Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
August, 2014, Vol. 14, Issue 08
Study Finds Massage Therapy Supports Senior Health
By Massage Therapy Foundation Contributor
Contributed by Beth Barberree, RMT, BA; Jolie Haun, PhD EdS, LMT, April Neufeld, BS, LMP
Do you ever wonder who will help keep your body moving around safely as you get older? According to JoEllen Sefton and fellow researchers, massage therapists could be key players in maintaining health of older persons, particularly postural control.This month's Massage Therapy Foundation article outlines the findings of Sefton's study that explored the effects of therapeutic massage on balance, neurological and cardiovascular outcomes in older adults. The results of this study were published in the International Journal of Therapeutic Massage and Bodywork in 2012, and it is the second of a two-part study conducted collaboratively by researchers at Auburn University and Samford University in Alabama.
The risk of falling is a major health concern for older people. Falls in the elderly population impact personal health, affecting patients physically and psychologically and often result in significant healthcare and rehabilitation costs. Decreased mobility due to falls can lead to loss of vitality and increased morbidity.
Sefton and colleagues wanted to explore whether therapeutic massage could restore muscle balance and function, improve appropriate muscle activation, decrease spasms, correct postural imbalances or improve gait and movement confidence. They hypothesized that therapeutic massage would produce an immediate increase in instability, then improve postural stability and decrease cardiovascular measures over time, and improve long-term stability and cardiovascular functioning. Positive changes in these measures may improve confidence and allow for increased independence in older individuals.
The study was conducted in the lab with 35 adults ranging in age from 50 to 69 years old. Participants were excluded if they reported any chronic diseases or medications that would affect the study's physiological measures. Participants were then randomized to the therapeutic massage treatment group or relaxation control group. The treatment group received six weekly 60-minute full-body massages that followed a standardized protocol, but left some flexibility for the massage therapists to respond to individual patient needs. The relaxation control group rested quietly in the treatment room for 60 minutes.
A number of assessments were conducted on both the therapeutic massage and control groups to test the study hypotheses. Static and functional balance were tested with the participants on one and both feet, and with eyes open and closed. Neurologically, motor neuron pool excitability, activation and modulation at the soleus muscle were assessed. Heart rate and blood pressure were recorded as the cardiovascular measures.
Immediate Treatment Effects
Assessments of postural control and cardiovascular measures were completed before the treatment, and then immediately after, 20 minutes after and 60 minutes post-treatment. Nervous system measures were completed pre-treatment and then 60 minutes post-treatment. The purpose of these tests was to determine whether the therapeutic massage intervention produced increased instability for participants immediately after.
The results replicated the researchers' earlier findings showing that instability did not increase immediately after therapeutic massage. This implies that current cautionary measures implemented for our clients are likely sufficient and should be continued, although some sensitivity with clients who have special circumstances will always occur. Interestingly, the results did not support previous studies that showed therapeutic massage to decrease cardiovascular measures immediately following treatment.
Week Six Short Term Effects
To determine differences that occur during the 60 minutes after a therapeutic massage intervention, balance and cardiovascular measures were assessed immediately post-therapeutic massage to 60 minutes post-therapeutic massage. The results of the balance and postural control measures together suggest an increase in postural stability through the 60-minute period following therapeutic massage when compared to the control group.
Nervous system measures were taken pre- and 60 minutes post-therapeutic massage only. The results again echo the researchers' earlier work, finding that when compared to only one session of therapeutic massage, an additional six weeks of treatment did not produce better performance on the assessments for the nervous system. The researchers speculated this may be due to decreased fatigue that would occur during each therapeutic massage application.
Cardiovascular measures indicated a trend of decreased systolic and diastolic blood pressure from immediate to 60 minutes post-treatment in the treatment group compared to the control. No changes in heart rate were found, and studies thus far have reported conflicting results. This led the researchers to recommend additional research on the mechanisms affecting cardiovascular measures and blood flow.
Long Term Effects
So, what was found one week after the last therapeutic massage session? The long-term treatment effects were assessed by comparing the therapeutic massage and control groups on balance, nervous system and cardiovascular measures pre-treatment at week six with those obtained at the follow-up testing session at week seven. The researchers found some effects to be fairly robust.
Assessment of balance at week six indicated no significant differences between the treatment and control groups. However, by week seven, testing showed significant differences between the therapeutic massage and control groups. This indicates that the treatment group had an improved ability to maintain balance at week seven.
No long term nervous system differences were found between the treatment and control groups, but the authors note there may be some methodological considerations that could be addressed in future work. With respect to cardiovascular effects, although there were no significant differences at week six, there were lower systolic blood pressures in the treatment group by week seven. No differences in diastolic blood pressure were found. Heart rate was higher for the treatment group at week six, but then by week seven, no differences were found when compared to the control group.
The researchers made a couple of observations about the study design that may have impacted research outcomes. First, participants were all healthy older adults who could be considered "young old," rather than "old old." Second, results may differ in individuals experiencing conditions common with aging such as osteoarthritis, high blood pressure or diabetes. The researchers also identified some limitations that should be considered when interpreting the findings, specifically that the participants self-selected to join the study. To account for these potential confounding elements, the team recommended a larger study in the future to include a wider range of participants.
As massage therapists see more clients who are aging, it becomes increasingly important to know how to appropriately care for them, and manage the instability that may occur when they get up off the treatment table. Understanding the physiological changes in the client, both immediately and over time, can equip us with information needed to provide good home care instruction.
The results reported by Sefton and colleagues indicate that therapeutic massage could be a beneficial non-pharmaceutical option to improve blood pressure and postural stability in older adults, short and long-term. These findings have implications for practice and policy, from the treatment room to reimbursement. The true impact of research such as Sefton's will come from replication and dissemination of findings and continued efforts to use research evidence to inform practice guidelines and standards of care.
To learn more about therapeutic massage and associated outcomes, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search Pub Med for massage outcomes studies.
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