Objective To investigate whether a support intervention (warm touch enhancement) influences physiological stress systems that are linked to important health outcomes. Growing evidence points to a protective effect of social and emotional support on both morbidity and mortality. Methods In this study, 34 healthy married couples (n = 68), aged 20 to 39 years (mean = 25.2 years), were randomly assigned to a "behavior monitoring" control group or participated in a 4-week intervention study in which clinic levels of plasma oxytocin, 24-hour ambulatory blood pressure, and salivary cortisol and alpha amylase were obtained pre and post intervention, at the same time salivary oxytocin was taken at home during weeks 1 and 4. Results Salivary oxytocin was enhanced both early and late in the intervention group and alpha amylase was reduced at post treatment in intervention group husbands and wives relative to controls. Husbands in the intervention group had significantly lower post treatment 24-hour systolic blood pressure than the control group. Conclusion Increasing warm touch among couples has a beneficial influence on multiple stress-sensitive systems.

Influence of a "warm touch" support enhancement intervention among married couples on ambulatory blood pressure, oxytocin, alpha amylase, and cortisol.

Lumbar spinal stenosis (LSS) affects more than 200 000 adults in the United States, resulting in substantial pain and disability. It is the most common reason for spinal surgery in patients over 65 years. Lumbar spinal stenosis is a clinical syndrome of pain in the buttocks or lower extremities, with or without back pain. It is associated with reduced space available for the neural and vascular elements of the lumbar spine. The condition is often exacerbated by standing, walking, or lumbar extension and relieved by forward flexion, sitting, or recumbency. Clinical care and research into lumbar spinal stenosis is complicated by the heterogeneity of the condition, the lack of standard criteria for diagnosis and inclusion in studies, and high rates of anatomic stenosis on imaging studies in older people who are completely asymptomatic. The options for non-surgical management include drugs, physiotherapy, spinal injections, lifestyle modification, and multidisciplinary rehabilitation. However, few high quality randomized trials have looked at conservative management. A systematic review concluded that there is insufficient evidence to recommend any specific type of non-surgical treatment. Several different surgical procedures are used to treat patients who do not improve with non-operative therapies. Given that rapid deterioration is rare and that symptoms often wax and wane or gradually improve, surgery is almost always elective and considered only if sufficiently bothersome symptoms persist despite trials of less invasive interventions. Outcomes (leg pain and disability) seem to be better for surgery than for non-operative treatment, but the evidence is heterogeneous and often of limited quality.

https://www.bmj.com/content/bmj/352/bmj.h6234.full.pdf

Management of lumbar spinal stenosis

In recent years, the term integrative medicine has gained acceptance in medical academia. The Consortium of Academic Health Centers for Integrative Medicine defi nes this term as “the practice of medicine that reaffi rms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.” 1 Integrative oncology has been specifi cally described as both a science and a philosophy that focuses on the complex health of people with cancer and proposes an array of approaches to accompany the conventional therapies of surgery, chemotherapy, molecular therapeutics, and radiotherapy to facilitate health. 2 The SIO and its Medline -indexed journal ( Journal of the Society of Integrative Oncology ), founded by leading oncologists and oncology professionals from major cancer centers and organizations, promote quality research and appropriate application of useful, adjunctive complementary modalities T he Society for Integrative Oncology (SIO) is an international organization dedicated to encouraging scientifi c evaluation, dissemination of evidence-based information, and appropriate clinical integration of complementary therapies. Practice guidelines have been developed by the authors and endorsed by the Executive Committee of the SIO. Guidelines are a work in progress; they will be updated as needed and are available on the SIO Web site ().

/pdf/evidence-based-clinical-practice-guidelines-for-integrative-4imvpok6hg.pdf

Evidence-Based Clinical Practice Guidelines for Integrative Oncology: Complementary Therapies and Botanicals

Background:Wet needling uses hollow-bore needles to deliver corticosteroids, anesthetics, sclerosants, botulinum toxins, or other agents. In contrast, dry needling requires the insertion of thin mo...

/pdf/dry-needling-a-literature-review-with-implications-for-34m4mg7e11.pdf

Dry needling: a literature review with implications for clinical practice guidelines.

Background. Massage is a popular treatment choice of athletes, coaches, and sports physical therapists. Despite its purported benefits and frequent use, evidence demonstrating its efficacy is scarce. Purpose. To identify current literature relating to sports massage and its role in effecting an athlete’s psychological readiness, in enhancing sports performance, in recovery from exercise and competition, and in the treatment of sports related musculoskeletal injuries. Methods. Electronic databases were used to identify papers relevant to this review. The following keywords were searched: massage, sports injuries, athletic injuries, physical therapy, rehabilitation, delayed onset muscle soreness, sports psychology, sports performance, sports massage, sports recovery, soft tissue mobilization, deep transverse friction massage, pre-event, and post exercise.

/pdf/the-role-of-massage-in-sports-performance-and-rehabilitation-3c9q8eto72.pdf

The role of massage in sports performance and rehabilitation: current evidence and future direction.

This project assessed the nature of collaboration between complementary and alternative medicine (CAM) and traditional, research-intensive (TRI) institutions among the nine National Center of Complementary and Alternative Medicine (NCCAM)-funded Research Education Partnership Project Awards (R25 grant program). A blinded 43-question, IRB-approved survey was administered to primary investigators from 19 awarded CAM and TRI institutions. Quantitative data were analyzed descriptively. Short-answer questions were assessed qualitatively. The survey was completed by 84.2 % of the sample. Their collaborations included faculty exchanges, TRI institution seminars and mentorship of CAM faculty and students in research, joint development of courses and evidence-based practice (EBP) resources, and two-way consulting (TRI-CAM and vice versa). The collaborations were characterized as mutually respectful and personally rewarding, being collective efforts, instilling confidence in each others’ work, having open communication, resulting in mutual learning, and leading to subsequent collaborations. The most important success included training and collaboration among faculty (n = 9), developing EBP knowledge and educational materials (n = 7), improving research infrastructure and collaboration opportunities (n = 6), and cultural change toward EBP (n = 5). The greatest progress included providing educational and research opportunities for students and faculty. The primary challenges were related to time constraints of faculty. Over 70 % of respondents believed that the TRI institution influenced culture change in CAM faculty, and 30 % of TRI institutions reported that the R25 collaboration led to culture change at their own institutions. The responses indicated the CAM-TRI collaborations provided important benefits to both types of institutions, laying the groundwork for continued partnerships and collaboration.

Benefits, Challenges, and Culture Change Related to Collaborations Between Complementary and Alternative Medicine and Traditional Research-Intensive Institutions

Jennifer M. Dexheimer

Papers

Benefits, Challenges, and Culture Change Related to Collaborations Between Complementary and Alternative Medicine and Traditional Research-Intensive Institutions

Morphometric differences of cavitating Z joints