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I'm sorry, I just don't get research....

I started another blog post on the future of the massage profession and happened to mention research. It turned into a discussion on research. I decided to start a new blog post.

I'm sorry, I just don't get research. I'm not interested in it really even though I do have more of a science background than most massage therapists (AA degree in Biology). I am interested enough that I do keep trying to learn about it but I am just not getting it. The way researchers talk is beyond me. The best thing I can think of is the theories in a book called "Made to Stick" where they talk about a few things like the "Curse of Knowledge" where people know too much and forget that others don't know what they know and how to take info and put it into usable formats so that all understand.

What good will it do to have one or two studies that show promise in one area? All of the research on cancer and we still don't have a cure for it although Candace Pert says she has one but she can't get funding to study it. No one wants the answer. (updated post - actually I think Candace Pert says she has the cure for aids not cancer - my mistake!)

So what if there were 20 or 100 studies done on a topic? Would that prove that it works? No, not really. When I took a research class on cancer with Tracy Walton a few years ago she said to say something like 'research shows promising results in this area".

I am also quite skeptical having a friend in research at a prominent univ. where she manages researchers who are always skewing the results and throwing out data that doesn't fit their hypothesis. It is funded by big drug companies of course and the researchers want to continue to play and have their jobs.

Who is interpreting research for us? Is there someone who is going through research and analyzing it saying things like who did funded the study, what were the results, how good of a study was it etc? I would guess that people reading research could interpret the results the way they want to see them. How is research being used? How will it improve my business or practice? I do mainly injury work but don't feel any need for research. If massage doesn't work within a few weeks or a month, I send people on their way maybe even to another massage therapist. If research says it will work -does that mean my technique and presence will work?

And speaking of research - What I would like to see researched is how many hours of training do we need as a massage therapist? Is massage licensing needed or even working to do anything for the profession? I would love to see research on just using presence and the healing process. How would you measure that?

So I don't really know where I am going with this. I sort of have this interest but bad taste about research. I am going to the conference so I am sure I will be writing about it later!

Julie

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Comment by Annemarie K on December 8, 2014 at 1:52pm

You have a good point here.  Does the fact that research came to a certain conclusion mean that people with a certain condition will definitely be helped by massage (or acupuncture, reiki, etc.)?  The simple answer is no, but that does not mean that research is useless.  It definitely has a place in helping the profession of massage gain recognition as a legitimate health care modality. 

The way that mainstream medicine works is that nothing will be accepted without research to back it.  Of course, one can say who cares if mainstream medicine accepts massage therapy?  I would answer that the acceptance by mainstream medicine will only make it so that the medical profession will not actively discourage their patients from getting massage. 

Even if they don't recommend it to their patients themselves, at least if a patient comes and says they are going for massage, the doctor will not convince them to stop.  Since most people have great respect for their physicians, this would help the massage profession as a whole. 

I would use as an example prenatal massage.  Almost every pregnant woman is regularly seeing her doctor, and if she is going for massages too, it would be much better if her doctor says that going for massage is good, or at least not bad.  While there will always be some doctors who will recommend against it, the more research there is, the more likely it is that physicians will be happy with their patient's decision to go for massage.  The more research there is for alternative healing modalities, the better they will eventually be accepted. 

Annemarie

http://njmassage.info

Comment by Al Meo LMT,CN,CPT on December 28, 2010 at 9:41am
Possibly look into the work of Dr. James Oschman, one of the leading researchers on  Fascia, along with Alfred Pischinger, and Serge Paoletti, and it's implications for health, and supporting Homeostasis, Hydration, electrical response etc. Incredible information we should all be acquainted with!
Comment by Walt Fritz, PT on April 15, 2010 at 9:54am
Myofascial Release has taken hits over many years for the lack of foundation science to back up the claims. The mechanistic rational that I was taught, and is still taught, lacks credence. Add into the mix forays into quantum physics that has been professed and it subtracts further from the credibility of the work and the teachers and practitioners who profess these theories.

