Sunday, May 10, 2009


Conditions: Task 2 – Ankylosing Spondylitis
Victoria Walden
Due 18th May 2009

Description of Ankylosing Spondylitis:

Ankylosing means joining together or stiffening .
Spondylitis means inflammation of the vertebral bones of the spine.
Ankylosing spondylitis is a chronic, systemic, inflammatory arthritis leading to calcification and fusion (ankylosing) of the joints, usually the spine and scaroiliac joints (Salvo, S, G. 2008, p.132). This type of arthritis often runs in the family genes, also men are three times more likely to get this disease.
This disease is usually diagnosed in young adults with a peak onset between 20 and 30 years of age and can range from a mild to more severe disease in patients.


Ankylosing spondylitis is considered an autoimmune disease with the genetic basis (genetic basis means that is type of arthritis runs in the family genes, therefore if AS is common in a family, then it is more likely that in that family AS will occur)
With the disease this is the process of what occurs:
· Inflamed joints become infiltrated with inflammatory cells such as fibroblasts, repair begins.
· Collagen is laid down and organised into fibrous scar tissue.
· Tissues undergo the process of calcification and ossification (forming bone), leading to joint fusion and loss of flexibility.


One out of 10,000 people has Ankylosing spondylitis. It affects males more than females and usually is found between the ages of 20 and 40 (Springhouse, 2005).
It may develop in children younger than 10 years of age.

Signs and symptoms:

· This Disease affects the sacroiliac joints, intervertebral disk spaces and costo-vertebral joints commonly.
· It rarely affects the larger synovial joints e.g. hips, knees, shoulders.
· The spine becomes rigid and appears like bamboo, like in X-rays (Dr. Premkumar, K. 2000).
· Disease has exacerbations (can be made worse)and remissions (slight reduction of disease).
· Pain becomes worse when the body is at rest – pain reduces by mild activity.
· Patient complains of constant or irregular low back pain.
· Approximately 30% of this disease shows signs of systemic nature, such as fatigue, weight loss and low grade fever.
· 30% experience bowel inflammation with diarrhoea, eye inflammation and light sensitivity.
· Pain may radiate to the thigh area
· Through reduced movement of vertebral column the curvature of lumbar area is slowly lost.
· In the late stages of disease the spine becomes fixed.
· If costo-vertebral joints are fixed it can have an effect on lung volume.
· Kyphosis (hunchback) occurs when thoracic or cervical areas are affected and the weight of the head compresses the vertebral bodies therefore bends the spine forward, Head becomes hyperextended to maintain field of vision.

Indications and contraindications for massage therapy:

· Client should be positioned to what feels comfortable with plenty of support from pillows.
· Clients with Kyphosis need extra neck support.
· Pillow under knee can relieve tension on hamstrings, also cause pelvis to tilt backwards and straighten lumbar spine.
· From this disease Osteoparosis is common, which can lead to compression fractures
(Salvo, S, G. 2008, p.132).
· Ribcage expansion during inspiration is reduced if costo-vertebral joints are fused therefore client may experience breathing difficulties.
· AIM: Retain mobility of the joints, strengthen weak muscles and stretch tight muscles.
· YES: Gentle massage to the back and limbs.
· YES: Hot packs will help ease pain
· NO: Do not forcibly mobilize ankylosed joints.
· NO: No spinal manipulation
· NO: No deep pressure as osteoporosis is common.
· NO: Avoid massage to inflamed areas
· Advice client to sleep in supine position if possible
· Encourage client to do breathing exercises to regularly move the thorax (help breathing)
· MAJOR: Client maybe on painkillers therefore giving the wrong reading to pain scale.
· Address any other medical conditions e.g. osteoarthritis in treatment plan
· Physician consulted in clients with severe deformities.


Dr. Premkumar, K. (2000). Pathology A to Z: A handbook for massage therapists, (2nd ed.). Canada: VanPub Books.

Professor, Dougadlas, M. (2005). Orphanet. Ankylosing spondylitis. May, 9th, 2009, from

Salvo, S, G. (2008). Mosby’s Pathology for Massage Therapists, (2nd ed.). Elsevier Health Science.

Wikipedia, Retrieved May, 9th, 2009 from

Springhouse. (2005). Professional Guide to Diseases, (8th ed.). Lippincott: Williams & Wilkins.

Thursday, May 7, 2009

Professional Practice

Professional Practice
Assessment Task 1 – Blog 1
Victoria Walden
Due 8th of May 2009

Does the scope of practice as defined by massage New Zealand fit within the legal requirements under the act: Healthcare Professional Competency Assurance Act 2003.

Yes, the scope of practice defined by Massage New Zealand does fit within the legal requirements under the Healthcare Professional Competency Assurance Act 2003. The reasoning why this scope of practice does fit is because of the way that Massage New Zealand has arranged their wording in their scope and also the professional way they approached this task.
With regards to Massage New Zealand they have incorporated the clinic competence and also the educational competence. As through learning the scope of practice will increase in each massage therapist as they continue with their study. From the clinic side of things the scope of practice in detail shows what the massage therapist is able to do and to achieve the best results from each client, as each client is not the same.

