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Dance therapy uses psychotherapeutic movement to support the cognitive, emotional, physical, and social integration of a person. Dance therapy may be of value for people with developmental, medical, social, physical, or psychological impairments.To evaluate the hypothesis that dance therapy has therapeutic benefits by systematically analyzing and summarizing the evidence.Thirteen databases were searched for systematic reviews and randomized controlled trials (RCTs) on the effectiveness of dance therapy. The Overall Quality Assessment Questionnaire (OQAQ) was used to assess review quality, and RCT quality was assessed using the Jadad Scale.Eight reviews and 18 RCTs about the effectiveness of dance therapy met our inclusion criteria. According to the OQAQ seven of the eight reviews were of poor methodological quality. The quality of the RCTs ranged from poor to good. In most cases, the reviews and trials reported positive benefits related to improvements in quality of life, self-esteem, or coping with a disease.Most studies have found therapeutic benefits of dance therapy, although these results are based on generally poor-quality evidence. Dance therapy should be considered as a potentially relevant add-on therapy for a variety of conditions that do not respond well to conventional medical treatments. Well-performed RCTs and observational studies are highly recommended to determine the real value of dance therapy.

Even though complementary and alternative medicine (CAM) is generally practiced as distinct systems of medicine, almost all CAM research has focused on single therapies. In order to more adequately evaluate the effectiveness of these medical systems, studies that evaluate the outcome of intact whole systems are needed. One challenge lies in defining the whole medical system (and any medical system it is compared to) in a way that ensures treatment fidelity.This paper presents a proposed method to measure treatment fidelity (treatment criteria) in studies of the naturopathic medical system.Illustrative example of the theory-based development and post-hoc "testing" of treatment criteria against an existing database of actual treatments prescribed by a random sample of naturopathic physicians.Treatment criteria for 3 conditions--menopausal symptoms, bowel dysfunction, and fatigue/fibromyalgia--and their comparison to actual treatments prescribed.A set of meaningful, measurable treatment criteria based on the naturopathic practice principles were defined that could have generated the majority (82%-93%) of treatment prescriptions given at visits for these conditions. Several of the treatment criteria components are common across the 3 conditions studied, and might be appropriate for all visits to doctors of naturopathy (NDs). Others are specific to each condition. In addition to ensuring model validity, these criteria help identify critical components of care, enable study replication, provide a measure of quality of care, and are one step toward allowing CAM to be studied as it is generally practiced-as distinct systems of medicine.Work was performed at Bastyr University and the University of Arizona.

Rigorously evaluating acupuncture and other complementary and alternative medicine (CAM) therapies presents researches with many challenges. The failure to satisfactorily address these challenges has resulted in poorly designed studies, which yield findings that are difficult to interpret. Despite the publication of more than 10 randomized trials evaluating acupuncture as a treatment for chronic low back pain, the efficacy and effectiveness of acupuncture for this common problem remain unclear. We discuss the rationale for and design of a five-arm randomized controlled pilot clinical trial that addresses the major methodological shortcomings of previous studies (e.g., poorly justified treatment and control groups and lack of masking) and that lays the groundwork for a full scale trial evaluating acupuncture as a treatment for chronic low back pain. Although development and pilot testing of these design features required substantial time and resources, we believe that this investment in rigorous groundwork is essential to ensure that full-scale trials evaluating CAM treatments produce valid and interpretable results.

Visit length is an important component of physician payment systems. As use and insurance coverage of complementary and alternative medicine (CAM) increases, equitable reimbursement strategies for CAM providers will be needed. Little information is available about the time CAM providers spend with patients.To describe the length of visit and determinants of visit time to chiropractors and acupuncturists.Survey of CAM practitioners that collected information on providers (e.g., socio-demographics, practice patterns, training) and professional visit encounters (e.g., patient demographics, payment source, problem acuity, visit length, procedures performed).Random sample of 130 licensed chiropractors and 133 licensed acupuncturists surveyed in 1998-1999, each from one Western and one Northeastern US state.Patient, provider, and visit factors associated with visit duration were analyzed using weighted linear regression.Data were available on 2550 chiropractic and 2561 acupuncture visits. Mean chiropractic visit length was 21.5 minutes (SE = 0.8). Mean acupuncture visit length was 56.6 minutes (SE = 0.7) In both professions, new patient visits took longer, while visits for wellness or chronic problems were shorter. Preventive counseling by the chiropractor increased visit time, as did use of manual (vs. instrument) spinal manipulation, soft tissue techniques and physiotherapeutics. Acupuncture visits were shorter when specialized needling techniques (e.g. auricular or scalp acupuncture) were used, and longer with other adjunctive Asian therapies (e.g., cupping or magnets). Self-paid acupuncture visits were longer, as were visits with acupuncturists who had less practice experience or fewer years of training.For both chiropractic and acupuncture, certain visit factors, provider characteristics, and procedures increase visit length, many of which parallel those observed in conventional medical settings. Thus, a similar time-based payment scheme may be a reasonable starting point for developing methods for reimbursing CAM providers.