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Rolfing brings woman relief from disorder

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Rolfing brings woman relief from disorder

Our Review Summary

This was a very flawed story about the use of rolfing – a form of massage therapy – in two patients – one with tardive dyskinesia-dystonia and the other with nerve damage after back surgery. The piece was built mainly on anecdote, with several major shortcomings.  Most notably, there was no description of how rolfing is actually done, no evidence to support its use, and no discussion of quantifiable benefit or harm.

There was also no unbiased, independent expert interviewed.  A rolfing practitioner is interviewed who promotes his practice via the story.  The story also includes a link to a website promoting alternative health services.  Including at least one unbiased expert would have substantially strengthened the piece, especially a medical practitioner or researcher who did not stand to benefit from rolfing or similar CAM (complementary and alternative) therapies. Better sources of consumer information would have also strengthened the piece (E.g. http://nccam.nih.gov/health/backgrounds/manipulative.htm

The story briefly lists unsuccessful trials of muscle relaxants, pain medications and acupuncture in the case of these patients’ experience with chronic pain and movement conditions.  Rolfing is touted as "life altering", but both patients still manage chronic pain and movement limitations. While these patients may have found temporary relief via tissue and fascia manipulation, rolfing needs to be placed in the context of evidence-based medical therapies.

The story does not list the cost of treatment.  This is a great oversight in a story on a complementary therapy, which is typically not covered by health insurance and may need to be part of on-going pain management.  While some health insurers may pay a portion of  therapeutic massage for some conditions, there are few regulatory bodies that guide pricing for these therapies.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not list the cost of treatment.  This is a great oversight in a story on a complementary therapy, which is typically not covered by health insurance and may need to be part of on-going pain management. 

While some health insurers may pay a portion of  therapeutic massage for some chronic conditions, there are few regulatory bodies that guide pricing for these therapies.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

There is no discussion of quantitative evidence that rolfing relieves pain or improves quality of life in people with movement disorders or chronic pain conditions. The story focuses solely on positive anecdotes of pain relief from two patients who sing the praises of their rolfer who promotes his practice via the story.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

There are few harms with massage treatment, even with deeper massage treatments such as rolfing.  However, the story neglects to mention that contraindications for massage include deep vein thrombosis, burns, skin infections, eczema, open wounds, bone fractures, and advanced osteoporosis.  Bodywork that involves intensive manipulation or stretching of the deeper layers of body tissue are not suitable for people who have undergone recent surgery or have recently suffered severe injury. In the case of the man who had back surgery, the story could have mentioned that there are some risks associated with manipulation of the spine (though these would be very rare with the force used in deeper massage therapies such as rolfing). Any spinal manipulation (but particularly neck) can be associated with risk in older people.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story provides no evidence from any published literature on rolfing for pain relief, or as a complementary therapy for movement disorders.  The story does not mention that most complementary and alternative therapies such as rolfing are unregulated and not covered by health insurers.  Also, hyperlinks provided in the story are poor sources for credible health information. Better sources include: http://nccam.nih.gov/ and http://www.parkinson.org/NETCOMMUNITY/Page.aspx?&pid=413&srcid=375

Does the story commit disease-mongering?

Not Satisfactory

 The patient "horror story" of developing tardive dyskinesia from antipsychotics is unusual, particularly so severe a case. 

The story states that the number of people with tardive dyskinesia-dystonia is unknown but then goes on to state that 40 million Americans have general movement disorders.  This leaves the impression that massage therapy/rolfing may have benefits for many of these people, which is not proven. 

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story focuses on two patients who had positive results from rolfing. The story also interviews a rolfing practitioner.  The story includes a link to a website promoting alternative health services.  Including at least one unbiased, independent expert would have substantially strengthened the piece, especially a medical practitioner who did not stand to benefit from rolfing or similar CAM (complementary and alternative) therapies.  A researcher of CAM therapies (perhaps someone listed on the NIH website: http://nccam.nih.gov/health/backgrounds/manipulative.htm) could have provided some balance to the story; this person could have discussed medical therapies typically used in conjunction with mind-body techniques.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story briefly lists unsuccessful trials of muscle relaxants, pain medications and acupuncture in the case of Karen Harkin’s experience with tardive dyskinesia and Wade Penn’s nerve damage.  Rolfing is touted as "life altering", but both patients still manage chronic pain and movement limitations. While these patients may have found temporary relief via tissue and fascia manipulation, rolfing needs to be placed in the context of evidence-based medical therapies for conditions as serious as tardive dyskinesia.

Most patients with this sort of severe tardive dyskinesia-dystonia or related problems would be under the care of a neurologist, where muscle relaxants and other mainstream therapies could be applied.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The story does not establish how widely available and accessible are trained rolfers.  The story also does not mention the type or duration of training involved to become a certified rolfer.  The story could have provided much more information on both points by listing information via the Institute cited in the story: http://www.rolf.org/

Does the story establish the true novelty of the approach?

Not Satisfactory

The story does not discuss the relatively recent history of rolfing or its role as a complementary therapy in helping people with chronic  pain conditions improve their quality of life.  

 

Does the story appear to rely solely or largely on a news release?

Not Applicable

We can’t be sure if the story relied solely or largely on a news release.

Total Score: 0 of 9 Satisfactory

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