Dissertationen zum Thema „Alternating Therapy“

Massage therapy is often used to treat musculoskeletal symptoms and to promote wellness. While evidence regarding its effectiveness is increasing, research related to actual practice and studies seeking to understand the mechanisms of massage therapy are needed. The purpose of this research was to describe the characteristics of massage therapists and their clients and to understand the role of communication in massage therapy outcomes. The first study examined the outcome expectations, expectancies, and behaviors of a random sample of massage therapists in Iowa (n=151) using a cross-sectional survey. The second study used a practice-based research design incorporating two samples of massage therapy clients (n=320 and n=321) to develop and validate a measure of client expectations of massage, the Client Expectations of Massage Scale (CEMS). The third study examined the influence of client expectations and massage therapists' interpersonal attractiveness on pain and satisfaction following massage. Social Cognitive Theory and Expectancy Violation Theory were used as frameworks to demonstrate how health behavior and communication theories can provide insight to massage therapy research. Results indicated that massage therapists had high expectations regarding the benefits of massage therapy and engaged in a variety of behaviors that reflect the clinical, educational, and interpersonal nature of massage therapy. In addition to using a variety of manual therapies, the massage therapists educated their clients in areas such as diet, stress management, and exercise to improve client health. Similarly, clients had positive expectations as measured by the outcome, clinical, educational, and interpersonal subscales of the CEMS. Positive outcome expectations predicted significant improvements in pain and serenity. High interpersonal expectations were related to negative changes in serenity. The third study revealed that high satisfaction was influenced by positive interpersonal attractiveness but more research is needed to understand the influence of client expectations being met on satisfaction. Initially high educational expectations, exceeded educational expectations, violated interpersonal expectations, and positive interpersonal attractiveness were related to less pain following massage. In conclusion, this research demonstrated that client expectations and massage therapist interpersonal attractiveness are important constructs to consider when evaluating the effects of massage therapy.

Syftet med denna studie var att kartlägga alternativa behandlingsmetoder för behandling av tidiga klimakteriebesvär, kring menopaus. Studien genomfördes som en litteraturstudie med beskrivande design, där tjugo vetenskapliga artiklar granskades. Resultatet visar fem alternativa behandlingsmetoder: akupunktur, yoga, fysisk aktivitet, naturläkemedel och fytoöstrogener. Både akupunktur och yoga gav en signifikant förbättring vad det gäller värmevallningar, nattliga svettningar, sömnkvalitet och livskvalitet. Med ökad fysisk aktivitet upplevde kvinnorna färre fysiska och psykiska besvär kopplade till klimakteriet och förbättring av allmänna välbefinnandet, ingen skillnad sågs vad det gäller vasomotorbesvär. När naturläkemedel och fytoöstrogener jämförts med placebo, ses möjligen en minskning av värmevallningar och nattliga svettningar, samt ökning av livskvaliteten med dessa olika preparat men samma förbättring ses i dessa studier även med placebopreparat. Ingen av de alternativa behandlingsmetoderna hade effekt på vaginalslemhinnan och förbättrade därmed inte de urogenitala besvären. Slutsats av denna litteraturgenomgång av alternativa behandlingsmetoder är att vissa behandlingsmetoder innebär en förbättring vad det gäller tidiga klimakteriebesvär och livskvalitet, men att flera behandlingsmetoder inte är mer effektfulla än placebo. Ytterligare forskning, med fler stora randomiserade kontrollerade studier är nödvändig för att se effekten av och utvärdera de för närvarande tillängliga alternativa behandlingsmetoderna. Ännu ett forskningsområde är att studera kvinnornas upplevelser av alternativa behandlingsmetoder.

The aim of this study was to describe complementary therapies for treating early climacteric complaints, around menopause. The study was conducted as a literature review with a descriptive design, where the author examined twenty scientific articles. The result shows five complementary therapies, acupuncture, yoga, physical activity, herbal medicines and phytoestrogens. Both acupuncture and yoga significantly reduced hot flushes and night sweats, they also improved subjective sleep quality and quality of life. Increased physical activity made women report fewer physical and psychological symptoms attributed to menopause and improved general well-being, but it had no effect on vasomotor symptoms. When herbal medicines and phytoestrogens have been compared with placebo, they all showed a similar small relief of hot flushes and night sweats and improvement in quality of life. None of the complementary therapies showed effect on vaginal tracts and did not improve urogenital symptoms. The conclusion from this literature review is that some complementary therapies show improvement in the early menopausal symptoms and quality of life, but some treatments are not more powerful than placebo. Further research, with larger randomized controlled studies are necessary, both to see the effect of the currently accessible alternative treatments, but also to examine how women perceive the impact.

