonly used to treat edema. This month's Massage Therapy Foundation research column summarizes two recent reviews on the lymphatic and immune effects of lymphatic pump treatment. The first article, by Lisa Hodge and Fred Downey, "Lymphatic Pump Treatment Enhances the Lymphatic and Immune Systems," was published in the journal Experimental Biology and Medicine in October 2011. The second article, by Lisa Hodge, "Osteopathic Lymphatic Pump Techniques to Enhance Immunity and Treat Pneumonia," was published in the International Journal of Osteopathic Medicine in March 2012.
Lymphatic pump techniques, also known as lymphatic pump treatments, affect the lymphatic system and are a staple of osteopathic manipulative medicine. Leukocytes traveling in the blood and lymphatic system perform an important role in the body known as "immune surveillance," searching for foreign bodies that will trigger an immune response. Thus, it is important that the flow of lymph not be restricted, as it is in lymphedema. Skeletal muscle contraction, intestinal peristalsis and respiration are already known to increase lymphatic pressure and flow. Additionally, LPT may enhance lymphatic and venous drainage, improving immune surveillance during times of infection.
Despite slowly mounting research evidence, the question remains: Is LPT helpful for infection? Small sample sizes limit the validity of pilot studies that suggest LPT can enhance innate immunity in patients with acute infection and healthy individuals. Though we often refer to human studies to give guidance on effective treatments, laboratory-based animal studies (often referred to as "basic" or "bench" research) also inform the mechanisms and efficacy of modalities such as LPT. Animal studies have demonstrated that abdominal and thoracic pumping increase thoracic duct flow in dogs and rats.
These animal studies point toward lymphatic pump treatments enhancing the uptake of lymph into the lymphatic system, thus increasing the immune function of this system. Previous research on anesthetized dogs by Hodge and her collaborators has shown that four minutes of abdominal lymphatic pump treatment may increase the flow of immune cells from both the innate and adaptive immune systems. That research showed LPT can mobilize white blood cells and other immune cells from GI tissue into lymph. Other research on dogs has found similar results whereby LPT to the abdomen mobilizes immune cells from the mesentery, though the effect sizes and clinical relevance are less well-established.
The lymphatic flux, or molecules per minute of lymph collected, of additional inflammatory mediators such as interleukins and cytokines, are also enhanced by LPT when measured during four minutes of LPT, when compared to the time immediately pre-LPT and 10 minutes post-LPT. Also, LPT improves thoracic duct leukocyte flux without increasing mean arterial pressure, at least under the condition of anesthesia.
More recent research in Hodge's laboratory has focused on a rat model employing LPT to the abdomen at a rate of one compression per second for four minutes. As in dogs, LPT in rats temporarily increases lymph flow and concentrations of immune cells, suggesting that LPT boosts immune surveillance. LPT releases mature, activated lymphocytes, including IgA+ and IgG+ B cells into both thoracic and mesenteric lymph. However, this canine and rodent research has only looked at abdominal LPT due to technical difficulties with performing thoracic LPT in the controlled experimental setting, so the effects of thoracic LPT in these animal models is still unknown.
However, thoracic LPT has been shown in a few studies to enhance antibody response in humans. Hodge points out the need for further experimentation to clarify the differences between abdominal and thoracic LPT.
Hodge, Downey and a group of collaborators used a rat model of pneumonia to study whether LPT improves lymphatic clearance of pneumococcal bacteria. In this study, 20 rats received four minutes of daily anesthetized LPT, another 20 rats received daily anesthesia and a sham treatment of light touch, and another 20 rats served as controls. Eight days after infection, the researchers found that the amount of S. pneumoniae bacteria in the lungs was significantly reduced in both treatment groups compared to control. Compared to the sham treatment, LPT led to an even higher amount of bacteria clearance.
