Sunday, November 12, 2017

Measuring the Effects of various Manual Therapy Interventions

Here's my response to a reader who is interested in "Measuring the Effects of various Manual Therapy Interventions".

People typically get Manual Therapy to 

*  Increase mobility/flexibility and/or to
*  Reduce Pain.

The reader pointed out - The Effects of various Manual Therapy Interventions typically cannot be tested/measured using cadavers or computer modeling, and often there is no valid “sham” therapy to measure against.

Let's look into this....

First let's start with a few references....

* Standardized Outcome Measures in Manual Therapy

* Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial - Commentary: Bootstrapping simplifies appreciation of statistical inferences

* Assessment tools for OT

* Guide to Outcomes Measurement for Patients With Low Back

The effectiveness of manual therapy, physiotherapy and treatment by the general practitioner for chronic non-specific back and neck complaints

Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial

Patient-Reported Outcome (PRO) questionnaires for people with pain in any spine region. A systematic review

Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care

Physical Therapy Evaluation and Management of the Shoulder Complex

Effectiveness of Manual Physical Therapy for Painful Shoulder Conditions: A Systematic Review

Efficacy of Manual Therapy

The Science and Practice of Manual Therapy - body language

Immediate Changes Following Manual Therapy in Resting State Functional Connectivity As Measured By Magnetic Resonance Imaging (fMRI) In Subjects With Induced Low Back Pain

 * Placebo response to manual therapy: something out of nothing?

Based on the above...."Measuring the Effects of various Manual Therapy Interventions" might be accomplished by....

*   Ask the patient whether the manual therapy is effective or not.  Listen to their story/narrative.  Observe body language.  Perhaps, use questionnaires.  

*  You can use more sophisticated efficacy measurement tools like fMRI, but these are usually out of the reach of most practitioners.  Stress/Pain Measurement Tools like those used in Biofeedback can be used to test relaxation level (skin conductance and/or heart rate variability).  Since stress/tension increases muscle tightness and increases pain, probably anything to reduce stress/anxiety will help therapy effectiveness

*  The Therapist could increase the perceived effectiveness of the therapy by words/actions.  This is due to enhancing the inherent Placebo Effect, which is a part of any health intervention. 

*  Lastly, if the perceived or measured effectiveness is slow going or non-existant, please consider psychological/emotional reasons for the chronic patient - "Are You “Sick and Tired” of Being “Sick and Tired”?" - Especially see questions therein.

*  I'm sure there are more ways to measure efficacy of Manual Therapy.  Perhaps the Measurement/Testing Modalities of related Health/Medical Interventions might be useful to measure the efficacy of Manual Therapy, too.  Please add your comments to add to this discussion.


Article is for information only and is not medical advice.  See full disclaimers at TG Ideas LLC.

Thursday, October 5, 2017

Has anyone had their Medicines Blessed to Make Them Seem to Work Better?

Some churches bless pets, houses, boats, etc.  Why not Medicines? - Especially on a Regular Basis, e,g. Weekly, As needed, etc.

Action - If you like this idea, ask your Religious Leader to Bless Your Medicines and Hope the Medicines DO indeed work better.

You might find it work better to have a Religious Leader bless your medicines, instead of yourself.  Your Religious Leader probably has more Healing Power than you do.

By blessing medicine, what do you/we have to lose? Nothing?  
And what might you/we gain? - Relief from Symptoms? 


I could find all kinds of blessings for all kinds of things, but not much for medicine, treatments, etc.

Could this be an overlooked Alternative/Complementary Healing (CAM) Modality?

Yet, It might be extra powerful, invoking both a Spiritual component, as well as a Placebo Effect Component - working in Unison!    
God probably works in many ways - in the Medicine/Treatment itself and the Belief that the Medicine/Treatment will work....or even work better after blessing.

Might this work for the current Opioid Crisis ? - making Pain Medicine seem to work better and thus reduce medicine usage?

By blessing medicine, what do we have to lose?  And what might we gain?  

I wouldn't think doctors would have any ethical concerns, since the doctors wouldn't be doing the blessings.  Of course, patients should advise doctors of what they are doing.  
Wouldn't it be great if a Patient's Doctor participated in the Blessing Ritual?

Wouldn't this be a great Value-Added Option for Religious  Based Hospitals, Clinics, etc.?  Combining Faith Healing with Traditional Medicine, for those patients who are interested in this powerful combination.


