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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.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
March, 2016, Vol. 16, Issue 03
Hand Massage in the ICU for Post-Op Cardiac Patients
By Massage Therapy Foundation Contributor
Contributed by MK Brennan MS, RN, LMBT, BCTMB; Derek R. Austin PT, DPT, MS, BCTMB, CSCS; S. Pualani Gillespie BCMT, MSN, RN
Massage therapy may be an effective non-pharmaceutical approach to pain management. This month, the Massage Therapy Foundation research review presents a study that considers massage for post-operative pain relief. As non-pharmaceutical approaches for pain relief are increasingly considered, massage could potentially decrease pain perception based on the Gate Control Theory. This theory is the idea that the stimulation of large diameter nerve fibers by massage contributes to inhibiting nociceptive stimuli transmitted by smaller nerve fibers in the spinal cord. The study, "Feasibility and acceptability of hand massage therapy for pain management of postoperative cardiac surgery patients in the intensive care unit," by Géraldine Martorella, RN, PhD, Madalina Boitor, RN, BSN, Cécile Michaud, RN, PhD, Céline Gélinas, RN, PhD, was published in Heart & Lung in 2014.
The main purpose of this study was to examine the acceptability and feasibility of providing hand massage for surgical intensive care unit (ICU) patients. Acceptability is described based on appropriateness, convenience, effectiveness, risks/adverse reactions, and adherence. This was determined through interviews with both the treatment group and the control group participants. Feasibility relates to the ability to provide the treatment and considers challenges to do so.
Field notes entered by the one trained research nurse who provided both treatments as well as video recordings of the treatments were used when looking at the feasibility of the massage treatments. The nurse documented environmental items such as lighting, noise, and alarms as well as any interruptions or concomitant interventions (medications, lab blood draws, and physical examinations, for example) in her field notes. The patients' responses were also noted. The video analysis focused on the patient's awake/asleep status and activity around the patient. Experimental Hand Massage (EHM) and Control Hand Holding (CHH) were established as the treatment groups. The authors reviewed previous studies done in ICU settings but found a wide range of massage treatments, dosing, areas of the body massaged, and timing of the massage as well as patient conditions. They based this study on a previously conducted pilot study of postoperative pain in cardiac surgery patients that indicated a decrease in pain intensity for the massage treatment group.
Inclusion criteria for this qualitative study were patients 18 years of age and older, able to speak English or French, elective surgery that required a sternal incision, an ejection fraction of 35% or more, and able to answer questions and report pain levels. Exclusion criteria included those with cognitive or psychological disorders, pulmonary artery pressure >50mm Hg, right ventricular failure, body mass index >30 or abnormalities to one or both hands. A total of 40 patients participated in the study from a pool of 70 who were approached. Sixteen of the 70 did not meet the inclusion criteria and another 14 chose not to participate in the study.
In the EHM, the research nurse held the patient's right hand for five seconds and applied five to 10 ml of lavender massage cream to the hand and wrist. Massage was then performed for 5 minutes on the palm and back of the hand and procedure was repeated on the other hand. The total duration of the massage was 15 minutes and was followed by a 30-minute rest period. In the control group (CHH), the treatment consisted of holding the hand for five seconds and applying the lavender cream. The research nurse then held each of the patient's hand in her hands for 5 minutes per hand without performing massage therapy. The goal was to deliver two to three treatments per participant in both groups in the 24 hours following their admission to the ICU. All of the 40 individuals in the study received the first two treatments, but 28 did not receive the third one. The lack of a third treatment was most commonly due to discharge of the patient from the ICU.
The results on acceptability indicate that the criteria used were met based on comments by the participants. The comments included themes of feeling calmness or relaxation, wanting the session to last longer, wanting the treatment to occur at the moment the patient went to the ICU, and appreciation for the human touch. The majority of patient quotes used in the table indicate a relief from pain, even if only temporarily, and were more prevalent in the EHM group. There were eight participants who did not feel that it was beneficial. Six of those were from the control group. Feasibility was more challenging due to the ICU environment with open rooms that contributed to ambient noise, especially during the rest period. Support of the medical team was beneficial in being able to provide the treatment without interference but did not completely eliminate it. Some interruptions, however, were related to needs of the patient due to shortness of breath, thirst, and nausea for example. Staff acceptance and the length of the treatment need to be considered when developing a massage plan for patients in the ICU to help minimize interruptions.
Limitations of the study included acceptability being determined based on only the patients' perspectives. Three sessions were rarely done which impacted feasibility. Scheduling was challenging since there was only one research nurse providing the EHM and CHH and the participants may have also have commented in appreciation of the therapist and not necessarily the treatment. Finally, using lavender cream may have confounded the perceived benefit of the treatments due to its relaxing properties.
Future studies are warranted to examine the support and opportunities for implementation of massage therapy in the ICU. These can include the use of more than one person providing the massage sessions and possibly comparing having a family member or friend providing the hand holding. Identifying the times for the treatment in order to achieve the greatest therapeutic effect is another consideration for future research.
To read other studies regarding massage, please view the Massage Therapy Foundation review article archives, browse accepted MTF Research Grant abstracts, or search PubMed for massage therapy research.
Registration is now open for the International Massage Therapy Research Conference in Seattle May 12-15, 2016. Visit www.massagetherapyfoundation.org for more updates and registration information.
Click here for more information about Massage Therapy Foundation Contributor.
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