Am I just wasting my time?

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Permalink Reply by Don Dillon, RMT on April 5, 2010 at 8:24am

Hi Kim,
This is a great initiative and I heartily encourage you. There is a groundswelling by a number of courageous practitioners in Canada trying to forward the initiative as well. I think they sometimes become discouraged too.

As a practitioner I don't want to do research or read research papers. I want to use research to educate my patients and build credibility with other health care professions, the government and insurance industry. I suspect a large number of practitioners see research as desirable but aren't necessarily interested in developing a new skill set to interpret or perform research.

I want a layperson's summary of what research was done and the findings so I can pass that information on to my patients. I would love to see a coordinated North American effort between the research facilities and the pool of practitioners (or interested parties) to decipher and distill the essential information of what exists and make that available for a fee to interested practitioners. These practitioners can use the distilled, comprehensive results to quote research findings in their practice to support their care, defend their treatment plan to insurers when requesting funding, and to generally build the credibility of the profession.

I think then you would get more converts who become interested in performing research. Right now, there are the few who are trying to excite the many, and the many largely aren't interested in research at that level. But the many do understand they can use the findings of research studies for their benefit.

So, let's get the U.S. and Canadian existing research foundations together, a pool of academically-trained practitioners or researchers and put funds into deciphering and distilling the key messages the masses of practitioners can practically use in their day to day practice - for a fee. I know I would pay to subscribe.

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Permalink Reply by Lisa on April 5, 2010 at 10:00am

Hi Kim,

I for one have no real interest in research...at least not on the part of doing research or reading up on it. The only time I venture into research is if I'm trying to persuade a potential client that massage would help their particular issue. however, if the research comes from a massage based place, it holds no weight with the client since it's like one MT telling another how great we are. So I typically look for a traditional medical based article which seems to hold more weight with a client. However, with that said, it can be very hard to find articles that recommend massage specifically, with research proving it's positive affect, on any particular issue. it'd be great to have a medical library of such things to be able to go to for ease. Is that what you are trying to make your web site like?

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Permalink Reply by Kim Goral on April 5, 2010 at 4:22pm

Hi Don,

Thanks for the feedback. Your insight and ideas are actually quite interesting. I did not intend to include broad research summaries in my project, but maybe it's not a bad idea. I had originally intended for this project to be more of a "teach a person to fish so they can fish for themselves" as opposed to just feeding them fish type of thing where people would not necessarily learn how to conduct research, but that they could gain new skills and knowledge to find and interpret research on their own. Maybe I could do a combination of the 2: have the informaiton available for those who want to be more self-sufficient to find and understand research on their own, and have sort of a "summary by category" for those who just want the bottom line on certain topics.

I can see the benefit to both, and I can understand and respect that not everyone has the time, resources, or desire to understand research on a more advanced level. Doing a "laymens' terms" summary of every research article out there would be nearly impossible. However, doing a overall summary of some well done review articles on a given topic could definitely be possible, though time consuming.

Doing a massive collaboration between the US and Canada is beyond the scope of my current project idea, but not an idea to be ruled out for long term.

This is valuable feedback and I appreciate your honesty. Thanks again!

Don Dillon, RMT said:

Hi Kim,
This is a great initiative and I heartily encourage you. There is a groundswelling by a number of courageous practitioners in Canada trying to forward the initiative as well. I think they sometimes become discouraged too.

As a practitioner I don't want to do research or read research papers. I want to use research to educate my patients and build credibility with other health care professions, the government and insurance industry. I suspect a large number of practitioners see research as desirable but aren't necessarily interested in developing a new skill set to interpret or perform research.

I want a layperson's summary of what research was done and the findings so I can pass that information on to my patients. I would love to see a coordinated North American effort between the research facilities and the pool of practitioners (or interested parties) to decipher and distill the essential information of what exists and make that available for a fee to interested practitioners. These practitioners can use the distilled, comprehensive results to quote research findings in their practice to support their care, defend their treatment plan to insurers when requesting funding, and to generally build the credibility of the profession.

I think then you would get more converts who become interested in performing research. Right now, there are the few who are trying to excite the many, and the many largely aren't interested in research at that level. But the many do understand they can use the findings of research studies for their benefit.

So, let's get the U.S. and Canadian existing research foundations together, a pool of academically-trained practitioners or researchers and put funds into deciphering and distilling the key messages the masses of practitioners can practically use in their day to day practice - for a fee. I know I would pay to subscribe.

