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Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
February, 2016, Vol. 16, Issue 02
Evaluating the Use of Gas Discharge Visualization to Measure Massage Therapy Outcomes
By Massage Therapy Foundation Contributor
Contributed by Renee Stenbjorn MPA, LMT; April Neufeld LMT; Jolie Haun PhD, EdS, LMT
Massage therapy outcomes research is commonly conducted on individual systems of the body, such as the nervous, immune and cardiovascular systems.However, therapists often observe and report an observable effect of massage that impacts the whole person, represented by a general sense of relaxation or rejuvenation that recipients present after a massage. Research in a recent publication of the Journal of Complementary and Integrative Medicine, published by one of our contributing reviewers, Jolie Haun and her colleagues, examined a potential method of evaluating massage therapy outcomes to capture these whole person outcomes using an innovative measure.
The physiological benefits of massage are well documented and, at this time, widely accepted by the public as well as the medical community. Some benefits of massage can be easily measured, such as effects on immune function and sleep patterns. These findings can be measured physiologically or with biomarkers such as immune cell counts, serotonin levels and electrocardiograms. The validity of these findings is considered valid as the measures have been reproduced across studies.
Subjective self-reporting measures are used to demonstrate outcomes such as decreases in stress and anxiety. While many massage studies rely on self-reporting questionnaires for these outcomes, some researchers in the field are seeking a more objectively measurable tool for evaluating changes in subjects receiving massage. This research study had several objectives: evaluating a specific tool to assess the energetic changes a client undergoes during a massage session; evaluating the physical, psychological and emotional effects of massage using standard self-reporting methods; and determining the correlation of gas discharge visualization (GDV) parameters with traditional self-reporting outcome measures. The researchers use the term "bioenergetics effects" to describe this change many experience as a result of the massage.
The researchers describe GDV measurement as a means of "electrophoton capture" (EPC) suggesting, "The GDV uses modern optics, electronics and computer processing for analyzing photon emissions stimulated by a pulsed electromagnetic field." The authors theorize that the energy emitted from a person can indicate the individual's bioenergetic field. Thus, it should be able to be measured and quantified. The theory is that the energy photons represent the dynamic bioenergy of the person and the image represents their energy field. The image is capturing the displacement of gas particles emitting from the subject, either from fingertips or a full body projection. It is theorized that the emissions represent the level and balance of energy flow in the meridians, but it is important to note that the authors state, "GDV measures are not very well defined regarding their meaning." Although this device is widely known to measure these discharge levels, the mechanism remains unclear.
The research question explored by these authors is whether or not the GDV imaging pre- and post-massage correlates with self-reported changes of the client's physical, emotional and energetic experience as a result of the massage to examine the feasibility of using such an innovative measure to evaluate whole person outcomes associated with massage. There were 23 research subjects and inclusion criteria focused on healthy subjects who had received massage in the past. Four massage therapists provided massage to participants, each with at least five years of professional experience and each therapist was trained in the Swedish protocol used in this study.
The GDV measurements were used as a dependent variable, i.e., did the measurements change in response to the massage the subjects received. The GDV measurements were taken from the fingertips of the subjects. Therefore, the massage did not include the hand to avoid the measurements being effected by application of lotion used in the treatment. GDV electrophotography was used to assess the bioenergetics whole person effects of massage therapy. The authors explain the 16 parameter measurements of the full-body assessment used in the study. Briefly, there are 16 areas of the body emitting photons and these are captured by the device then analyzed for strength and symmetry of signals.
Each subject was given one 50-minute full-body Swedish massage according to the protocol. The questionnaires and GDV measurements were taken before and after the massage. The subjects were asked to self-report items on Visual Analog Scales, including pain, muscle tension and stress at several time points, two before the massage and two after the massage. The data shows a statistically significant change in self-reported levels of pain, stress and muscle tensions and some quantitative changes in the bioenergetics field.
It is important to remember that the study was designed to assess the correlation between changes in the GDV measurements and the self-reported outcomes. It is widely accepted that massage changes self-reported levels of stress, pain and muscle tensions. As seen in many other studies, this is true in this study. This study aimed to see if an objective bio-marker measure correlated with the self-reported changes. Findings indicated the GDV bio-marker measures were significantly correlated with the self-reported change in measures.
The study examined 16 GDV measurements on each subject, looking at projections of energy from the right side of the body, left side of the body, etc. They also measured the symmetry of the projects between the right and left side of the body. Of these 16 measurements, the most significant finding was an increase in symmetry on the front of the body – theoretically representing a whole person measure of energetic symmetry. Some subjects showed an increase in energy on one side of the body, contributing to a more balanced field. Other subjects showed a decrease in energy on one side, also achieving more balance in the field. They suggest the increase in balance of the field demonstrates that some people need to relax during a massage while others need to experience rejuvenation. The authors state that this change in symmetry shows a positive finding for the potential use of GDV in future massage studies. The frontal symmetry measurement is one of 16 GDV measurements that were not significantly correlated. The measurements on this one field variable were mixed between increasing and decreasing energy projections.
The authors state the pilot study findings warrant further study of the use of GDV to measure massage outcomes and report common limitations with massage therapy studies, recommending future studies with larger randomized controlled trials to further explore the potential use of the GDV. If we can identify a valid method for evaluating the energetic changes people feel with massage, we can advance the science of massage research.
This research, though a small pilot study, has implications for research and practice. The validation of non-traditional biomarkers to evaluate the whole person effects of massage is not only needed, but can advance the science of massage therapy outcomes research. Although these findings warrant further investigation, much larger randomized controlled trials will be necessary to determine the role of GDV in measuring massage outcomes. This research also speaks to the observations that massage recipients often experience: individualized effects of massage that may result in relaxation or rejuvenation, depending on the person's need; and changes that impact not just individual bodily systems but the whole person.
If you are interested in learning more about the topic of research in massage, consider attending the International Massage Therapy Research Conference. It will be held in Seattle May 12-15, 2016. For more information, visit www.massagetherapyfoundation.org/research-conference/.
Case reports also play an important part in advancing the skills of massage therapy practitioners. The Massage Therapy Foundation Practitioner Case Report Contest is now open. The deadline to submit is October 3, 2016. For more information, visit www.massagetherapyfoundation.org/student-practitioner-case-report-contests/.
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