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February 18, 2008
Pondering Research
They've added a new class into our line-up. It involves research, writing and how to make clinical decisions based upon best evidence. As I read my new text book, I was struck with all the ways that research is applied in the clinical practice and I thought about massage therapy.
Most of the techniques I use are based upon what I learned at school. The continuing education classes I chose sounded interesting, had a clinical bent, and suited my intuitive side. However, as far as measurable outcomes, they may not have been tested. It's one thing to apply a modality to a client and have them leave feeling better and it's completely another to have the modality tested with a control group for efficacy.
Massage therapy is just now trying to find evidence-based research to back up the efficacy of what we do. Incidentally, physical therapy is not that far ahead. Spear-headed by Dr. Tiffany Field, the Touch Research Institute was credited with the largest body of research evidence regarding massage therapy when I graduated massage school.
Many of the choices we as massage therapists make within the clinic fall under only two or three realms of research. I practiced mostly under trial and error, which is time-consuming at best. The other choices I made were based upon what had historically been done to address "X" condition--this may not be the best choice for condition "X". Finally, anecdotal evidence, otherwise known as a case study, is what we hear mostly when we collaborate with our peers. Over the past two or three years, our professional journals have begun to search out and publish evidence-based studies that help bolster the legitimacy of what massage can and cannot do.
Some of the research findings have been surprising. When I graduated massage school, massage was contraindicated for cancer for fear that moving blood would encourage the cancer to metastasize. Thanks to research, we now know that massage is wonderful treatment for persons with cancer. However, care and special training should be taken when working with this medically fragile population.
Another age-old maxim of massage claims that it improves circulation. Through research, it was found that, blood is moved, especially in the lower extremities where blood has a tendency to pool, while the massage is being performed. There is no evidence that massage has any lasting improvement in circulation once the massage is over. A lot of people thought this was the death knell for the massage therapy industry as a valuable player in health care. Contrary to that, the fact that the massage industry is examining itself is a crucial step forward in legitimacy in the eyes of the medical community. And, as a result, through research many benefits of massage are being discovered further securing massage therapy's place in health care.
For further reading on how massage therapy affects circulation consult the following references:
1. Shoemaker JK, Tidus PM, & Mader R. Failure of manual massage to alter limb blood flow: Measures by Doppler ultrasound. Medicine and Science in Sports and Exercise 1997;1:610-14.
2. Hovind H, & Nielsen SL. “Effect of massage on blood flow in skeletal muscle.” Scandinavian Journal of Rehabilitation Medicine. 1974;61.
3. Wakim KG, et al. The effects of massage on the circulation in normal and paralyzed extremities. Archives of Physical Medicine. 1949;301:35-144.
tags: massage massagetherapy wellness massage therapy bodywork health
Posted by linda at February 18, 2008 9:45 AM
