Adaptation of the CARE Guidelines for Therapeutic Massage and Bodywork Publications: Efforts To Improve the Impact of Case Reports

Case reports provide the foundation of practice-based evidence for therapeutic massage and bodywork (TMB), as well as many other health-related fields. To improve the consistency of information contained in case reports, the CARE (CAse REport) Group developed and published a set of guidelines for the medical community to facilitate systematic data collection (http://www.care-statement.org/#). Because of the differences between the practice of medicine and TMB, modifying some sections of the CARE guidelines is necessary to make them compatible with TMB case reports. Accordingly, the objectives of this article are to present the CARE guidelines, apply each section of the guidelines to TMB practice and reporting with suggested adaptations, and highlight concerns, new ideas, and other resources for potential authors of TMB case reports. The primary sections of the CARE guidelines adapted for TMB case reports are diagnostic assessment, follow-up and outcomes, and therapeutic intervention. Specifically, because diagnosis falls outside of the scope of most TMB practitioners, suggestions are made as to how diagnoses made by other health care providers should be included in the context of a TMB case report. Additionally, two new aspects of the case presentation section are recommended: a) assessment measures, which outline and describe the outcome measures on which the case report will focus, and b) a description of the TMB provider (i.e., scope of practice, practice environment, experience level, training, credentialing, and/or expertise) as part of the intervention description. This article culminates with practical resources for TMB practitioners writing case reports, including a TMB Case Report Template—a single document that TMB practitioners can use to guide his or her process of writing a case report. Once the template is adopted by authors of TMB case reports, future efforts can explore the impact on the quality and quantity of case reports and how they impact TMB practice, research, education and, ultimately, the clients

Massage Therapy for People with HIV

Massage therapists celebrated along with other complementary and alternative medicine (CAM) practitioners at the release of Eisenberg et al.\u27s follow-up of a national survey on the trends in the use of CAM in the United States from 1990-1997. Not only did the use of CAM increase from 33.8 percent to 42.1 percent, massage was one of the therapies that increased the most (Eisenberg et al., 1998). In addition, although 71.5 percent of the visits were not covered by any insurance, massage therapy was the second most popular CAM therapy used, accounting for 18.1 percent of the 628.8 million total visits (Eisenberg et al., 1998

Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports: A Systematic Review and TMB Adapted CAse REport (CARE) Guidelines Audit

poster abstractIntroduction: Case reports are a fundamental tool through which practitioners in applied disciplines are able to inform research and impact their field by detailing the presentation, treatment, and follow-up of a single individual they’ve encountered in practice. Ideally, published case reports contribute to reductions in the research/practice gap by allowing practitioners to describe current practice situations and outcomes to researchers. Unfortunately, inconsistencies in case reporting across applied disciplines have limited the impact of these fundamental sources of clinical evidence. In 2013, reporting guidelines for case reports (CARE guidelines) were published to standardize the reporting of medical case reports. In recognition of discipline differences and reporting needs, the therapeutic massage and bodywork (TMB) adapted CARE guidelines were published in late 2014 to specifically guide reporting of case reports involving massage therapy applied as a treatment. The TMB adapted CARE guidelines identified 5 primary case report components (pre-manuscript, Introduction, Case Presentation, Results, and Discussion), each with unique subcomponents (e.g., title, keywords, abstract for the pre-manuscript component) ranging in number from 6 - 31. By checking off each component and subcomponent included in any given case report, a summary score for TMB adapted CARE guidelines compliance (range: 0 – 65) can be derived. In order to determine whether the consistency of TMB case reporting is improved after publication of the TMB adapted CARE guidelines, a pre-guideline state of TMB case reports is needed. The current study seeks to provide rich descriptive statistics about the state of TMB related case reports in the literature prior to 2015. Methods: A systematic review using PubMed and CINAHL databases identified 935 unique citations using first the MeSH term “Therapy, Soft Tissue” as the subject heading and publication type “case reports” and then a keyword search in PubMed (acupressure, shiatsu, zhi ya, chih ya, reflexology, rolfing, bodywork, massage, case report, case reports, case study, case studies NOT carotid sinus massage, heart massage, cardiac massage, animals) and CINAHL (subject headings: massage therapists, massage, reflexology, case study). Study inclusion/exclusion criteria required: case report, human, English, peer-reviewed, published prior to 2015. Administered massage treatment(s) had to have been from a professional TMB practitioner who had a role in the case’s reporting and publication. N=34 articles met inclusion criteria and were reviewed by two independent reviewers. Through a REDCap data collection form, components and subcomponents of the TMB adapted CARE reporting guidelines included in each article were identified. Variable coding and descriptive statistics were completed using SAS 9.3 by a non-reviewing team member. TMB adapted CARE reporting compliance scores were determined for each case report. Results: Preliminary results for n=30 (final presentation to include all N=34) indicate mean compliance scores = 40.3 (±9.2) and ranged from 10-50. Article sections with the most robust scoring included pre-manuscript items and introduction with average section scores obtaining 75% and 70% of the possible points, respectively. Case presentation and results sections scored the poorest, obtaining an average of 58% and 53% of the possible points, respectively. Conclusions: Case reports in the TMB field published before possible exposure to the TMB adapted CARE guidelines demonstrate inconsistent and deficient reporting. If case reports in the TMB field are to have an impact, consistent and rigorous reporting must be adopted. In an effort to improve the state and impact of TMB case reports in the literature, TMB practitioners should use the TMB adapted CARE guidelines as a checklist when preparing their case reports for publication

Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014

INTRODUCTION: Case reports are a fundamental tool through which therapeutic massage and bodywork (TMB) practitioners can inform research and impact their field by detailing the presentation, treatment, and follow-up of a single individual encountered in practice. Inconsistencies in case reporting limit their impact as fundamental sources of clinical evidence. Using the TMB-adapted CAse REport (CARE) guidelines, the current study sought to provide a rich description regarding the reporting quality of TMB practitioner authored TMB case reports in the literature. METHODS: 1) Systematic identification of published, peer-reviewed TMB case reports authored by TMB practitioners following PRISMA recommendations; 2) audit development based on TMB-adapted CARE guidelines; 3) audit implementation; and 4) descriptive analysis of audit scores. RESULTS: Our search identified 977 articles and 35 met study inclusion criteria. On average, TMB case reports included approximately 58% of the total items identified as necessary by the TMB-adapted CARE guidelines. Introduction sections of case reports had the best item reporting (80% on average), while Case Presentation (54%) and Results (52%) sections scored moderately overall, with only 20% of necessary Practitioner Description items included on average. Audit scores revealed inconsistent abstract reporting and few audited case reports including client race (20%), perspective (26%), and occupation/activities (40%); practitioner practice setting (12%), training (12%), scope-of-practice (29%), and credentialing (20%); adverse events or lack thereof (17%); and some aspect of informed consent (34%). Treatment descriptor item reporting varied from high to low. Various implications of concern are discussed. CONCLUSION: The current audit and descriptive analysis highlight several reporting inconsistencies in TMB case reports prior to 2015. Reporting guidelines for case reports are important if standards for, and impact of, TMB case reports are desired. Adherence to reporting specifications outlined by the TMB-adapted CARE guidelines could improve the impact and usability of TMB case reports in research, education, and practice

Physiological Adjustments to Stress Measures Following Massage Therapy: A Review of the Literature

Use of massage therapy by the general public has increased substantially in recent years. In light of the popularity of massage therapy for stress reduction, a comprehensive review of the peer-reviewed literature is important to summarize the effectiveness of this modality on stress-reactive physiological measures. On-line databases were searched for articles relevant to both massage therapy and stress. Articles were included in this review if (i) the massage therapy account consisted of manipulation of soft tissues and was conducted by a trained therapist, and (ii) a dependent measure to evaluate physiological stress was reported. Hormonal and physical parameters are reviewed. A total of 25 studies met all inclusion criteria. A majority of studies employed a 20–30 min massage administered twice-weekly over 5 weeks with evaluations conducted pre-post an individual session (single treatment) or following a series of sessions (multiple treatments). Single treatment reductions in salivary cortisol and heart rate were consistently noted. A sustained reduction for these measures was not supported in the literature, although the single-treatment effect was repeatable within a study. To date, the research data is insufficient to make definitive statements regarding the multiple treatment effect of massage therapy on urinary cortisol or catecholamines, but some evidence for a positive effect on diastolic blood pressure has been documented. While significant improvement has been demonstrated following massage therapy, the general research body on this topic lacks the necessary scientific rigor to provide a definitive understanding of the effect massage therapy has on many physiological variables associated with stress

Measuring the Effects of Massage on Exercise Performance and Cardiopulmonary Response in Children With and Without Heart Disease: A Pilot Study

Background: Congenital heart disease, a common and serious birth defect, affects 8 per 1000 live born infants. Decreased exercise capacity and development of obesity is common in this population. These children may benefit from therapies, such as massage therapy, that could enhance cardiovascular and skeletal muscle function when they exercise. Purpose: A pilot study conducted at the pediatric cardiology clinic of the Mattel Children’s Hospital of the University of California–Los Angeles examined the safety and feasibility of measuring the effects of pre-exercise massage on exercise performance and cardiopulmonary response in children with and without heart disease. Participants and Methods: Sixteen children (mean age: 9.2 ± 2.2 years) participated in the study. Ten participants had various forms of heart disease, and six children were healthy. A female certified massage therapist with specialized training in pediatric massage provided a 30-minute massage to the participants. Using a standard protocol, each participant underwent two exercise tests: one test with and one without pre-exercise massage. Heart rate, blood pressure, and oxygen uptake (VO2) were measured in the participants. Results: All recruited participants completed the study. No adverse events occurred during any of the exercise tests or massage sessions. Measurements during exercise with or without a preceding massage were compared, and the pre-exercise massage condition yielded a significantly higher heart rate and higher minute ventilation. Measurements during exercise in children with heart disease and in healthy participants showed no significant differences in peak heart rate, blood pressure, peak VO2, peak work rate, minute ventilation, or respiratory quotient. Conclusions: In this study, peak heart rate, peak VO2, and peak minute ventilation were higher when children received a massage before exercise testing. Larger studies will be needed to investigate the strength of this finding. Future studies should include measurements of anxiety and psychological factors in addition to cardiopulmonary measures