Example from the Certified massage therapy scope of practice:
· Delivery of relaxation massage according to the treatment plan which
could include the following massage strokes - effleurage, petrissage, deep
longitudinal, broad cross fibre, compression, vibration, tapotement.

Example from the Remedial massage therapist scope of practice:
· Clinical reasoning of the client condition presenting where information
gathered from history taking and physical assessment is assimilated to
produce an effective and relevant treatment plan.

I feel that the Healthcare Professional Competency Assurance Act (HPCA) is very strict as to what the massage therapist scope of practice is. Yet I feel in some way if Massage New Zealand does go under the HPCA that the flexibility of adapting to each client will be lost, there will be more restrictions to our practice and less freedom. Then again it could give more structure and credibility to the profession of massage therapists if Massage New Zealand did go under the act. Also massage would be under a government recognition giving massage therapists a more high profile name, as David quoted in the elluminate session of what a professional is:

“Professional – work ...requires the application of theories, principles and methods typically acquired through completion of a baccalaureate degree or higher or comparable experience; requires the consistent exercise of discretion and judgement in the research, analysis, interpretation and application of acquired theories, principles and methods to work product (West Virginia Interactive, 2008).”
(Elluminate, 2009).

From this quote it states that we do, do all of these things and more. The next step in the massage industry I feel is to get the positive go ahead from the government and HPCA can help with that.
Does our scope of practice as defined by MNZ accurately reflect our scope of practice?

I believe that Massage New Zealand’s scope of practice does accurately reflect our scope of practice because like the scope of practice we are striving to be professionals within massage therapy.
I believe that we all have our own approach to the scope of the massage industry but we all have to follow by the guild lines that Massage New Zealand has produced. Through these guild lines (scope of practice) we as massage therapists can apply any treatment within the scope and effectively produce a professional healthcare relationship with each client.

Elluminate April 8, 2009.
Massage New Zealand. (2009). Retrieved May 7th 2009 from

Wednesday, May 6, 2009

Evaluation of Research Findings

Research Methods Assessment Task 1 - Blog 4 - Evaluation of Research Findings
Victoria Walden
Due Date 1st May 2009 (with extension)

Bodywork e-News. Unraveling the mysteries of Unwinding. (2008). Retrieved May, 8, 2009 from

‘Unravelling the mysteries of unwinding’, is an article of information referring to the techniques of Myofascial Release. Through reading this article I found that it had some good aspects and some less ones.

The first aspect that I liked about it was that the introduction explains the title of the article in the first two sentences. For Example, ‘The term “unwind” is in general used with a meaning to relax, become less tense, or take an ease. “Unwind your body” is a common phrase used to promote relaxation bodywork (Bodywork e-News, 2008). From these first two sentences the article has set up the article to inform the reader about relaxation of the body.

Another great aspect to this article is that it is well laid out and easy read. If a client is to receive Myofascial Release, this background information could set their mind at ease. The pictures and the explanation of what would occur during the session are simple and easily understood.

Unfortunately after reading the article a few times I still do not know whom the article is written for, as Simon also states in his blog (S, Marks, 2009).
My reasoning to this outcome is that the article is lacking in depth. It only brushes the surface of a lot of topics, therefore only giving enough information for someone to keep looking in other sources to acquire the full details of the article.

Another reason, which points the way to whom this article is written for, is contained in the remarks through the article stating where Myofascial Release is offered and that taking a seminar would be beneficial and helpful. To me in an article that was written to inform personal about the Myofascial techniques should not have marketing statements through the article. I would however accept the marketing comments at the end of the article, therefore giving the reader something to think about after reading the information and how myofascial release can help them.

This follows on to my next point, where arrangement of the article’s information is not in an order that flows. The article jumps from one topic to the next, not introducing or rounding up each topic. Therefore from this I found that someone who did not yet understand a little about the topic would find this article hard to follow.

My last comment to this article is that the article describes emotional release yet never goes into any depth about its effects from this treatment. For example in a paragraph with describes Dr. Frymann as mainly having developed the technique of unwinding, the article states that ‘unwinding was never intended nor used by her to provoke emotional release.’

From this I read that the client may have an emotional release from the treatment. Unfortunately it does not state what this means. Throughout the article from what I can tell, the author wants to inform the reader of the connection of the muscles with the mind as a way of increasing release from different areas of the body. I feel that emotional release is a major part of that, yet it is not fully explained in the article.

From this I find that the article has potential and could be beneficial for first time clients to read about the effects of Myofascial Release as well as helping the client to understand what is going on in their body.


LoBiondo-Wood, G., Haber, J. & Krainovich-Miller, B. (2002). Critical Reading Strategies: Overview of the Research Process. Chapter 2 In LoBiondo-Wood, G. & Haber, J. (editors). Nursing research: Methods, critical appraisal, and utilization. 5th ed.). St Louis: Mosby. Retrieved May, 8, 2009 from

Marks. S. (2009). Essay. Retrieved May, 8, 2009 from

Bodywork e-News. Unraveling the mysteries of Unwinding. (2008). Retrieved May, 8, 2009 from