Taking the new research that now exists as alternate neuro-based rationales does not compel me to discard what I do, it allows me to view my work through a second set of filters. Using this new information I have an opportunity to grow further.

Discarding my profession is not an option to me. I value credibility in myself and others and work to grow my knowledge base. Research can be an essential key to all of this.

Walt Fritz, PT
www.myofascialresource.com
Comment by Christopher A. Moyer on April 15, 2010 at 9:44am
Thanks for responding and clarifying, Julie.

Tracy and Ruth are being overly careful, in my opinion. I understand their position - more evidence is always better than less, and new evidence could overturn previous findings. But even taking these things into consideration, it simply isn't true, in any meaningful sense, that research cannot prove things. It can and does all the time.

If one wants to be an extreme literalist, it could be noted that true "proof" only ever occurs in mathematics. In math it is actually possible to reach a proven conclusion that is logically rock solid and that faces no threat of being overturned.

But by a more realistic, everyday sense of the word "proof," it is accurate to say that research proves things. Physics research has proven that objects with mass exert a gravitational field. Biology research has proven that plants make their own food from sunlight. Massage research has proven that this treatment tends to reduce anxiety (though this conclusion is not as well researched as my first two examples).

As a scientist, I would add that it is proven that cigarettes cause lung cancer. The evidence is overwhelmingly clear, despite the fact that we have never done, and cannot ethically do, a randomized controlled trial of cigarette smoking on humans. No reasonable and educated person today can assert that cigarettes do not play a causal role in the development of lung cancer.
Comment by Julie Onofrio on April 14, 2010 at 9:45pm
as far as research proving anything beyond a doubt - from what I have been reading and hearing from Tracy Walton and Ruth Werner that it you can't really say "It is proven that this or this or this happens when you get a massage". One or 10 studies won't "prove it". Tracy Walton actually said in a class that we should say "Research shows that (this) looks promising" or something like that.

This is from Ruth on Facebook on the MT Foundation Group
But for the record, "Proven" isn't a word you'll find a lot because that would mean it would have to be true every single time-- that doesn't happen much, which is why cigarettes are not "proven" to cause lung cancer.
Comment by Christopher A. Moyer on April 14, 2010 at 3:12pm
and the thing is that research doesn't 'prove' anything really.

Sure it does.

I must not understand what you mean by that. Could you expand on what you actually mean by that?
Comment by Julie Onofrio on April 14, 2010 at 10:02am
What do I have to be prepared for? I am going to learn. I have to say I have been doing some reading and am more interested in research and also how can I help to make it more understandable...I think that people just don't understand the importance of research because most massage therapists are more feeling and intuition based or so it seems. I know I am that way and have never been asked to prove if something works nor have I even wondered if the work I do or the classes I take have ever been proven to work. I actually don't know how anyone could even decide on that since there isn't much research and the thing is that research doesn't 'prove' anything really. One or two or even 10 studies doesn't mean much but help us make the next studies from what I gather. (I find other people's perspective on that interesting and have no judgments about you choosing that way. It is all good information for getting perspective on all of this.) I do what feels good to me and seems to do the same for my clients.

I have to say I probably wouldn't be going to the conference if it wasn't a block away from my office!
Julie
Comment by Stephen Jeffrey on April 14, 2010 at 9:54am
Thanks Emmanuel, you raise some good points.

For those of you who missed it there was this discussion that raised some important related points. http://www.massageprofessionals.com/forum/topics/evidence-based-mas...

Julie, do you feel you are now better prepared for the conference ?
Comment by Kim Goral on April 14, 2010 at 9:46am
"There are so many things we do not know or understand about our world or our bodies yet, that banning things just because they are not proven *yet* does not make sense to me. It would indeed be unethical to tell a client that research has proven that x works, when in fact doesn't, but to stop doing something that the client wants just because you don't have the evidence yet?"

