Complementary Therapies for Physical Therapy: A Clinical Decision-Making Approach

340 Pages·2007·8.3 MB·English

by  Judith E. Deutsch PT PhD

11830 Westline Industrial Drive
St. Louis, Missouri 63146
COMPLEMENTARY THERAPIES FOR PHYSICAL THERAPY: ISBN-13: 978-0-7216-0111-3
A CLINICAL DECISION-MAKING APPROACH ISBN-10: 0-7216-0111-1
Copyright © 2008 by Saunders, an imprint of Elsevier Inc.
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responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient,
to determine the best treatment and method of application for the patient.
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ISBN-13: 978-0-7216-0111-3
ISBN-10: 0-7216-0111-1
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Contributors
Ellen Zambo Anderson, PT, MA, GCS Gary L. Goldberg, PhD
Associate Professor Clinical Psychologist, Siegler Center for
Department of Rehabilitation and Movement Integrative Medicine
Sciences St. Barnabas Ambulatory Care Center, Livingston,
Doctoral Programs in Physical Therapy New Jersey
University of Medicine and Dentistry of New Jersey Assistant Professor, ICAM and Department of
Newark, New Jersey Medicine
University of Medicine and Dentistry of New Jersey
Glenna Batson, PT, DSc Newark, New Jersey
Assistant Professor
Winston-Salem State University Susan Gould Fogerite, PhD
Director, Wellness Partners in the Arts, Inc. Director of Research, Institute for Complementary
Durham, North Carolina and Alternative Medicine (ICAM)
Associate Professor, Department of Clinical Lab
Judith E. Deutsch, PT, PhD Sciences
Professor and Director, Rivers Lab School of Health-Related Professions University
Department of Rehabilitation and Movement of Medicine and Dentistry of New Jersey
Sciences Newark, New Jersey
Doctoral Programs in Physical Therapy
University of Medicine and Dentistry of New Jersey Richard Lund
Newark, New Jersey Director
Wellness Through Tai Chi
Chantel Dickinson, PT Woodbridge, New Jersey
Certifi ed Pilates Instructor
Energy Balancing Pilates Studio Ellen D. Mandel, MS, PA-C, RD
Englewood, New Jersey Assistant Professor
Department of Physician Assistant
Mary Lou Galantino, PT, PhD Seton Hall University
Professor South Orange, New Jersey
Doctoral Program in Physical Therapy
The Richard Stockton College of New Jersey John Maypole, MD
Pomona, New Jersey Assistant Professor of Pediatrics
Adjunct Research Scholar Boston University School of Medicine
Center for Clinical Epidemiology and Biostatistics Chief of Pediatrics
University of Pennsylvania School of Medicine South End Community Health Center
Philadelphia, Pennsylvania Boston, Massachusetts
Bill Gallagher, PT, CMT, CYT Suzanne McDonough, PT, PhD
Director Professor
The East West Rehab Institute School of Health Sciences
New York, New York University of Ulster
Belfast, Ireland
Susan Gerik, MD
Associate Professor of Pediatrics and Family Patricia Quinn McGinnis, PT, PhD
Medicine Associate Professor
Director of Children’s Special Services Doctoral Program in Physical Therapy
University of Texas Medical Branch The Richard Stockton College of New Jersey
Galveston, Texas Pomona, New Jersey
v
vi CONTRIBUTORS
Sheelagh McNeill PhD, LicAc, BAC, SMISCP James Stephens, PT, PhD
Senior Orthopaedic Physiotherapist Clinical Assistant Professor
Physiotherapy Department Department of Physical Therapy
Sligo General Hospital Temple University
The Mall Philadelphia, Pennsylvania
Sligo, Ireland
Cindy Wolk-Weiss, BSW
John Musser, MD Director and Integrated Holistic Counselor
Center for Clinical Epidemiology and Biostatistics Center for Healing Journeys
University of Pennsylvania School of Medicine Bound Brook, New Jersey
Philadelphia, Pennsylvania
Perry Wolk-Weiss, DC
Diane Rigassio Radler, PhD, RD Director and Chiropractor
Assistant Professor Get Well Center
Graduate Programs in Clinical Nutrition Bound Brook, New Jersey
University of Medicine and Dentistry of New
Jersey Lori Zucker, PT, DPT
School of Health-Related Professions University Private Practice
of Medicine and Dentistry of New Jersey Livingston, New Jersey
Newark, New Jersey
Cathy Caro Scarpito, PT
Owner, ProCare Physical Therapy
Piscataway, New Jersey
Reviewers
John A. Astin, PhD Shoshanna Katzman, MS, LAc
Research Scientist Acupuncturist, Qigong Professional, and Energy
California Pacifi c Medical Center Medicine Specialist
San Francisco, California Director
Red Bank Acupuncture and Wellness Center
Simona Cipriani Tinton Falls, New Jersey
Pilates, Massage Therapy, Feldenkrais
