A Viable Intervention for Stress Reduction in Children with Autism Spectrum Disorder

Angela Burke 

Objective: To present research data representing short and long-term stress reduction in a child with an Autism Spectrum Disorder using Zen Shiatsu as a complementary and alternative treatment.

Methods: A seven year old male with a diagnosis of Autism was given twenty-minute Zen Shiatsu sessions weekly for six consecutive weeks.  Using a 5-point stress scale that utilized facial expressions with corresponding stress values, the client indicated his stress level prior to the session, as well as afterwards.  Measurement comparing the levels demonstrated a decrease in stress within the twenty minute period.  In addition, the parent was given the PEDS QL 4.0 Young Child Questionnaire to determine the child’s HRQoL (Health Related Quality of Life) prior to the six-week Zen Shiatsu treatment to establish a baseline.  The parent completed the same questionnaire after the six weeks of sessions to compare results.

Results:  Stress levels decreased in the client after receiving Zen Shiatsu after all six sessions.  The PEDS QL 4.0 showed higher HRQoL scores in all domains, indicating that the child’s overall quality of life improved within the six weeks of receiving Zen Shiatsu.

Conclusions:  Zen Shiatsu, a form of Traditional Chinese Medicine, has the potential to be a viable treatment for stress reduction in children with Autism Spectrum Disorders, therefore improving overall quality of life.

Key Words: Zen Shiatsu, Autism Spectrum Disorder, Traditional Chinese Medicine, Stress Reduction

AWARD TYPE:  Past Poster Presenter

Blood Flow Within Active Myofascial Trigger Points Following Massage

Albert Moraska, PhD
University of Colorado at Denver
Aurora, CO
$30,000

Myofascial pain syndromes are associated with a high percentage of chronic pain disorders and are characterized by the presence of myofascial trigger points (MTrPs). Massage therapy has been shown to be effective at alleviating myofascial pain presenting as back pain or tension-type headache and specifically reduce point tenderness associated with MTrPs. However, mechanisms by which massage therapy exerts an effect are poorly understood. The MTrP is a tightly contacted nodule within skeletal muscle and research evidence suggests it impedes blood flow, subsequently causing tissue distress and production of pain evoking chemicals. The purpose of this research study is to investigate blood flow at the MTrP following massage to provide inroads into a mechanism of action for massage in the treatment of myofascial pain and MTrPs. Research subjects with myofascial pain expressed as tension-type headache and an active MTrP in the upper trapezius muscle will be randomly assigned to receive trigger point release massage or a control treatment at the MTrP. Interstitial fluid within the MTrP will be collected before and after massage from which markers to assess blood flow will be determined.

AWARD TYPE:  Research Grants

Blood Flow Within Active Myofascial Trigger Points Following Massage

Albert Moraska, PhD
University of Colorado at Denver
Aurora, CO
$30,000

Myofascial pain syndromes are associated with a high percentage of chronic pain disorders and are characterized by the presence of myofascial trigger points (MTrPs). Massage therapy has been shown to be effective at alleviating myofascial pain presenting as back pain or tension-type headache and specifically reduce point tenderness associated with MTrPs. However, mechanisms by which massage therapy exerts an effect are poorly understood. The MTrP is a tightly contacted nodule within skeletal muscle and research evidence suggests it impedes blood flow, subsequently causing tissue distress and production of pain evoking chemicals. The purpose of this research study is to investigate blood flow at the MTrP following massage to provide inroads into a mechanism of action for massage in the treatment of myofascial pain and MTrPs. Research subjects with myofascial pain expressed as tension-type headache and an active MTrP in the upper trapezius muscle will be randomly assigned to receive trigger point release massage or a control treatment at the MTrP. Interstitial fluid within the MTrP will be collected before and after massage from which markers to assess blood flow will be determined.

AWARD TYPE:  Research Grants

Bowenwork for Migraine – Is it all in the Head?

