Pediatric Massage Study Finds Surprising Results

By Tracy Walton, LMT, MS

I had the great pleasure of attending the American Massage Therapy Association National Convention in Minneapolis this year, and hearing a panel discuss pediatric massage research. Among the presenters was Dr. Sean Phipps, a psychologist and researcher at St. Jude Children’s Research Hospital in Memphis.

He presented a large study of massage and humor therapy in children undergoing stem cell transplant (SCT).¹ Stem cell transplant is typically used to treat certain types of cancer and blood diseases. It is a rigorous procedure, with multiple medical risks to the patient.

This is an important and useful study for a number of reasons:

1. It was a large study of 178 pediatric patients, in four locations across the U.S. and Canada.

1. It was a randomized, controlled trial, designed to high standards in clinical research.

1. The study reported that massage had no effect on any of the outcomes studied. Not one.

I’ll leave the explanation and importance of the first two points to the various resources in massage research literacy.² Instead, I want to focus here on the last point, that the study observed NO effect from massage or humor therapy in pediatric SCT patients. The audience was understandably surprised, and some of us were stunned. What happened?

Background

The study staff recruited 178 pediatric SCT patients. Because stem cell transplant is notoriously strong treatment, associated with high degrees of distress for patients and families, the study looked at both patient- and parent-targeted interventions. This was not the first time the group attempted research in this area; Previous, smaller studies had documented the feasibility and appeal of massage and humor therapy,³ and had even suggested some benefit to warrant this further study, which was a larger scale, NIH-funded controlled trial.

The patients, aged 6-18, were randomized into three arms. One was a child-targeted intervention composed of massage and humor therapy. Another group received the child-targeted intervention in addition to a parent-targeted intervention that involved massage and relaxation/imagery. The third group, the control group, received only standard medical care.

A standard massage routine was provided by professional massage therapists, with the intended dose set at three half-hour sessions per week for 4 weeks, beginning at 1 week before transplant. The actual average massage dose turned out to be 8.8 sessions over the course of the study, as timing and other logistics often affect the actual amount delivered. The researchers measured somatic distress, mood disturbance, length of hospitalization, the time to engraftment (for the transplant to “take”) and the use of opioid pain relievers and antiemetics (antinausea drugs).

Findings

As stated above, the investigators found that massage therapy and humor therapy made no difference in any of the outcomes. The patients’ experiences of SCT appeared to be unchanged by these two complementary therapies. Even the addition of the parent-targeted therapy, in which the designated parent received massage on the same schedule as the child, along with relaxation therapy, seemed to make no difference. In fact, Dr. Phipps showed graphs of the three groups that were almost identical. Changes in mood and distress measures did occur in all three groups over the course of 4 weeks, but they were typical ups and downs over the course of the procedure. During SCT, the mood and distress measures get worse before they get better, and the patterns were the same in all three groups.

There were no differences in the medical outcomes, either. The time to engraftment, length of hospital stay, and use of pain relievers and antiemetics were surprisingly similar across the three groups.

What Do We Make Of This?

The study authors admitted being surprised by the results, and even disappointed. One important quality in a research paper is humility, and the authors were quick to point out possible limitations in the study design: perhaps they weren’t measuring exactly the right outcomes, or the timing of the measurements was not perfect. The age range of 6-18 years in their patient may have been too broad to fully standardize the treatments. They also report that the results of a single study–theirs–is not sufficient for firm conclusions. More studies, from additional researchers, are needed before we can determine whether to advise massage for this population.

One of the most potent observations in this paper, and in the talk that I heard, was that the standard medical care during SCT has improved much in the past years, and that patient distress is so well-managed that it is difficult to improve upon it with massage. In fact, levels of distress in the study sample were quite low to begin with, and throughout the study. While SCT-related distress still exists, it may be that standard medical care is already reducing it to the lowest levels possible, and massage cannot be expected to take it any further.

I was impressed by the care taken in this project, by the findings, and by the reflections of the investigator. I have a few of my own thoughts to add to discussion:

First, it is important for researchers to publish work like this, when the outcomes do not meet the researcher’s hypothesis. If we reported only the “good” or “bad” news in massage research (a problem called publication bias), then it would hold back the science of massage, and take longer to learn its true impact. I hope that other massage therapy trade publications also report on these findings, as disappointing as they are, so that the news is balanced.

Second, as much as I might wish for massage to have an effect in this population, the science and my own wishful thinking are two separate things. Massage is powerful therapy, but it is unlikely to be a cure-all. If it really is true that massage has no significant effect on a given population, we need to know that. As a profession, it’s important to know if massage is less effective in some populations than in others. If it is, we can direct our study and practice where we know it is effective. Perhaps other patient populations are more responsive to massage, or there are places where the medical management of a condition falls short, and massage could play a larger role. If so, perhaps we should focus our efforts there. This would not mean denying massage to people undergoing SCT. Instead, it would mean that we continue to study the impact of massage, learn where it’s most effective, and make sure we act on that information.