The Art of Control David M. Kietrys, PT, MS, OCS
Mount Kisco, New York Associate Professor
Doctoral Program in Physical Therapy
John Cottingham, PT, MS University of Medicine and Dentistry of New
Christie Clinic in Rantoul Jersey-SHRP
Department of Physical Therapy Stratford, New Jersey
Rantoul, Illinois
Sandy Matsuda, PhD, OTR/L
Nancy Davidson, PT, MPH, Pac, LAc Assistant Professor
Traditional Acupuncture and Rehabilitation Occupational Therapy
Raleigh, North Carolina University of Missouri-Columbia
Columbia, Missouri
Moshe Frenkel, MD
Associate Professor Diane Miller, JD, MS
University of Texas, Medical Branch Legal and Public Policy Director
Family Medicine National Health Freedom Action
CAM Education Project St. Paul, Minnesota
Galveston, Texas
Jim Oschman, PhD
Mary Lou Galantino, PT, PhD Nature’s Own Research Association
Professor Dover, New Hampshire
Doctoral Program in Physical Therapy
The Richard Stockton College of New Jersey Adam Perlman, MD, MPH
Pomona, New Jersey Hunterdon Endowed Professor of
Adjunct Research Scholar Complementary and Alternative Medicine
Center for Clinical Epidemiology and Biostatistics Executive Director and Associate Professor
University of Pennsylvania School of Medicine Institute for Complementary and Alternative
Philadelphia, Pennsylvania Medicine
School of Health-Related Professions University
Earlene Gleisner, RN of Medicine and Dentistry of New Jersey
Reiki Master, Author, Publisher Newark, New Jersey
Private Practice
Laytonville, California Carla Oswald Reed, PT
Guild Certifi ed Feldenkrais Practitioner, Physical
Martha Hinman, PT, EdD, MHEd Therapist
Professor, Department of Physical Therapy Movement to Wholeness
Director, Transitional DPT Program Sterling, Virginia
Hardin-Simmons University
Abilene, Texas
vii
viii REVIEWERS
Ellen C. Ross, PT, PhD Dalia Zwick, PT, PhD
Professor and Program Director Post-Professional PT Senior Rehabilitation Supervisor
Physical Therapy Premier Health Care
Department of Rehabilitation and Movement New York, New York
Sciences
University of Medicine and Dentistry of New
Jersey
Newark, New Jersey
Judith C. Stern, MA, PT, Certifi ed Teacher of
the AT
Senior Faculty
American Center for the Alexander Technique
Private Practice
Rye, New York
Judith E. Deutsch
In loving memory of my father, Hans P. Deutsch, who taught me to value intellectual pursuits,
hard work, and perseverance—but more importantly, kindness and love
To my husband, Joel Stern, and our children, Sarah and Daniel,
whose love and joy make my life whole
Ellen Zambo Anderson
To my husband, Scott, and our children, Kevin, Derek, and Taylor,
whose laughter and love have complemented my life in immeasurable ways
Preface
WHO WILL BENEFIT FROM THIS BOOK? ORGANIZATION
The purpose of the book is to provide physical The book is organized into two parts. Chapters 1 to
therapy students and clinicians with a book on 3 describe CAM, the clinical decision-making model
complementary therapies (CAM) that are most that is used throughout the book, and potential
likely encountered in rehabilitation. We feel it is modifi ers of the clinical decision-making approach.
important that the reader practice a clinical deci- The second part has fi ve sections. Each section is
sion-making approach that incorporates principles defi ned by the domain of CAM as established by
of evidence-based practice. The process to evaluate NCCAM. They are as follows: Whole Medical
the appropriateness of a complementary therapy Systems, Mind Body Interventions, Biologically
based on evidence, patient preferences, and their Based Therapies, Energy Therapies, and Manual
clinical experience is modeled and reinforced Body-Based Therapies. An overview of the domain
throughout the book. Given the rapid rate of dis- is provided in each section, followed by chapters
covery in CAM, the evidence-based content may that include a case scenario for which a complemen-
become outdated, but the general principles of tary therapy is investigated, described, and either
CAM and the process to evaluate it will not. included or not, in the plan of care. For example, in
the Mind-Body Interventions section, there are spe-
cifi c chapters on Yoga and Tai Chi. In the Manual
WHY IS THIS BOOK IMPORTANT TO
Body-Based Therapies, there are chapters on The
THE PROFESSION?
Ida Rolf Method of Structural Integration, Felden-
Why write another book on complementary and krais, Alexander, Craniosacral Therapy, and Pilates.