Bronze Award Winner
Sandra Gustafson, MHS, BSN, RN
Bodega Bay, CA

Description: This case report described one migraineur’s response to Bowenwork (gentle, soft-tissue bodywork technique) for reducing migraine occurrence and pain, pharmaceutical analgesic consumption, and improving her health-related quality of life, wellbeing and activities of daily living.  The client, a 66 year-old Caucasian female, had a history of debilitating migraines since childhood and severe neck pain resulting from 2 motor vehicle accidents sustained as an adult.  She reported experiencing severe migraine and neck pain 3 – 4 times a week, and taking up to 10 tablets of Ibuprofen 200mg per day, placing ice-packs on her neck and lying in a quiet, dark space until her symptoms abated.  She had previously sought medical and pharmaceutical treatment, chiropractic, massage and other bodywork techniques to relieve her condition.

Method: The case-study reports on the client’s responses to receiving fourteen Bowenwork sessions, weekly to two-weekly, over a 4-month period, using the self-reporting Measure Yourself Medical Outcome Profile version 2 to evaluate clinically meaningful changes. Prior to each Bowenwork session, data were recorded to track changes in migraine and neck pain occurrences, medication use, daily functional ability and general sense of wellbeing.  Specific Bowenwork procedures were applied in each session to address the client’s symptoms which varied from neck and jaw pain to middle and lower back pain.

Results: During the 4-months of receiving Bowenwork, the client progressively reported decreased migraine and neck pain; and by session 14, no further migraine, neck or jaw pain, nor medication use; and increased quality of life, daily activities and wellbeing, for 10 months thereafter, and continues to be migraine-free at the time of this report.

Conclusion: Bowenwork had a positive effect for one client and may offer non-pharmaceutical relief for migraineurs.  Further research on larger populations is indicated.

AWARD TYPE:  Case Report ContestPractitioner

Comparing the Effects of Rest and Massage on Return to Homeostasis Following Submaximal Aerobic Exercise

Gold Award Winner
Portia Resnick, MA, ATC, LMT
Honolulu, HI

Background: Post-exercise massage can be utilized to help promote recovery on the cellular level as well as systemically by increasing parasympathetic activity. No studies to date have been done to assess the effects of massage on post-exercise metabolic changes and parasympathetic activity.

Objectives: The purpose of this case study was to compare the effects of massage recovery and resting recovery on a subject’s heart rate variability (HRV) and selected metabolic effects following a submaximal exercise session.

Methods: One healthy 24-year old female performed submaximal treadmill exercise prior to resting or massage recovery sessions.  Metabolic data and HRV were evaluated for two 10-minute intervals after each of two 30-minute recovery sessions, either resting or massage.

Results: Heart rate returned to below resting levels more quickly with massage recovery. Heart rate variability showed a more immediate shift to the parasympathetic state and ventilations per minute decreased following 30 minutes of massage recovery. After 60 minutes of resting recovery levels of HRV and ventilation approached those found after 30 minutes of massage recovery.

Conclusion: Massage immediately following submaximal exercise lead to lowered heart rate more quickly than resting alone.  Massage during recovery showed a decrease in sympathetic control and an increase in parasympathetic tone.  A greater relaxation response was seen with massage recovery as evidenced by the VE*VO2-1 response.

AWARD TYPE:  Case Report ContestPractitioner

Contralateral Treatment for Centrally Sensitized Chronic Shoulder Pain” A Case Report

Honorable Mention
Rosie Goldsmith, BA, LMT, DAFNS
Portland, OF

Background and Objectives: Severe chronic pain affects up to 100 million Americans. Central sensitization (CS) of pain is where there is an increased pain responsiveness of the central nervous system to slightest touch or movement. Acute musculoskeletal injury induced pain may develop into CS pain. Contralateral manual therapy and exercise of the opposite arm has been shown to stimulate muscles and pain signaling of an affected limb. This case report investigates whether contralateral inhibitory exercise techniques can be effective to treat a patient with central sensitization of chronic shoulder pain.

