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.
May, 2015, Vol. 15, Issue 05
Research Examines Effectiveness of Thai Massage and Physical Therapy
By Massage Therapy Foundation Contributor
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.
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