OK, so how many massage therapists does it take to help build a research agenda for massage therapy for the next ten years?
Answer: well, how many are in the room?
Astoundingly, after two and a half days of incredibly exciting and happily exhausting, non-stop information absorption and networking at the International Massage Therapy Research Conference in Boston (April 2013), nearly every attendee – and all of the presenters who could — mustered the personal juice to not only show up for “round table discussions” about setting a research agenda for the next ten years, but to actively and passionately participate. Picture arms flailing, fingers pointing, faces scrunching, magic markers flying, brows furrowing, timers being ignored, and a whole huge ballroom of earnest noise. No cold, calculating crowd, plotting the ways and means to insurance reimbursement, this. Nope; this was one ballroom filled with passion. This was about access.
Participants were assigned the job of taking the point of view of one of a list of groups that have an interest in the types of, and the prioritization of, research about massage therapy to be done in the next ten years – to ask, “what type of information does your group need in order to make decisions about massage therapy?” Examples of the groups: massage therapists, massage educators, medical providers (MDs, DOs, NPs, DCs, DAOMs), other health care providers who might refer (NDs, PAs, nurses, PTs, OTs), hospital administrators, larger employers, federal government (as payer for DOD, Medicare, Medicaid), and consumers. In addition, participants were asked to address the types of studies (clinical trials, comparative effectiveness / cost effectiveness studies, basic science studies and studies focusing on mechanism, and practice-based research) that their particular group would be the most interested in, and why. The results of these group discussions will be folded in with the results of surveys done with other stakeholders, a review of the initial massage therapy research agenda created by the Massage Therapy Foundation in ———-, the comments by presenters at the conference, and the political and funding landscape in which we live in order to build an updated research agenda (the first research agenda was published in 1999) for massage therapy, a task that the Massage Therapy Foundation is happy to oversee.
I don’t know about you, but I don’t usually think about research discussions as being loaded with emotion and dramatic gesticulation. This one certainly was, though. But therein is the nugget about massage therapists, right? We know that, when it’s done well, this is good, good work. In our bones and our hearts and our spirit we know it. We know that the evidence will show it. We know that some evidence might surprise us. And we’re not afraid to learn and to adjust and to hone and to argue about what we do, because in the end, whatever is good for the human being at our hands is good for us, and good for the future of massage therapy.
And will help all people to have access to it.
Sharon Marden Johnson is on the Board of Trustees for the Massage Therapy Foundation.
Putting yourself in another’s shoes is much easier said than done. However, when it is genuinely and successfully attempted it can provide us with some of the most powerful and insightful learning tools. The 2013 IMTRC provided such an opportunity to attendees in break-out sessions held during the final day’s push towards ascertaining a new massage therapy research agenda for the coming years. Each break-out session was designed to “see” massage therapy from a different vantage point as well as to assess strengths and challenges that developed from their new viewpoint regarding the legitimacy and acceptance of massage.
As a massage therapist in a family of doctors and more traditional practitioners, I am consistently reminded of many overarching issues that arise when practitioners from holistic and western philosophies attempt to collaborate. Sitting in on the discussion of massage therapy from the perspective of physicians, the conversation I absorbed was very familiar to me. In general, there is a need for massage to be redefined, protocoled, and for dosage studies to get underway in order for the efficacy of massage to accurately be measured. With such studies, syntax and documentation for massage therapy will also need to be addressed and streamlined. For weeks after this conversation I had the ringing of a physician’s voice in my ear with “what is massage? what is massage? we need to DEFINE MASSAGE!,” I then began to ask myself this. I have been doing this for 4 years now and here I am at my clinic, working with my clients and all of a sudden I cannot manifest a singular definition for massage. As a result, I asked my clients.
To many of my clients, massage is an opportunity for them, after surgery, to get range of motion and soft tissue screening between appointments with their surgeons. For many of my clients, massage is a process in which they can begin to accept their body again after facing any of a spectrum of body image alignments. For many of my clients, massage is a time during which they can be educated about how work and deconditioning are present in their body; a starting point for setting goals. Truly quantifiable feedback from my clients only came when exact measurements had been taken: range of motion and strength-based assessments specifically.
My observations at the conference as well as direct feedback from my clients, led me to strongly encourage the enforcement of education reform in massage schools. For studies of massage efficacy to occur successfully, the measurable components of massage and bodywork need to be isolated. Therapists need to know how to use a goniometer, how to take blood pressure, how to assess gait and limb discrepancies. I see massage therapists as important teachers to clients. We spend more time with our clients than nearly any other practitioner has the luxury of doing. Understanding functional movement screening and quantifiable outcomes is invaluable to our practice. This knowledge will give us a solid starting point from which we can BEGIN to understand the effects of massage on our clients in a much more specific light.