Finally, I am interested in the massage design and dose. I have to ask, in this and other studies, whether the massage dose is sufficient to bring about a change? Do we need to schedule daily massage in some populations, so that after logistics have taken their toll, the participants end up receiving 4-5 sessions per week? If so, would 4-5 sessions per week be sufficient, or too much? Does scheduling massage at certain points compromise its effectiveness, and, instead, it should be provided on demand the way some pain medications are administered? Are certain massage strokes, or body areas of focus essential for massage to be effective?

As disappointing as these results were, the study offers an important contribution to the body of research. I am not ready to abandon massage of SCT patients, nor do the investigators suggest that we should. But the study asks good questions. I am grateful to the investigators for their care, expertise, and clear reporting. As good research, this study invites further reflection, discussion, and, of course, more research.

References

1. Phipps S, Barrera M, Vannatta K, Xiong X et al. Complementary therapies for children undergoing stem cell transplantation: report of a multisite trial. Cancer 2010 Jul 12. (Epub ahead of print)
2. Menard MB. Making Sense of Research (2nd ed). Toronto: Curties-Overzet Publications, 2010. Also Walton T. “Massage Research in Massage Practice,” in Medical Conditions and Massage Therapy: A Decision Tree Approach. Philadelphia: Lippincott Williams & Wilkins, 2011.
3. Phipps S, Dunavant M, Gray E, Rai SN. Massage therapy in children undergoing hematopoietic stem cell transplantation: results of a pilot trial. Journal of Cancer Integrative Medicine 2005;3(2):62-70. Also Phipps, S. Reduction of distress associated with paediatric bone marrow transplant: complementary health promotion interventions. Pediatric Rehabilitation2002;5(4):223-34.

Source: Massage Today

Acupressure, Yoga, Featured as Heart-Healthy Treatments

A New Way to Deal With Chronic Pain?

Massage therapy is the natural choice for pain relief—an understatement, as prescription pain medication abuse has now reached “epidemic” proportions.

That was asserted this week by two top U.S. health agencies.

“The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration state that prescription drug abuse is an epidemic,” Mike Wahl, M.D., F.A.C.E.P., F.A.C.M.T., medical director of the Illinois Poison Center, said. “Prescription painkillers, specifically, are responsible for the bulk of this public health crisis.

Massage therapy has been found to reduce headache pain, back pain, and pain in cancer and general hospital patients, in numerous, unrelated studies.

Painkillers (analgesics) were the number one substance most frequently involved in all human exposure cases reported to poison center in 2011. In addition, analgesic (painkiller) exposures as a class increased more rapidly than any other substance over the past 11 years, according to the American Association of Poison Control Centers‘ National Poison Data System.

Source: Massage Mag

Get Noticed with a Remarkable Resume

by Cherie Sohnen-Moe

The purpose of a resume is to get you a job interview. Rarely is anyone hired solely on the basis of a resume. Indeed, most employers use resumes for the initial screening of job applicants. A resume that inspires a potential employer to interview you is one that conveys your talents and clearly demonstrates your ability to produce results that align with the particular company’s goals. This is why it’s so important to research your potential employers.

Make certain you know to whom you are writing: learn about the company’s history, its mission, needs and problems; determine the ways your skills can contribute to the company’s success; and finally, ascertain the name and title of the person in charge of hiring (which isn’t always the personnel administrator).

Your cover letter is an integral part of your resume packet. This is where you build rapport. Keep your tone friendly and use terminology that’s appropriate to your field. Open your letter with something you find interesting about the company and describe how you can be of direct benefit to the company. Close your letter by requesting an interview.

In the massage field, your resume may be very different from traditional ones, where the focus is demonstrating results, and that may be difficult for you to do. It’s important to think of your resume not in terms of a biography, but as a prospectus for your future.

The two major types of resumes are chronological and functional (see below). A chronological resume is used when you want to emphasize a good work history that is directly related to your desired job. A functional resume is used when you want to emphasize your talents, abilities and potential—not your work history. In most instances, massage therapists use more of a functional resume or sometimes just a targeted personal letter. ‘

A resume is a useful tool for promotion, even if you own your own business. If nothing else, the process of developing your resume clarifies your strengths and reinforces your self-esteem.

Landing the Interview

Jump-start your career by getting a job before you graduate!

Most students are so overwhelmed with all the tasks necessary to complete their education that they wait to start their job search after they graduate. Take advantage of this and start your job search early to get your name higher on the “potential employee” list. One of the personality traits employers highly value is initiative and by contacting potential employers while you are still in school demonstrates your foresight and motivation.

