Niki Munk , PhD, LMT
Indiana University-Purdue University, Indianapolis, IN, USAPractice-induced challenges to massage research and education include those related to disparate training standards, requirements, and expectations across the US, North America, and internationally. These challenges should not overshadow the need for practice to inform research and education, especially in light of the move towards effectiveness research. What remains constantly applicable to massage practitioners of all locations and from all backgrounds are treatment details regarding the techniques used, client/patient characteristics, condition/issue of complaint, provider and client/patient expectations, and outcomes. Case reports provide a venue for this information to be shared across all practitioners, educators, and researchers. While many massage practitioners are not trained in scientific writing, preparing and publishing a case report need not be daunting, especially with writing partners when writing burden can be shared. Writing in isolation can be challenging, even for trained researchers. Perceived practitioner contribution and credit are not reduced when authorship in a manuscript is shared; rather it may be enhanced with an experienced partner.
KEYWORDS: scientific writing help , negative results , practice informing research , practice informing education
Greetings IJTMB readers. I am truly delighted to have the opportunity to serve as the Practice Editor for this wonderful Journal that brings together three key aspects of the massage profession in an open access format: research, education, and practice. I have walked in each of these: twelve years as a massage practitioner, four years as a massage educator and key school administrator, and currently, I am a full-time massage researcher and gerontologist in an academic setting. Having chosen to give up my massage practice to pursue massage research in academia full-time, this position allows me to continue close involvement with practitioners in the massage field, stay current with practice interests, and facilitate the informative power of practice to both massage education and research.
My predecessor, Karen Boulanger(1) and others such as Jerrilyn Cambron,(2) Ruth Werner,(2) and Michael Hamm,(3) have heralded the import of case reports for the massage profession, education, and research. I second and support these sentiments. I am often asked by massage practitioners about avenues to participate in research and understand the frustration many feel with the multiple barriers to what they perceive as substantive research experiences. Case reports are an excellent way to get started in research and/or contribute in a significant way to the building of the massage therapy evidence base. Plus, participation in the development and publication of a case report is accessible to all massage practitioners. Case reports are essential building blocks of research and, while they may not “look like” or be talked about like the gold-standard randomized controlled trials (RCTs) in research, the bottom line is that case reports are one of the most fundamental and informative aspects of research.(4) Completing a case report, having it peer-reviewed and published, provides an opportunity for massage practitioners to show credibility for themselves when approaching traditional clinical and non-clinical researchers with regards to an interest they may have in a research topic. In addition, with clinical research moving towards effectiveness (how things work in the real world) approaches,(5) research that is practice-informed becomes even more important if practitioners of the field wish for the research being conducted to be relevant and translatable to everyday massage practice.
As a researcher, I find that one of the challenges in designing relevant and practice reflective massage research protocols is the lack of consistent, international, national, or even regional standards and expectations for massage education and licensure/ certification. As such, detailed descriptions of those who perform massages provided in research studies in addition to the techniques utilized are important.(6) While these sorts of descriptions are becoming more common in the massage research literature, almost all of earlier and many current contributions to massage research continue to lack these details. This editorial is not the venue for a detailed discussion of the merits and detriments to the field regarding standardization; I bring this up only to highlight that a practice-induced challenge to massage research and education with no foreseeable expectation for remedy that an international journal such as this must remain cognizant of if we are to be relevant to our whole audience. While these issues may be particularly needling to researchers and educators, it is important that we in the practice arena focus on what remains constant despite these disparate training standards, requirements, and expectations across the US, North America, and internationally. What remains constantly applicable to massage practitioners of all locations and from all backgrounds are treatment details regarding the techniques used, client/patient characteristics, condition/ issue of complaint, provider and client/patient expectations, and outcomes. Case reports provide a venue for this information to be shared across all practitioners, educators, and researchers, especially when published in an open access journal or available online, as is the case in the online Case Reports Research Repository .(7)
A misconception may exist that the only case reports of interest are those that document successful outcomes. This is certainly not the case when other fields publish case reports that deal with massage therapy treatment(s), primarily highlighting alarming adverse events and other negative outcomes while often neglecting likely informative practitioner details. (8) I’d argue that case reports describing ineffective treatments and techniques from massage practitioners are incredibly important, especially for publication, so that a more rounded evidence base is created for practitioners, researchers, and educators. These, in addition to case reports with positive outcomes, are areas where this Journal and our practitioner contributors can really make a large difference in the substantive development of practice-based education and research-informing contributions.
