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What are your thoughts, beefs, opinions on massage therapy becoming evidence based practice?
I have posted 2 articles here and here

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Hi Andrea,

Thanks for your interest. At the moment I've trying to establish a collaboration between the MT schools and the U of A. I'll let you know how it goes and keep you in mind for possible research. I have several ideas but have to find out what they want to do first.

Andrea Rose said:
I am curious about what kind of study you are interested in doing. I recently graduated from Cortiva myself. I may be interested if you can give me any info.

Robin Byler Thomas said:
My thoughts exactly Jan. I'm trying to do just that. I've been a LMT for 15 years and a part-time grad student at the U of A for the past 3. I'm preparing for my internship before graduating and would like to set up a colloboration with Cortiva, PCC, or the Providence Institutes, and the U for either student research case studies or a micro-longitudinal pilot study. You and I met more than 15 years ago at DIHA when I was just starting out; I don't expect you to remember as we talked only once and I actually graduated from SWIHA. I have a UA professor who is interested in helping with my project and I'm gathering information now to get this ball rolling. Do you have any contacts you could recommend left at Cortiva that I could talk to who might be interested?

Jan Schwartz said:
In my opinion Evidence Based Practice is critical for the advancement of our profession, especially for those who want to be a part of the American health care system. I understand that some therapists do not want to go there, and that's fine--I'm speaking about those who do. EBP makes the most sense for massage because, as you point out Bodhi, it is a three pronged approach, taking into account the patient/client preferences and clinical experiences as well as using best available evidence.

The first step is to get research literacy into the schools so that new graduates can evaluate research and use it appropriately. Then we need massage therapists to actually conduct research. At least in this country, most research having to do with massage is being conducted by other health care professionals--as the principal investigator. That too needs to change and requires massage therapists to have a higher level of education. The result of research is the evidence, and who better to conduct it than those who were trained in it?
A needs assessment would be a great first step, perhaps in stead of focusing on EBM do a research literacy/attitude survey. This would naturally flow in to EBP work. I find some of the comments posted here ripe for the picking.

Robin Byler Thomas said:
Hmmm, maybe we should find out. Maybe instead of a research study I should start with a needs assessment among ABMP members surveying the need, or interest for EBP? Unless this was your intent Bodhi?
They are not mutually exclusive, both go hand in hand

Dennis Gibbons said:
Evidence or Experienced based?
Dennis your comments are correct in that no evidence is not evidence of no effect. Further with outcomes based research one can measure the results you get in your therapy. Its possible to measure pain relief, increased function, quality of life etc.

Dennis Gibbons said:
approximately three weeks ago I had a medical doctor on my table for back pain, he was asking many questions on how this technique worked. after I had explained many of the theories to him he said to me, "What scientific proof do you have of these statements?" My reply to him was, "What scientific proof do you have that refutes what I am telling you?" I further asked him, "Do you feel better?" His reply was, "Yes." I then replied, "What more proof do you need then how you feel." I do believe that it would be good to get this evidence based massage but in my 23 years of practice and having worked on thousands of individuals it would be difficult for me to set up a study of 100 people that have exactly the same issue. I do know that after talking to many of the researches at the Cleveland Clinic that it takes them a long time to come up with a satisfactory group to study. Their asset though is that the pharmaceutical companies are funding the research. I do believe it would be difficult to have comparable studies without that type of funding. If large enough grants were available I would be happy to compare the theory I developed, Muscle Release Therapy, MRTh(R) to many other modalites.
You can always study the results of your therapy, its not necessary to first understand the mechanism at work. If your intention is to cause a certain change in your patients life then that change is measurable.

Lina Petridis said:
Totally agree Elena...We don't need scientifically proven evidence to prove data.. We cannot deny the advances made in science like stem -cell research...ex: growing a new finger.. but to prove a method as universal...is also a dilemma . The placebo effect,.where Japanese scientists asked for volunteers to expose themselves to poison Ivy..and resulted in an itching red burning rash were eventually told it was not poison Ivy.
You could replace that experiment with any practise..its the belief in what the client is exposing themself to that has the result they expect.
How do you measure what the mind believes? Isn't this a question with a simple answer?


