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Spa and Integrative Medicine: The Future of Health and Wellness Brent A. Bauer MD Director, Complementary and Integrative Medicine Program Mayo Clinic Department of Medicine Learning Objectives Understand the evolution of CAM and the emergence of “Integrative Medicine”.

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Spa and integrative medicine the future of health and wellness l.jpg

Spa and Integrative Medicine: The Future of Health and Wellness

Brent A. Bauer MD

Director, Complementary and Integrative Medicine Program

Mayo Clinic

Department of Medicine


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Learning Objectives

  • Understand the evolution of CAM and the emergence of “Integrative Medicine”.

  • Be able to communicate the evidence from Integrative Medicine and how that science validates Spa

  • Prepare strategically for the opportunities where Spa and IM meet


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Quotable quote

“The greatest opportunity to touch the lives of the greatest number of people with a lifestyle that promotes wellness and health is where Spa and Integrative Medicine meet”

Brent A. Bauer MD,

2009 ISPA CONFERENCE


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Scope of the Issue

  • United States Adults

    • 2/3 are overweight or obese

    • 1/2 have a chronic disease

      • e.g. heart disease, stroke, diabetes, cancer

    • One in four have heart disease

    • One in three have high blood pressure

    • 24 million Americans have type 2 diabetes

Trust for America’s Health (www.healthyamericans.org)


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Obesity Trends* Among U.S. AdultsBRFSS, 2007

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


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1988-2008; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey (April to April) 1988-2008.


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Barnes, 2008 Data from the Current Employment Statistics Survey (April to April) 1988-2008.


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Integrative Medicine Data from the Current Employment Statistics Survey (April to April) 1988-2008.

“The practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing."

Consortium of Academic Health Centers for Integrative Medicine


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Institute of Medicine Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Integrative Medicine:

    • “Orienting the health care process to create a seamless engagement by patients and caregivers of the full range of physical, psychological, social, preventive, and therapeutic factors known to be effective and necessary for the achievement of optimal health”.

www.iom.edu


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Institute of Medicine Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • “…to explore issues, opportunities, and approaches for shifting our health care system to a focus on efficient, evidence-based prevention, wellness, and patient-centered care that is personalized, predictive, preventive and participatory.”

www.iom.edu


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Time for a change? Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • “If no one wants to be hospitalized and no one wants to be sick, then it’s time to establish a health care system that not only treats sickness, but also focuses on keeping people healthy”.

    Denis Cortese, M.D., CEO emeritus, Mayo Clinic Mayo Clinic Health Policy Center


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Time for a change? Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Taking charge of your health.

    • Eat a healthy diet

    • Get regular exercise

    • Don’t use tobacco

    • Actively manage stress

      “These practices will keep you healthier, happier and more productive”

Denis Cortese, M.D., Mayo Clinic


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Massage Therapy – Mayo Clinic Data from the Current Employment Statistics Survey (April to April) 1988-2008.

Pilot trial

  • 58 cardiac surgery patients

  • Massage therapy vs. quiet relaxation

  • Decreased

    • Pain

    • Anxiety

    • Tension

Bauer, Comp. Therap.Clin. Practice, Submitted


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Massage Therapy after CV Surgery Data from the Current Employment Statistics Survey (April to April) 1988-2008.

VAS

Anxiety Level


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Massage Therapy after CV Surgery Data from the Current Employment Statistics Survey (April to April) 1988-2008.

VAS

Pain Level


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Massage Therapy – Mayo Clinic Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Randomized, controlled trial

    • 113 cardiac surgery patients

    • MT therapy days 2,4 vs. quiet relaxation

    • Decreased pain p <0.001

    • Decreased anxiety p <0.001

    • Decreased tension p <0.001

    • Increased relaxation p <0.001

Bauer, Comp. Therap. Clin. Practice, In press


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Massage Therapy – CRS Data from the Current Employment Statistics Survey (April to April) 1988-2008.

