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The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Research Examines Effectiveness of Thai Massage and Physical Therapy
Contributed by April V. Neufeld, BS, LMP; Jolie Haun, PhD, EdS, LMT; & Renee Stenbjorn, MPA, LMT
If you have ever plunged into the details of an original published research article, then you know how tedious some research can be to read. However, if you have ever been too afraid to explore an original article, then let this month's Massage Therapy Foundation research column review be a call to face your fears! The research in a recent publication of Clinical Interventions in Aging is a great place to start exploring scientific writing. "The efficacy of traditional Thai massage in decreasing spasticity in elderly stroke patients" is an easy read compared to most research papers, and although it has it's fair share of statistics and graphs, the authors do an excellent job of explaining their process.
The purpose of this study was to compare the effectiveness of traditional Thai massage to traditional physical therapy for decreasing muscle spasticity in stroke patients over the age of 50 years. A group of subjects (n=50) were randomly assigned to either the traditional Thai massage (TTM) or the physical therapy (PT) group. Since muscle spasticity causes pain and can limit functional abilities affecting posture and joint contracture, this condition often affects quality of life (QoL) and emotional states. The researchers measured anxiety and depression, activities of daily living (ADL), limb motor function and muscle spasticity. Functional abilities in self care and mobility were measured with the Barthel Index (BI), where a high score (0-20) means better function. The modified Ashworth Scale (MAS) measured spasticity (0 = no increase in muscle tone and 4 = the effected body part is ridged in flexion or extensions).
The study outlines the participant exclusion process and presents a clear flowchart (Figure 1) to illustrate their approach to screening 220 people at study onset to the final follow-up at week 6 of the 50 subjects. For readers who might be considering creating their own research study, this figure in conjunction with the methods section provides an excellent illustration of how small sample sizes can result in useful research. It's often difficult to find willing volunteers; volunteers who are not excluded for various risk factors and who are dedicated to finishing the study protocol. If you read through Figure 1, you will see that of the 26 people assigned to the PT group, 4 of them did not complete the final follow-up due to "inconvenience." This is fairly common in research studies involving any volunteers.
The TTM routine was standardized by an unnamed Thai massage organization and performed by certified practitioners. Often research articles do not describe the massage therapy techniques being studied in clear enough detail for replication. Fortunately, this publication (see Table S1) described the TTM routine, areas and duration of treatment (in minutes). Unfortunately, the PT description was lacking similar detail. Both groups (TTM n=24, PT n=26) received one hour treatments, twice a week for six weeks.
If you read the original article, the statistical analysis and results sections may seem intimidating at first, but I encourage you to read through them. The authors provide simple and accurate descriptions of their findings and provide an excellent discussion of the study limitations. If you do read through the study and if you do not have training in statistics the results may appear to you to support TTM over PT, but for each test category the study found no statistical difference between PT and TTM groups.
Here is an outline of the results at week six:
The authors do an excellent job discussing the limitations of this study, suggesting future research is needed with larger sample sizes. Also they suggest subjects with a low functional mobility score (low BI at the beginning of the study) could have indicated a higher likelihood of developing spasticity and a lower likelihood of recovery. This study did not evaluate the long-term effects of either TTM or PT on spasticity.
Based on the findings, you may be wondering what the benefit is for stroke patients receiving TTM when the standard treatment is equally effective. First, it is important for patients and healthcare providers to know that alternative (TTM) and traditional (PT) options of treatment are available which produce similar outcomes. This can support individualized treatments plans based on personal preferences. Second, in a world of challenges with insurance and billing, increasingly treatment options are directed by effectiveness of treatment and cost. Although this study does not address this subject, cost of TTM and PT should be considered. In general, the health care industry is in need of cost effective options, as such cost comparison studies are needed to determine how much could potentially be saved, in the case where different treatment options may not produce statistically different outcomes.
Overall, this study provides an example of bodywork therapy research that is clearly illustrated and mostly replicable, making an important contribution to the field of massage therapy research. For those readers interested in case reports, this study could potentially be used as a roadmap for writing your own report. The methods used to evaluate effects of TTM on spasticity (measuring spasticity, QoL, depression, anxiety, and functional ability) could be used to measure the efficacy of TTM on other conditions or massage therapy's effect on spasticity.
Are you a massage therapy student who has an interesting case of your own? The deadline to submit to the MTF Student Case Report Contest is June 1, 2015. If you or your students are interested in learning how to write and submit a case report of your own, check out the MTF's five-part case report webinar series to learn the how to write a winning case report.
To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation review article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.