Elena Barrioz said:
Hmmmm, why is it, that unless it can be proven "scientifically", it must not be viable. Massage (to me) is such an individual experience. I would question the intent behind EBM, is it just monetary (to be more readily accepted by the insurance companies) or is it to find techniques/modalities that consistently provide clients with positive results. I would think that answer would then be used to skew the data to favor which ever outcome was wanted.
I agree, Jennifer. I think we have to look to scientifically sound, well designed studies as models for research in MT and guess who is doing those well designed studies? I have a few cousins who are post-doc.'s doing pure science research (gene splicing and the like) and they make their livings from grant $$$ and teaching. If we want to attract this caliber mind, there needs to be a living in it for the researchers.

Jennifer L. Hensley said:
I think part of the problem is that we are not hiring enough people with adequate scientific background in research to help the profession figure out what it can do to have massage and bodywork appropriately studied: we seem to have lots of people involved with a B.S. in various science disciplines, but what about PhDs with a decade or more of experience in post-grad biological or organic chemistry research? I think a lot of times the thought is "Oh, they don't have a massage or bodywork background, so what could they do to help?" And the answer is plenty.
Bodhi is good at making research sound less intimidating to the masses. I have a huge collection of massage school catalogs from the US, and not one of them includes in their program anything about research methodology. A few require a "research project," but they don't give students any real scientific background to work with in order to do that, so it's too informal to be acceptable as validated information, and not publication-worthy. Most therapists just don't know how to conduct a study. But as Bodhi says, if you intend to cause a certain change in the patient's life, that is measurable.

EBM has to start with us. We can't, and shouldn't, leave it to some Ph.D. in a laboratory. Tiffany Fields can't do everything by herself! The working massage therapists are the ones with the most opportunity to document results. We just have to be educated on how to properly do it. There are several informative articles on the AMTA website on how to conduct good research. http://www.massagetherapyfoundation.org/or_methodsintro.html

Bodhi Haraldsson said:
You can always study the results of your therapy, its not necessary to first understand the mechanism at work. If your intention is to cause a certain change in your patients life then that change is measurable.

Lina Petridis said:
Totally agree Elena...We don't need scientifically proven evidence to prove data.. We cannot deny the advances made in science like stem -cell research...ex: growing a new finger.. but to prove a method as universal...is also a dilemma . The placebo effect,.where Japanese scientists asked for volunteers to expose themselves to poison Ivy..and resulted in an itching red burning rash were eventually told it was not poison Ivy.
You could replace that experiment with any practise..its the belief in what the client is exposing themself to that has the result they expect.
How do you measure what the mind believes? Isn't this a question with a simple answer?


Elena Barrioz said:
Hmmmm, why is it, that unless it can be proven "scientifically", it must not be viable. Massage (to me) is such an individual experience. I would question the intent behind EBM, is it just monetary (to be more readily accepted by the insurance companies) or is it to find techniques/modalities that consistently provide clients with positive results. I would think that answer would then be used to skew the data to favor which ever outcome was wanted.
Employ them in what way? Leave it all up to the scientists? Pay a Ph.D. to come into their office? The best way to reach the most therapists would be if schools would include that in their training. As Jan Schwartz has pointed out, not everyone has any interest in research or EBM. For those that do, including an elective research track in massage programs would be a big step forward; those with the appropriate skills and education could be employed to teach that. AMTA also includes a research track at every national convention. I've attended several and found them to be very helpful.

Jennifer L. Hensley said:
I suppose you know the process to go through review boards and to make your case ethically sound.

No? Neither does the average or even advanced MT. You said it yourself: we're not trained. So why would we not employ those trained to help us do research?

