Registered Massage Therapists Research Articles

Survey of the quality and origins of websites on penile low-intensity shockwave therapy in Canada.

The aim of this study was to establish the quality of patient-facing websites advertising low-intensity shockwave therapy (LISWT) for erectile dysfunction (ED) and Peyronie's disease (PD) patients in Canada. Canadian websites offering LIWST for ED or PD were identified using online web searches. The characteristics of these websites were reviewed, along with examining the presence of HONCode certification, assigning a brief DISCERN score (a tool designed to evaluate health information online) and readability scores. We also examined the LIWST technology advertised, as well as benefits of LIWST cited by the websites. Twenty-five unique websites linked to 46 clinics were identified and reviewed. Twenty-four percent of websites were run by a urologist. Other specialties offering LISWT included general practitioners, anesthesiologists, naturopaths, nurse practitioners, physiotherapists, and registered massage therapists. Twenty-four percent of the websites advertised the use of a focused shockwave generator. Forty percent of the websites had peer-reviewed references. The average brief DISCERN score was 14 (standard deviation 3.4). There was no association between the physician-or non-physician-led websites and the use of peer-reviewed references, readability scores, the number of clinic locations, or higher brief discern scores. LISWT is readily advertised online for ED and PD patients in Canada; however, only a minority use a focused shockwave generator. There is a wide diversity of practitioners offering LISWT. Websites offering LISWT are generally of poor quality and do not provide adequate information for patients to make educated treatment decisions.

Variation determinants within massage therapists' professional identity.

Individuals have multiple, competing identities that vary in importance to the self. Professional identity is a way in which individuals attribute meaning to their contribution to society and is influenced by complex factors. Globally, the roles and responsibilities of massage therapists (MTs) vary, making it challenging to articulate a cohesive professional identity. This article describes the investigation into the variables which influenced response regarding MTs' professional identity in Ontario, Canada. An online questionnaire was distributed to active MTs with available email addresses in the public register of the College of Massage Therapists of Ontario. Chi-square tests of independence were used to compare dependent variables with independent variables. Significance was adjusted post hoc, using Bonferroni's correction, to reduce the chance of a type I error occurring. The threshold for significance was adjusted from p≤0.05 to p≤0.01 as multiple analyses were conducted with a high response rate. The results provided insight into the variables associated with differences in responses. Variation was seen based on gender, primary practice setting, length in practice, additional education, additional roles within the profession, additional designation as a healthcare provider, and membership in the RMTAO (Registered Massage Therapists' Association of Ontario). While previous studies sought to describe the common and unifying features of MTs' identity, these findings provide insight into variables that determine differences in responses. These findings are valuable for the development of future studies. They provide a priori assumptions regarding the inclusion of these demographic items that can inform decisions regarding enrollment of the sample and data analysis.

A Survey of Acupuncture-Providing Registered Massage Therapists in Ontario, Canada: Motivation, Training, and Practice Characteristics

An increasing number of licensed massage therapists in several countries are providing acupuncture to their clients, but little is known about this practice. To characterize the motivations, training backgrounds, practice patterns, and clinical experiences of licensed massage therapists who perform acupuncture. The study used a cross-sectional, online survey design involving acupuncture-providing registered massage therapists (RMTs) in the province of Ontario, Canada, where acupuncture is explicitly permitted within the massage therapy profession's scope. Analysis involved descriptive statistics and thematic content analysis of qualitative findings. The survey response rate was 33.7% (n=212), representing 25.5% of all Ontario RMTs rostered to practice acupuncture. Participant demographics mirrored the RMT profession as a whole, except that providers were, on average, several years older than other RMTs. Most respondents (72.7%) had completed over 200 hours of training in acupuncture; most training included clean needle technique (96.8%), clinical supervision (93.5%), traditional Chinese medicine content (83.4%), and a final examination (96.8%). Respondents typically used acupuncture in about one-third of their sessions (mean 32.3%, SD 5.0) with an average of 10.5 weekly clients (SD 14.3). Acupuncture-providing RMTs had been initially motivated by acupuncture's potential effectiveness for musculoskel-etal conditions (97.2%), a wish to attract more clients (61.3%), and physical fatigue from delivering manual therapies (48.3%). Most reported being more likely to achieve excellent clinical results (84.9%), experience greater professional satisfaction (79.9%), and attract or retain clients (64.8%) since using acupuncture. A minority also reported earning a higher income (34.6%) and experiencing more adverse events in practice (21.5%). Qualitative responses added explanatory nuance to numeric results. This study of the use of acupuncture by Ontario's licensed massage therapists represents a first scholarly account of an emerging global trend that holds promise in enhancing clinical care, professional stability, and provider longevity. Additional research is needed to investigate the practice's use in other jurisdictions, and to establish international standards for safe and effective practice.