The treated rats also exhibited fewer immune cells in the lungs, indicating their infections were improved compared to the controls. While this article focuses on the effects of LPT, it is interesting that light touch also had a significant effect compared to control. Light touch is often used as a "sham treatment" comparison group compared to a form of massage or bodywork. If light touch has a therapeutic effect, then it may not serve as a good control or comparison group.
In humans, LPT is used as an adjunct therapy to improve cleansing of the bronchi and trachea, increase sputum production and shorten the duration of cough in patients with lower respiratory disease, such as pneumonia.
The most significant recent research into LPT in humans is the Multi-Center Osteopathic Study in the Elderly (MOPSE). This randomized, double-blind, controlled trial compared light-touch, osteopathic manipulative therapy (OMT) and traditional care. The study involved 406 hospitalized elderly patients with pneumonia who were followed for outcomes including length of hospital stay, antibiotic use and respiratory failure or death.
As may be expected with many forms of bodywork, OMT led to a significantly higher report of increased musculoskeletal pain, compared to light touch and traditional care. While the MOPSE intention-to-treat analysis, which includes those randomized to receive OMT who may or may not have actually received it, did not show any significant differences between groups, the results were different for those who actually received OMT.
In that statistical breakdown, referred to as a per-protocol analysis, patients who received OMT plus conventional care had decreased length of hospital stay, duration of IV antibiotics and frequency of respiratory failure or death compared to the conventional care group alone.
Future research may illuminate other interesting benefits of LPT. Another rodent study by Hodge and various collaborators showed LPT partially prevented the development of pulmonary tumors in rats implanted with tumor cells. The amount of solid tumors was reduced by 30% and the number of immune cells, including B-cells, T-cells, NK cells and macrophages in the lungs, increased. Additionally, historical data from the H1N1 flu pandemic of 1917-1918 shows treatment under the care of an osteopathic physician significantly decreased mortality, especially in patients who had influenza complicated by pneumonia. Osteopathic manipulative medicine of this era already included lymphatic pump treatments that have only been studied rigorously in the 21st century.
The way by which LPT enhances immune system function and patient outcomes appears to be through at least two major mechanisms. LPT improves immunological memory, which may aid in the clearance of pathogens and prevent chronic infection. LPT also increases pulmonary trafficking of gastrointestinal immune cells, possibly providing immune protection in the lungs. Despite these benefits of LPT, other studies have had less-positive results. One study showed LPT does not increase serum interferon levels in healthy individuals, though interferon is not normally elevated in healthy people. A clinical trial also showed mild, but significant worsening of lung function in patients with COPD following LPT. Subjectively, however, the patients reported feeling better after LPT. And while LPT has been shown in some studies to enhance the immune-system response to vaccination, it did not increase antibody titers against influenza in a recent human study.
The development of antibiotic-resistant bacteria, including MRSA and resistant forms of pneumonia, has led to a serious search for non-antibiotic methods of treating infectious disease. While the research evidence is generally preliminary, laboratory and clinical studies are beginning to show that LPT has a significant immune-boosting effect. It is still unknown what quantitative effect LPT has, especially in humans, and particularly for diseases other than pneumonia. Furthermore, some studies confound LPT with other manipulative medicine techniques that may not be in the scope of practice of massage therapists.
Overall, with research showing significant results when LPT is applied for a duration of only four minutes, it may be an easy technique to incorporate into a massage session with proper training. Of course, some clients may not want their abdomens vigorously pumped. However, the health benefits may convince them otherwise.
These data provide important implications for the application of LPT in clinical practice, particularly when immune effects are a desired outcome. Furthermore, these findings provide a solid scientific basis, including both basic and applied research, to support the use of LPT when making treatment recommendations to clients and patients. These published findings support the field of massage therapy and bodywork in the clinical setting as professionals and research scientists continue to establish the scientific merit of modalities such as LPT.
One of the two reviews discussed in this article is available for free in PubMed Central. To learn more about the effects of modalities such as LPT, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.
Click here for more information about Massage Therapy Foundation Contributor.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.