Laura Allen said:
Bodhi is good at making research sound less intimidating to the masses. I have a huge collection of massage school catalogs from the US, and not one of them includes in their program anything about research methodology. A few require a "research project," but they don't give students any real scientific background to work with in order to do that, so it's too informal to be acceptable as validated information, and not publication-worthy. Most therapists just don't know how to conduct a study. But as Bodhi says, if you intend to cause a certain change in the patient's life, that is measurable.

EBM has to start with us. We can't, and shouldn't, leave it to some Ph.D. in a laboratory. Tiffany Fields can't do everything by herself! The working massage therapists are the ones with the most opportunity to document results. We just have to be educated on how to properly do it. There are several informative articles on the AMTA website on how to conduct good research. http://www.massagetherapyfoundation.org/or_methodsintro.html

Bodhi Haraldsson said:
You can always study the results of your therapy, its not necessary to first understand the mechanism at work. If your intention is to cause a certain change in your patients life then that change is measurable.

Lina Petridis said:
Totally agree Elena...We don't need scientifically proven evidence to prove data.. We cannot deny the advances made in science like stem -cell research...ex: growing a new finger.. but to prove a method as universal...is also a dilemma . The placebo effect,.where Japanese scientists asked for volunteers to expose themselves to poison Ivy..and resulted in an itching red burning rash were eventually told it was not poison Ivy.
You could replace that experiment with any practise..its the belief in what the client is exposing themself to that has the result they expect.
How do you measure what the mind believes? Isn't this a question with a simple answer?


Elena Barrioz said:
Hmmmm, why is it, that unless it can be proven "scientifically", it must not be viable. Massage (to me) is such an individual experience. I would question the intent behind EBM, is it just monetary (to be more readily accepted by the insurance companies) or is it to find techniques/modalities that consistently provide clients with positive results. I would think that answer would then be used to skew the data to favor which ever outcome was wanted.
Teachers and practitioners interested in "evidence based" massage therapy would do well to track the progress and make suggestions regarding the current effort to establish a foundational "body of knowledge" for all massage modalities being practiced in the USA. This can be done by going to http://www.mtbok.org/
Good point Noel and that's what we're trying to do in the EBP Group which Bodhi started--if we can ever get the conversation to go there. Seems we are still arguing about the merits of EBP there too. I don't think anyone is saying that all massage therapists need to go there, but those who desire to see that model should be able to work toward it collaboratively. Of course that requires more participation than 4 or 5 people. I'm not sure that the MTBOK is the place for this to happen, but maybe.

Noel Norwick said:
Teachers and practitioners interested in "evidence based" massage therapy would do well to track the progress and make suggestions regarding the current effort to establish a foundational "body of knowledge" for all massage modalities being practiced in the USA. This can be done by going to http://www.mtbok.org/
Jan: My perspective is that currently "EBP" reflects the intellectual/financial research interests of those in our industry with the most money to spend. While I understand it, I remain uncomfortable about the likely impact on the field we all feel passionate about of the current "single-factor" bias in scientific research, especially when combined with the vast number of trademarked massage modalities/practice protocols.

Additionally, as an MBA who entered the corporate world in 1974, I suspect that the end result of this MTBOK project (given its sponsoring organizations) will likely become the "Gold Standard" for our industry and wonder what others think about this prospect.

Jan Schwartz said:
Good point Noel and that's what we're trying to do in the EBP Group which Bodhi started--if we can ever get the conversation to go there. Seems we are still arguing about the merits of EBP there too. I don't think anyone is saying that all massage therapists need to go there, but those who desire to see that model should be able to work toward it collaboratively. Of course that requires more participation than 4 or 5 people. I'm not sure that the MTBOK is the place for this to happen, but maybe.

Noel Norwick said:
Teachers and practitioners interested in "evidence based" massage therapy would do well to track the progress and make suggestions regarding the current effort to establish a foundational "body of knowledge" for all massage modalities being practiced in the USA. This can be done by going to http://www.mtbok.org/
Hi Noel
Perhaps those of us that are interested in EBP are promoting it because it will improve the profession and the care it provides.
I invite you to read my 2 articles on the subject, they can be found here and here

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