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Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
January, 2016, Vol. 16, Issue 01
Does Massage Affect the Immune System Following Exercise?
By Massage Therapy Foundation Contributor
Contributed by April Neufeld, BS, LMT; Beth Barberree, BA, RMT; Derek R. Austin, PT, DPT, MS, BCTMB, CSCS
Massage therapy increasingly is integrated into the healthcare plan for individuals suffering from a multitude of conditions.In particular, athletes, and those people supporting the athletes, believe that massage therapy can yield many benefits that could aid the athlete biomechanically, physiologically, neurologically, and psychologically. However, when research articles were reviewed to examine the effects of massage therapy on the immune system, researchers found that the benefits were unclear. This month, the Massage Therapy Foundation's research column reports on a literature review published in Physical Therapy in Sport (2014): Immunological effects of massage after exercise. "The purpose of this [literature review]," wrote the authors, "was to describe and review the current literature on massage and its role in modulating immune parameters when applied after intense physical activity."
The authors searched databases (Pubmed Medline, PEDro, and Cochran) for controlled studies conducted between 1970 and 2012 using specific keywords: massage, myofascial release, acupressure, recovery, warm up, exercise-induced muscle damage, exercise, sport, immunology, and lymphocytes. And they only included studies where "massage was the main intervention, control subjects received a placebo treatment, immunological variables were measured, and all study participants were healthy people. Studies were excluded when subjects had a history of systemic disease, had less than 5 hours of physical activity each week, smoked, had been involved in intense exercise during the previous 4-months, or had a contraindication of training." While the literature search appears thorough, the authors did not clarify why they excluded articles where participants had been involved in intense exercise.
Of the original 739 studies initially identified that examined some aspect of immunology, massage therapy, or randomized controlled trials (RTC) relating to post-exercise recovery massage, all but five studies were excluded for final review because they did not meet at least one of the inclusion criteria. "The inclusion criteria were as follows: massage is the main intervention; control subjects receive a placebo treatment; immunological variables are measured, and all study participants are healthy individuals." This last inclusion, that study participants must be healthy, is of particular interest because often research is performed on populations with health problems and yet many massage therapists report their clients are mostly healthy individuals.
"The results of this review suggest that massage may exert an influence on immune parameters, especially when applied after high-intensity exercise," wrote the researchers. Some evidence suggested that massage helps support immune system response by impacting the levels of proinflammatory cytokines (important in the anti-inflammatory response). For example, in a study where massage was performed on Quadriceps, cytonkine levels s were found to be higher in the non-massaged Qquadriceps than in the treatedmassaged legQuadriceps. Since exercise can cause a potentially damaging inflammatory response, decreasing the levels of proinflammatory cytokines could be beneficial. The authors also wrote of the speculation that massage therapy induces a parasympathetic response and so "improvements in local circulation may indirectly reduce the proinflammatory cytokines." However, since much of this research is performed on only a single body part (e.g. one leg), it is difficult to assess the overall role of massage therapy on the parasympathetic system.
Two studies were compared that described the movement of neutrophils towards the focus of post exercise inflammation. But since each study examined different sized muscles, and each had different intensities and duration of exercise prior to the intervention, the researchers concluded that it is difficult to make generalizations about the effects of massage on neutrophil count without further research.
Despite the impact on a variety of immune system constituents, it was noted that only a reduced IgA level is associated with increased risk of infection. The review yielded only one study on the impact of post exercise massage on IgA levels, and that study found that significant recovery of IgA levels occurs following massage, especially in females.
Also notable to readers, may be that three of the five studies in the review found "no robust evidence of an immunological improvement after massage" (Hilbert, Sforzo, Swensen, 2003; Smith et al., 1994; Stock, Baum, Rosskopf, Schober, Weiss, Liesen, 1996). In contrast, only two studies supported the immunological benefits (Arroyo-Morales et al., 2009; Crane et al., 2012).
Systematic reviews can be useful for readers to get a broader understanding of a particular topic, but can raise more questions than they answer. Readers will recognize that there are many factors that can influence the results of a study: sample size, type of massage therapy performed, timing of the intervention, type of exercise the subjects were engaged in, and duration and intensity of the exercise. Of the five studies examined, all had different sample sizes. All studies used healthy and active subjects but not all studies examined the same kind of exercise or frequency of the physical activity. Each study had the massage therapy application applied to different body parts. Additionally, the review examined four studies that indicated there were greater immunological effects when the massage therapy was applied following a 2-hour delay post exercise. "The differences in training mode and intensity may have produced corresponding variations in the immunosuppressive effects obtained, influencing evaluations of the recovery achieved by massage," wrote the researchers. "The data in this review suggest that massage may have a more relevant effect on the immune response after exercise with a higher cardiovascular demand. However, further research is required to confirm this possibility."
The researchers report there were several weaknesses in the studies selected for the review. One was that there was no information on any adverse effects that could have indicated complications with massage therapy as an intervention. Sports massage therapists might be tempted to read the information about the 2-hour delay and think that they should use that model on the athletes they work with. However, it is important to remember that while the subjects studied were young and healthy, none of them participated in professional sports or were elite athletes who practiced at moderate/high-intensity levels of physical activity.
The authors of this review clearly pointed out that a main limitation of the studies was that although some reported cell count changes, further research is needed to understand if these cells are simply relocating in the body as part of an immune response or actually proliferating.
Systematic reviews are excellent ways for readers to get a broad view of various studies examining a single topic. And as researchers explore topics before beginning new studies, a review is especially helpful to inform new projects by seeing what studies could be improved upon.
For more information on other reviews that have been done on massage therapy, please read the Massage Therapy Foundation review article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.
The Massage Therapy Foundation continues to support and promote research as seen in this month's review. Registration is now open for the 2016 International Massage Therapy Research Conference (IMTRC) that will be held in Seattle, Washington, May 12-15. Registration information as well as conference updates are now available on the website at www.massagetherapyfoundation.org.
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