Massage and Bodywork Magazine for the Visually Impaired - Open Your Mind to Research

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September/October 2013 Issue

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Open Your Mind to Research

By Jerrilyn Cambron
[Somatic Research]

The word research leads to various responses from people in the massage therapy community. Most people know they should incorporate research into their practice, but for many, research articles can be boring to read or even seem like they’re in a different language. 

Regardless, it’s important to understand how to use the information. What are some ways you can incorporate research into your practice? 

Develop Your Best Treatment Plan

We want the best for our clients—all health-care professionals do. However, many times in medicine, physicians have discovered that what they thought was beneficial to their patients was actually harmful. In the 19th century, physicians used mercury to treat many human ailments—for example, as an ointment for knee scrapes and a pill or syrup for constipation. We now know that mercury causes heavy-metal poisoning, but it took decades to discover this unfortunate outcome. Those early health-care professionals were not intentionally harming their patients; they simply did not have the right information. 

We now have many resources that can assist us in better understanding the potential benefits and detriments of various health-care treatments. Massage therapy research continues to grow each year, with more and more articles about the efficacy of massage therapy being published. Within these newly published articles, we can find gems of information that may strengthen our practices, helping us maximize the potential benefits of our therapies and minimize the potential risks. 

One prevalent condition seen in massage practices is back pain. There is a growing body of literature strongly supporting massage therapy for back pain. The research studies vary in types of massage, duration of treatment, and types of clients. Some of the articles include the integration of massage with other forms of care, which helps us better understand how clients will respond to a collaborative approach. There are articles on dosage of massage to better understand the optimal number of visits per week, while other articles include a very specific population as subjects, such as those who have workplace injuries or are pregnant. Reading a variety of articles focused on the same condition (such as back pain), but including different subjects or methods, will give us a better sense of how our varied clientele might respond differently to massage. 

Focusing on the benefits of massage—as demonstrated through research literature—can be very educational, and even uplifting. However, there are some case reports that show adverse events after a massage. In a 2013 review article, 17 case reports and one case series demonstrated serious adverse postmassage events, including consequences such as bladder rupture, paraplegia, and stroke.1 

Reading each article individually gives us a better understanding of the situations surrounding each case, as well as the clients’ comorbidities and the treatments utilized so we may minimize the risk of injury to our own clients. These case reports help raise our awareness as to when side effects may occur with massage care and might help us ask better questions about risk factors or medications that could be associated with a negative consequence after massage. Within the studies, we might also look for patterns in the types of treatment rendered by massage therapists, including depth of touch, technique, and body parts included in the treatment, to avoid those in our own practice. 

Articles that include both positive and negative results will help us better understand the outcomes our clients may experience, which will only make us better practitioners. 

Collaborate with
Health-Care Providers

In medical school, physicians are trained in evidence-based medicine. (The massage therapy profession sometimes calls this evidence-informed practice.) This term was developed in the 1980s to describe a form of practice that incorporates research findings along with a clinician’s expertise and the patient’s desired form of care. In order for physicians to be able to utilize new findings, they are thoroughly trained in the critical appraisal of research articles. Therefore, massage therapists’ efforts to collaborate with other health-care professionals might be facilitated by providing research articles about massage therapy and bodywork. 

For example, if you were interested in collaborating with an obstetrician at a women’s health clinic, you may want to share the recent study that demonstrated a reduction in the severity of labor pain through the use of massage.2 In this clinical trial, the experimental group received 30 minutes of massage to the lumbar area, whereas the control group received only a friendly conversation. The researchers found that at the end of the intervention, the Visual Analog Scale pain scores in the massage group averaged 52 millimeters (on a 100 millimeter line) and the control group averaged 72 millimeters, demonstrating a significantly lower amount of pain in the massage group. 

Medicine is driven by evidence, and bringing attention to articles that demonstrate the positive outcomes of massage therapy shows that the massage therapy profession is also focused on evidence. You can speak the language of other health-care providers and give them what they need to make an evidence-based decision to include massage therapy in their patients’ care. 

In addition to individual providers who read and incorporate research findings for their patient care, some professional associations complete reviews of the literature in order to make it easier on their constituents. These evidence-based clinical-practice guidelines include the gold standard of care for the condition of interest based on the highest level of evidence. People who work in an integrative setting can better understand the current standard of care based on these clinical-practice guidelines. 

As an example, in 2013, the American College of Chest Physicians did a review of the literature assessing complementary therapies and integrative medicine for lung cancer. This review included the following statement: “In lung cancer patients whose anxiety or pain is not adequately controlled by usual care, addition of massage therapy performed by trained professionals is suggested as part of a multi-modality cancer supportive care program.”3 Having a recommendation such as this from a highly regarded association will build your professional credibility, possibly leading to better collaboration and collegiality. 

Discover Your Passion

Most therapists start their careers with a general focus, and as time goes by they drift toward a more specific clientele—whether that is athletes, pregnant women, senior citizens, or another population. This shift may occur naturally as clients refer other people who have similar characteristics or conditions; however, some therapists are inspired to reach out to, and focus on, underserved or distressed populations. 

The decision to focus on a specific population may be based on a past experience, a high level of interest, or by reading research about the population. Knowing that there is evidence supporting massage therapy for a certain condition or a certain type of client may provide the background support that is needed in order to feel comfortable pursuing the type of clients you want. 

At the recent International Massage Therapy Research Conference in Boston, Massachusetts, Mary Fabri discussed her experience with massage therapy for torture survivors.4 Her talk was both shocking (the horrendous treatment that some people have undergone) and inspiring (the fact that massage was able to help some of these victims). During her presentation, my thoughts went back and forth between the type of massage that would need to be utilized with the victims of such abuse and the massage therapists who were treating these clients. This type of work is usually a calling for people who feel compelled to be of service to a specific community. 

There are many communities of people in need of massage. But how can you learn about the different possibilities that are available? One way is through reading research articles. Frequently, health-care providers who treat unique populations will write research articles based on their experience. For example, there are research articles on massage for increasing the weight of premature infants, as well as on improving quality of life for cancer patients. There are articles on massage for people who abuse drugs, as well as for people who are homeless. 

The Bottom Line

There are many reasons to read research articles, and there are many ways to incorporate research into your practice. The bottom line is that we do not know what interesting, important, compelling, or touching studies are out there until we start reading and discovering for ourselves. As this column progresses, I will present different areas of massage therapy and bodywork research and consider what they might mean for your practice: how they will affect the way you work with clients, collaborate with other health-care professionals, and build your practice. Reading research articles can open our minds to new possibilities for massage, helping to build our practices and our profession. 

Notes

1. P. Posadzki and E. Ernst, “The Safety of Massage Therapy: An Update of a Systematic Review,” Focus on Alternative and Complementary Therapies 18, no. 1 (2013): 27–32. 

2. R. B. Silva Gallo et al., “Massage Reduced Severity of Pain During Labour: A Randomised Trial,” Journal of Physiotherapy 59, no. 2 (2013): 109–16.

3. G. E. Deng et al., “Complementary Therapies and Integrative Medicine in Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines,” Chest 143, no. S5 (2013): e420S–36S. 

4. M. Fabri, “Massage Therapy for Torture Survivors” (presentation, International Massage Therapy Research Conference, Boston, Massachusetts, April 26, 2013). 

Jerrilyn Cambron, DC, PhD, MPH, LMT, is an educator at the National University of Health Sciences and president-elect of the Massage Therapy Foundation. Contact her at jcambron@nuhs.edu.

To read this article in our digital issue, click here.



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