Emmanuel- This is something that comes up a lot and I just want to make a clarification that apparently I did not make clear before. There is a big difference between something not being proven "yet" because it has not been researched (or there is a little research done on it that so far shows a positive indication for the need of further research on it) and something that has been researched and consistantly fails to show evidence of effectiveness (in repeatable, good quality studies). And on the "yet" note, there is no "yet" in research; if we knew what the outcome was going to be, what would be the point of doing it? We can make a hypothesis, have a predicted outcome, but there is no "it's not proven yet".

If something just has not been researched, or shows preliminary positive findings, then by all means- I would not completely scrap it (though in some instances maybe it would be more appropriate to use something "proven"- I think that needs to be judged on a case by case basis). That sort of instance is maybe a good time to try to find someone doing research in your area (or even not in your area!) and contact them and say hey- I've found this interesting effect in my practice, would you be interested in doing some research on it?". It's not a guarentee that a researcher will jump on it right away, but you never know if it would be workable in the near future (and maybe you could even be involved in it!).

The distinction is, there comes a point where something has been studied enough and consistently shows the same results (negative) and you could study it in different ways until the cows come home but you will never get different results (significantly)- so why waste valuable time, energy, and resources on continuing to study it?? Research takes a loooooong time. It is not a quick process at all. It also is expensive (to do it well). Just to give you a general idea of what goes into 1 single projoect- Chris and I developed a proposal for a project for my thesis. We started generating ideas last fall, and finally settled on a topic in late Jan/early Feb of this year. We wrote our proposal, submitted it to the MTF in March. We won't hear back about if we got it or not until probably June (lots of submissions take a lot of time to go through). If we get the grant, we start work in late August. We will begin screening participants (inclusion/exclusion criteria- all studies go through this process) in September. We will do the actual study (first trial) probably Oct-Nov. Begin to analyze data in Dec. Start the process over again in Jan, run participants Feb-March, analyze data in April, and finish the report in May-June, to aim for submission for publication in July. Total process: 19 months. For 1 study. Cost? $25-30k. So I ask again- why continue to study something already found in multiple instances to be ineffective when we could way better utilize time and resources on something that does show promising results?

I'll come back to the ethics of it later...have to go for now.
Comment by Emmanuel Bistas on April 14, 2010 at 8:57am
These discussions move so fast, one needs to be here full-time to keep up.

Since the topic here is "I don't get research" I should start by saying that I do get research, or more accurately, I get the value of research. I would love to see research that is done well, without agendas, and with an open mind. So, I agreed with Kim's original answer to Julie's questions.

Now the term "evidence-based" is emerging again along with comments about not using modalities that are not yet proven, and I am getting a bit uneasy.

There are so many things we do not know or understand about our world or our bodies yet, that banning things just because they are not proven *yet* does not make sense to me. It would indeed be unethical to tell a client that research has proven that x works, when in fact doesn't, but to stop doing something that the client wants just because you don't have the evidence yet?

Our work with our clients is defined as "client-centric", not "evidence-centric". We ought to "do no harm", "do much good", and "be of service", no? So, if as Stephen said you have a modality that intuitively you know it works, and as long as you stay within the scope of practice and obtain informed consent, and as long as you have the clients' best interests in mind, why not?

Kim mentioned cognitive dissonance about “beliefs that you currently hold are challenged by new conflicting information”. There is a lot of “new” information out there that is in conflict with many things we have studied in mainstream science. As an example, when I took Biology in college I was taught that we are products of evolution and the DNA contained the answers to our illnesses. Now, epigenetics comes into the picture and tells me that it is not quite so. An experience that a person has in their lifetime can impact their genes and their children’s genes, even if it doesn’t alter their DNA. How about that? What other experiences can impact our biology? Can faith affect our biology? Is there a predictable way to create the placebo effect? I want to know and it can only be done with research - again, research that is done well, without agendas, and with an open mind.

We are learning new things every day, I would hope that the search for evidence goes in all directions. I wonder if hundreds of years from now, those who are now called “woo woo” practitioners will be considered evidence-based and the M.D. who gave me the Vioxx samples for my shoulder pain will be considered a quack.

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