Methods: The patient, a 45 year old man with a history of 3 years post-injury severe chronic right shoulder pain, showed all the signs of central sensitization. He was assessed for range of motion and pain. His pain contraindicated direct touch. Over a course of 12 sessions spanning 24 weeks, Visual Analogue Scales were used for pain, and the patient kept a log of the use of his need to wear a transcutaneous electrical nerve stimulation (TENS) unit to interrupt the pain signaling. Part way through the series practitioner obtained informed consent and recruited patient’s wife to assist with exercises at home. Practitioner lightly palpated to find the most painful sites on the right shoulder, then used slow resisted range of motion, or concentric isotonic contractions to homologous muscles and tendons of the left arm.

Results: Patient had a substantial reduction in pain, improvements in sleep and confidence. He was able to resume normal activities in his home and family, and return to work for the first time in three years.

Conclusion: This case report showed a beneficial effect of contralateral massage and exercise treatment for centrally sensitized pain. It merits further study under controlled conditions.

AWARD TYPE:  Case Report ContestPractitioner

Dynamic Angular Petrissage (DAP); A Novel Therapeutic Approach for Axillary Web Syndrome (Coding/We

Silver Award Winner
Paul Lewis, NCBTMB, RMT, CDT
Mississauga, Ontario

Background and objectives: Axillary web syndrome (AWS), also called lymphatic cording, typically presents in the weeks after axillary surgery for breast cancer. This painful condition is likely angiolymphatic in origin. It restricts use of the upper extremity, and has no established treatment although physical therapy and other approaches have been used to variable effect. We applied therapeutic massage techniques using Dynamic Angular Petrissage (DAP) with the aim of quickly but gently reducing upper extremity pain and improving range of motion in the case of a young woman with AWS.

Methods: Patient assessment included self-report of pain (5 on a scale of 0-10), extent of flexion of the glenohumeral (GH) joint (140 degrees by goniometer), and visual and physical determination of extent of cording (taut, from axilla to wrist). She received two therapeutic massage sessions including the DAP approach: passive manipulations of the involved joint through all possible angles of movement, lengthening and shortening the target muscle(s) while simultaneously adapting petrissage techniques to the condition of the underlying soft tissue. The cord was considered part of the arm structure restricting motion, rather than a tissue to be torn or broken. Specified home care exercises were also used by the patient.

Results: After a 1.5 hour session using DAP, pain was reduced to 0/10 and flexion was improved to 170 degrees. The cord was visibly reduced. Following a second 0.5 hour DAP treatment the cord was only residually apparent, with no restrictions 4 even during hyperextension. Long-term outcome was complete resolution with no recurrence.

Conclusion: The techniques of DAP are simple for the trained therapist to apply. We propose that DAP may be an efficient, comfortable and effective approach to treating axillary web syndrome.

AWARD TYPE:  Case Report ContestPractitioner

Effectiveness of Intradialytic Massage on Muscle cramping in Dialysis Patients

Diane Mastnardo

Introduction: Patients on dialysis can experience pain caused by muscle cramping that may result in shortened treatment times that have been linked to worse outcomes. 1,2 It is estimated that up to 88% of dialysis patients experience cramping and one study reported that 15% of patients with shortened treatment cited muscle cramping as reason.3 Over the past ten years research studies using massage in cancer patients have shown decreases in pain, inflammation and feelings of anxiety.4 Although there is limited evidence available about massage in dialysis patients, it may be an effective treatment modality for hemodialysis-related lower extremity cramping.

Aim: To determine the effectiveness of intradialytic massage on the frequency of cramping among hemodialysis patients prone to lower extremity cramping.

Methods: Our study protocol, approved by the Institutional Review Board at MetroHealth Medical Center included a 2- month training period during which licensed massage therapists were trained in massage techniques and tested for inter-therapist consistency. 32 (16 intervention, 16 control) hemodialysis patients with frequent lower extremity cramps, were enrolled in our study. Frequent cramping during dialysis treatments was defined as 1 or more episodes of lower extremity cramps during or after dialysis over the previous 2 weeks. The intervention group received a 20 minute massage of the lower extremities during each treatment (3 times per week) for 2 weeks. The control group received usual care by dialysis center staff.