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Permalink Reply by Kim Goral on April 5, 2010 at 4:36pm

Hi Lisa

OK, so I just typed up a very lengthy response and then realized- I think I've gone way off track! So I'm starting over. To answer your question simply, yes that could certainly be part of my project. I think my response to Don would be a good fit here as well. Thanks for the feedback

Lisa said:

Hi Kim,

I for one have no real interest in research...at least not on the part of doing research or reading up on it. The only time I venture into research is if I'm trying to persuade a potential client that massage would help their particular issue. however, if the research comes from a massage based place, it holds no weight with the client since it's like one MT telling another how great we are. So I typically look for a traditional medical based article which seems to hold more weight with a client. However, with that said, it can be very hard to find articles that recommend massage specifically, with research proving it's positive affect, on any particular issue. it'd be great to have a medical library of such things to be able to go to for ease. Is that what you are trying to make your web site like?

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Permalink Reply by Kim Goral on April 5, 2010 at 5:37pm

Sam, thank you for the lengthy reply! I appreciate the time and effort you put into it. I'm going to break it up to make it easier to respond to.

"I agree unfornately whole heartedly with Don. I don't think alot of people are really interested with the research of massage until they need it to use for a specific client or in regards to gaining a particular type of client that wants more background and substance to massage- to know it will help them."

I agree with this and respect it. It would be difficult for someone to know the entire body of literature around massage therapy, especially if you want to go into the literature of other therapies as you mention below as well. I think that picking and choosing topics is wise, and not out of line with what I picture. I would like to be able to give people the "tools and knowledge" to then find and understand research in topical areas of interest (for example, anxiety, or depression, or fibromyalgia, or tension headaches, etc).

"Although, as therapists doing the research and being in a setting that it could have no bias in results would hopefully for everyone in turn let us to gain a little respect in our massage field. Honestly, I would be static as a therapist to perform research with specific factors in mind with people, unfornately with research comes money and expenses. And i'm not that knowledgeable with grants, etc. for research. That's an idea though- someone should open a clinic based solely on research of massage and the techinques, benefits thereof, would love to see more studies concerning herbs & supplements, aromatherapy, hydrotherapy, etc. as well though."

The project I want to complete would not make researchers out of massage therapists; that is well beyond the scope. My hope is that massage therapists could be educated consumers of research that has already been done. I also did not intend to cover other topics than specifically massage therapy, though going off of Don's idea this could be a possibility for later on.

"Do the placebo controlled studies that allow massage itself to make it or fail, such as with techniques like acupressure, and the more energy side of the massage work, etc.
Do studies concerning the effects massage can have with weight loss, or fibromylagia, pain relief, stress/anxiety compared to massage and aromatherapy combined, etc."

I read this a couple of times but I'm not exactly sure what it means. Could you elaborate or explain it a bit differently?

"Pick the areas of todays time that people really want to find something more they can do for themselves to help them- such as the things mentioned above. Esp.ly like Lisa has brought up before with the mental illness side of things, I would personally and professionally be interested in seeing those results. Even the common issues- like depression,and anxiety-- you really wouldn't believe how many people we as therapists could get to if massage proved to be a step in the right direction for those folks."

Yes- this goes along with Don's idea and I will give it serious consideration.

"But above all- once this research is completed and is laid out for everyone to see- put it as well like Don said in a "layperson's summary". I enjoy reading when it's outlined in a short article, or has the bulletin points- I'm not one to read a 100 page study and to try to understand the probability value or factor the significance of the study. I want it told to me."

Again I appreciate the honesty, it is helpful. Just as a sidenote, most research articles are about 10 pages or less ;) But I get the point.

"I wouldn't mind personally doing the work it took to get the study completed and the research needed- but i'm just not one to understand the scientific and statistical methods to determining the outcome. I just like that explained to me as simplily as possible."

What if you had a user-friendly, easy to understand format to learn the "big picture" items of an article? Would you read research articles about conditions of interest then? This is an honest question, and if your answer is still "no", I'd like to know. This has been very helpful so far.

"I think your idea for a website with hopefully doing these types of studies, etc. would be a hit amoung therapists and potential clientele if you could make it so. Unfornately at this time, personally with one hand in massage doing what I love and the other out trying to make a living on the side- I would not probably subscribe at a fee if that was the case. It would be an extra expense that as of the time wouldn't benefit me all that much. To hand off an idea where it would be included in a fee such as getting liability insurance through a company, etc. it would possibly lean me towards that company as a great extra that I would get as part of my "package" if you will."

