Integration of Surface Anatomy with Massage Therapy: Impact on Musculoskeletal Anatomy Knowledge and Student Wellness

Abstract

Surface anatomy is important for medical students who are learning how to apply gross anatomy to the living body, and a critical knowledge base for effective physical examination. However, in compressed anatomy courses, time for didactic instruction on surface anatomy may be limited. In an effort to provide an opportunity for interested students to engage with surface anatomy, we developed an optional workshop course that used massage therapy as a medium for exploring surface anatomy. The course ran parallel to the first year gross anatomy course, consisted of four 2.5 hour sessions over 6 weeks, and was led by an anatomist and a massage therapist. Prior to each session, students viewed videos produced by the course instructors to review key anatomical landmarks and preview the massage techniques for that session. As a control, a separate population of students participated in the course by only viewing the weekly online videos.The study design was a randomized controlled study, wherein students were randomized into each group (hands‐on, n=20; online‐only, n=20), and completed a set of assessments before and after the course to assess musculoskeletal surface anatomy knowledge, knowledge and attitudes about massage therapy and student wellness. The anatomy knowledge assessment was a 23‐item assessment with varied question formats and was developed by the instructors based on course objectives. The wellness assessment was the World Health Organization Quality of Life‐BREF assessment of personal wellness. This assessment measures wellness over four domains (physical, psychological, social and environmental).Students in both groups demonstrated marked increases in anatomy knowledge after the course (p<0.001). Pre‐course scores were similar between the hands‐on and online‐only groups (44.13% ± 12.13 vs. 41.52% ± 12.89, p = 0.51). Post‐course scores were significantly higher in the hands‐on group (73.48 ± 11.28 vs. 67.39 ± 11.15, p = 0.04). The region with greatest learning impact was the back and neck (71.67% vs. 62.5%) with less impact on the limbs. The anatomical concepts that were most strongly affected were relationships to vertebral levels (83.33% vs. 61.67%) and bony landmarks (82.73% vs. 71.36%) with less impact on soft tissue landmarks. Knowledge and attitudes about massage therapy were both similarly enhanced in the hands‐on group compared with the online only group. Students in the hands‐on group also demonstrated improved wellness in two domains, physical (58.10 ± 11.21 vs. 63.85 ± 12.86, p = 0.06) and psychological (64.60 ± 12.58 vs. 69.50 ± 16.56, p = 0.03). The online‐only group demonstrated no change in wellness (physical: 64.55 ± 12.93 vs. 64.55 ±12.73) or a decrease (psychological: 69.20 ± 9.38 vs. 67.95 ± 9.78) during the same time period.The results of this study illustrate an innovative, practical way to explore surface anatomy and enhance learning outcomes specifically in the back and neck and with regards to bony landmarks. Integration of massage therapy has additional benefits to student well‐being and broadens student perspectives about interprofessional health care.Support or Funding InformationThis research was funded by a grant from The University of Iowa Council on TeachingThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.