Results: Patient reported cramping at home decreased by 2.5 in the intervention group compared to 0.3 in the control group (p = 0.005) and patient reported cramping during dialysis decreased by 1.6 in the intervention group compared to 0.9 in the control group (p = 0.44)

Conclusion: Intradialytic massage appears to be an effective way to address muscle cramping. Larger studies with longer duration should be conducted to test for similar results.

AWARD TYPE:  Past Poster Presenter

Effects of Massage Combined with Eccentric Resistance on Ankle Flexibility and Balance in Adults Aged 50-65 Years

Jeffrey Forman, PhD, NCTMB*, Michael E. Rogers, PhD, FACSM
Mikalea Bunyan, MEd 
Nicole L. Rogers, PhD
Jeremy A. Patterson, PhD, FACSM,*De Anza College; Wichita State University

Reduced flexibility and balance are associated with aging and increased fall risk. The purpose of this study was to determine the effects a single active muscle therapy treatment on ankle flexibility and balance in adults aged 50-65 years.

Method: Thirty-one volunteers (26 women, 5 men; 58.5 + 4.6 yrs; ; 84.6 + 22.7 kg; 166.1 + 8.2 cm; mean + SD) had their balance measured with the FDA-approved Sway Balance TM mobile application (Sway Medical, Tulsa, OK) which uses the built-in tri-axial accelerometer within an iPhone or iPod Touch to measure postural sway. Participants held the device against the chest while standing with feet together, in tandem, and on one foot for 10 sec each. Sway measures from each stance were compiled into a single score with 100 being perfect (no sway). In addition, ankle dorsi and plantar flexion flexibility were measured using a digital inclinometer. Participants then underwent a 2.5 min warm-up massage to each foot, ankle, and lower leg, a 2.5 min stripping massage (7/10 on a verbal pressure scale) on each tibialis anterior muscle while eccentrically resisting an elastic resistance band, and a similar 2.5 min massage with resistance on the gastrocnemius/soleus groups. After the 15-min massage intervention, balance and flexibility measures were repeated. Results: Balance scores increased (p = 0.024) 4.8% (pre: 83.0 + 15.0; post: 87.0 + 11.0). All measures of flexibility improved (p < 0.001). There was a 15.4% increase in dorsiflexion, 9.6% increase in plantar flexion, and 12.5% increase in overall ankle ROM. Conclusions: Results indicate that combining eccentric resistance with massage improves balance and ankle flexibillity in adults aged 50-65 yrs immediately post-intervention. Future research is needed to determine the effects in older populations, long term effects of this treatment, effects of multiple treatments, and the effects on fall incidence.

AWARD TYPE:  Past Poster Presenter

Impact of Massage Therapy on Spasticity in People with Multiple Sclerosis

Deborah Backus, PT, PhD
Shepherd Center, Atlanta, GA
$29, 998

The purpose of this pilot study is to assess the effectiveness of massage therapy for decreasing fatigue, pain, and spasticity in people with multiple sclerosis, in order to improve their health perception and quality of life. Participants will receive a standardized routine of massage therapy by a licensed massage therapist one time a week for 6 weeks. Measures of fatigue (primary outcome measure), and pain, spasticity, and quality of life (secondary outcome measures) will be collected before and immediately after the completion of the 6-week intervention phase.

Click here to view Dr. Backus and her research featured on CBS-WTAJ in central PA.

Click here to view another story that features Dr. Backus and her research.