Are personal characteristics of massage therapists associated with their clinical, educational, and interpersonal behaviors?

Background: Social Cognitive Theory suggests that characteristics of health professionals, such as their beliefs in the effectiveness of their care, influence their behavior. Studying the characteristics of massage therapists may, therefore, provide insight into their clinical, educational and interpersonal behavior, which ultimately affects their client interactions. Purpose: To examine the association of three personal factors (outcome expectations, expectancies, and practice experience) of the massage therapist and the practice environment with the frequency of three interventional behaviors (clinical, educational, and interpersonal) using Social Cognitive Theory as a theoretical framework. Methods: A random sample of licensed massage therapists in Iowa completed a mailed questionnaire. Questions included training in massage, use of specific massage techniques and practices, 11 outcome expectations, and 17 different behaviors with their respective expectancies for contributing to favorable client outcomes. Factor analyses were conducted on the behavior and expectancy items. Regression analyses were used to examine the relationship of massage therapist characteristics to the different categories of behavior. Results: The response rate was 40% (N = 151). The most common techniques employed were Swedish massage, trigger point therapy, and stretching. The most common practices recommended to clients were encouraging water intake, heat application, stretching, stress management, and exercise counseling. Expectancies was the only Social Cognitive Theory variable that significantly predicted the frequency of every category of behavior (clinical, interpersonal, education; all ps < .01). Outcome expectations predicted clinical (p = .03) and educational (p < .01), but not interpersonal behavior. No other associations reached statistical significance. Conclusions: Massage therapists’ belief in massage to enact a favorable change in a client is strongly associated with their clinical, educational, and interpersonal behavior. Massage therapists were optimistic regarding the ability of massage to provide a favorable outcome, especially if the desired outcome was supported by research

Adaptation of the CARE Guidelines for Therapeutic Massage and Bodywork Publications: Efforts To Improve the Impact of Case Reports

Case reports provide the foundation of practicebased evidence for therapeutic massage and bodywork (TMB), as well as many other healthrelated fields. To improve the consistency of information contained in case reports, the CARE (CAse REport) Group developed and published a set of guidelines for the medical community to facilitate systematic data collection (http://www.care-statement.org/#). Because of the differences between the practice of medicine and TMB, modifying some sections of the CARE guidelines is necessary to make them compatible with TMB case reports. Accordingly, the objectives of this article are to present the CARE guidelines, apply each section of the guidelines to TMB practice and reporting with suggested adaptations, and highlight concerns, new ideas, and other resources for potential authors of TMB case reports.The primary sections of the CARE guidelines adapted for TMB case reports are diagnostic assessment, follow-up and outcomes, and therapeutic intervention. Specifically, because diagnosis falls outside of the scope of most TMB practitioners, suggestions are made as to how diagnoses made by other health care providers should be included in the context of a TMB case report. Additionally, two new aspects of the case presentation section are recommended: a) assessment measures, which outline and describe the outcome measures on which the case report will focus, and b) a description of the TMB provider (i.e., scope of practice, practice environment, experience level, training, credentialing, and/or expertise) as part of the intervention description.This article culminates with practical resources for TMB practitioners writing case reports, including a TMB Case Report Template—a single document that TMB practitioners can use to guide his or her process of writing a case report. Once the template is adopted by authors of TMB case reports, future efforts can explore the impact on the quality and quantity of case reports and how they impact TMB practice, research, education and, ultimately, the clients

Measuring Bird Damage to Three Fruit Crops: A Comparison of Grower and Field Estimates

Birds are common pests in fruit orchards. They frequently consume and damage fruit resulting in decreased yields for growers. The true extent of damage is difficult to measure. Producer surveys are often implemented to estimate damage, but the accuracy of these estimates is uncertain. We compared damage estimates obtained through field studies with estimates from a producer survey for three fruit crops: wine grapes, sweet cherries, and ‘Honeycrisp’ apples. We also analyzed relationships between use of various damage management methods and levels of bird damage. We found wine grape and sweet cherry growers accurately assessed bird damage, while ‘Honeycrisp’ apple growers may overestimate damage. Growing region appears to be an important damage predictor for wine grape and sweet cherry crops. Significant relationships between management methods and damage were positive, suggesting growers only use these methods when bird damage is substantial