The Effects of Combined Tui Na and Sports Massage on Overuse Knee Injury Recovery - Essay Example

I. Plan Working The Effects of Combined Tui Na and Sports Massage on Overuse Knee Injury Recovery Contents Page Aim 2 Objectives 2 Introduction 2 Aetiology and Incidence 3 Clear Identification of Topic 3 Identification of Sports Therapy 4 Evidence of Negotiation with Practitioners for Access 4 Action Plan 5 Timetable 5 Contingency Timetable 5 Selection of Appropriate Research Methodology & Justification 6 Design of Data Collection Instrument 7 Additional Resource Material 7 Identification of Resources/Information to Complete Project 7 II. Development 8-9 III. Evaluation 9-12 References 13 Appendix 15 Aim It is expected that participants treated with a combination of Tui Na and sports massage for an overuse knee injury will have a greater degree of recovery as compared to those who receive only sports massage. It is anticipated that the proposed research shall answer the primary research question: Does Tui Na in combination with sports massage has a positive effect on the recovery from sports injury Objectives This research had two primary objectives: 1) To determine the actual effects of Tui Na in combination with sports massage to aid overuse knee injury recovery. 2) To contribute to the broader field sports therapy. Introduction Sports therapy is an essential discipline in 21st century society, as people grow in their awareness of the biopsychosocial impacts of sport, health and fitness, on personal and community well being (Benjamin & Lamp, 2005). The increased demand for sports massage to aid recovery and to enhance performance has been dramatic over the past two decades. Sports research points to rigorous studies in order to determine the best forms of sports massage to maximize the benefits to the health and well being of people taking part in sports (Martin, Zoeller, Robertson, & Lephart, 1998; Jonhagen, Ackerman, Eriksson, Saartok, & Renstrom, 2004). Tui Na, a form of Traditional Chinese Medicine massage may be a viable complement to traditional sports massage used in the West. Aetiology and Incidence Overuse knee injury is commonly referred to as patellofemoral syndrome, to describe pain on and around the kneecap (patella). It is most commonly the result of damage to the surface underneath the kneecap, through a blow or fall, of from continuous rubbing on the bone underneath (Devan, Pescatello, Faghri, Anderson, 2004). Other names for the injury are chondramalacia patellae, patella pain syndrome or runner's knee. If the injury is not treated that it becomes a chronic condition that does not respond well to recovery methods. The pain can originate from over-tightness of the illio-tibial band (ITB), with the tendon rubbing on the knee bone. As a result the patella does not move or track correctly when the knee is bent from being outstretched (i.e., it does not move toward the inside surface of the knee) to position correctly in the intercondylar notch of the femur. The cartilage under the patella can become damaged, and the ITB inflamed. It is a common injury for runners aged 10-20 years. It is also more likely for those who have small kneecaps, or those whose feet roll in (pronate). Weak quadriceps muscles can increase likelihood of experiencing the condition. There is increased incidence among long distance running and hill running athletes, or those who have had previous knee injury. Clear Identification of Topic Sports massage can help stretch the ITB, as tight knots within the tendon may be causing it to shorten. Soft tissue and deep friction massage are traditional sports massage techniques to aid in stretching the ITB, as well as myofascial releasing techniques. In contrast, Tui Na treats the whole body by working on meridians (energy channels) that are connecting the body's organs with acupressure points. Tui Na uses rolling massage techniques and deep thumb pressure on the meridians, as well as vigorous motion. This form of massage focuses on "Qi" the universal life force energy, and so works at a deeper level to aid injury recovery. However, there is limited literature as to the benefits of Tui Na in combination with sports massage to aid recovery of overuse knee injury. Identification of Sports Therapy Tui Na is an ancient healing art and a hands-on technique implementing combinations of acupressure, acupoint identification, soft tissue massage and bonesetting techniques (Oyayo, 1997). Literature shows that Tui Na prevents and treats sports injury by applying manual methods to remove obstructions in the meridian pathways (energy channels) by promoting the increase of universal life force, Qi, and blood circulation. This can aid the recovery of soft tissue injuries by way of modifying the functions of the internal organs and nerve regulation, as well as joint mobility and flushing of wastes from cellular tissue. The massage is grounded in the philosophy of Tao, which advocates awareness as opposed to rigid adherence to logic and rational theories (Oyayo, 1997). There is a definite lack of literature evaluating the effects of Tui Na in combination with sports massage (Hu & Wang, 2003; Jun, Xi-Lin, & Jun-Tao, 2007; Merceti, 1997; Mills, Allen & Morgan, 2000; Wu, Zu, & Gong, 2007). Evidence of Negotiation with Practitioners for Access. A letter to negotiate access with the practitioners of . was mailed out, with a follow-up phone call to provide comprehensive details of the study (see Appendix). Action Plan Timetable Contingency Time Plan Selection of Appropriate Research Methodology & Justification This study will use a pre-post experimental design. As this study will use random allocation of participants to groups it is considered to be an experiment. It is hypothesized that an independent variable causes changes in a dependent variable, and that alternate hypotheses can be provided by other factors that are able to influence the results. The design randomly