Institutes. What ARE Complementary & Alternative Medicine (CAM)

Transcription

1 DOES COMPLIMENTARY and ALTERNATIVE MEDICINE (CAM) HAVE a ROLE IN SPORTS MEDICINE PRACTICE? MARJORIE A. KING, PHD, ATC, PT DIRECTOR OF GRADUATE ATHLETIC TRAINING EDUCATION PLYMOUTH STATE UNIVERSITY MAKING1@PLYMOUTH.EDU EATA 69 TH ANNUAL MEETING ~ 2017 What ARE Complementary & Alternative Medicine (CAM) Allopathic Conventional of main stream medicine Complementary medicine Medical practices outside of main stream medicine used in conjunction with conventional medicine Alternative medicine Medical practices outside of main stream medicine used without any additional conventional medicine Integrative medicine The blending of conventional and complementary medicine National Center for Complementary and Alternative Medicine (NCCAM) Mind Body Practices Five (5) Domains Alternative Medical Systems Mind-body Interventions or techniques (facilitates mind s effect on bodily functions and symptoms) Biologically-based systems (such as herbalism) Manipulative and body based methods (chiropractic, massage therapy) Energy Therapies Yoga Chiropractic Osteopathic manipulation Meditation Massage therapy Tai chi Qigong; Qi gong; Chi Kung/Gung Healing touch Hypnotherapy Relaxation Techniques Breathing exercises Guided imagery Progressive muscle relaxation Movement Therapies Feldenkrais method Alexander techniques Pilates Rolfing Structural Integration Trager psychophysical integration Institutes 1

2 Chopra Foundation Sara Lazar, Ph.D. Neuroscience of Yoga and Meditation Neuroscience of Yoga and Meditatioin

3 Department of Medicine, Division of Preventive and Behavior Medicine Benson-Henry Institute for Mind Body Medicine Katherine A. Gallagher Integrative Therapies Program Acupuncture Art Therapy Massage Therapy Music Therapy Chigong Tai Chi Integrative Studies Historical Archive & Repository JOURNALS Interdisciplinary Scholar s Hub JOURNALS Journals ~ cont. The Journal of Alternative and Complementary Medicine Evidence Based Complimentary and Alternative Medicine (2015 Impact Factor 1.931) Complimentary Therapies in Medicine Journal of Traditional and Complementary Medicine Asian Journal of Complementary and Alternative Medicine A-CAM BioMed Central Complementary and Alternative Medicine (Impact factor 1.375) Global Advances in Health and Medicine 3

4 Familiar Aspects of Medicine management/guide/shoulder pain MECHANISMS management/knee pain/picture of the knee procedures tendonitis Forgotten Aspects of Medicine Comfort Level. Energy Medicine Comfort Level.. 4

5 Mechanism(s) The Body s Communication Information Delivery Electrical Hormonal Information Delivery System Nervous system (sympathetic, parasympathetic, enteric) Information Receivers Receptors Nervous system Autonomic Sympathetic & parasympathetic & enteric Communicate through receptors Eyes, ears, nose, tongue, skin Receptors communicate Mechanically Chemically All of which create or redistribute energy. Transportation systems microtubles. Electrical: Neuron Depolarization Nervous System Communication nervesystemscolstons Hormonal Communication Hypothalamic-Pituitary-Thyroid Axis illustration activationstress system human anatomy image Overview of sites of thyroid hormone regulation of metabolism by American Physiological Society Rashmi Mullur et al. Physiol Rev 2014;94:

6 RECEPTORS Cell Membrane ~ Protein Functions of diabetes/type1/understanding type 1 diabetes/how the body processes sugar/blood sugar otherhormones/ EYE RECEPTORS Body Activity Taken for Granted and cones t/olc/art_quizzes/0675fq.htm&afooter=/usr/web/home/ mhhe/biosci/genbio/maderbiology7/student/olc/art_quizzes/0675fa.htm&test=/usr/we b/home/mhhe/biosci/genbio/maderbiology7/student/olc/art_quizzes/ 0675q.txt&answers=/usr/web/home/mhhe/biosci/genbio/maderbiology7/student/olc/ar t_quizzes/0675a.txt TOUCH RECEPTORS dylan_sanders/waves.html EAR RECEPTORS Fall%202011/chapter_10%20Fall% htm 6

7 SMELL RECEPTORS TASTE RECEPTORS final/ AUTONOMIC NERVOUS SYSTEMS Nervous System VOLUNTARY INVOLUNTARY ~ AUTONOMIC breathing is the key to your autonomicnervous system/ TWO CONTROL SYSTEMS Brain GUT (ENS) Woo ~ Woo?? Electrical Energy Chemical/Hormonal Energy Autonomic Nervous System (3) Receptors Furness, JB Nature Reviews Gastroenterology and Hepatology 9, (May 2012) doi: /nrgastro

8 Complimentary and Alternative Medicine in Sports Medicine Possible Modalities Not much out there. Pain Management Anxiety Management Cancer Care Acupuncture Cupping Gua Sha Fascial Tensegrity Mindfulness & Meditation Breathing Yoga Feldenkrais & Alexander Techniques Motor Learning Selected Outcome Measures Acupuncture vs Dry Needling Pain ROM Functional movement Performance Balance Whole person health Performance of the overall system Quality of Life Easier to sleep Feel less tension Hurts less Acupuncture Balance the energy flow within the body Open up the channels of the body meridians (5) Needle inserted into a meridian point Dry Needling Orthopedic in Nature Focuses on Trigger Points Needle inserted into the trigger point of the muscle The body will heal itself Medical Acupuncture (MD, DO) Dry Needling Technique center/dry needling treatment/ Dry Needling Mechanism 8