Lucky for you (and everyone else)- I intend to make the website 100% free and accessible to anyone who wants it. I am not looking for any sort of profit here, just trying to help those understand research (consuming it, not conducting it) who are interested in doing so. :)

Thank you again for your feedback. I welcome anyone else's too, positive or negative. What I'm trying to do right now is more or less a "needs assessment" to find out what therapists would want and use the most and get the most benefit out of.

Samantha J. Bennett said:

Hi Kim,

I agree unfornately whole heartedly with Don. I don't think alot of people are really interested with the research of massage until they need it to use for a specific client or in regards to gaining a particular type of client that wants more background and substance to massage- to know it will help them.

Although, as therapists doing the research and being in a setting that it could have no bias in results would hopefully for everyone in turn let us to gain a little respect in our massage field. Honestly, I would be static as a therapist to perform research with specific factors in mind with people, unfornately with research comes money and expenses. And i'm not that knowledgeable with grants, etc. for research. That's an idea though- someone should open a clinic based solely on research of massage and the techinques, benefits thereof, would love to see more studies concerning herbs & supplements, aromatherapy, hydrotherapy, etc. as well though.

Do the placebo controlled studies that allow massage itself to make it or fail, such as with techniques like acupressure, and the more energy side of the massage work, etc.
Do studies concerning the effects massage can have with weight loss, or fibromylagia, pain relief, stress/anxiety compared to massage and aromatherapy combined, etc.

Pick the areas of todays time that people really want to find something more they can do for themselves to help them- such as the things mentioned above. Esp.ly like Lisa has brought up before with the mental illness side of things, I would personally and professionally be interested in seeing those results. Even the common issues- like depression,and anxiety-- you really wouldn't believe how many people we as therapists could get to if massage proved to be a step in the right direction for those folks.

But above all- once this research is completed and is laid out for everyone to see- put it as well like Don said in a "layperson's summary". I enjoy reading when it's outlined in a short article, or has the bulletin points- I'm not one to read a 100 page study and to try to understand the probability value or factor the significance of the study. I want it told to me.

I wouldn't mind personally doing the work it took to get the study completed and the research needed- but i'm just not one to understand the scientific and statistical methods to determining the outcome. I just like that explained to me as simplily as possible.

I think your idea for a website with hopefully doing these types of studies, etc. would be a hit amoung therapists and potential clientele if you could make it so. Unfornately at this time, personally with one hand in massage doing what I love and the other out trying to make a living on the side- I would not probably subscribe at a fee if that was the case. It would be an extra expense that as of the time wouldn't benefit me all that much. To hand off an idea where it would be included in a fee such as getting liability insurance through a company, etc. it would possibly lean me towards that company as a great extra that I would get as part of my "package" if you will.

P.S. - in regards to slow replies from others on this subject and others in general- it does seem as if people are more busy in their daily lives and aren't coming on here as much as they used to (when I first signed up anyways). And unfornately (me highly included) wouldn't have typically read your forum read since it was more so of a longer read. I think as people in general- whatever it is we're reading- want the short version or bulletin point version...that way we trick our brains that whatever is the subject we have the time to respond, rather than a long version of the same subject and thinking it's more complicated....my opinion though! Take it or leave it! :) Good luck with it all !!!! tc

PSS- kinda like after I just posted this- it turned out way long for me, I'd rather just read Lisa's response compared to my own if i was just scanning though....lol...funny....anyways sorry for the long response all! :)

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Permalink Reply by Kim Goral on April 5, 2010 at 8:19pm

Sam-
"And as for reading an easy to understand article on the conditions- given the fact you're not relating them directly to massage and for or by therapists to be a part of - just as the conditions or illnesses themselves- no i probably wouldn't read them, there's a lot of other resources out there already that I can go to for that....i'm sorry i guess I misunderstood the concept of your design/website. gl...tc"

No, I meant articles about massage on certain conditions :) Like how massage effects anxiety, or headaches, or cancer, etc. Basically, so that if a client of yours came in with X condition and you were not familiar with treating it (or even if you were, but were interested in maybe learning new ways to treat it) you would then have the knowledge and skills to #1 locate an appropriate research article (not a magazine or newspaper article) and then be able to read and understand the big picture of it, thereby hopefully learning something new that could help this client and add to your practice. Does that make sense? Let me give an example.