Syftet med denna studie var att beskriva effekten av alternativ och kompletterande kommunikation för personer med autism. Metoden som användes var en litteraturstudie där 11 vetenskapliga studier användes som underlag till resultatet. Resultatet visade att personer med autism bl.a. kan utveckla sin symbolförståelse, sitt spontana tal samt öka antalet ord vid användandet av alternativ och kompletterande kommunikation. Några av barnen visade även på en positiv utveckling av förmågan att generalisera sina kunskaper till andra situationer och kommunikationspartners.

Resultatet av denna litteraturstudie bör inte generaliseras till andra person än de som ingår i studierna då deltagarantalet är lågt och deltagarna befinner sig på ungefär samma kommunikationsnivå.

Students with autism spectrum disorder (ASD) have challenges with communication, social interactions, and behavior, which can limit their functioning in school settings. They need to have functional communication skills to access the curriculum and have their needs met across all social environments. Special education teachers often experience barriers to successful implementation of augmentative and alternative communication (AAC) interventions appropriate for these students. The purpose of this case study was to understand how special education teachers experience AAC intervention processes, and illuminate the conditions for effective AAC implementation. A qualitative case study was conducted using interviews from 6 credentialed special education teachers who worked with ASD students for a minimum of 2 years in a school district in a western state. Coding and thematic analysis of data from interviews and work journals was conducted using Ely’s condition of change theory as a framework. Findings for teachers’ perspectives of conditions needed to successfully implement an AAC intervention reflected the need for more time, resources, knowledge and skills, and investment from stakeholders. Recommendations included provision of resources to special education teachers for autism specific materials, on-going autism specific training and assistance, additional time for preparation and related duties necessary for working with these students. Future research on overall strengthening of AAC interventions and overcoming challenges for change is needed. Results of this study might assist schools in empowering ASD students by facilitating their functional communication skills, involvement, learning and academic opportunities across social environments.

Alternative education students face many interacting challenges that put them at significant risk of dropping out of school (Carver & Lewis, 2010), as well as deleterious health and psychological outcomes, and intergenerational cycles of sociopolitical disadvantage (Laird, Kienzel, Debell & Chapman, 2007). Despite the persistent national epidemic of school dropout, few studies have investigated treatments for alternative education students, often characterized as “difficult to reach” given the chronic substance abuse, low motivation, and poor attendance typical of this population (Rumberger & Lim, 2008).

This study investigated the effectiveness of a novel music therapy intervention, Recorded Music Expressive Arts (RMEA), with alternative education students. The purpose of RMEA in this context was to engage students in a potentially motivating, culturally relevant treatment that satisfies identified provisions to ameliorate dropout (Kim & Taylor, 2008). RMEA employs narrative therapy concepts as a framework for treatment, and integrates songwriting, music production, and recording into psychotherapy. Through the song-creation process, participants were encouraged to “tell their story” to re-author problem-saturated personal narratives and discover more self-affirming ways of being (White & Epston, 1990).

Participants were 10 adolescent boys, age 14–18, attending an alternative education school in the San Francisco Bay Area. Ten 60-minute individual RMEA sessions were delivered twice weekly over 7–19 weeks. Pre/post data was analyzed using Vargha-Delaney’s A. Large effect sizes were found for a) coping (problem focused engagement, cognitive restructuring, problem solving, and emotional expression); b) substance misuse (decreased marijuana use) and co-occurring psychological disturbances (decreased school and behavior problems); c) increased contemplation and action readiness to respond to intervention; d) behavior (decreased internalizing, behavior, learning problems, and suspension rates); and e) attendance (increased attendance for RMEA sessions and days on which RMEA was delivered). Overall, the results indicate that RMEA is a viable and effective treatment for alternative education high school students. Analysis of participant interviews and song content further support results, as well as RMEAs proposed therapeutic mechanisms of action, including narrative therapy concepts. Findings highlight the need for replication studies with larger sample sizes, inclusion of adolescent girls, and other alternative education school settings.

