Massage & Bodywork

January/February 2011

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SOMATIC RESEARCH Case reports are considered anecdotal evidence, and as such, are less scientifically rigorous than controlled clinical trials involving a larger sample size. are an increasing number of peer- reviewed journals that are encouraging the submission of case reports (British Medical Journal, Elsevier) or have launched journals dedicated to compiling case reports (The Journal of Medical Case Reports, The Case Report Journal, The International Case Reports Journal). The call for contributions to the evidence base from individuals in the field is on the rise, across conventional and alternative disciplines. WRITING A CASE REPORT First, identify what you are curious about. Do you have a client with a particular condition that you would like to learn more about or are effective in relieving? Or are you more interested in knowing if others do what you do? Is there one aspect of a client interaction that interests you, or do you wish to tell the whole story? Narrow down your interests and identify the style that best suits the story you wish to tell. There are three presentation styles for writing case reports: educational, assessment, and treatment or management. Educational. These case reports illustrate common situations and are used to establish a baseline for practices. Individual aspects of a practice are described—intake procedures, assessment tools, treatment techniques, and homework assignments—for typical conditions so that atypical presentations have a comparison. This style is used to depict who we are, who our clients are, what we do, and how we do it. Outcomes are not the central focus of educational case reports. Basic information recounted with great detail is paramount and is used to build the foundation that defines our work. Assessment. These case reports describe and discuss analytical methods used to evaluate a client with uncommon conditions. This assumes there are documented standards of care for common conditions. In the case of many massage and bodywork disciplines, standard assessment protocols are not entirely defined. This opens the door for us to individually define the assessment tools and techniques we use for particular conditions—common or uncommon—so we can begin to culminate standard practices. This style of case report invites us to go beyond simply identifying the tools and techniques we employ, and pushes us to describe our clinical decision- making process: why we picked that tool and how it influenced our treatment plan. A good example of this type of case report is "Clinical Reasoning in Massage Therapy," by Kim LeMoon,6 which spoke of a series of interview questions that helped her identify the source of her client's pain, changed her treatment approach, and finally provided the client relief. Treatment or Management. These case reports are most common. A treatment- focused report follows a client through a session or series of sessions and describes everything from the client profile to the treatment outcomes. The client's condition is discussed, including a full literature search on the condition, symptoms, and common treatments. The treatment plan is identified and its implementation described in detail. Subjective and objective measurements from before and after the treatments are compared and outcomes are charted on graphs. Outcomes are the primary focus, detailing each step along the way. Several examples of this style can be found at www.massagetherapyfoundation. org/practitionercontest.html. All three styles of case reports can be written from either a prospective or retrospective approach. Prospective reports are conducted in real time. A client is identified, one that presents a particular challenge or represents a 116 massage & bodywork january/february 2011

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