allocates participants to two or more groups (i.e., treatment group/s and a control group) (Tabachnick & Fidell, 2007). Due to these random procedures, experimental methods allow for generalization of results to a wider population, as the sample is more likely to be representative of that population. Purposive sampling will be used to recruit participants as it can effectively group participants according to criteria selected before the research begins (Patton, 2002). Purposive sampling is a popular method, as the sample size does not have to be fixed before the project begins. It is provides an advantage for this study as the sample size is constrained by time and available resources (Mack, Woodsong, MacQueen, Guest & Namey, 2005). Snowball sampling is a common purposive technique, often termed as chain-referral sampling. Participants tap into their social networks to refer potential participants to the researcher (Mason, 1997). People taking part in sports that have experienced overuse knee injury within the last two weeks. The sample will be across gender, ages, ethnicities and sporting activities. Design of Data Collection Instrument A survey was developed for this study using a combination of yes/no, and open questions to gather demographic information (i.e., gender, age, ethnicity, sporting areas), and Likert scale items for perceptions of pain and sporting ability, as well as attitudes towards the use of massage therapy as an aid to recovery. The survey consisted of 10 questions on 5-point Likert scales. Additional Resource Material Secondary data will also be used to develop the literature review of this research and to inform conclusions drawn from analysis of results. Secondary data can be defined as information collected by researchers that are used for purposes other than its original intention (Saunders, Lewis, & Thornhill, 2005). Secondary data collection can be either qualitative or quantitative. Secondary data can be used as a research method for comparing studies on a given topic (Padget, 2004). In its qualitative form, data is collected from diaries, newspapers, letters, general literature and novels as well as hand-books and policy statements (Padget, 2004). In its quantitative form secondary data is sourced from published statistics such as government documents and research journals, professional bodies, data archives and the Internet. Identification of Resources/Information to Complete Project Resources would include; use of a computer and the Internet; a therapy room; massage table; powders and oils for massage/acupressure; paper and photocopying facilities. II Development The practitioner at was contacted and their permission obtained to undertake the study at their facility. Flyers were posted on the facilities notice board, and in their weekly newsletter to recruit participants with overuse knee injury. Also notices were posted at local sporting clubs, in their newsletters and a post in the local paper to recruit as many participants as possible. Ultimately 7 men and three women of Anglo ethnicity participated, their ages ranging from 28-45 years, with a mean age of 33 years (SD = 12 years). Two of the participants ran only for exercise (6 km a day), and the rest of the participants were triathletes, training ranging from 25-25 km a week of running. Each participant was informed of their rights as a participant (anonymity, confidentiality and voluntary withdrawal) and signed an informed consent form that was stored separately to their responses on the questionnaires. Each participant was then randomly assigned to either a combination of Tui Na and sports massage therapy (n = 5) or to a group that received only sports massage (n = 5). They completed the pre-questionnaire and then underwent their assigned treatment for a 3 week period, having therapy once a week for one and a half hours. Sports massage therapy included: Soft tissue massage of the ITB: Broad-handed techniques, sustained pressure and friction techniques. Deep friction massage of the ITB: Transverse friction, trigger point therapy, myofacial therapy, deeper sustained pressure. Stretching of the ITB: Static stretches, and proprioceptive neuromuscular facilitation (PNF). Tui Na massage therapy included (Oyao, 1997): Ma (slipping): The palmar aspect of the thumbs was placed on the skin and then slipped back and forth, to the left and right around the ITB. An Rou (an = pressing; rou = stationary circular movement): The acupoints are pressed by the thumb, palm or digital joint with gradually increasing pressure. The direction of the force is perpendicular to the ITB. The pressure is let go and then applied again to massage the deeper tissues. Stationary circular movements were then made. The three leg yang meridians (stomach, gall bladder, bladder), and the three leg yin meridians (spleen, liver, kidney) were the acupoints. Each participant then completed a post-questionnaire which was identical to the pre-questionnaire. Following the three week study all participants were thanked and told about the reasons behind the research. They were also informed of a website on which they could access a summary of the results of this study following its being handed in. The practitioner of the facility where the research was undertaken was also thanked, and it is believed will they will remain a firm contact within the investigators network of practitioners for future consultation, advice and liaison. III Evaluation Total scores on the questionnaires revealed that a combination of Tui Na and sports massage was significantly different to that of sports massage alone on the post questionnaire, t(9) = 3.12, p< 0.05. The comparison of post-test means for each group is displayed in Figure 1. Sports Massage Combination Groups Figure 1. Graph of means for post-questionnaire. Overall, there was a significant difference between pre and post questionnaire scores across the groups, t(9) 5.27, p Read More