References -  

Blessings for things

Prayer for Taking Medication

Efficacy of prayer - Medical Views


Anointing of the Sick

Blessing of the Throats

"A survey released in May 2004[71] by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health in the United States, found that in 2002, 43% of Americans pray for their own health, 24% pray for others' health, and 10% participate in a prayer group for their own health." - from Prayer


Prayer When Taking Medication or Chemotherapy


Disclaimer - Article is for Information only and is not Medical Advice.




Thursday, September 14, 2017

Thursday, January 12, 2017

Managing "Morbid Fears", "Irrational Fears", or Phobias

Definition - A phobia is a type of anxiety disorder, defined by a persistent fear of an object or situation.  The word phobia comes from the Greek: φόβος (phóbos), meaning "aversion", "fear", or "morbid fear".


Here are some resources to that might help manage morbid fears or phobias:

Internet Links....

  1. Phobias: Causes, Symptoms, and Diagnosis - Medical News Today and
  2. The Phobia List

  3. The Treatment of Phobias - The Phobia List

  4. Understanding Phobias -- Treatment - WebMD

  5. Phobias - Treatment - NHS Choices

  6. Phobias and Irrational Fears: Symptoms, Treatment, and Self-Help for ...

  7. Iranian Journal of Psychiatry and Behavioral Sciences - Short-term ...

  8. Dealing with a Fear of Death - Uncommon Help

  9. A cure for social anxiety disorders

  10. Social anxiety disorders? Cognitive therapy most effective treatment

  11. The Many Treatment Methodologies for Phobias: Finding the Best Fit ...

  12. Reducing Fear Without Fear Itself

  13. NLP Technique | Fast Phobia Cure

  14. Phobia - Hypnotherapy 

  15. PressTV-Scientists use Virtual Reality to treat phobias

  16. Overcome a Phobia With Self Hypnosis - Health Guidance

  17. Thames Medical Lectures - Phobias Script for Clinical Hypnosis ...

  18. Hypnosis Scripts for Fears & Phobias | Hypnotic World

  19. Phobia Hypnosis Scripts | Hypnosis Tutorials

  20. The Effect of Play Therapy on Phobia in 5-11 Years Old Children Who ...

  21. Prevalence of social phobia disorder in high school students in Abhar ...

  22. Effect of Meta-Cognitive Therapy on Self Assertiveness Skill in ...

  23. Full Text (PDF) - Iran Red Crescent Med J - The Effectivenessof Mindfulness-Based CognitiveTherapy on Iranian Female Adolescents Suffering FromSocial Anxiety


  1. Cognitive-behavioral Group Therapy for Social Phobia: Basic Mechanisms and Clinical Strategies by Richard G. Heimberg, Robert E. Becker, Guilford Press, 2002 
  2. Handbook of Phobia Therapy: Rapid Symptom Relief in Anxiety Disorders by
    Carol G. Lindemann, J. Aronson, 1989 
  3. Phobia: the facts, by Donald W. Goodwin, Oxford University Press, Incorporated, 1983 
  4. The Anxiety and Phobia Workbook, by Edmund Bourne,
    New Harbinger Publications, 2011

Disclaimer - Article is for information only and is not medical or legal advice.

Wednesday, December 24, 2014

Four Powerful Concepts to Maximize Healing

Doctors, Please Consider Combining These Four Powerful Concepts to Maximize Your Patient’s Healing

Patients, Are You Getting the Best Treatment from Your Healthcare Professional?

Whether doctors and patients like it or not, there is a mind-body interaction. Healthcare professionals can leverage this interaction for enhanced healing.
As a healthcare professional, please consider these concepts to improve total diagnosis and treatment: 

1. Knowledge and Medical Skills
2. Bedside Manner
3. Maximize the Placebo Effect
4. Minimize the Nocebo Effect 

Knowledge and Medical Skills are taught very well in medical schools. Little need be said on this concept. It is the basis of many medical practices. 