A Series of Case Reports Regarding the Use of Massage Therapy to Improve Sleep Quality in Individuals with Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a common mental health diagnosis in Canada with prevalence estimated at about 2.4% in the general population. Previous studies have suggested massage therapy may be able to reduce the symptoms of PTSD. One of the symptoms commonly experienced is difficulty falling or staying asleep. No previously published massage therapy research has specifically assessed sleep symptoms of PTSD. The research question was, "For individuals who have PTSD as a result of experiencing traumatic events, does MT have an effect on sleep quality?" A prospective series of case reports describing 10-week MT treatment plans provided by Registered Massage Therapists at Sutherland-Chan Clinic's Belleville location. Three individuals with PTSD were recruited using promotional posters in the community. Treatment focused on improving sleep quality and followed a pragmatic treatment protocol using light to moderate pressure. Outcomes were measured using a sleep diary, Pittsburgh Sleep Quality Index, and the Leeds Sleep Evaluation Questionnaire. Data collected at baseline and throughout the series showed inconsistent improvement and worsening of symptoms amongst participants. Treatment was well tolerated and attended. No harmful incidents were noted. For these participants, MT did not predictably impact sleep quality. It is possible, as the underlying cause of poor sleep quality was unlikely resolved, the participants did not have a significant change in their sleep quality. This differs from findings of previous studies in which MT improved sleep for patients with poor sleep quality due to exposure to traumatic events. There is need for further understanding of how MT affects sleep.

Quantitative ultrasound of trapezius muscle involvement in myofascial pain: Comparison of clinical and healthy populations using texture analysis

Myofascial pain syndrome (MPS) diagnosis is currently a source of contention amongst clinicians. Physicians, chiropractors, and registered massage therapists do not agree on the criteria they deem diagnostic of MPS. Ultrasound imaging is widely used in medicine to qualitatively identify anatomical structures and lesions. Quantitative ultrasounds methods such as texture features have been used to characterize normal and pathological tissue in muscular disorders. We propose that quantitative ultrasound imaging techniques can be used to differentiate muscle with myofascial pain diagnosis from healthy controls. Therefore, we assessed whether texture features could differentiate upper trapezius muscle in patients with MPS relative to healthy participants. We collected B-mode ultrasound images of the upper trapezius muscle in 15 healthy participants and 17 patients with MPS. The following texture features were extracted from the images: blob area, blob count, and 10 local binary patterns (LBP) ( Fig. 1 ). A principal components analysis (PCA) was performed to reduce the features to those that accounted for the most variability in the images ( Table 1 ). A MANOVA was then performed to determine whether healthy or MPS group membership could be differentiated by the reduced features ( Table 2 ). The PCA identified two components that accounted for 93% of the variability. Features with the highest loading factors included: LBP2, LBP6, LBP10, blob area, and blob count. All features but blob area could statistically differentiate healthy from myofascial pain groups ( P < 0.001). Texture features are capable of differentiating muscle tissue in patients with MPS relative to healthy individuals. These findings may be used to develop an accurate diagnostic tool for clinicians to diagnose patients with MPS.