• Create a list of potential employers. Get their addresses, phone numbers and the names and titles of the people who have hiring authority.
• Network, network, network! Talk to people; let them know you’re available. Ask for leads. Remember, quite often it’s who you know that gets you the job.
• Set up initial contact on the phone. You must be well-organized; know your purpose and goals for this call. The primary goal, of course, is to get an interview.
• Send your resume and cover letter. If you don’t get an interview from this initial contact, send a resume with a cover letter, or just send a letter.
• Be persistent. If you have not received a response within five days of the potential employer having received your letter, call them.
• Stay visible. In some cases, endurance pays off. If you keep yourself so visible that an employer is fully aware you really want to work for her company, you may get the job out of sheer persistence.

Anyone who practices massage therapy recognizes at some point there’s an energetic component to massage. The best massage therapists learn to understand how energy affects their clients.

Huna, the ancient Hawaiian science of consciousness and energy healing, teaches people how to get in touch with their mana (life-force energy) and how to harness this energy. We do this by connecting with our higher consciousness, which allows us to tap into energy.

Most massage therapists who come to my trainings have experienced clients become emotional during a massage. When this happens, they have hit more than just a cramp or a tight muscle. Skillful deep-tissue massage can trigger an emotional response by touching upon a negative emotion stored within the physical body. I call these stored negative emotions “black bags.”

Here are some basic tips for massage therapists to help their clients release their black bags:

• Be attuned to the ways the mind affects the physical body. Pay attention to your clients’ reactions during massage as well as their comments about their mental and physical health.
• Encourage the client to share. When a client expresses emotions during a massage, stop and ask the client what they are feeling and experiencing.
• Offer to assist the client in resolving the problem. If the client responds positively, he or she may want to share more about the origins of their feelings.
• Ask the client to envision releasing the negative energy they have stored in their body. As you continue the massage, ask the client to communicate the emotions they are experiencing.
• Be aware: When a trapped negative emotion is released, the body may have an almost instantaneous response. Clients may express this release through tears, laughter or words of relief.

Understanding how to flow energy involves training in the four basic forms of energy—air, fire, water and earth—and how they are manifested in us. Massage therapists who take the time to study these energies will find rewards in the ways they can help their clients heal in body, mind and spirit.

Source: FutureLMT

As part of your journey toward entering the rewarding world of massage therapy, you’ve probably wondered what it takes to become a successful massage therapist. While there are many steps needed to accomplish this, some of the most essential ones relate to creating and maintaining a professional image.

After more than 18 years as a massage therapist, educator, business owner and coach, I’ve learned a few secrets for this first step to success. Read them and see where you might have room to grow.

Understand professionalism

Besides acting ethically and following applicable licensing laws, it is essential for a professional massage therapist to be friendly, courteous and honest, as well as skilled in the art of communication. Therapists need to be able to anticipate, understand and respond to clients’ needs and requests on and off the table. Additionally, remembering clients’ preferences, likes and dislikes of temperature, pressure, scents and sounds shows that a therapist is committed to service and details.

It is also our responsibility to educate and guide clients about relevant self-care as well as particular treatments or products that will help them achieve their desired goals. This includes knowing what is and is not allowed in our scope of practice and referring to other professionals as needed.

Other qualities that create a professional image and identity include being flexible, focused, caring and persistent as well as thoughtful, organized, prompt and polite. In general, therapists who are able to create a demand for the services and healthy practices they provide are much more than talented technicians—they are well-rounded individuals who are always striving to be better, seeking to learn more and embracing the opportunities available to them.

The first impression

Everything that touches clients or prospective clients and helps them make the decision to do business with you, or not, is part of your marketing. These touches, or impressions, start the second someone visits your website, picks up your business card, walks in your office or meets you in person. As such, it is vital to consider exactly how you are touchingthem before they even get on your table.

Some things to review:

• How easy your website is to find, read and navigate
• The safety, location and accessibility of your office
• Your social media profiles, pages, pictures and posts
• How neat or cluttered your treatment room and waiting area are
• Your own grooming, attire and appearance
• Your outgoing message, e-mail address and e-mail signature
• How long it takes you to respond to incoming messages, texts or e-mails

As you review each of these areas, ask yourself if you would be proud or embarrassed if any or all of these were seen or experienced by your mother, grandmother, child or boss. Consider each area from your perspective as a patient in another medical professional’s office. Would you trust a physician or chiropractor who dressed the way you do? Learn to think through the discerning eyes of your potential clients and prepare each area of your business accordingly.

If you’re not sure where to begin, take a deep breath and commit to receiving outside feedback about the impression you make, from your clients, classmates, teachers or friends. Ask them for positive feedback about what they like most about any of the areas above and what one improvement they would suggest. Catalog their answers and determine where you can take one or two immediate action steps toward improving your professional image.

Creating a professional image as a massage therapist takes care, attention to detail and a commitment to showing the best of yourself and the profession to the world. Start by examining the aforementioned areas and look for new ways to share the best of yourself and massage through your practice. Like the rest of us, you are an amazing work in progress.

Source: FutureLMT