Say you have a new client who comes in tomorrow for a massage. For sake of the example, let's say you have little to no experience treating clients with fibromyalgia and want to learn what forms of treatment have been found to be effective. You search the phrase "massage and fibromyalgia" and this article comes up (attached). You read it and learn that while massage is effective, manual lymph drainage therapy was more effective in this particular study. Maybe you are already trained in both types of bodywork- so you can then say to your client, so and so, I found this research that shows mldt might be more beneficial to you than connective tissue massage; would you like me to try this?" and you have an educated treatment plan based on an actual study. Just for the record, I have not thoroughly read this article so I'm not necessarily endorsing it, just using it to present an argument.

Does that make sense?

Attachments:

• fibro.pdf, 3.3 MB

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Permalink Reply by Rajam K Roose on April 5, 2010 at 9:08pm

Kim, I am interested in reading research publications. It helps for me to read the study as I can form my thoughts easier when I see how the study was played out. Often, just because I was able to read the study, I have been able to realize that it was still really inconclusive and not to jump on the bandwagon about it. Whereas, if one just reads the outcome without knowing how it was carried out, the reader can jump to conclusions based on a poorly done study.

I enjoy reading research because I'm a curious person and like to know why what I'm doing works and how it works, and in what applications it can be used.

My problem is that it is really difficult to find good massage research as I don't have the funds to spend on the sites. I do subscribe to the Journal of Bodywork & Movement Therapies and enjoy reading those, although it's expensive it's worth it as almost all the info is relative to my work as a massage therapist. It would be nice if the bodywork and massage related research could be under one umbrella site, rather than having to look on various sites and pay their fees to search. So, even if there was a small fee, as long as all the information was geared for bodywork and massage, I would pay it. But free is best!!

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Permalink Reply by Rajam K Roose on April 9, 2010 at 2:40am

Hi, I'll post this here as well

Many therapists don't seem to be interested in research and it probably won't matter how simple of a format you make the reading. In fact, if you make it too simple and I was reading the report, I might question the validity of it just because you will have to omit details that are important to an astute reader. Most massage therapists that I know just want to rub on folks and lower the levels of cortisol (a hormone created by the adrenals that is increased with stress) in their clients--although most therapists don't realize that's what massage has been shown to do through research. By measuring the amounts of cortisol in saliva before and after massage, researchers can measure the changes in the levels of cortisol.

Research really isn't that difficult to understand, I think it's more the mindset of what massage therapists' perceive as research that needs to change. For instance, say a person enjoys reading non-fiction, it would make sense that they first read about the author and their experiences and how those experiences qualify her/him to write the book in the first place? I'd be surprised if most even cared about those things, most people just read the back cover or hear about it from another source and that's how they make the decision to purchase the book. And it's not because people don't care, but I think more so because the reader is lazy and it's easier to just accept and believe everything one reads or hears from "trusted" sources. It's nice to go into our own little worlds and agree with things just because they sound good, isn't that how folks are swindled into giving away their life savings?

I'm only writing this because I have only a year and half of college education behind me and maybe just two and a half years of official high school (although I did graduate) and yet I have no problem reading research documents (or the health care bill for that matter). I might not understand every little nuance, but I usually can understand most of it. One difference is the use of discernment; knowing what is being read and who wrote it and what was the writer's background and education in order to present and write about the topic. Example, a research article came out recently that stated that sitting in uncomfortable positions in Zen meditation helps lower sensitivity to pain by thickening a part of the brain that regulates emotion and painful sensations. However if you read the actual study it shows they looked at only meditators sitting in uncomfortable positions, what about meditators who sit comfortably? Are their cortexes thickened as well? Just by reading that study, I found it inconclusive and here I have barely a college education. That is why I think it's a deeper issue than educational, it's whether or not the therapist has the inquisitive mind to delve deeper into the subject and not take everything they read for granted.

I can't tell you how many articles I get in my email box from well-wishers about health and food and so on, and the articles sound great, but when you actually read into them, there isn't much to back up the information that is initially touted as good research. Another example, many years ago my aunt ( a head nurse in the heart surgery unit) sent me some research about how people needed eight hours of sleep a day in order to be healthy. Upon further investigation (of my own) I discovered that the research was funded by a company that also makes medications to aid in sleep. So what about that? Even if the study was sound, just the nature of the company who produced it was suspect.

