During the course of attending massage school at A New Beginning School of Massage, students are given a number of assignments that requiring research and writing. Some of these assignments result in very insightful and well-thought-out information and decision-making outcomes. I am happy to share some of their assignments for you to enjoy.
When researching new knowledge or scientific material, it can be tricky to find reliable sources. There will be confounding information all over the place, and sorting through to find the best sources is important. Having credible information is pertinent for any profession in which advice is given to clients. Massage Therapy falls under this professional advisory because the therapist will want to impart knowledge and information to their clients that is reliable and accountable of truth. Research articles that have been peer-reviewed or published in scholarly journals are a valid source to find material for a massage profession, even though they can still hold bias. They are valid because these articles are reviewed by experts in the field of study that the author is writing about; and prior to an article being published in a journal, it must be rigorously evaluated and revised. To determine whether or not the information one has researched about is applicable or correct, it must be found and published as a scholarly article in an established journal or magazine, or by a credible source with reputable evidence. Otherwise, it is easy to find any random article off the internet, those of which tend to hold a lot of misinformation, biased reports, or false claims. Research is important in a massage therapy profession because it is imperative to present reliable advice to a client, with a quality of critical and logical thinking. Examining data and study methods from many different credible viewpoints will help ensure a comprehensive approach to answering questions, issues, or problems that may present themselves with clientele. When sorting through articles to find information about a research question, it is essential to look under scholarly sources, such as National Institutes or a government website for scientific research. When looking for information to answer the research statement I was interested in, "Does massage help rid the body of cellulite," I went to PubMed and Google Scholar. After sifting through various articles to find those that apply to my question at hand, I found that massage alone does not rid the body of cellulite (otherwise known as gynoid lipodystrophy) and that one must have other contributing treatments to help reduce signs of cellulite.
When searching to find answers to my research statement, I found three articles that discussed relative to my research findings. The first article was a longitudinal evaluation for the treatment of gynoid lipodystrophy using manual lymphatic drainage. The study included 20 women from 20 to 40 years of age, 15 of which completed the study. Using an open, prospective, intervention method, once a week for fourteen sessions, these women received manual lymphatic drainage on their lower limbs and buttocks. The results concluded that manual lymphatic drainage, as an isolated approach to cellulite management, was safe but not effective. These women were observed to have a significant improvement in their quality of life, even though massage alone was not able to reduce their cellulite. It is necessary to have further research studies completed that are randomized, controlled or comparative studies to test whether or not manual lymphatic drainage is effective for cellulite control. The second and third articles that pertained to my research statement discussed the use of mechanical massage, which seemed to have better results for cellulite management than manual massage alone.
When researching the findings of the statement I chose to examine, I found more information about mechanical massage techniques than I did for manual massage alone. The second article I chose assesses the "Effects of mechanical massage, manual lymphatic drainage and connective tissue manipulation techniques on fat mass in women with cellulite." The objective of this study was to compare and evaluate the effectiveness of three noninvasive treatment techniques for patients with cellulite, looking at fat mass and regional fat thickness. Sixty subjects were divided into three randomized groups, one for each different treatment technique, which is indicated in the title of the article above. After the treatments, all groups had improvement in thinning of subcutaneous fat, but it does not state if any improvement were made directly relating to cellulite. The article concluded that all treatment techniques were effective in decreasing the values of regional fat for patients with cellulite. In the third article I examined, efficient treatment for cellulite was found using a combination of bipolar radio frequency (RF) and intense infrared light (IR) with mechanical massage and suction. This split study evaluates the efficacy of the combined system through which various treatments were performed on areas located in the buttocks that had cellulite. The study used one buttock as the untreated control, while the other was used for treatment of 12 sessions of 30 minutes each. There were ten patients and sessions were conducted over a period of 12 weeks, twice a week. The treatment session results concluded that combined RF, IR and mechanical massage and suction produced overall improvement in skin condition and cellulite appearance, was complication free and that further treatment sessions could lead to lasting results. The authors recognized that a small number of participants produce limited statistical power, and further studies are warranted with a larger patient population. Out of all three articles I examined, this third article had the most qualifying outcomes about the research statement I was interested in.
The research findings I assessed support the statement I examined in some ways, and in other ways, they did not. When answering the question, does massage rid the body of cellulite, it seems the straightforward answer would be no. Massage alone does not rid the body of cellulite, although massage, combined with other mechanical massage manipulation techniques, does seem to have more of an effect for improvements in cellulite reduction. The implications that this understanding has for my own knowledge base and practice is that I now know what to tell clients if they ask if massage will help reduce their areas of cellulite. I will be able to explain that massage alone does not seem to have the evidence to back up this claim but that there have been other studies using massage manipulation techniques that do seem to have significant results. This effect matters to me because I wish to be able to tell clients credible information with significant evidence to back up the claims that are asked about. In my massage beliefs and professional beliefs in general, it is important to me to think in a critical and logical way about the many health claims that appear in this field of work. In the end, we still do not know the best way to effectively reduce cellulite in the body, and further studies with larger randomized groups are necessary.
