Massage & Bodywork

January/February 2011

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THE CASE FOR CASE REPORTS Writing and Sharing Your Research In my first Somatic Research column ("Massage Therapy: The Invisible Profession," January/February 2010, page 114), I put out a call for action. I challenged us to influence research by attending research conferences and engaging in dialogue with the investigators. I called on you to tell your clients' stories—to write case reports and get them published—so all could learn of our transformative and caring work. One year later, there is some evidence of progress, but we have a long way to go. While attendance more than doubled at the Highlighting Massage Therapy in CIM Research conference this year, as compared to 2005, the number of case reports submitted to the Massage Therapy Foundation (MTF) student and practitioner case report contests decreased. Only nine case reports were submitted to each contest, down from 21 in previous years. PubMed published 11 case reports on massage therapy in the past year—one written by a chiropractor, two by physical therapists, and two by traditional Chinese medicine practitioners.1 If research is to reflect the practices of massage and bodywork therapists, then we need to be contributing to the evidence base. I am heeding the call to make case reporting easy and compelling, and encourage you once again to rise to the challenge, tell your stories, and inform our profession's body of knowledge. I'll start by sharing why I am a proponent of case reports: I find this to be the perfect format for telling the powers that be (researchers, referring health-care providers, policy makers) who we are (complex and unconventional), what we do (more than just a back rub), why people choose us (we touch more than their physical pain), and how powerful intentional touch can be. It is a blessing not to be able to diagnose, leaving us free to see clients as human beings to partner with, whose stories lead us on a path toward wholeness, rather than only relating to the illness—something to name and conquer. Our stories will likely not focus on unusual conditions or describe novel treatment procedures, because our ordinary client approach is still unusual to many. Our job is to illuminate the reader of the totality of a massage or bodywork session. WHAT IS A CASE REPORT? Case reports consist of a detailed description of an individual client interaction, coupled with a literature review of research on similar subject matter. They tell of our day-to-day experiences and pose the questions we contemplate in our practices. The reports may focus on the norm— describing a typical client, assessment tools, or technique application, or they may tell of an unusual outcome or unique approach to a condition or disease. A case report that is well observed and linked to published literature can be valuable even if there is nothing unique in the details.2 Case reports stimulate learning and research and they complement evidence-based medicine.3 Practitioners can learn from each other's successes and failures without being in close proximity; internships are sorely lacking in our profession, making sharing knowledge through case reports even more critical. Results of a single case report cannot establish cause and effect, but they can lead researchers to do the kinds of studies that might. Most importantly, case reports develop critical thinking and problem-solving skills that hone our aptitude as practitioners. Case reports are considered anecdotal evidence, and as such, are less scientifically rigorous than controlled clinical trials involving a larger sample size. Proponents argue that case reports have scientific value due to their role in discovering new diseases and unexpected effects (adverse or beneficial), and educational value due to their descriptive nature. They are considered one of the cornerstones of medical progress and are encouraged in conventional medicine.4 New on the scene are interactive blogging sites, inviting health-care providers to submit their medical case reports and solve other cases.5 There earn CE hours at your convenience: abmp's online education center, 115

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