resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
July, 2014, Vol. 14, Issue 07
Forced Work Reduction for Massage Therapists
By Massage Therapy Foundation Contributor
Contributed by Derek R. Austin, MS, CMT, BCTMB, CSCS, MK Brennan, MS, RN, LMBT, and April Neufeld, BS, LMP
This month's Massage Therapy Foundation research column looks at the factors that lead to the reduction of work hours for massage therapists and bodyworkers due to injury, referred to as injury-forced work reduction (IFWR).Massage therapy and bodywork are considered to be very physically demanding professions. The authors cite that 80% of people who begin careers as massage therapists and bodywork practitioners drop out after two years. Previous research has shown a high risk for musculoskeletal disorders among massage therapists, including carpal tunnel syndrome and low back pain. There has been little research to date, however, on what demographics, work attitudes or perceptions make a massage practitioner more likely to become injured. This new research from the team at Temple University hopes to illuminate some of these issues.
The article, "Correlates of Injury-forced Work Reduction for Massage Therapists and Bodywork Practitioners," was published in the International Journal of Therapeutic Massage and Bodywork (IJTMB) in 2013. (Free full text is available from IJTMB.) The authors define injury-forced work reduction as a "work-related injury adversely affecting the hours worked or number of clients treated." The authors tested two hypotheses. Their first hypothesis (H1) was that accumulated costs – the amount of time, personal effort, education, money and training that a practitioner has invested in their occupation – would be associated with injury-forced work reduction. The authors further hypothesized (H2) that physical exhaustion – including body fatigue, low energy, tiredness and work exhaustion, mental frustration, feeling overwhelmed and being emotionally strained – would both be associated with injury-forced work reduction.
An online survey was conducted in the fall of 2006 by the Federation of State Massage Therapy Board (FSMTB) about Career Patterns (CP) along with their Job Task Analysis (JTA). The JTA required approximately 45 minutes to complete followed by 15 minutes for the CP survey. There were 2,089 massage therapists and bodyworkers who completed the CP survey, making up approximately 3% of the 75,000 practitioners contacted across the United States. The survey was made up of questions organized into five groups: 1) Control/demographic variable set; 2) Work attitude/perception variables set; 3) Accumulated cost variables set; 4) Exhaustion variables set; and 5) Injury-forced Work Reduction (IFWR). IFWR was measured by two questions: "I can no longer work the hours I previously worked due to occupational injury," and "I can no longer treat as many clients per day due to work injury (e.g., carpal tunnel syndrome, lower back pain)." Most items were measured using a Likert scale, where 1 = strongly disagree, 2 = disagree, 3 = slightly disagree, 4 = slightly agree, 5 = agree, and 6 = strongly agree.
Overall, the researchers found "high levels of job satisfaction (5.47/6) and affective occupation commitment (5.44/6); low levels of accumulated costs (2.76/6), continuing education costs (2.77/6), and physical exhaustion (2.46/6); and very low levels of work exhaustion (1.75/6) and IFWR (1.84/6)." Affective occupation commitment was measured with questions such as, "I strongly identify with the massage/bodywork/somatic therapy occupation." Continuing education costs were measured with questions such as, "It costs too much for me to take required continuing education." In general, massage therapists and bodyworkers, or at least those who responded to the survey, are satisfied with their jobs and identify with their occupations. They also have generally low levels of costs invested, costs associated with continuing education, mental and physical exhaustion and injury.
The authors used a stepwise regression model to evaluate their hypotheses. In other words, they added each variable set to the model one at a time in order to control for demographic and other variables. Among the control/demographics variables set, being female and having more years in practice were significantly associated with IFWR. None of the individual work attitude/perception variables were significant. Having more continuing education costs but not accumulated costs was significantly associated with IFWR, partially supporting the authors' first hypothesis (H1). Physical exhaustion and work exhaustion were both significantly associated with IFWR, supporting the authors' second hypothesis. Overall, 34% of the variance in IFWR was explained by all of the variables that were studied, and physical exhaustion was the single greatest contributor to IFWR.
The authors note that their finding of physical exhaustion relating to IFWR had the strongest support and was consistent with other research on the physically demanding nature of massage therapy and its occupational risks. Work exhaustion had a significant independent positive association with IFWR. Thus, both physical wear and tear and the mental fatigue of work exhaustion appear to increase injury risk for massage therapists and bodyworkers. The authors speculate that such mental fatigue may be related to particular work factors, including isolated work settings, physical concerns and possibly public misconceptions about the nature of massage therapy or bodywork. The authors conclude that taking breaks between patient appointments and varying the techniques used could improve a massage therapist's physical and mental energy and thereby limit these risk factors.
The authors compared this research to their previous research on massage therapists and bodyworkers. They write, "None of the four work attitude and perception variables that each significantly impacted being forced to stay in occupation (i.e., job satisfaction, affective occupation commitment, occupation identification or limited occupation alternatives) had a significant impact on IFWR in this study." IFWR appears to be a separate variable that is highly influenced by certain types of accumulated costs (specifically, the perception of high continuing education costs), physical and work exhaustion, being female and working for more years.
There are several important limitations to this research study. Chief among them is that correlation cannot be separated from causation because this research is a cross-sectional study. In other words, it is possible that higher IFWR causes higher physical exhaustion, and not the other way around. The authors also did not identify specific injuries among the massage therapists and bodywork practitioners surveyed. Finally, the respondents were self-selected, and participants could possibly have different characteristics than the overall population of massage therapists. For example, a massage therapist who has reduced his or her work hours due to carpal tunnel syndrome may not volunteer to complete a one-hour online survey.
For massage therapists and bodyworkers, it is worth further investigation as to the short career span for practitioners and what preventative measures can be taken. Addressing IFWR and any of the contributors to it would be beneficial, especially as the authors also cite an expected growth in massage therapy and bodywork by 20% between 2010 and 2020.
Not sure what to make of a regression analysis, correlation, confidence interval, p-value or t-test? The MTF offers an easy-to-use online course, where you will learn basic research vocabulary and concepts, how to use various databases to look up research, evaluate published research articles for their validity and apply research findings to massage practice to improve outcomes. Basics of Research Literacy is an online, 8-hour, NCBTMB-approved workshop that teaches massage therapists and educators how to incorporate the principles of research literacy into your practice and teaching.
To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.
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