Live music is a popular activity that many adults attend regularly. Qualitative research on live music from a listener’s perspective and the meaning it brings to individuals’ lives is lacking. The purpose of this heuristic inquiry was to investigate the lived experience of attending live-music events from the perspective of adult concert-goers between the ages of 18 and 65 years. This phenomenon was explored through the primary research question, “What is the experience of attending live-music events?”

Eight co-researchers were selected to participate via a convenience sample recruitment strategy. Data was collected via open-ended interviews and analyzed through stages following the qualitative method of heuristic inquiry (Moustaskas, 1990).

Three main themes were found to be the core essence of the live music experience: (a) live music connects people deeply; (b) live music is a full body experience; and (c) live music can be transcendent. An increased energy or vitality was evident before, during, and after the live-music events. Co-researchers used these repeated experiences to release, renew, and recharge the positive emotions, and mental resources that they would in turn bring back to their everyday lives.

Findings from this research suggest that listening to live music is a mind-body-spirit practice that can be used by individuals to connect deeply to themselves, others, and something greater than what they know. As an inherently pleasurable activity, live music influenced people’s ability to be open-minded and appreciative for what they have in life. The experience positively impacted the participants physically, mentally, emotionally, and spiritually, which may have implications on overall well-being.

This is the first qualitative study that demonstrated ways in which people can participate in live-music events as a method of self-care to enhance their sense of well-being through meaningful connections, mind-body awareness, and transcendent experiences. Future research studies should examine the effects of live music on overall health outcomes and components of well-being. Keywords: live music, well-being, transcendence, appreciation, mind-body-spirit practice

Back problems continue to be a leading cause for disability in all of medicine and are the number one symptom disorder for consulting integrative medicine practitioners. Feldenkrais® practitioners aim to clarify new functional interrelationships towards an improved neuroplasticity-based change in the cognitive construct of one’s own background body schema. These phenomena have been found to clinically correlate to chronic pain through concurrent distortions in the reorganization of usual sensory-motor cortical representations in the brain – being further associated with altered body perception (Wand, et al. 2016). The Feldenkrais Method ® (FM) is a comprehensive approach being manifested through manual sensory contact (FI®) techniques and movement experiences (ATM®) and has been anecdotally purported to improve symptoms and functions in Chronic Non-specific Low Back Pain (CNSLBP). However, there is little scientific evidence to support superior treatment efficacy.

A Randomized Controlled Trial compared a novel Virtual Reality Bones™ / Feldenkrais® Movement (VRB³/FM) intervention against more conventional protocols for Core Stabilization Biofeedback / Motor Control Exercises (CSB/MCE). The (VRB ³)™ treatment component consisted of full-scale skeletal models, kinematic avatars, skeletal density imagery, temporal bone-vestibular system relationships, and haptic self-touch techniques being aimed to re-conceptualize participant’s prior notions and beliefs regarding body schema and low back pain (LBP). N=30 participating patients with CNSLBP were assigned to either the experimental group (VRB³/FM @ N=15) or the control group (CSB/MCE @ N=15). Known confounding biopsychosocial variables were controlled via stratified-random assignment on the FABQ. Treatment Outcome measures included VAS-PAIN, RMDQ, PSFS, and Timed Position Endurances Tests – including Flexion / Extension Ratios at baseline, 2-weeks, 4-weeks and 8-weeks. Statistical Analysis was conducted using Wilcoxon Rank Sum and paired, two-tailed t-test. Results showed that the VRB³/FM group demonstrated greater improvement in all treatment outcome measures as compared to the matched CSB/MCE control group.

This is the first RCT study to demonstrate that a Feldenkrais Method® based approach being combined with Virtual Reality Bones™ can be more efficacious for the treatment of CNSLBP than the current and accepted physical medicine standard of isolated Core Stabilization Biofeedback / Training and Motor Control Exercises. Future multi-site RCT studies with larger sample sizes are therefore recommended.