alternative medicine (CAM) or therapies? Clearly,
the public, not only in the United States but around
DISTINCTIVE FEATURES OF THIS BOOK
the world, is interested in and seeking these thera-
pies. Our clients are performing their own web In this book the reader will fi nd:
searches and arriving for physical therapy sessions • A background and description of CAM use and
with pointed questions. We are being asked to serve research
as consultants, advisors, and in some instances, as • A clinical decision-making process for incorpo-
providers of the so-called complementary thera- rating complementary therapies into a rehabili-
pies. It is important to do this in an educated tation plan of care
manner. • Legal, ethical, and cultural modifi ers that infl u-
In parallel with the public’s interest in CAM is ence clinical decision-making for CAM
the development of evidence-based practice. Tools • Overview chapters on each of the National
for evaluating effi cacy of therapies are available. Center on Complementary and Alternative
The evidence-based approach, with its triad of Medicine’s (NCCAM) fi ve domains of comple-
patient values, clinician expertise, and evidence, mentary and alternative medicine
offers an excellent model for evaluating comple- • Specifi c therapy chapters that model the clinical
mentary therapies. decision-making process
The ability to address our client’s queries using • Case scenarios for which the integration of a
an evidence-based approach is the reason we have complementary therapy into a plan of care is
written this book. We have placed the evidence- considered
based approach into the larger context of physical • A review of complementary therapy and its scien-
therapist clinical decision making to offer the reader tifi c literature as it relates to the case scenario
a framework for making those important clinical • Clinical hypothesis generation, examination,
decisions. Our goal is to provide not only content intervention, and evaluation of addition of CAM
information on CAM, but much more importantly, to the plan of care
to suggest a process by which CAM can be • Resources for identifying practitioners, addi-
evaluated. tional reading, and patient education materials
xvii
Acknowledgments
As with the writing of most books, the work thanks go to our photographers, Joel Stern and
and credit for this book is shared with many Karen Clarkson, and models Soraya Zahedi and
individuals. We are fortunate to be surrounded by Taylor Anderson. Their images made this book
colleagues, peers, friends, and students who have more attractive and complete. We appreciate the
inspired, directed, and supported our work. There publishing staff consisting of Kellie White, Kelly
are many people to thank. Milford, Teri Zak, Marion Waldman, and Andrew
We are indebted to our contributors, who rep- Allen for their tireless support, patience, and gentle
resent physical therapy, medicine, chiropractic, prodding. Finally, we are deeply grateful for our
dietetics, clinical sciences, and complementary colleagues and students of the Doctoral Program in
therapies. Their expertise and knowledge have pro- Physical Therapy at the University of Medicine and
vided the breadth and enriched the content of the Dentistry of New Jersey-School of Health-Related
book. We value the reviewers, who provided excel- Professions. The supportive environment that we
lent feedback to clarify and enhance the text. Many work in has made this book possible.
xix
Foreword
Complementary and alternative medicine The use of randomized controlled trials is impor-
(CAM) is maturing. Increasingly, it is being tant in clinical decision making. Judy Deutsch and
integrated into the mainstream of health care. This Ellen Anderson have taken the “top of the hierar-
book is an excellent illustration of that. Physical chy” evidence-based approaches and merged them
therapy is an established allied health science with with practical step-by-step approaches useful for
an integral role in many areas of medicine, ranging health care delivery. In addition, this book pro-
from assistance in managing congenital deformi- vides a useful description of the context of practice,
ties to sports medicine to the aged. Its focus is on including legal and ethical issues, medical malprac-
the whole person, a variety of symptoms and func- tice, professional standards, and quality of care
tions, and on healing. Therefore, it is not surprising issues—all important components of delivering
that it has a philosophical and practical affi liation appropriate integrative medicine. Especially inter-
with CAM. When I was director of The Offi ce of esting are the case examples, in which the discus-
Alternative Medicine at the National Institutes of sion is framed both theoretically and through
Health (NIH) from 1995 to 1999, I found the most specifi c illustrations of how the principles outlined
use of complementary medicine within the physical in the book are applied in real life. From these, any
therapy department. As a military physician inter- practitioner with appropriate training can under-
ested in integrative medicine in the Department of stand how to integrate these practices for their
Defense, I found that practices such as acupuncture own use.
and manipulation were already integrated into the After the smoke has cleared from the debate on
PM & R clinics at places like Walter Reed and the science and complementary medicine, the suffering
National Naval Medical Center. patient still stands before us. The patient is our
Physical therapy has taken the lead in the inte- primary audience—the customer we serve. In the
gration and establishment of standards for use of midst of confl icting agendas driven by economics,
complementary and alternative medicine within new devices, family and social forces, professional
health care. This book takes the next step by pro- turf, and reimbursement, it is the patient and service
viding clear approaches to the use of evidence- to the patient that we must always keep in mind.
based medicine and step-by-step clinical decision Many allied health practices and especially physical
making for complementary medicine. Drs. Deutsch therapy, have emphasized patient-centered care.
and Anderson have done an admirable job in pro- With this book, physical therapy leads the way in
viding a blueprint for the integration of CAM and the practical integration of CAM into practice. This
physical therapy that other health professionals can book is a guide for physical therapists on integrative
emulate. The CCC and PICO approach that they medicine. The hope is that others will also read it,
have provided form a rational framework for devel- use it, and improve on it in the years ahead.
oping standards of care in integrative medicine.
Evidence-based medicine processes can be Wayne B. Jonas
complex. A single approach (e.g., using only “top President and CEO
of the hierarchy” evidence for making clinical deci- Samueli Institute
sions) is often not adequate in day-to-day practice. Alexandria, Virginia
xi