The Characteristics, Experiences and Perceptions of Registered Massage Therapists in New Zealand: Results from a National Survey of Practitioners

Massage therapy is widely recognized as offering many health benefits, with a growing number of studies finding it has value in stress management, pain reduction, and overcoming physical limitations. However, there are few studies of massage therapists practices and perceptions in New Zealand and internationally. This paper reports the findings from the first national survey examining the characteristics, perceptions, and experiences of New Zealand-based massage therapists on a range of aspects related to their role and practices. This study sought to ascertain the characteristics, experiences, and perceptions of massage therapists in New Zealand, particularly in the aspects of: integration of health care; attitudes and practices related to research; and evidence and attitudes to registration. Massage practice in New Zealand (nationwide survey). Members of Massage New Zealand (a massage practitioners association). Massage practitioners were surveyed online, using a 65-part questionnaire, on a range of characteristics of their practices and their attitudes to research, integration, and registration. Statistical analysis was performed using STATA. Statistical significance was set at 0.05. Four hundred massage therapists (MTs) were invited to participate and 115 responded, providing a response rate of 29%. MTs valued research (95%) and perceived that it had an impact for their practices (88%). Significant correlations were found for research value and: mean case-load (p = .009) and level of academic qualification (p = .004). The majority of MTs (79%) supported integration with conventional practitioners, and 83% referred clients to general practitioners, with 75% receiving referrals from general practitioners. Ninety-three percent of MTs supported registration, with 67% of those supporting statutory registration. Massage practitioners perceive that they make a significant contribution to health care, but area of practice, such as research, and referral and integration into mainstream health care require more in-depth investigation.

A Survey of Healthcare Practitioners on Myofascial Pain Criteria.

The goal of this study was to assess agreement on signs and symptoms of myofascial pain for chiropractors, physicians, and registered massage therapists. 337 healthcare practitioners participated in the survey. The questionnaire probed clinician agreement with the chosen signs and symptoms using a 7-point agreement scale (1=absolutely agree, 7=absolutely disagree). Agreement was assessed using intraclass correlation within chiropractor, physician, and registered massage therapist groups and across all groups. Descriptive statistics, including mean response values, were used to assess which signs or symptoms were most often associated with myofascial pain. There was poor agreement within chiropractors, physicians, and registered massage therapists on the criteria that represent myofascial pain syndrome. Physicians and massage therapists were in agreement on 4 items and disagreed on 2 items. Chiropractors were in agreement on a different set of signs and symptoms relative to physicians and registered massage therapists, and they expressed neutrality on most statements in the questionnaire. Registered massage therapists were in most agreement amongst each other as a group (intraclass correlation coefficient [ICC]=0.80) relative to chiropractors (ICC=0.59) and physicians (ICC=0.51). Our results suggest that there is a lack of agreement within and between healthcare practitioner groups on the signs and symptoms that define myofascial pain syndrome. We suggest the demonstrated variability in diagnostic knowledge be remedied through the establishment and universal use of official validated criteria. Future research should focus on developing criteria specific to myofascial pain syndrome. Finally, knowledge translation strategies may be implemented to increase clinician knowledge of available criteria.

Exploring the awareness of research among registered massage therapists in Ontario.

An increase in available research has highlighted that knowledge changes over time as theories are challenged and adjusted or dismissed. This is particularly important to healthcare practitioners, including massage therapists, who need to frequently review current research and adjust practice accordingly. However, when research findings related to practice are generated, there is considerable delay in implementation. Few studies measure actual knowledge of current evidence for practice. The objectives of the study reported here were to (a) describe current awareness of evidence for practice among registered massage therapists (RMTs) in Ontario and (b) identify the sources of information RMTs use to inform their awareness of current evidence and the reported importance and frequency of use for each source. An online questionnaire-based mixed-methods cross-sectional study was conducted. Ontario RMTs were invited to participate. This report focuses on the quantitative analysis. In total, 1,762 questionnaires were included. Of seven sources of information provided, respondents rated cumulative professional experience as most important, followed by recent research studies and education. Cumulative professional experience also rated as most frequently used, followed by other RMTs and education. There was a tendency for respondents to agree with positive statements about MT, or disagree with negative statements, regardless of correctness. The results suggest that RMTs need to improve their awareness of the current evidence for practice. Furthermore, cumulative professional experience was ranked most frequently used. This has the potential to not include the most current research. Improving communication of research findings to RMTs might improve awareness.