N = 20


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Massage Therapy – Mayo Clinic Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Randomized, controlled trial

    • 130 cardiac pts going to invasive procedure

    • MT x 20” prior vs. quiet relaxation

    • Decreased pain p <0.001

    • Decreased anxiety p <0.001

    • Decreased muscle tension p <0.001

    • Improved satisfaction

Bauer, submitted


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Massage Therapy – Mayo Clinic Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Echocardiographers

    • 45 full-time cardiac-sonographers

    • 30” chair massage each week vs. stretching

    • Modest impr. in work-related discomfort

    • Marked increase in satisfaction

Bauer, submitted


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Massage Therapy – Mayo Clinic Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Cardiac Cath Lab personnel

    • 50 staff members (MD’s, RN’s, technicians)

    • On-site, table massage, 30” x 10

    • Outcomes: pain, fatigue, anxiety

    • Preliminary

      • Positive feedback

Bauer, analysis


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Massage Therapy - MSKCC Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Memorial Sloan-Kettering Cancer Center

    • 1,290 patients treated over 3 yr period

    • Pre- and Post-therapy sxs recorded

      • Pain

      • Fatigue

      • Stress/Anxiety

      • Depression

      • Nausea

Cassileth, J Pain Symptom Manage. 2004


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Massage Therapy - MSKCC Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Results:

    SymptomImprovement

    Pain 40%

    Fatigue 41%

    Anxiety 52%

    Nausea 21%

    Depression 31%

Cassileth, J Pain Symptom Manage. 2004


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Massage and Fibromyalgia Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Clinical Trial, N = 50 women w/ FMS

    • Manual lymph drainage = 25

    • Connective tissue massage = 25

    • 5X/week for 3 weeks

    • Improved

      • Pain intensity, pain pressure threshold, HRQoL

      • AM tiredness, anxiety, FIQ better with MLD

Ekici, J Manip. Physiol Ther 2009


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Massage and Fibromyalgia Data from the Current Employment Statistics Survey (April to April) 1988-2008.


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CAM and the Relaxation Response Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Therapies with good efficacy/ low risk

    • Massage - Meditation

    • Acupuncture - Music Therapy

    • Yoga - Hypnosis

    • Spirituality - Tai chi

    • Guided imagery - etc.


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Relaxation Response Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • RCT N = 41, U of Wisconsin

    • Meditation vs. wait list control

    • 8-wk program > vaccinated

    • Meditators had

      • Measurable change in brain electrical pattern

      • Higher antibody titers

        “…meditation may change brain and immune function in positive ways”

Davidson, Psych Med 2003


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Davidson, Psych Med 2003 Data from the Current Employment Statistics Survey (April to April) 1988-2008.


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Davidson, Psych Med 2003 Data from the Current Employment Statistics Survey (April to April) 1988-2008.


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ISPA Data from the Current Employment Statistics Survey (April to April) 1988-2008.

“Spas offer…a time and place to…recharge your mind, body and spirit.  The opportunity to bring your physical, mental, emotional and spiritual selves back into alignment”.

http://www.experienceispa.com/spa-goers/why-spa/


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Ruth Stricker Spa and Wellness Award Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Created in 2008

  • First recipient - Dr. Jen Seda

    “Our research is designed to show the biological, emotional, and mental benefits of a typical spa experience”


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Ornish, Lancet Oncology 2008 Data from the Current Employment Statistics Survey (April to April) 1988-2008.


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“Comprehensive lifestyle modification” Data from the Current Employment Statistics Survey (April to April) 1988-2008.

  • Lifestyle modifications included:

    • Low fat, whole foods, plant-based diet

    • Mod. aerobic exercise (walking 30”/d, 6 d/wk)

    • Stress management (gentle yoga stretching, breathing, meditation 60”/day, 6 d/wk)

    • 1-h group support session once per week.

Ornish, Lancet Oncology 2008


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Questions??? Data from the Current Employment Statistics Survey (April to April) 1988-2008.

[email protected]


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