resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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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