The perspectives of educators, regulators and funders of massage therapy on the state of the profession in British Columbia, Canada

BackgroundRegistered Massage Therapists (RMTs) are valuable members of the healthcare team who assist in health promotion, disease prevention, treatment, rehabilitation and palliation. RMT visits have increased across Canada over the past decade with the highest increase in British Columbia (BC). Currently, RMTs are private practitioners of healthcare operating within a largely publicly funded system, positioning them outside of the dominant system of healthcare and making them an important case study in private healthcare. In another paper we examined the perspectives of RMTs themselves. Here, we offer perspectives of regulators, educators and funders of Massage Therapy (MT) on advancement of the profession.MethodsWe interviewed 28 stakeholders of MT in BC – including members of the MT regulatory board, representatives from MT colleges in BC and public and private health insurers.ResultsAll three groups identified research, particularly on efficacy of MT, as playing a vital role in enhancing the professional credibility of MT. However, participants noted that presently research is not a large feature of the current MT curricula and we analyze why this may be and how it can improve. Finally, conferral of baccalaureate degree status could assist RMTs in gaining recognition with the general public and other healthcare professionals.ConclusionRMTs have potential to ameliorate population health in a cost-effective manner. Their role in British Columbia’s healthcare landscape could be expanded if they produce more research and earn degree status.

Massage Therapy and Labor Outcomes: a Randomized Controlled Trial

Massage is a time-honored method by which women have received comfort throughout the millennia, yet it has not been rigorously evaluated in the modern day delivery suite. No study to date that we are aware of has evaluated the effect of massage therapy by a regulated massage therapist on labor pain. The purpose of this study was to evaluate the effectiveness of massage therapy provided by registered massage therapists in managing pain among women in active labor. BC Women's Hospital, Vancouver, BC. a randomized controlled trial. 77 healthy nulliparous women presenting in spontaneous labor. Swedish massage administered for up to five hours by a registered massage therapist during labor vs. standard care. Main outcome measures include: cervical dilation at the time of administration of epidural, compared using estimated marginal means in an analysis of covariance. We also compared perception of pain at three time periods during labor according to cervical dilation at 3-4 cm, 5-7 cm, and 8-10 cm using the McGill Present Pain Intensity Scale. The mean cervical dilation at the time of epidural insertion after adjustment for station of the presenting part, cervical dilation, and status of membranes on admission to hospital was 5.9 cm (95% CI 5.2-6.7) compared to 4.9 in the control group (95% CI 4.2-5.8). Scores on the McGill Pain Scale were consistently lower in the massage therapy group (13.3 vs. 16.9 at 3-4 cm, 13.3 vs. 15.8 at 5-6 cm, and 19.4 vs. 28.3 at 7-8 cm), although these differences were not statistically significant. Our findings from this pilot study suggest that massage therapy by a registered massage therapist has the potential to be an effective means of pain management that may be associated with delayed use of epidural analgesia. It may therefore have the potential to reduce exposure to epidural analgesia during labor and decrease rates of associated sequelae.

How Can Massage Therapy Move Forward? Registered Massage Therapists Touch on Key Points Shaping Their Profession in British Columbia, Canada

Registered Massage Therapists (RMTs) are valuable members of the health care team who assist in creating positive outcomes in health promotion, disease prevention, and rehabilitation. This article explores RMTs’ views regarding the status and future of their profession in British Columbia, Canada. It highlights, for the first time, key issues for advancing the profession from their perspective. RMTs believe increased recognition for their roles in health care would enhance their careers. They note that research on the beneficial aspects of MT and communication of these benefits to other health care professionals, particularly MDs, and the general public, would also help. Some noted that increasing their work within interdisciplinary health care teams, particularly inside publicly funded health care, would elevate the status of their profession. Finally, RMTs discussed their desire to gain recognition of their rigorous education programs by earning degrees instead of diplomas. However, significant barriers to these aspirations exist.