9 Acupuncture Meridians Mechanism No Consensus Animal Models Release of endogenous opiates Release of serotonin Influence on receptors to excitatory amino acids at the spinal cord level Regulation of the immune system through the autonomic nervous system Lin, Jaung-Geng, and Wei-Liang Chen. "Acupuncture Analgesia: A Review of Its Mechanisms of Actions." The American Journal of Chinese Medicine (2008): Web. Mechanisms Mechanism Local Spinal Pain relief through neuropeptides Gate control Vagus Nerve (autonomic nervous system) Anti-inflammatory: regulation of the inflammatory response Protein regulation Positively influences splenic tumor necrosis factor (alpha) Supraspinal mechanisms Descending pain inhibitory system through the sympathetic nervous system Cortical Possibly placebo Carlsson, C. "Acupuncture Mechanisms for Clinically Relevant Long-term Effects - Reconsideration and a Hypothesis." Acupuncture in Medicine (2002): Web. Lim, Hee-Don, Min-Hee Kim, Chan-Yong Lee, and Uk Namgung. "Anti-Inflammatory Effects of Acupuncture Stimulation via the Vagus Nerve." Plos One 11.3 (2016): n. pag. Web. Transport Mechanism: Microtubule CUPPING Heat the air inside the cup Cooling of the air creates suction Blood vessels expand ~ redness myths truths behind myofascial cupping therapy/ 9

10 Olympic Pseudo-Science Efficacy ~ Multiple Applications. guan ancient chinese therapy/ Pain ~ no consensus Kim, Jong-In, Myeong Soo Lee, Dong-Hyo Lee, Kate Boddy, and Edzard Ernst. "Cupping for Treating Pain: A Systematic Review." Evidence-Based Complementary and Alternative Medicine 2011 (2011): 1-7. Web. Neck Pain ~ no consensus Chi, Lee-Mei, Li-Mei Lin, Chien-Lin Chen, Shu-Fang Wang, Hui- Ling Lai, and Tai-Chu Peng. "The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial." Evidence-Based Complementary and Alternative Medicine 2016 (2016): 1-7. Web. Potential Benefits Cao, Huijuan, Xun Li, and Jianping Liu. "An Updated Review of the Efficacy of Cupping Therapy." PLoS ONE 7.2 (2012): n. pag. Web. Gua Sha Science of Gua Sha An instrument-assisted unidirectional press-stroking of a lubricated area of the body surface to intentionally create transitory therapeutic petechiae called sha representing extravasation of blood in the subcutis. Outcome Increase in micro-perfusion Anti-inflammatory Heme-oxygenase-1 Immune effect Effects pain, stiffness, fever, chill, cough, wheeze, nausea, etc. Effects acute and chronic internal organ disorders Nielsen, Arya. "Gua Sha Research and the Language of Integrative Medicine." Journal of Bodywork and Movement Therapies 13.1 (2009): Web. Nielsen, Arya, Nicola T.m. Knoblauch, Gustav J. Dobos, Andreas Michalsen, and Ted J. Kaptchuk. "The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects." EXPLORE: The Journal of Science and Healing 3.5 (2007): Web. TENSEGRITY RESOURCES (soft tissue) Add strain to the system and the deformation gets distributed across the structure Tensegrity Ingber,DE. The Architect of Life. Scientific American, 1998:48-57 Strolling Under the Skin tu.be In the body pain break down at the weakest link Structural Basis of Life 10

11 Mindfulness / Meditation Neuroplasticity Alterations in Brain Function (cognition) Brain Changes = NEUROPLASTICITY Changes Neurobiology Alterations in Brain and Immune Function doi: /01.PSY E3 Jon Kabat-Zinn ~ Meditation & Telomeres Telomeres Alteration in Gene Expression Telomerase Activity doi: /tp Telomeres protect the ends of the DNA When telomeres are lost It leaves the DNA unprotected against change Broken DNA is dangerous (changes gene expression) finallyreveals how you can actually revese aging.aspx telomeres-and-cancer-prevention/ Mindfulness & Meditation Mindfulness ~ Meditation Meditation vs Vacation Effect Improvements in Cellular Health (identified by blood markers) Improved regulation of stress response Improved regulation of immune function Improved regulation of amyloid beta metabolism (amino acid involved with Alzheimer's; amyloid plaques) doi: /tp Increase in Grey Matter Increase in Learning & Memory Processes Improved Emotional Processing doi: /j.pscychresns Results in Functional and Structural Plasticity doi: /scan/nss056 11

12 Other Consideration Other Considerations Breathing Yoga Imagery (Motor Learning Literature) Systemic effect of Emotional Chemistry Role of Micro-Biomes N Engl J Med 2016;375: DOI: /NEJMra Autism and Autism Spectrum Obesity Cancer Role of the western diet Other Considerations Epigenetics vs Genetics (5%) Role of Inflammation Heart Disease Cancer Obesity Alzheimer's Whole Body Interventions Peterson, C. T. et al. Identification of Altered Metabolomic Profiles Following a Panchakarma-based Ayurvedic Intervention in Healthy Subjects: The Self-Directed Biological Transformation Initiative (SBTI). Sci. Rep. 6, 32609; doi: /srep32609 (2016). The Challenge Identifying the Mechanisms Alternative Medicine Complimentary Medicine Integrated Medicine Person as a kinetic chain 12