International Journal of Therapeutic Massage & Bodywork (IJTMB)
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A Survey of Licensed Massage Therapists’ Perceptions of Skin Cancer Prevention and Detection Activities
Background: Skin cancer is the most common cancer in the US. Training massage therapists (MTs) in skin cancer prevention and detection cre-ates opportunity for reducing skin cancer burden. Little is known about MTs’ perceptions of skin cancer prevention and detection, their discussions of these topics with clients, or their referral recom-mendations for suspicious skin lesions. Purpose: We surveyed MTs’ perceptions of their role in engaging in conversations about skin cancer prevention, viewing the skin for suspicious lesions, and referring clients with such lesions to health care providers.Setting, Participants, Research Design: We ad-ministered an online survey from 2015–2017 of licensed MTs practicing in the US and at least age 21 years (n = 102); quantitative and qualitative data were analyzed in 2017.Main Outcome Measures: The main variables assessed were MTs perceptions of (a) appropriate-ness for asking clients about skin cancer history, skin cancer prevention, suspicious lesion referral and follow-up; and (b) comfort with recognizing and discussing suspicious lesions, recommending a client see a doctor for suspicious lesion, and discussing skin cancer prevention.Results: Quantitative data revealed that most MTs were amenable to discussing skin cancer prevention during appointments; few were en-gaging in these conversations. MTs were more comfortable discussing suspicious lesions and recommending that a client see a doctor than they were sharing knowledge about skin cancer and sun safety. Categories based on qualitative content analysis were: sharing information for the client’s benefit, and concerns about remaining within scope of practice.Conclusions: MTs have boundaries for skin cancer risk-reduction content to include in a client discussion and remain in their scope of practice. These findings will help support a future educa-tional intervention for MTs to learn about and incorporate skin cancer risk-reduction messages and activities into their practice
Striving to Make Massage Therapy Accessible to Older Adults: an Interview with Niki Munk, PhD, LMT
First she became a licensed massage therapist in Kentucky. Then, in a quest to improve the care she provided to her elderly clinical population, Niki Munk continued her journey by furthering her education and receiving her doctorate in ger-ontology. Dr. Munk, a massage therapy researcher at Indiana University’s IUPUI campus, shares in this interview her optimism on the future of the massage therapy profession and massage therapy research. Dr. Munk also provides insight into the way she makes decisions, and from whom she would like to receive advice
Improving Body Mechanics Using Experiential Learning and Ergonomic Tools in Massage Therapy Education
Introduction: Current industry data suggest that the rise in occupational injuries for massage therapists is contributing to a significant number leaving the profession after a few short years. While many massage therapists are taught meth-ods for proper body mechanics and self-care within their career educational programs, there are few consistencies in the theoretical approaches to these concepts, even though it is a required component in massage therapy career training.Purpose: This study demonstrates a measurable and effective teaching method using a combination of experiential and transformative learning theory models and authentic ergonomics measurement tools to teach effective body mechanics in entry level career training that may be sustainable for new massage therapists entering the field. Methods: Four cohorts of students (N = 17) enrolled in a kinesiology course for massage thera-pists were studied using a mixed-methods time series experimental design. A pre- and post-test was conducted by utilizing two industry standard ergo-nomics risk factor assessment tools as measurable data for score comparison, to denote improvements in each student’s risk factor tendencies and provide evidentiary support of learning transfer. Between the pre- and post-test, students participated in a series of experiential learning exercises within class sessions during the semester and completed two reflection journals discussing their experiences. Results: The results showed that there was a statistically significant reduction in ergonomics risk factor scores for all students studied. Conclusion: The success of this study demon-strates that the instructional design using expe-riential and transformative educational theory and general ergonomics concepts is an effective approach to teaching proper body mechanics to massage therapy students which can be adopted into universally accepted curriculum on many levels and could eventually contribute to reduction of occupational injury in the future
A Regional Analysis of U.S. Insurance Reimbursement Guidelines for Massage Therapy
Introduction: Massage techniques fall within the scope of many different health care providers. Physical therapists, occupational therapists, and chiropractors receive insurance reimbursement for health care services, including massage. Although many patients pay out of pocket for massage services, it is unclear how the insurance company reimbursement policies factor provider qualifications into coverage. This project examined regional insurance reimbursement guidelines for massage therapy in relation to the role of the provider of massage services.Methods: A qualitative content analysis was used to explore guidelines for 26 health insurance policies across seven US companies providing coverage in the northeastern United States. Publicly available information relevant to massage was obtained from insurance company websites and extracted into a dataset for thematic analysis. Data obtained included practice guidelines, techniques, and provider requirements. Information from the dataset was coded and analyzed using descriptive statistics.Results: Of the policies reviewed, 23% explicitly stated massage treatments were limited to 15-minute increments, 19% covered massage as one part of a comprehensive rehabilitation plan, and 27% required physician prescription. Massage techniques mentioned as qualifying for reimbursement included: Swedish, manual lymphatic drainage, mobilization/manipulation, myofascial release, and traction. Chiropractors, physical therapists, and occupational therapists could directly bill for massage. Massage therapists were specifically excluded as covered providers for seven (27%) policies.Conclusion: Although research supports massage for the treatment of a variety of conditions, the provider type has not been separately addressed. The reviewed policies that served the Northeastern states explicitly stated massage therapists could not bill insurance companies directly. The same insurance companies examined reimbursement for massage therapists in their western U.S. state policies. Other health care providers were able to bill directly for massage services to companies that did not accept direct billing by massage therapists. The specific exclusion of massage therapists as eligible providers violates the Affordable Care Act’s non-discriminatory provision. Massage therapists should continue to advocate for reimbursement privileges to spur wider acceptance of massage therapy in health care