I hear massage therapists talking about how massage cannot be measured; “it’s too subjective.” The important thing to remember, I believe, is that patients are always, first and foremost – human – nebulous and subjective. There are always aspects of patients that are perhaps not measurable or easily captured. This, consequently, often relates to how therapists feel about the entire field of massage. Many clients choose their therapists based on a “certain something,” something special and perhaps not easily expressed or found in another therapist. Many massage therapists talk about this, concerned that if we start to take the holistic nature out of massage by throwing it into the science realm, clients will lose that relationship. Regardless of how “scientific” or measurable a modality is, our clients will always be able to see that side of us. Now it is our responsibility to find a way to meld what will become a more protocol-oriented treatment regimen WITH that certain something, and create a new type of massage that is both intuitive and organized around proven outcome-based techniques. I truly believe that this is our future and I truly believe that it will be powerful and meaningful for the entire medical field.
Sarah Rogers resides in Cambridge, Massachusetts and is a massage therapist and personal trainer. Her work centralizes around client awareness and (re) education. She loves the desert and is originally from Arizona.
This five-part case report webinar series dissects the essential sections of a case report and demystifies the writing process, making it easy for you to write your own case report! Join the Massage Therapy Foundation (MTF) for a new, complimentary webinar series in collaboration with Associated Bodywork & Massage Professionals (ABMP).
Missed out on the live webinars? Click on each topic for your access to a FREE viewing of each webinar!
Each year, the MTF offers two Case Report Contests, one for students and one for practitioners. Once the winners of each contest go on to have their case report published in a scientific journal they will receive a cash prize. The 2013 Student Case Report Contest (SCRC) submission deadline is June 1, 2013. Learn more about the SCRC.
The 2013 Practitioner Case Report Contest (PCRC) is now open. While the deadline to submit a case report to the PCRC won’t be until October 1, 2013, it’s never too early to start writing your report, and the webinar series below can help you along the way.
1. Writing a Case Report: Where do you start?
Presenter: Jerrilyn Cambron, PhD
Watch the recording of “Writing a Case Report: Where do you start?”
A case report is a description of a client seen in clinical practice which is written in a scientific manner. Case reports may be the only evidence published on massage therapy for a given condition, and may be the “springboard” for researchers to develop larger studies. In this introductory webinar, you will learn how to decide which case might be worth documenting. You will also learn about the different sections of the case report and how to choose the journal to which you will submit your report.
Jerrilyn Cambron, LMT, DC, MPH, PhD, is a professor in the department of research at the National University Health Sciences, where her focus in on complementary and alternative medicine research (CAM) and evidence-based practice. She has been involved in CAM research since 1988, has published extensively in scientific literature, and teaches courses on research design, evidence-based practice, research literacy, and epidemiology. Jerrilyn is currently president-elect of the Massage Therapy Foundation (MTF). She has taught “How to Write Case Reports” for many years, and has worked with numerous health-care professionals to get their case reports published.
2. Introduction and Discussion Sections – Making Your Case
Presenter: Ruth Werner
Watch the recording of “Introduction and Discussion Sections – Making Your Case” This webinar will delve into some strategies for writing the introduction and discussion sections of a good case report, with special emphasis on using other scientists’ work to help inform and advance your own project. While acknowledging that writing a case report is an ambitious project, this webinar helps break the “elephant” into bite-size pieces. Listeners interested in doing a case report will come out of this hour with step-by-step suggestions for how to go about the important task of writing outstanding introduction and discussion sections.
Ruth Werner is a retired massage therapist, writer, and educator with a passionate interest in massage research and the role of bodywork for people who struggle with health issues. She has been on the Case Report Contest Review Committee for the Massage Therapy Foundation since 2007, and she now serves as president of the Massage Therapy Foundation, a philanthropic organization that works to advance the knowledge and practice of massage therapy by supporting scientific research, education, and community service.
3. Reporting the Case – What to Leave in and What to Take Out
Presenter: Karen Boulanger, PhD
Watch the recording of “What to Leave in and What to Take Out”
This webinar focuses on how to write the methods and results section of the case report. This includes describing the client, the specific intervention (massage technique), assessments used, and the results of the treatment. In addition, advice on how to determine the best measurements to use and how to appropriately present the results will be given.