Citations
Bayrakci Tunay, V., Akbayrak, T., Bakar, Y., Kayihan, H. and Ergun, N. (2010). Effects of mechanical massage, manual lymphatic drainage and connective tissue manipulation techniques on fat mass in women with cellulite. Journal of the European Academy of Dermatology and Venereology, 24: 138-142. doi:10.1111/j.1468-3083.2009.03355.x
Caballero, N., Herrero, M., Romero, C., Ruiz, R., Sadick, N.S., and Trelles, M. (2009). Effects of cellulite treatment with RF, IR light, mechanical massage and suction treating one buttock with the contralateral as a control. Journal of Cosmetic and Laser Therapy, 10(4), 193-201. doi:10.1080/14764170802524403.
Schonvvetter, Bl, Soares, J.L.M., and Bagatin, E. (2014). Longitudinal evaluation of manual lymphatic drainage for the treatment of gynoid lipodystrophy. Anais Brasileiros de Dermatologia,89(5), 712-718. http://doilorg/10.1590/abd1806-4841.20143130
During the course of attending massage school at A New Beginning School of Massage, students are given a number of assignments that requiring research and writing. Some of these assignments result in very insightful and well thought out information and decision-making outcomes. I am happy to share some of their assignments for you to enjoy.
As the massage profession evolves, so too does the need for standards governing best practices. Research is becoming increasingly more important as a tool to achieve this goal. Research can generally be categorized as qualitative or quantitative. As a discipline, it began with simple clinical observations, which constitute the basis of qualitative investigation. These are descriptive studies of naturally occurring events. A practitioner would note symptoms of a given patient, try various remedies and reject those that did not work. When another patient would exhibit those same symptoms, previously effective remedies would be tried first.
In time, quantitative studies developed, based more on the scientific method of empirical testing. These are generally comprised of standardized clinical trials involving a control group and a very specific set of criteria for participation. Quantitative studies are widely accepted as providing the strongest link between cause and effect, and they appear to be good predictors of outcome of a given treatment if the study's results are shown to be statistically significant and if the results are performed exactly as in the study.
However, both types of research are valid and should be combined in order to find the most effective treatment method for each client. In order for research results to be valid, they must be able to be reproduced. The establishment of any cause and effect relationship as it pertains to results must also rule out other factors. There is also the issue of bias in a research study, which is important to consider: selection bias, attrition bias or measurement bias can all skew the results.
Evidence-based practice involves integrating current research findings with the expertise of the practitioner and the individual needs of the client in order to provide the best possible care. Research can be helpful in treating clients with specific conditions if the practitioner has not previously handled the condition. Research is important to the massage profession, not only in helping to provide good care to the client but also in establishing support for the profession as a whole. As massage therapists, research helps us become "fluent in the scientific language of the larger medical community" and provides credibility to the profession. (2) Research studies can establish institutional support for massage, as there is evidence that research studies suggesting efficacy of a certain treatment can lead to insurance coverage for the treatment. Citing research studies to clients can also encourage them to consider spending money on massage as part of their wellness program. Finally, on a broader scale, it can give massage therapists the confidence to treat previously contra-indicated conditions, such as cancer. Oncology massage has grown as a practice, in part, due to research studies on the positive effects of massage on cancer patients. On the opposite end of the spectrum from oncology massage, there is massage for non-life-threatening conditions.
The question has been posed as to whether or not massage can be effective in ridding the 
body of cellulite (gynoid lipodystrophy). Cellulite is a topographic alteration in adipose tissues, particularly in hips, thighs, buttocks and abdomen. It is studied because it is generally considered undesirable, although it does not pose any health risks. In the study "Intensive Treatment of Cellulite Based on Physiopathological Principles", researchers hypothesized that lymphatic stasis results in an accumulation of all the substances drained by the lymphatic system, since the accumulation of such in the interstitial space in adipose tissue is present in the initial stages of cellulite. They proposed that manual and mechanical lymph drainage could decrease the amount of cellulite on the treated areas. The study sample consisted of 10 patients ranging in age from 25 to 59 years, diagnosed with grade IV cellulite identified by clinical evaluation. The patients received a 4-hour treatment of manual and mechanical lymph drainage combined with 15 minute intervals of cervical stimulation in the form of 10 sessions over a 2-week period. The technique of cervical stimulation involved an apparatus which performed 25-30 flexion and extension movements of the sole of the foot per minute. The patients were measured and photographed before and after the research was conducted and the results were analyzed by two examiners. Significant reductions were measured for all patients participating in the study, according to researchers, with the mean reduction of 5.6 cm being statistically significant.
The research findings appear to support the statement, however the study only involved 10 participants. It would be important to reproduce the study's results perhaps with a wider survey. In addition, the treatment of 4 hours per day for 10 sessions over 2 weeks is aggressive treatment by most standards. A therapist may need to know if the results could be reproduced with fewer treatments in order to make the statement viable for a potential client.
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