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UrduWhile experts have long believed that CAM therapies could benefit patients in acute rehab, less is known about which benefits are most advantageous to these individuals’ quality of life. This retrospective study examines the impact of specific benefits of CAM therapies based on surveys of 100 patients with diagnoses that included spinal cord injuries, strokes, post-operative orthopedic surgeries, traumatic brain injuries and debility secondary to underlying medical conditions.
“We are at an interesting time in medicine where more and more people are trading pills for holistic remedies while the country battles the overuse of certain prescription medications,” said Tochi Nworu, MD, a resident physician at Burke Rehabilitation Hospital and the study’s co-author. “Regardless of one’s treatment preference, the end goal is usually the same; reduce or eliminate sequela of medical conditions including pain, anxiety and other factors affecting quality of life. CAM therapies are an effective adjunct to traditional medical management in helping patients recover and cope from the byproducts of their illnesses. These therapies are generally safe, and they give patients additional or alternative options to managing issues such as pain, anxiety and poor sleep. They could potentially have a positive impact on reducing certain medication use and improving quality of life.”
Study participants included patients who identified a need or goal that could be met through the use of CAM. Patients were offered individual or group sessions based on each patient’s needs, goals and preferences. Yoga, breathing exercises, discussion/ education, sensorimotor exercises, guided meditation, acupressure, lymph drainage, massage/ reflexology and cranio-sacral therapy were among the therapies offered to the participants.
At time of discharge, participants were given a Likert scale survey developed by the researchers. The patients were asked to evaluate the impact of their therapies, rating the treatments’ perceived effects on their pain, stress, sleep and other quality of life measures. Fifteen outcomes were evaluated: effects on relaxation/stress, comfort/anxiety, energy levels, self-image, sense of well-being, alleviation of pain, development of pain management strategies, quality of sleep, control of emotions, ability to identify stressors, benefit from resource materials, likelihood of practicing these techniques after sessions and post-discharge, whether CAM should continue to be offered in inpatient clinics, and the likelihood of participating in outpatient CAM at the same institution.
When they evaluated the survey responses to measure the impact of CAM therapies on the various measures, they found that 50.3% of patients responded “a great deal,” 15% responded “somewhat,” 3.9% responded “a little,” 2% said “not at all,” 5.3% said they were “undecided,” and 22% left blank responses.
“Future research will aim to identify a dose-related correlation between the type and amount of therapy to the perceived benefit. This will allow for more effective and personalized treatment plans,” said Dr. Nworu and co-researcher Alexandra Oudheusden, Director of Therapeutic Recreation at Burke. According to their study, most patients are likely to continue CAM therapies outside of the in-patient setting. “We are also beginning to see insurance companies cover therapies such as acupuncture, biofeedback and massage. If CAM therapies continue to elicit beneficial effects, then perhaps insurers will extend and increase coverage for more CAM therapies. Ultimately, the hope is that CAM becomes more accessible and affordable for everyone as well as for better reimbursement for providers.”
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The Association of Academic Physiatrists (AAP) is a professional society with a mission to create the future of academic physiatry through mentorship, leadership, and discovery. Its members are leading physicians, researchers, educators and in-training physiatrists from 35 countries. The AAP holds an Annual Meeting, produces a leading medical journal in rehabilitation: AJPM&R, and leads a variety of programs and activities that support and enhance academic physiatry. On March 4-9, 2020, the AAP is hosting the ISPRM World Congress in Orlando, Florida. To learn more about the association, the specialty of physiatry and the World Congress, visit physiatry.org and follow us on Twitter at @AAPhysiatrists.
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