Karen Boulanger has a PhD in community and behavioral health and has been a nationally certified massage therapist since 1999. Her career has included massage therapy, education, and research. She is currently the practice section editor for the International Journal of Therapeutic Massage & Bodywork, and serves on the board of the Massage Therapy Foundation. In addition to her office in San Jose, California, Karen provides care to patients at Packard Children’s Hospital at Stanford.
4. Research Posters – An Option for Case Presentations
Presenter: Kim Goral Stevenson
Watch the recording of “An Option for Case Presentations”
Research posters are a visual snapshot of information contained in research articles and case reports. They are a great way to communicate the effects of massage therapy in a variety of settings such as your office, a health fair, or even a research conference. In this webinar, participants will learn how to design and create a research poster, building on concepts discussed in the previous “Writing a Case Report” webinars. Different uses of research posters will also be discussed.
Kim Goral Stevenson, MS, LMT, NCTMB, has been practicing massage since 2006. In addition to her passion for massage, Kim also has a love for science and research and works in the Clinical and Translational Science Institute at Boston University as an evaluation research analyst. Kim has worked on a number of research and evaluation projects and her primary research interest related to massage therapy is its effect on psychological disorders such as anxiety and depression.
5. Case Report Contest Winner – Experience from the Field
Watch the recording of “Experience from the Field”
This webinar will be presented by Rosemary Chunco, a Massage Therapy Foundation Case Report Contest gold award winner. She will discuss the challenges encountered in writing a case report and will also give some tips and encouraging reasons why students and practitioners should consider writing a report. She will also provide personal insights on how going through the experience positively changed her outlook on her work.
Rosemary Chunco has been operating her own massage therapy practice in Plano, Texas, since 2003. She previously worked as a software engineer for more than a decade, but following some serious back issues, and being on the receiving end of massage, she changed careers and now enjoys debugging muscular issues! She was the gold award winner in the Practitioner Case Report Contest in 2010 and continues to use massage research to aid with informed, therapeutic decision making in her practice.
The poster session reception on Day 2 of the International Massage Therapy Research Conference allowed researchers to present their results to conference attendees, and for those in attendance to get a clearer picture of the kinds of research being done. Being relatively new to the world of massage research, I was eager to get a feel for what it was all about, so I grabbed a plate of fruit and dove right in.
The first thing that struck me was the diversity of the studies presented. There were several case reports, at least one of which I recognized from the AMTA National Convention in Raleigh. There were comparison studies, randomized controlled trials, and qualitative studies of massage therapists. There were posters that involved massage, of course, but also Feldenkrais, energy work, and Kinesio taping. A few were studies looked at educational methods. One was about the Affordable Care Act. So there was definitely something for everyone, even if you weren’t a research geek in general.
The second thing that stuck out to me was the fact that there was a LOT of Kentucky represented in the poster session. I’d never heard of the University of Kentucky having any sort of massage program, so I cornered researcher and LMT Katie Stewart and asked her about it. She confirmed my understanding–there is no massage therapy program at UK–and explained that the university had received a large grant to study complementary and alternative medicine, and they called her out of the blue to ask her about doing some research with them. She agreed, not knowing exactly what she was getting into, but quickly became immersed in the process. One of the neat things about her research was how it was represented by not just one, but two posters: one about the unique protocol used, and a second one that showed the results. Researcher Niki Munk also had a methodology poster and a results poster. It was educational to see how multiple dimensions of learning can come from the same study if the researchers are committed to looking at it from different angles.
I was a little surprised to see how many studies were done by researchers who were not themselves massage therapists. I spoke with Carolyn Palmer, a Feldenkrais practitioner with a Ph.D. in psychology, who was the presenter of a poster that examined the thinking of dual practitioners who practice both Feldenkrais and massage. She noticed that people came to Feldenkrais from many different backgrounds, but massage therapy was particularly common, and she wanted to know how this particular background affected their work. She learned that the massage therapists/Feldenkrais practitioners felt that both their lines of work were supported by the other. Their massage training had given them a better understanding of anatomy and soft tissue, while their Feldenkrais training made them more aware of bones and body movement. I enjoyed peeking into the massage profession from an outsider’s perspective. It was also really gratifying to see a non-massage therapist who was so enthusiastic about the possibilities presented by massage therapy.
Some of the studies were unique for the modality used. Stephanie Owen saw that the kind of hands-on energy work she was providing wasn’t being provided by other practitioners. She decided to show its effectiveness by studying it herself. Her study on children and youth with Asperger’s indicated that her work provided a wide variety of physical, emotional, and social benefits. Perhaps we’ll see one of those fascinating mechanism studies that we heard so much about during the first day of the conference as a follow-up in three years!