AWARD TYPE:  Research Grants

Impact of Massage Therapy on Spasticity in People with Multiple Sclerosis

Deborah Backus, PT, PhD
Shepherd Center, Atlanta, GA
$29, 998

The purpose of this pilot study is to assess the effectiveness of massage therapy for decreasing fatigue, pain, and spasticity in people with multiple sclerosis, in order to improve their health perception and quality of life. Participants will receive a standardized routine of massage therapy by a licensed massage therapist one time a week for 6 weeks. Measures of fatigue (primary outcome measure), and pain, spasticity, and quality of life (secondary outcome measures) will be collected before and immediately after the completion of the 6-week intervention phase.

Click here to view Dr. Backus and her research featured on CBS-WTAJ in central PA.

Click here to view another story that features Dr. Backus and her research.

AWARD TYPE:  Research Grants

Massage for Survivors of Human Trafficking

Willie Martin
New Orleans Community Outreach, New Orleans, LA
$4,000

New Orleans Community Outreach is a non-profit organization that provides access to programs and services offered by the New Orleans Healing Center to the under served in the community.The grant will be used to provide massage to women in Louisiana who are survivors of human trafficking. After years of exploitation, this population has developed a negative association with physical contact and we are working to change that. Since starting the program in September, massage therapists have been meeting regularly with these women and providing massage while talking about different techniques for relaxation. The women live at Eden House, a residential home in New Orleans that provides two years of housing for the women as they rebuild their lives.

AWARD TYPE:  Community Service Grants

Massage Therapy Treatment and Outcomes for a Patient with Parkinson’s Disease

Gold Winner
Youlanda Casciaro
MacEwan University
Edmonton, AB, Canada

Abstract

Background: Parkinson’s Disease (PD) is a complex neurological disorder. The root cause is unknown, and while treatment with pharmacotherapy is successful, eventually the effectiveness of the medications wears off. The disease is progressive and eventually results in severe disability. Symptoms are well-documented, with the most recognizable manifestations being resting tremor, bradykinesia, and rigidity.
Objective: To determine if massage therapy can produce favourable outcomes with respect to the severity of rigidity and tremor in a patient with PD. Methods A 63-year-old female patient with idiopathic, long-standing, Hoehn-Yahr Stage four PD was treated with massage therapy five times over the course of six weeks. A SPES/SCOPA Motor Impairments rating scale was used to measure rigidity and tremor pre- and post-treatment, to gauge treatment effectiveness. The massage treatments consisted of deep longitudinal stroking, muscle squeezing techniques, passive range of motion movements, and general relaxation techniques to encourage a soothing environment while promoting a decrease in muscular tone and hyperactivity.
Results: The results obtained indicated that massage therapy treatment had a positive effect on reducing resting and postural tremor in a patient with long-standing PD. The treatment was also effective to temporarily reduce rigidity during treatment, but did not produce a lasting effect.
Conclusion:
MASSAGE TREATMENT & OUTCOMES FOR A PATIENT WITH PD 4
Further study is required; however, the results of this case were consistent with the limited research available on the subject of massage therapy and Parkinson’s Disease, in that positive change with respect to resting tremor – and to a lesser degree, rigidity – were achieved with focused, intentional treatment.

AWARD TYPE:  Case Report ContestStudent

Reducing Forearm Contractures with Myofascial Massage

Renee Stenbjorn

Purpose: Investigate the use of myofascial massage therapy as treatment for longstanding contractures.

Introduction: Contractures develop when the soft tissues in the muscle and surrounding fascia are replaced by inelastic, fibrotic tissue, making it hard to stretch the area and prevent normal movement1.
Contractures are a concern for patients with strokes, spinal cord injuries and other debilitating diseases. Severely limited range of motion inhibits many activities of daily living. The usual care for contractures include surgery, medication, braces and botulinum toxin2.

Prevalence: The prevalence of contractures varies widely among patient population. The prevalence of contractures among Multiple Sclerosis patients was found to 56%3. In one study, contractures were a complication for 73% of stroke survivors at the one year mark4.

Methods: Subject was 23 year-old male massage student with history of contractures of the left arm and wrist since age six, when he suffered three left arm injuries over a one year period.