Bedside Manner is becoming more important as many practices are becoming consumer driven. Perhaps some healthcare professional have inherited good bedside manner. Others might want to learn. Some medical schools are combining "people skills" along with the usual curriculum. For those who want to learn more, some references are listed at the end of this article. In addition, here are good Internet search strings for even more information:
  1.  listening-skills (patient OR doctor OR nurse)
  2.  body-language (patient OR doctor OR nurse)
  3.  (listening-skills OR body-language) tutorial
  4.  (listening-skills body-language) tutorial
Most healthcare professionals do not consider Placebo/Nocebo Effects, though these effects are as powerful in many cases as medicine and treatment. Again, good techniques can be learned. General references are at the end of this article. To find more information on the Internet, use these search strings:
  1.  placebo-(effect OR response) (words OR wording OR ritual OR enhance OR maximize) (patient OR doctor OR nurse OR physician)
  2.  nocebo-(effect OR response) (words OR wording OR ritual OR minimize OR diminish) (patient OR doctor OR nurse OR physician)
Use of these four concepts is somewhat of a judgment call by the practitioner. Some patients want only the facts and expertise. Some patients respond more to Bedside Manner. Some respond to Placebo/Nocebo whereas some do not.
Patient-Doctor communication is bilateral. As people-skills are learned and practiced, doctors can pick up the patient's body language combined with listening to them. From that, the doctor or nurse can decide how to adjust his or her own words, body language, and actions. Maybe someday, there will be "Emotional Stress Indicators" on patients to help the doctor decide whether they are helping or hurting the patient.
Medical practice is evolving. As much as there is hope for patients, there is hope for doctors and nurses willing to consider and learn new concepts and skills.
  1.  Patient-Doctor communication is becoming more and more important, as healthcare becomes more consumer-driven.
  2.  Bedside Manner, Placebo Effect, and Nocebo Effect can all be leveraged for enhanced and sustained healing. The progressive and caring healthcare professionals can learn all these.As a patient, find a practitioner that fits you as a person. Ask around, explaining what is important to you, as a health care consumer. Give each practitioner a fair chance, but do your part to communicate your needs and wants. Healthcare professionals are not "Mind-Readers".
For more information: 
  1.  Bedside Manner 
  2.  Can Better Bedside Manner Be Taught? 
  3.  Bedside Manner: Concept Analysis and Impact on Advanced Nursing Practice 
  4.  Patient-Physician Communication: Why and How 
  5.  Bedside Manners: One Doctor's Reflections on the Oddly Intimate Encounters Between Patient and Healer by David Watts, M.D., Random House Digital, Inc., 2006
  6.  Listening to Patients: A Phenomenological Approach to Nursing Research and Practice by Sandra P. Thomas, PhD, RN, FAAN, et al., Springer Publishing Company, 2004
  7.  The Power of Hope: A Doctor`s Perspective by Howard Spiro, Yale University Press, 1998
  8.  The Placebo Effect: An Interdisciplinary Exploration by Anne Harrington, Harvard University Press, 1999
  9.  Program in Placebo Studies and the Therapeutic Encounter hosted at Beth Israel Deaconess Medical Center 
  10.  Specific Components of Bedside Manner in the General Hospital Psychiatric Consultation: 12 Concrete Suggestions 
  11.  As a Healthcare Professional, Are You Checking All the Vital Signs to Evaluate Total Patient Condition?
  12.  Medical Monitor with an Emotional Stress And/or Pain Indicator

Disclaimer - Article is for information only and is not medical advice.

Monday, September 22, 2014

End Homelessness by Using the New Healthcare Options in the U.S.

6 Best Ways to End Homelessness by Using the New Healthcare Options

Stop Talking About Homelessness and Start Helping the Homeless Help Themselves

Many, if not all of us, are "one serious accident", "one serious illness", "one economic downturn" away from being homeless. 

Imagine yourself having Alzheimer's and homeless. You might or might not know you need medical help. Even if someone told you that healthcare was now available, you might not even understand him or her or have the physical ability to enroll in this new health option. 

This is the plight of many homeless. They might know about the new health options, but do not know how to enroll. Some homeless are "so out of it", for whatever reason, they cannot understand or comprehend they have new healthcare options. 

Thus, creates a service opportunity for average people to help the homeless help themselves. Most homeless do not choose their lifestyle. Many are afflicted with physical or mental conditions that restrict their choices in life. Maybe they want to do better in life, if only they had the health they so long wanted, but was out of reach to them. 

Below are six suggestions for people, just like you and me, to help implement Affordable Health Care for homeless people. Your efforts might very well end or prevent homelessness for one or more persons. Even your tiniest effort will probably help. 