From Skeptic to Vital Partner in Massage Therapy Research: an Interview with Mark Hyman Rapaport, MD
Mark Hyman Rapaport, MD is a highly accomplished researcher, academician, and clinician. Dr. Rapaport has more than 180 publications, and his main research interests include biologic genesis of anxiety disorders, as well as immunity abnormalities and depression in mood disorders. His research investigating massage therapy has included study of inflammatory biomarkers, cancer related fatigue, and generalized anxiety disorder. He hascreated a successful partnership with the Atlanta School of Massage for the implementation of his research inquiry. Dr. Rapaport discusses with us a wide range of topics on massage therapy, including from where his inspiration for research comes
The Characteristics, Experiences and Perceptions of Registered Massage Therapists in New Zealand: Results from a National Survey of Practitioners
Background: Massage therapy is widely recognized as offering many health benefits, with a growing number of studies finding it has value in stress management, pain reduction, and overcoming physical limitations. However, there are few studies of massage therapists practices and perceptions in New Zealand and internationally. This paper reports the findings from the first national survey examining the characteristics, perceptions, and experiences of New Zealand-based massage therapists on a range of aspects related to their role and practices.Purpose: This study sought to ascertain the characteristics, experiences, and perceptions of massage therapists in New Zealand, particularly in the aspects of: integration of health care; attitudes and practices related to research; and evidence and attitudes to registration.Setting: Massage practice in New Zealand (nationwide survey).Participants: Members of Massage New Zealand (a massage practitioners association).Research Design: Massage practitioners were surveyed online, using a 65-part questionnaire, on a range of characteristics of their practices and their attitudes to research, integration, and registration. Statistical analysis was performed using STATA. Statistical significance was set at 0.05.Main Outcome Measures: Four hundred massage therapists (MTs) were invited to participate and 115 responded, providing a response rate of 29%. MTs valued research (95%) and perceived that it had an impact for their practices (88%). Significant correlations were found for research value and: mean case-load (p = .009) and level of academic qualification (p = .004). The majority of MTs (79%) supported integration with conventional practitioners, and 83% referred clients to general practitioners, with 75% receiving referrals from general practitioners. Ninety-three percent of MTs supported registration, with 67% of those supporting statutory registration.Conclusion: Massage practitioners perceive that they make a significant contribution to health care, but area of practice, such as research, and referral and integration into mainstream health care require more in-depth investigation
Shiatsu and Acupressure: Two Different and Distinct Techniques
Background: Although shiatsu has been taught in specialized schools in Japan since 1940, there is a limited amount of research for its practice. As a result, authors substitute shiatsu with acupressure to use available research on acupressure. It is the position of the authors that, while the two share common aspects, they are substantively different. This project was undertaken to describe technical differences and advocate for a clear distinction, especially in research studies and academic discussions.Methods: To understand whether it is appropriate to include acupressure studies in the evidence for shiatsu an analysis of the references included in a frequently cited systematic review was conducted to collect information about the protocols. In addition, a preliminary exploration of shiatsu practitioners’ perceptions about the differences between shiatsu and acupressure is described. This exploration used videos of shiatsu and acupressure techniques and asked practitioners to comment on their perception of similarity.Discussion: The results identified several key technical differences between the two, including type of pressure applied, the positioning of the thumb, and the way in which body weight is used. Researchers should separate shiatsu and acupressure in their designs and purposively choose one or the other. To facilitate such clarification, we have proposed a definition for shiatsu that may facilitate the differentiation between these two techniques.Conclusion: The authors hope to stimulate discussion about the differences between shiatsu and acupressure, and to question the appropriateness of using acupressure studies as evidence of the efficacy of shiatsu. A true understanding of the efficacy of shiatsu cannot be determined until studies use a common definition of shiatsu and discontinue substituting acupressure research for evidence of shiatsu efficacy. When this happens, it is proposed that a clearer picture of the safety, efficacy, and mechanism of action of both shiatsu and acupressure will emerge
Effects of Massage as a Combination Therapy with Lumbopelvic Stability Exercises as Compared to Standard Massage Therapy in Low Back Pain: a Randomized Cross-Over Study
Background: Little is known about the effects of providing massage as a combination therapy (CT) with lumbopelvic stability training (LPST) in management of chronic nonspecific low back pain (CLBP) among elite female weight lifters. It is unclear whether massage therapy (MT) together with LPST has any additional clinical benefits for individuals with CLBP.Purpose: The current study compares the thera-peutic effects of CT against MT as a stand-alone intervention on pain intensity (PI), pain pressure threshold (PPT), tissue blood flow (TBF), and lumbopelvic stability (LPS) among elite weight lifters with CLBP.Setting: The study was conducted at the campus for National Olympic weight lifting training camp.Participants: A total of 16 professional female elite weight lifting athletes who were training for Olympic weight lifting competition participated in the study.Research Design: A within-subject, repeated measures, crossover, single-blinded, randomized allocation study.Intervention: The athletes were randomized into three sessions of CT and MT with a time interval of 24 hrs within sessions and a wash out period of four weeks between the sessions.Main Outcome Measures: The PI, PPT, TBF, and LPS were measured before and after each session repeatedly in both groups of intervention. The changes in the PI, PPT, TBF, and LPS were analyzed using repeated measures analysis of vari-ance (ANOVA).Results: The results showed that the CT signifi-cantly demonstrated greater effects in reducing pain perception (45%–51%), improving pain pressure threshold (15% up to 25%), and increas-ing tissue blood flow (131%–152%) than MT (p < .001).Conclusion: The combination therapy of mas-sage therapy and LPST is likely to provide more clinical benefits in terms of PI, PPT, and TBF when compared to massage as a stand-alone therapy among individuals with chronic nonspecific low back pain