Professional status and interprofessional collaboration: A view of massage therapy

INTRODUCTIONMassagetherapyisoneofthefastestgrowingcomplementaryand alternative medicine (CAM) modalities in NorthAmerica. Massage therapy has been regulated under theRegulated Health Professions Act (RHPA) in Ontario,Canada since 1994. The RHPA governs physicians, nursesand midwives, among other health care professionals. Thereis a growing body of evidence for the efficacy of massagetherapy for a number of conditions considered a burdenfor patients and the health care system, such as musculo-skeletal pain, discomforts of cancer treatment, depressionand anxiety (Moyer, Rounds, & Hannum, 2004; Sturgeon,Wetta-Hall, Hart, Good, & Dakhil, 2009). Patient/publicdemand has contributed to CAM modalities, includingmassage therapy, being made available to patients on a feefor service basis within hospital and other medical settings(e.g. Soklaridis, Kelner, Love, & Cassidy, 2009).Despite the developing evidence for the role of massagetherapy in health care and patient/public demand for thisservice, it remains on the periphery of mainstream healthcare. The peripheral role of massage therapy is apparent byquestions about its legitimacy, and its absence in discussionsof interprofessional collaboration, in health care. Whileregulation is commonly associated with a move towardsprofessionalization and improvements in the status of healthcare professionals (Finch, 2009), these issues in relation tomassage therapy continue to be a challenge.A small number of studies have recently examined CAMin relation to interprofessional collaboration, yet massagetherapy was not the main focus (Gaboury, Bujold, Boon, M Soklaridis et al., 2009). The purpose of thisstudy was to explore perceptions of the professionalizationand status of massage therapists, and the implications forinterprofessional collaboration.METHODSAn exploratory case study approach (Yin, 2003) wasemployed to investigate health professionals’ views ofperceived barriers to increased professionalization, statusand interprofessional collaboration in relation to massagetherapy.Data collection and analysisParticipants were selected using purposive sampling toensure inclusion of massage therapists’ perspectives, as wellas the perspectives of other professionals who worked withmassage therapists in their daily practice. Semi-structuredinterviews were conducted with ten health care professionalsworking in hospital settings. The sample consisted ofphysicians (3), nurses(2), physiotherapists(2) and registeredmassage therapists (3). Eight of the participants were femaleand two were male. Participants had been in practice for arange of 2 to 20 years.Data were analyzed using inductive thematic coding togenerate key themes. This involved a process of initially“open” coding each of the transcripts before each of thesecodes was organized into provisional categories (themes).Through this process a coding framework was subsequentlydeveloped.Ethical approval was obtained before the studycommenced from a local Research Ethics Committee.Informed consent was secured before interviews took place.All data were anonymized and treated in confidence.

Communication between Medical Practitioners and Dancers

The purpose of this study was to investigate patterns of communication between professional and pre-professional dancers and medical practitioners. One survey was developed and randomly conducted among family physicians, sports medicine physicians, chiropractors, physical therapists, and registered massage therapists. A second survey involved volunteer ballet and modern dancers in professional dance training programs, college and university dance programs, and independent dance artists. One hundred and ninety questionnaires were distributed to medical practitioners, and 50 were returned. Of 380 questionnaires given to dancers, 202 were returned. The dancers were 18 to 49 years old, with a majority between the ages of 18 and 20. They averaged more than 10 years of dance training. All of the questionnaires were distributed in a single large Canadian city.The data shows that medical practitioners rarely communicated with each other concerning a common (dance) patient. They also failed to communicate, in most cases, with the dancers’ teachers, choreographers, and directors. This was not disconcerting to injured dancers, who tended to believe that such communication was not important to their recovery. Significantly, dancers did not fully understand the nature of their injuries when they sought medical advice, and they did not press the medical practitioners for additional information. Both groups generally believed that dancers would benefit by learning more about human anatomy.