I implore massage practitioners—share the interesting work you are providing your clients. I wish the IJTMB had been available to me ten years ago when a 40-plus year entrenched and significant arm tremor from polio resolved after two months of weekly massage therapy treatments in my client. I would have loved the opportunity to share the situation, treatments, and outcomes with the massage community, and contribute to the profession’s evidence base through an open-access, peer-reviewed forum. Help further the profession by writing, submitting, and publishing your case reports. Selfishly, as a researcher, I want to know what is and is not working in massage practice so I can build upon practice-informed evidence in my research.
For those of you who have not had training in scientific writing, do not let this prospect overwhelm you. Seek out writing help(1–3,7) and even partnership. For example, there are many university and college graduate students, doctoral candidates, and faculty who would be willing to serve as a second author on a paper thoughtfully devised and merited. Publications in peer-reviewed journals are important for academic career advancement (for them), and having a second author does not demote the significance or credit a practitioner receives as a first author. Such collaboration may also serve to cultivate further mentorship in scientific writing and research development. At times, this type of partnership is the very thing that will take an excellent case report that struggles with writing qualities and make it peer-reviewable and publishable. This advice is actually applicable even to those who have been trained in scientific writing, because writing in isolation is a lonely endeavor. Writing in teams is exceptionally rewarding, especially when the opportunity arises for continued development in effective communication. Although trained, I take every appropriate opportunity to seek writing assistance and partnership from a dear friend and colleague who is an excellent and prolific writer. In addition to her wisdom and writing insights, I also benefit from the guidance she received and continues to receive from her librarian mother. Every time I work with her or any other writing partner, my writing and critical thinking become stronger.
If the prospect of developing and submitting a case report is daunting to you, find a writing partner. If you have a case report that is not quite ready for peer-review, enlist a writing partner. If you have a case report that has been rejected for publication or sent back to you with the requirement of significant modifications, utilize a writing partner. It often makes all the difference in the world!
I look forward to facilitating the publication of your case reports and other reflective and informative practice-derived contributions to IJTMB in the issues ahead. In addition to case reports, I welcome case series, practice evaluations, letters to the editor, original theoretical practice devised discussions, and other practice-related contributions.
Thank you for your continued readership and support to IJTMB and I extend my warmest regards and best wishes to all of the IJTMB audience.
1 Boulanger K. From the Practice Section Editor’s perspective. Int J Ther Massage Bodywork. 2008;1(1).
2 Klawitter M. Writing Case Reports: Free Five-Part Webinar Series. Massage Therapy Foundation website. http://www.massagetherapyfoundation.org/blog/writing-case-reports-free-five-part-webinar-series/. Updated February 19, 2013. 1 July 2013.
3 Hamm M. Clinical case reports. In: Dryden T Moyer C, eds. Massage Therapy: Integrating Research and Practice. Champain, IL: Human Kinetics; 2012:233–254.
4 Vandenbroucke JP. In defense of case reports and case series. Ann Intern Med. 2001;134(4):330–334.
5 NCCAM. NCCAM Third Strategic Plan: 2011–2015. NCCAM website. http://nccam.nih.gov/about/plans/2011. Updated February 9, 2012. 12 June 2013.
6 Porcino AJ, Boon HS, Page SA, Verhoef MJ. Exploring the nature of therapeutic massage bodywork practice. Int J Ther Massage Bodywork. 2013;6(1):15–24.
7 Case Report Research Repository. CaseRe3 website. http://massageresearchonline.com:8080/xmlui/. Updated May 17, 2013. Accessed 13 July 13 2013.
8 Posadzki P, Ernst E. The safety of massage therapy: an update of a systematic review. Focus Altern Complement Ther. 2013;18(1):27–32.
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INTERNATIONAL JOURNAL OF THERAPEUTIC MASSAGE AND BODYWORK , VOLUME 6 , NUMBER 3 , September 2013