Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
The Hidden Hip in LBP: Critical Screening Tests
In 1998, Harvey used this test on 117 elite athletes and found excellent interrater reliability to differentially assess iliopsoas, quadriceps or TFL/ITB tightness.
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
October, 2014, Vol. 14, Issue 10
Study Examines Use of Massage on Those with Spinal Cord Injuries
By Massage Therapy Foundation Contributor
Contributed by MK Brennan MS, RN, LMBT; Renee Stenbjorn, BS, MPA, LMT and Derek R. Austin, PT, DPT, MS, CMT, BCTMB, CSCS
As massage therapy continues to gain recognition as a valid treatment option, studies that focus on its use with special populations or in mainstream medicine centers are more readily available.We at the Massage Therapy Foundation are always looking for new studies that help bring massage to populations who might not generally receive it. This month's review focuses on a feasibility study by Dr. Theresa Chase, Dr. Amitabh Jha, C.A. Brooks, MA and Amanda Allshouse, MS, published in the November 2013 issue of Spinal Cord that provided massage to patients with new spinal cord injuries (SCI) while they were being treated at a rehabilitation hospital.
This study researched the feasibility of integrating massage into the treatment protocols for these patients to address their pain. As the authors wrote, "Pain is not only a problem in itself, but may contribute to other conditions, such as negative mood states, depression, anxiety, sleeplessness and poor sleep quality and these, in turn, may interfere with participation in rehabilitation therapies and overall general well-being."
Working with a licensed massage therapist, a protocol was developed for the two arms of the study, broad compression massage (BCM) and light contact touch (LCT). These two treatment options provided an opportunity to test the effects of varying the amount of pressure during the massage since BCM used two to five pounds of pressure compared to two to three ounces of pressure with LCT. The treatment sessions were provided by 10 registered nurses who worked in the facility and were trained over an 8-hour course that included hands-on practice to provide the BCM and LCT treatments. The study was conducted over an 11-month period at a single site, the rehabilitation facility. Subjects were randomized to either the BCM-LCT group or the LCT-BCM according to the study's crossover design, which allowed all participants to receive the "active" treatment (BCM).
For inclusion in the study, the SCI patients needed to have pain, be medically stable and have an anticipated five week or greater length of stay at the rehab facility. This study highlighted the fact that patients with SCI suffer from pain due to injuries sustained during their trauma. Even patients with paralyzing accidents may be suffering from high amounts of pain. Additionally, the patients needed to be able to provide consent and answer questions in English. If they were participating in another clinical trial, they were excluded from the study. Prior to the start of the study, Institutional Review Board (IRB) approval was gained and all participates consented to be a part of the study.
The massage sessions were scheduled to last 20 minutes with limited conversation between the nurse and the patient. Treatments were provided three times a week for two weeks, followed by a one week break in between the BCM-LCT and LCT-BCM switch. A total of 40 adults were enrolled in the study, including seven females. A number of tools were used to gather data pre-treatment including an interview with the subjects by a research assistant to assess pain, fatigue and depressive symptoms. Demographic information, as well as injury severity and medication use for pain, was obtained through a medical chart review. During the study period, assessments were conducted the day after the treatments which may not have effectively captured the immediate effects of the BCM or LCT treatment on pain and fatigue.
Pain intensity was both higher at baseline and reduced more in the LCT-BCM group compared to the BCM-LCT group in the first two-week period (p=0.014). However, this pattern was not found in the second two-week period. LCT and BCM groups did not significantly differ on any secondary measures except the Patient Health Questionnaire-9 (PHQ-9), which measures depressive symptoms. Like pain intensity, the PHQ-9 score was reduced more in the LCT-BCM group in the first period (p=0.0085) though this trend was again not repeated in the second period. There was not a significant difference between the two groups when the first treatment period was analyzed in relation to the second treatment period. Both patients and nurses reported high satisfaction that having 20 minutes of uninterrupted time for the treatment provided, relating that this was usually the longest uninterrupted period of patient care during the day. However, the "researchers on this study believe there were beneficial effects and improvements in patient condition regardless of treatment."
One of the limitations of the study was the lack of balance between the two randomized groups at baseline for pain. Since one group started out with higher pain levels, it is likely that the treatment affected the groups differently. Additionally, the crossover design may have been flawed, as there were carry-over effects with a failure to return to baseline during the one week break in between the treatment sessions. This resulted in a difficulty to do a formal analysis of the cross-over design. Rather, changes in pain intensity were compared within each treatment period for the two groups. Since the type of pain wasn't defined, such as being musculoskeletal or neuropathic, an in-depth analysis was not possible.
One very interesting aspect of this study was the training and utilization of nurses to provide the massage therapy to these subjects. While massage provided by nurses used to be a part of routine patient care, that is not true nowadays. Is there a possibility that by using professionals other than massage therapists, the results may be different since the nurses were only given eight hours of training? Also, is there a possibility that the opportunity to participate in some research studies may not include massage therapists? However, this may indicate a great opportunity to form alliances with nurses. Massage therapists and nurses have similar goals for patients, in that both seek interventions that are beneficial, such as massage.
This pilot study showed that it is possible to integrate massage therapy in an acute rehab program for SCI patients using nurses to provide the sessions. For massage therapists, this provides an opportunity to take the results obtained, along with the items to consider for future studies and create proposals for further study with this patient population. As Massage Therapy Awareness Week starts, reaching out and providing massage to those who would not likely receive it may be worth considering with this study as an inspiration. The full text of the article is available online for free at PubMed Central.
To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.
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