So, that is really my point. Being a critical thinker takes a certain type of mentality that either therapists have it, or they don't. Most therapists (in my experience) aren't going to go out of their way to explore research in their field and although this is a sad state of affairs (in my opinion), I think the best way to incorporate research and the desire to understand it is in massage school, where the training is initiated. Still, to this day, schools are teaching about lactic acid being cleared by massage or that massage can heal just about anything. If these issues are addressed in the schools themselves, that might help therapists change their minds about whether or not they are interested in the idea of "from where does this information come"?...) If you can make research more accessible to folks who are educating our up and coming therapists, maybe that will help get the desire going!

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Permalink Reply by Rajam K Roose on April 9, 2010 at 2:42am

And here's the second part:

That being, I would still appreciate one site where all massage related research is posted. I would prefer the read research only and not plow through other info about other nutrition and other such semi-related stuff. Just bodywork please!! For instance the site posted in the other thread by Samantha on this topic really didn't have any research, it was just all articles describing different therapies, which is not the same thing as research!

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Permalink Reply by Vlad on April 9, 2010 at 8:42am

Good posts Rajam.

Most massage therapists that I know just want to rub on folks and lower the levels of cortisol (a hormone created by the adrenals that is increased with stress) in their clients--although most therapists don't realize that's what massage has been shown to do through research. By measuring the amounts of cortisol in saliva before and after massage, researchers can measure the changes in the levels of cortisol.
My understanding is that the cortisol question is still up in the air. Kim can keep us right on this. Within group analyisis might show it, but when between group comparisons are done, I think no signficance was shown. (Kim? Maybe I'm wrong, so keep me right)

It's nice to go into our own little worlds and agree with things just because they sound good, isn't that how folks are swindled into giving away their life savings?
Exactly. I also think that people do that because they think something sounds "cool".

I might not understand every little nuance, but I usually can understand most of it. One difference is the use of discernment; knowing what is being read and who wrote it and what was the writer's background and education in order to present and write about the topic
Hitting the nail on the head there! I think that most people think they need to understand 100% of a document, when in reality they can make a decent choice on whether to put any stock on it without understanding 100% of it if they have key questions in their head that are answered when reading it.

I can't tell you how many articles I get in my email box from well-wishers about health and food and so on, and the articles sound great, but when you actually read into them, there isn't much to back up the information that is initially touted as good research
Me too - I find that.
Also when someone is selling a modality and they're doing the research in it, just how much stock would anyone put in it? Independent studies are the only ones that I pay attention to now. Also, I think that most people on this site think that research articles are articles in massage magazines or websites. They're unaware of pubmed and they're not used to thinking "I need to go to the source" to check things out.

I think the best way to incorporate research and the desire to understand it is in massage school, where the training is initiated
Yup. I think so too. What I see as being a potential problem is that when you teach people to question, then it may backlash on the schools if they sell a lot of classes that have no decent research behind them. To me this is probably the biggest question on what is going on in the profession and it will be a test to see if the schools have high levels of integrity. Do we keep the students in the dark and keep selling them everything under the sun, or do we teach them how to be discerning consumers of research? When the students get to be discerning students of research, they'll be discerning consumers of CE and advanced classes. Yep, it'll be a test of the schools. The good ones with any level of integrity will teach research literacy and how to look at research with a discerning eye. I also predict that the ones that teach research will gain the reputation as being the best.

I think Kim's site could be used in the schools as a tool to help them teach it.

Having all MT research on one site? Do you mean all modalities too (like reflexology, CST, MFR etc)? Or do you mean massage manual manipulation of soft tissue only? I don't want to hog Kim's thread here, but I'm just wondering. I'll pop off this thread after that!

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Permalink Reply by Kim Goral on April 10, 2010 at 5:49pm

Hi Rajam,

I appreciate both of your posts! I agree with much of what you have said (though Vlad, yes you are right about the cortisol myth (see here http://www3.uwstout.edu/faculty/moyerc/upload/MT-meta-analysis-PB20... and here http://ecam.oxfordjournals.org/cgi/content/full/nem164v2).

My site will focus specifically on massage therapy- defined as the manual manipulation of soft tissue. I am not going to be posting general info about it, it will be about scientifically based information and articles (journal articles, not magazine articles). Hope that answers your question!

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Permalink Reply by Rajam K Roose on April 10, 2010 at 6:15pm

Yes, thank you Kim. About the cortisol, that is interesting--the Touch Research Institute headed by Tiffany Fields has a great deal of studies where the cortisol levels in saliva were measured, do the articles you posted basically cover that all cases of measuring cortisol are inconclusive for massage? Sorry to hijack the thread, I'll be happy to see your site!

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