A series of six myofascial massages was applied over the course of two months, focusing on eliminating fascial adhesions and restrictions. Direct fascial strokes were applied including compartment separation, fascial wringing and spreading, cross fiber friction, muscle energy techniques and compression of myofascial trigger points. Approximately 80% of the strokes were applied to anterior and posterior forearm, with the balance applied to upper arm and pectoral regions.

Results: Range of motion increased from severely limited supination, starting at approximately 70 degrees, to normal range of 182 degrees following the last massage5. Other measures focus on daily living, such as an ability to play the banjo without pain, have more fluid movements while massaging and more successfully complete small tasks such as using the brakes on his bike & open doorknobs.

This significant result warrants a more thorough investigation of massage therapy as a treatment for contractures.
1: http://www.nlm.nih.gov/medlineplus/ency/article/003185.htm
2. Farmer, SE. Contractures in orthopedic and neurological conditions. Disability and rehabilitation. 2001 Sep 10;23(13):549-58.
3. Hoang PD, Gandevia SC and Herbert RD. Prevalence of joint contractures and muscle weakness in people with multiple sclerosis. Disability and Rehabilitation. 2013 Nov 18. [Epub ahead of print].
4. Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C and Dewey ME. The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke. 2008 Dec;39(12):3329-34.
5. Measured with Goniometer Pro app for iPad.

AWARD TYPE:  Past Poster Presenter

The Use of Craniosacral Therapy in the Treatment of Constipation

Patricia Rogers

Introduction: Functional constipation, one of the most common somatic complaints encountered by practitioners, both negatively affects quality of life and leads to increased healthcare costs. Craniosacral therapy (CST) is a form of bodywork that addresses micro strain patterns which accumulate to create macro dysfunction. The core physiological intent of CST is to free restrictions in the cranial membrane and the dural tube to enhance central nervous system function. CST can elicit the release the somatic memories and residual effects of past injuries and negative experiences.

Objective: There is a paucity of data in the literature on the use of CST in the treatment of somatic complaints such as gastrointestinal distress. This case report highlights the effect of CST on functional constipation in a trauma survivor.

Case Presentation: A 49-year-old, Caucasion female with a history of childhood abuse and domestic violence presented with a chief complaint of difficulty with elimination. She was treated with CST twice per week for four weeks and once per week for four weeks. The Constipation Assessment Scale (CAS) rates the severity of constipation on a scale of 0-16, with 16 being most severe. The CAS was administered before the start of treatment and again at four and eight weeks.

Results: After eight weeks, a reduction in the severity of constipation was noted. The initial CAS score of 8 was reduced to 5 at four weeks and 2 at eight weeks.

Conclusion: CST facilitated the release of adverse mechanical strain patterns associated with somatic memories. Constipation decreased in severity. In this case study, CST was a useful tool in the treatment of constipation, underscoring the need for further evidence-based research in the use of CST to treat somatic complaints.

AWARD TYPE:  Past Poster Presenter

Therapeutic Scraping for the Treatment of Chronic Overuse Injury of the Shoulder of CrossFit Athlete

Honorable Mention
Stacey Meek
Louisburg, NC

Background: CrossFit is an exercise regimen of constantly varied (CV), functional movements (FM) performed at high intensity (@HI) in a communal environment and often includes the use of Olympic weightlifting techniques and gymnastic maneuvers to build muscle and increase cardiovascular endurance. The three Olympic lifts are the Clean, Jerk, and Snatch. All of these lifts require rotation of the shoulder under heavy load and CrossFit requires that these lifts be performed with speed, thus putting significantly more strain on the rotator cuff muscles than non-weight-bearing exercises.

Objective: This case study will test the effects of consistent, focused therapeutic scraping on a CrossFit athlete with chronic overuse injury to the right shoulder resulting in limited range of motion and, therefore, limited progress in training.

Method: This study spanned 5 weeks in which the client was assessed and treated every 7 days for 30-40 minutes with goniometric measurements of internal rotation in the right shoulder recorded at the beginning and end of each session. The client was treated with therapeutic scraping (TS). He was also encouraged to train as he normally would in between sessions and report improvements or concerns with his mobility.

