Massage News - October 2010

Massage News - October 2010

A single massage can boost the immune system Researchers from Cedars-Sinai Medical Center reported that a single massage produced measurable changes in the immune system and endocrine system of healthy adults. The research was conducted in an outpatient research unit in an academic medical center. Medically and psychiatrically healthy adults, 18–45 years old, participated in this study.The study design was a head-to-head, single-session comparison of Swedish Massage Therapy with a light touch control condition. The intervention tested was 45 minutes of Swedish Massage Therapy versus a light touch control condition, using highly specified and identical protocols. Blood samples were taken before the massage began and at regular intervals up to one hour after the massage was completed. Measurements were performed to determine oxytocin (OT), arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocytes markers, and mitogen-stimulated cytokine production. The study found several changes in the blood tests of the Swedish massage group that indicated a benefit to the immune system. Swedish massage caused sizeable decreases in arginine vasopressin (AVP), a hormone that contributes to aggressive behavior, and small decreases in the stress hormone cortisol. The Swedish massage participants also had an increase in the number of circulating lymphocytes, cells that help the immune system defend the body from harmful substances.However Oxytocin was not found to be influenced. The authors concluded that “Preliminary data suggest that a single session of Swedish Massage Therapy produces measurable biologic effects. If replicated, these findings may have implications for managing inflammatory and autoimmune conditions.” Reference: Mark Hyman Rapaport, Pamela Schettler, Catherine Bresee. A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic-Pituitary-Adrenal and Immune Function in Normal Individuals. The Journal of Alternative and Complementary Medicine. doi:10.1089/acm.2009.0634. Neck Mobilization vs. Manipulation Australian research has cast doubt over the necessity of vigorous spinal manipulations used by many chiropractors to treat neck pain. Dr Andrew Leaver from The University of Sydney and colleagues conducted a randomized controlled trial to compare the effectiveness of cervical spine manipulation (high-velocity, low amplitude thrust) versus cervical mobilization (involves the use of slow, oscillating movements directed at the cervical joints). The results are published in the journal Archives of Physical Medicine and Rehabilitation. Analysis of 182 people with recent onset neck pain revealed that participants treated with neck manipulation did not undergo a more rapid recovery than those treated with mobilization. Statistical analysis revealed no statistical significance between those receiving manipulation and those mobilization in terms of pain, disability, function, global perceived effect, or health-related quality of life. The authors conclude that manipulation is not appreciably more effective than mobilization and that the choice to use one over the other cannot be justified on the basis of superior effectiveness. “Neck manipulation is a highly controversial treatment as there are published studies that demonstrate an increased risk of stroke,” Dr Leaver, from the University of Sydney, said this week. “It makes us question why patients, or practitioners, would favour a treatment which possibly carries (the) risk of catastrophic outcome.” Reference: Leaver AM, Maher CG, Herbert RD, Latimer J, McAuley JH, Jull G, Refshauge KM. A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain. Archives of Physical Medicine and Rehabilitation. Volume 91, Issue 9, Pages 1313-1318 (September 2010)

The effects of the Bowen technique on hamstring flexibility over time The hamstring muscles are regularly implicated in recurrent injuries, movement dysfunction and low back pain. Links between limited flexibility and development of neuromusculoskeletal symptoms are frequently reported. The Bowen Technique is used to treat many conditions including lack of flexibility. A study led by the European College of Bowen Studies investigated the effect of the Bowen Technique on hamstring flexibility over time. The study was published in Journal of Bodywork & Movement Therapies. An assessor-blind, prospective, randomised controlled trial was performed on 120 asymptomatic volunteers. Participants were randomly allocated into a control group or Bowen group. Three flexibility measurements occurred over one week, using an active knee extension test. The intervention group received a single Bowen treatment. A repeated measures was conducted for the three time periods. The results revealed that a single treatment of the Bowen technique demonstrated immediate significant increases in the flexibility of the hamstring muscles in asymptomatic subjects, maintaining improvements for one week without further treatment. No significant change over time was noted for the control group. Explanations for the changes observed with the Bowen technique have not been well researched. The superficial pressure applied during the technique, yet lack of joint loading, weight bearing, warm-up or stretching, invalidates changes attributable to tissue creep through loading or plastic deformation of tissues. Many of the studies previously discussed have localised interventions specifically to the hamstring muscles. The present Bowen study provided manual stimulation to multiple regions including; the cervical, thoracic and lumbar spine, pelvic attachments; latissimus dorsi, hamstrings, gluteals, hip adductors and TFL. The anatomical linkage through the presence of inter and intramuscular fascial ‘slings’ and compartments has enabled a deeper, more integrated approach to understanding how manual stimulation or mechanical tension may be transmitted from one region to another. Muscles are linked to each other through fascial and ligamentous connections…the force of muscle contraction is potentially passed via specialized connective tissues to the skeletal structures and lumbopelvic articulations. Reference: Michelle Marr, Julian Baker, Nicky Lambon, Jo Perry. The effects of the Bowen technique on hamstring flexibility over time: A randomised controlled trial. Journal of Bodywork & Movement Therapies. Motor Control Exercises, Sling Exercises, and General Exercises for Patients With Chronic Low Back Pain Exercise benefits patients with chronic nonspecific low back pain; however, the most effective type of exercise remains unknown. A study from Norway published in Physical Therapist Journal compared outcomes after motor control exercises, sling exercises, and general exercises for low back pain. This was a randomized controlled trial with 1-year follow-up. The study was conducted in a primary care setting in Norway. The 109 participants were patients with chronic nonspecific low back pain. The interventions were low-load motor control exercises, high-load sling exercises, or general exercises, all delivered by experienced physotherapists, once a week for 8 weeks. The post intervention assessment showed no significant differences among groups with respect to pain or any of the outcome measures. This study gave no evidence that 8 treatments with individually instructed motor control exercises or sling exercises were superior to general exercises for chronic low back pain. Effects of Traditional Sit-up Training Versus Core Stabilization Exercises on Short-Term Musculoskeletal Injuries The US Army has traditionally utilized bent-knee sit-ups as part of physical training and testing. It is unknown whether the short-term effects of a core stabilization exercise program without sit-up training may result in decreased musculoskeletal injury incidence and work restriction compared with traditional training. The objective of this study was to explore the short-term effects of a core stabilization exercise program (CSEP) without sit-up training and a traditional exercise program (TEP) on musculoskeletal injury incidence and work restriction. The setting was a 16-week training program at Fort Sam Houston (San Antonio, Texas). The study participants were soldiers with a mean age of 23 years. Twenty companies of soldiers were cluster randomized to complete the Core stabilization exercise (10 companies of 542 soldiers) or the traditional exercise (10 companies of 599 soldiers). The Core stabilization included exercises targeting the transversus abdominus and multifidus musculature. The traditional exercise comprised exercises targeting the rectus abdominus, oblique abdominal, and hip flexor musculature. Research staff recorded all injuries resulting in the inability to complete full duty responsibilities. Of the 1,141 soldiers for whom complete injury data were available for analysis, 511 (44%) experienced musculoskeletal injuries during training that resulted in work restrictions. However there were no differences in the percentages of soldiers with musculoskeletal injuries between the two interventions. There also were no differences in the numbers of days of work restriction for musculoskeletal injuries overall or specific to the upper extremity. However, soldiers who completed the traditional exercise and experienced a low back injury had more days of work restriction

The authors concluded that incidences of musculoskeletal injuries were similar between the groups. There was marginal evidence that the Core exercise resulted in fewer days of work restriction for low back injuries.