  • Do not try to go it alone. Some homeless people might be very desperate, and maybe dangerous. Work with a team of some sort.
  • Try not to re-invent the wheel, e.g. creating your own flyers, etc. Find out what others are doing and maybe volunteer your time, efforts, and expertise.
  • Ask first before you do something. Your best-contrived efforts might not help at all and maybe even hurt. Bounce your ideas off like-minded people and see what they think.
  • Do not get discouraged. There is a lot of opposition to this new health care option. Do not let them get you down. You are working for the homeless and they do not have many options. You can make a positive difference in someone's life. Try it and see how it goes. Your reward might be the smile on someone's face as the person light up with renewed hope.
  • Learn about the new healthcare options in the U.S. The links below might be enough to get started. Your local library can help you "find more like this". In addition, your local library can offer additional suggestions how you could help locally where you live. Become familiar with the existing tools to aid in enrollment. Check out the "Enroll America" link below. Review the "Affordable Care Act Resource Kit", especially the section on "Take Action in Your Region, State and Community". Review the "Official Resources", especially "Other Partner Resources", to find promotion materials.
6 Best Suggestions - Pick one or more and start today!
  1. Ask at your local Homeless Shelter how you can help with the Affordable Care rollout. Tasks might include providing transportation, making and distributing flyers, informing the homeless of their new health care option, etc.
  2. Ask government officials how you can best help the homeless get the new Affordable Health Care.
  3. Build on the work of "Healthcare for Homeless Veterans (HCHV) Program". Collaborate with them and learn their best practices. Even if VA covers veteran's healthcare, spouses and dependents generally are not covered by VA benefits. Hence, the rest of the family still needs healthcare coverage.
  4. Teach your children and/or students about how the new Health Reform has great potential to end or prevent homelessness. Maybe they want to help in some way and need adult supervision. The students, themselves, might be in a homeless situation or know of someone who is. Teaching resources have been developed and are included in the references below.
  5. Share your experiences with others, so others can learn from you. You might find better ways to Enroll America. You might not end homelessness, but at least you know you have done all you can to provide an opportunity for others to receive affordable healthcare.
  6. On an ongoing basis, encourage poor or homeless people to use their healthcare opportunities. Show them how to help themselves. Suggest they get the help they need. If their health improves, maybe their homeless situation will take care of itself. When people feel better on the outside, they feel better about themselves on the inside, and want to help themselves. Someday those same people might help others help in similar situations.
  • The "Affordable Care Act" and newly expanded Medicaid have great potential to decrease homelessness.
  • Average people like you and me, can help Homeless Americans learn about their new health care options, help them enroll, and encourage them to participate in their own health care. By doing so, you are helping others help themselves.
For more information:  
Homeless Healthcare - Past, Present, and Future
How to Prepare and Take Action to Help the Homeless with Healthcare
Assistance in Actual Enrollment
Disclaimer - Article is for information only and is not medical or legal advice. Seek professional assistance as needed or wanted.

Sanfilippo Syndrome - Information and Resources

Here is What You Can Do About Sanfilippo Syndrome

Sanfilippo Syndrome - Information and Resources

Sanfilippo Syndrome might not mean much to most people. It means a lot, though, to those children and parents who are affected by this rare illness. The children's names might be Ben, Missy, Reed, Jonah, or maybe a name few can pronounce. 

Sanfilippo syndrome is a rare metabolic disorder that is passed along in families. It is caused by an enzyme deficiency. More information is below, but the essence of all this is the child withers away. At the time of writing this article, however, there are some new and promising treatment options. 

This article is meant to give hope by summarizing some of the resources available for Sanfilippo Syndrome. 

Once diagnosed with this Syndrome, here are some steps family-members can take to become informed, find others who have the same illness, alleviate discomfort, and maybe improve healing potential.
  • Of course, work with the health care professionals you have available. In addition, keep an open mind to Alternative and/or Complementary Therapies.
  • Connect with others who have experience with this Syndrome. Some Support Groups are listed below.
  • Set up an Internet Alert Service, e.g. .Google Alerts, to notify you of recent advancements. A Good Internet Search String is below.
  • Do your own research, in hopes of finding something new or overlooked. Share your findings with others, so that you all can build on each other's research. Libraries can help you find information, people, organizations, etc. Connect with the closest Medical Library. Find a library that you like working with, since there might be more than one in your locality. Connect with one, even if you aren't from that country or area, since most are very willing to help all. Whatever question you have they can help. Don't hesitate to ask, no matter what.
  • Do not give up hope. There is always something new "just around the corner". You might not have answers now, but you are doing all you can. Hang in there. It means a lot to a child just knowing they are loved and accepted, just as they are.
  • Sanfilippo Syndrome is a difficult condition, both for the child and the parents or caregivers.
  • There might not be many answers now, but a new treatment might be coming soon, that your doctor might not even know about.
  • There are action steps you can take to help your child and yourself, make the best of the situation.
For more information:
General Information - Sanfilippo Syndrome
Good Internet Search String - ("Sanfilippo syndrome" OR "Mucopolysaccharidosis III" OR "MPS-III")
Find a Medical Library near you in the U.S., Canada, and some other countries. Also List of Library Associations around the world.
Support Groups:
RareConnect - Sanfilippo Syndrome - Also, see links to other helpful resources.
New Patents/Applications:
Disclaimer - Article is for information only, and is not medical advice.