How Complementary and Alternative Medicine Practitioners Use PubMed

Background PubMed is the largest bibliographic index in the life sciences. It is freely available online and is used by professionals and the public to learn more about medical research. While primarily intended to serve researchers, PubMed provides an array of tools and services that can help a wider readership in the location, comprehension, evaluation, and utilization of medical research.Objective This study sought to establish the potential contributions made by a range of PubMed tools and services to the use of the database by complementary and alternative medicine practitioners.Methods In this study, 10 chiropractors, 7 registered massage therapists, and a homeopath (N = 18), 11 with prior research training and 7 without, were taken through a 2-hour introductory session with PubMed. The 10 PubMed tools and services considered in this study can be divided into three functions: (1) information retrieval (Boolean Search, Limits, Related Articles, Author Links, MeSH), (2) information access (Publisher Link, LinkOut, Bookshelf ), and (3) information management (History, Send To, Email Alert). Participants were introduced to between six and 10 of these tools and services. The participants were asked to provide feedback on the value of each tool or service in terms of their information needs, which was ranked as positive, positive with emphasis, negative, or indifferent.Results The participants in this study expressed an interest in the three types of PubMed tools and services (information retrieval, access, and management), with less well-regarded tools including MeSH Database and Bookshelf. In terms of their comprehension of the research, the tools and services led the participants to reflect on their understanding as well as their critical reading and use of the research. There was universal support among the participants for greater access to complete articles, beyond the approximately 15% that are currently open access. The abstracts provided by PubMed were felt to be necessary in selecting literature to read but entirely inadequate for both evaluating and learning from the research. Thus, the restrictions and fees the participants faced in accessing full-text articles were points of frustration.Conclusions The study found strong indications of PubMed’s potential value in the professional development of these complementary and alternative medicine practitioners in terms of engaging with and understanding research. It provides support for the various initiatives intended to increase access, including a recommendation that the National Library of Medicine tap into the published research that is being archived by authors in institutional archives and through other websites.

A survey of musculoskeletal injuries amongst Canadian massage therapists

A survey was administered to registered massage therapists (RMT) across Canada to determine the prevalence of musculoskeletal pain and discomfort to the low back, shoulders, neck, wrist and thumbs associated with therapeutic treatments. A total of 502 RMT responded to the survey. Despite the majority of the respondents indicating they received proper training in therapy postures and self-care, there was a high prevalence of pain reporting to all areas of the upper extremity. The highest reporting of pain and discomfort was reported in the wrist and thumb, followed by the low back, neck and shoulders, respectively. There were no significant gender differences in pain/discomfort reporting except for the neck. The results of this survey indicate a high prevalence of musculoskeletal pain and discomfort associated with delivering massage therapy treatments. Therapists must focus on proper technique posture and adhere to a regime of self-care to reduce the risks of pain and injury. Further research is needed to determine the effects of neuromuscular fatigue and technique accommodation as it relates to pain risk.

Pain and tension are reduced among hospital nurses after on-site massage treatments: A pilot study

Tension and pain are common occupational hazards of modern-day nursing, especially given recent changes to the health care system. The aims of the pilot study were (1) to evaluate the feasibility of carrying out a series of eight 15-minute workplace-based massage treatments, and (2) to determine whether massage therapy reduced pain and stress experienced by nursing staff at a large teaching hospital. Twelve hospital staff (10 registered nurses and 2 nonmedical ward staff) working in a large tertiary care center volunteered to participate. Participants received up to eight, workplace-based, 15-minute Swedish massage treatments provided by registered massage therapists. Pain, tension, relaxation, and the Profile of Mood States were measured before and after each massage session. Pain intensity and tension levels were significantly lower after massage (P < .01). In addition, relaxation levels and overall mood state improved significantly after treatments (P < .01). The results of this pilot study support the feasibility of an eight-session, workplace-based, massage therapy program for pain and tension experienced by nurses working in a large teaching hospital. Further research is warranted to study the efficacy of workplace massage in reducing stress and improving overall mood.