Results: The degree of internal rotation of the right shoulder increased directly following each treatment and decreased during the 7 days between treatments. The client reports significant improvement in mobility; the speed and fluidity in his Olympic lifts (primarily the Clean and Jerk) has improved greatly; and he also reports achieving personal records where progression had been difficult prior to starting treatment.

Conclusion: For this athlete, consistent, focused therapeutic scraping (TS) has proven to improve range of motion, decrease pain, decrease recovery time post-workout, and improve performance.

AWARD TYPE:  Case Report ContestPractitioner

Therapy to Relieve Chronic Low Back Pain

Laura Allen

Abstract
A 53-year old male, formerly employed as a construction worker, was referred for massage therapy for treatment of debilitating low back pain. He has pain in all areas of the back; although he sometimes experiences cervical pain and/or thoracic pain, he reports the majority of his pain is in the lumbar area. His objective for treatment is to cut down on pain medication, acetaminophen and oxycodone (Percocet), currently prescribed at 7.5 mg 4 times daily. The subject states he does not like to take it that frequently because it makes him feel lethargic and disoriented. The massage used was a combination of Swedish strokes (effleurage, petrissage, friction), muscle stripping, and myofascial release, techniques chosen based on the practitioner’s 14 years of experience in working with clients who are in pain. A treatment plan of 6 weekly visits was agreed upon with re-evaluation after the sixth visit. The subject is dependent on only his disability income and is unable to commit to more frequent visits. Progress was measured using the Oswestry Low Back Pain Scale and by subjective statements on his decreased pain level and decreased need for medication, and positive effects on his activities of daily living. The massage therapy intervention was so successful that the subject switched to monthly maintenance care after four sessions instead of six as originally planned. The success of this intervention for this subject suggests that massage therapy can be an effective intervention for chronic low back pain.

 

AWARD TYPE:  Past Poster Presenter

Touching Pain: Massage Therapy Techniques To Support Adaptive Body Awareness for Self-Management of Chronic Pain Related to Spondylosthesis

Honorable Mention
Krina Patel
Cortiva Institute
Boston, MA

Abstract
Background: Massage therapy techniques increase body awareness. Body awareness can be adaptive or maladaptive. Adaptive body awareness is shown to have a positive effect in the acceptance and management of chronic pain. Spondylolisthesis is a structural condition often accompanied with chronic pain.
Purpose: The present report investigates the efficacy of massage therapy techniques in enhancing and sustaining adaptive body awareness for the self-management of chronic pain related to Spondylolisthesis. Participant:  A 57-year-old female initially diagnosed with congenital spinal abnormality by a physician and subsequently with both congenital and degenerative Spondylolisthesis by a chiropractor presents with chronic low and upper back pain and frequent episodes of intense pain in these same areas usually brought on by physical activity. Client is familiar with general massage and acupuncture treatments.
Intervention: Therapeutic massage with the clear goal of increasing adaptive body awareness was introduced during a 4-week period. Five treatment sessions, each 45 minutes in duration used a treatment protocol that included diaphragmatic 4 breathing, various massage techniques in a ‘massage flow’ to relieve muscle tension and recommended home care. Verbal instructions encouraging patient to experience body awareness and sensations of muscles relaxing during massage were integral to the protocol.
Results: Client recorded a decrease in intense pain episodes between treatments, decrease in use of pain medication, no perceptible change in intensity of pain episodes and a better understanding of how to manage her chronic pain.
Conclusion: Patient feedback and therapist observation suggest that therapeutic massage with the clear goal of enhancing and sustaining adaptive body awareness through a treatment protocol carried out as a touch based dialogue between client and therapist may decrease pain-related anxiety and avoidance and increase capacity to accept and manage pain. This in turn may improve functioning and overall sense of wellness.

AWARD TYPE:  Case Report ContestStudent