Really, just seeing all the research being done, from the individual case report to the well-funded trial, was an exciting experience. But being able to speak with the researchers in person was invaluable. It helped me put the research into context in ways that the posters didn’t themselves explain: the motivations, struggles, and big ideas that accompanied the research. It was also fun to chat with people ask they geeked out about the work they were passionate about and had put many hours of effort into. Over desserts later that evening, a friend and I vowed to each other that in three years, we’d both have posters hanging up there in the hall. Will it actually happen? You’ll have to show up to the next research conference, or you’ll never know.
IMTRC Poster Session
Using Massage to Treat Fibromyalgia – Report of a Case Study
Phylis P Rotolo, RN, BSN, LMT
Confusion and Agitation Reduction in an Elderly Client
Nicole Riou, RMT
Massage Therapy for Essential Tremor
John Balletto BSc, LMT, CKTP
Massage and Kinesio Taping for Rheumatoid Arthritis: A Descriptive Case Report
Jeff Moggach, MT, MA
Human Patient Simulation Technology for Massage Therapy Education
Pamela Fitch, BA, RMT, Farbod Karimi, EdD, MEd, BBA, Marvin Mohring, BSc(Kin), RMT
Learning how to treat scars and write case reports as a means of fostering research literacy and capacity
Jennifer Merciér, Midwife, LMT, PhD, Karen Miller, LMT
Merciér Therapy Helps Infertile Women Achieve Pregnancy
Jan Worsley Cendese, LCSW, LMT, APP, CCP, Roger Olbrot, BA, LMT, David Hodges, Stephanie Owen, PhD, Kerry Dew, BA, MBA
Is there a place for energy work with children living with Autism: A qualitative study
Carolyn Palmer, PhD
The Feldenkrais Method of Movement Awareness: Lessons for Attunement and Ease
Luann Drolc Fortune, PhD, MA, LMT, NCBTMB, Glenn M Hymel, EdD, LMT
How Massage Therapists Execute a Whole Session with Established Clients
Diana L Thompson, LMP, Marissa Brooks, MPH, LMP, Michael Hamm, LMP, CCST, Benjamin Erkam, MA, Kenneth Pfaff, HFWLS, HPCUHGS
Summary of Evidence: Massage Therapy is an Integral Component in the Affordable Care Act’s Essential Health Benefits
Niki Munk, PhD, LMT, TB Symons, PhD, J Watkins, PhD, A Harrison, PhD, WG Elder, PhD, & F Zanjani, PhD
The evolution of methodology for a pilot study examining massage effects on physiological fatigue in healthy older adults
Kathryn Stewart, BS, LMT, RCST, N Munk, PhD, LMT, E Carter, BS, M Love, PhD, G Bruckner, PhD, WG Elder, PhD
Novel Clinical Massage Therapy Protocol Allows for Exploration of Real World Massage Therapy Practice
Jeffrey Forman, PhD, NCTMB, Michael E Rogers, PhD, Lisbeth Geertsen, MS, CMT
Effect of deep stripping massage vs. deep stripping massage combined with eccentric resistance on hamstring length and strength
Younes Jahangiri Noudeh, MD, Nasibeh Vatankhah, MDm, Hamid Reza Baradaran, MD
Reduction of current tension-type headache pain intensity after a simple neck and upper thoracic spinal massage and manipulation
Niki Munk, PhD, LMT and WG Elder, PhD
Older Clients Receiving Massage Therapy Report Larger Reductions in Perceived Pain
Kathryn Stewart, BS, LMT, RCST, N Munk, PhD, LMT, E Carter, BS, M Love, PhD, G Bruckner, PhD, WG Elder, PhD
Initial steps to inform primary care provider referral criteria to clinical massage therapy for chronic low back pain
Lynn E Watanabe, DDS, John Chien, JD, Ching-piao Chien, MD
Can Massage Help Reduce Dental Anxiety? A Randomized Controlled Trial
Tanya Zilberter, PhD, Anya Ferry, MEd, Roger Borbon, DC, DACNB, FACFN, CCCN
Neuro-immuno-endocrinology of the skin, brain-skin axis and hormesis as possible mechanisms of therapeutic modalities using cutaneous stimulation
About Kat Mayerovitch
Kat is a massage therapist who practices and writes in Cleveland, Ohio. Some of her writing can be found at LMT or Bust, a blog for massage therapy students and recent graduates.