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Apr 28 2015

The effect of foot massage on long-term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial

Published by under reflexology,research on massage

Moyle et al. BMC Nursing 2013, 12:5
Wendy Moyle1,2*, Marie Cooke1,2,3, Siobhan T O’Dwyer1,2, Jenny Murfield1,2, Amy Johnston1,2,4 and Billy Sung1,2
Background: Caring for a person with dementia can be physically and emotionally demanding, with many long- term care facility staff experiencing increased levels of stress and burnout. Massage has been shown to be one way in which nurses’ stress can be reduced. However, no research has been conducted to explore its effectiveness for care staff working with older people with dementia in long-term care facilities.
Methods: This was a pilot, parallel group, randomized controlled trial aimed at exploring feasibility for a larger randomized controlled trial. Nineteen staff, providing direct care to residents with dementia and regularly working ≥ two day-shifts a week, from one long-term care facility in Queensland (Australia), were randomized into either a foot massage intervention (n=9) or a silent resting control (n=10). Each respective session lasted for 10-min, and participants could receive up to three sessions a week, during their allocated shift, over four-weeks. At pre- and post-intervention, participants were assessed on self-report outcome measures that rated mood state and experiences of working with people with dementia. Immediately before and after each intervention/control session, participants had their blood pressure and anxiety measured. An Intention To Treat framework was applied to the analyses. Individual qualitative interviews were also undertaken to explore participants’ perceptions of the intervention.
Results: The results indicate the feasibility of undertaking such a study in terms of: recruitment; the intervention; timing of intervention; and completion rates. A change in the intervention indicated the importance of a quiet, restful environment when undertaking a relaxation intervention. For the psychological measures, although there were trends indicating improvement in mood there was no significant difference between groups when comparing their pre- and post- scores. There were significant differences between groups for diastolic blood pressure (p= 0.04, partial η2=0.22) and anxiety (p= 0.02, partial η2=0.31), with the foot massage group experiencing greatest decreases immediately after the session. The qualitative interviews suggest the foot massage was well tolerated and although taking staff away from their work resulted in some participants feeling guilty about taking time out, a 10-min foot massage was feasible during a working shift.
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* Correspondence:
1Research Centre for Clinical and Community Practice Innovation, Griffith University, 170 Kessels Road, Nathan, Queensland 4111
2Griffith Health Institute, Griffith University, 170 Kessels Road, Nathan, Queensland 4111
Full list of author information is available at the end of the article
© 2013 Moyle et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Moyle et al. BMC Nursing 2013, 12:5
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Conclusions: This pilot trial provides data to support the feasibility of the study in terms of recruitment and consent, the intervention and completion rates. Although the outcome data should be treated with caution, the pilot demonstrated the foot massage intervention showed trends in improved mood, reduced anxiety and lower blood pressure in long-term care staff working with older people with dementia. A larger study is needed to build on these promising, but preliminary, findings.
Trial registration: ACTRN: ACTRN12612000659808.
Keywords: Anxiety, Blood pressure, Care staff, Complementary and alternative medicine, Dementia, Long-term care, Massage, Mood state, Pilot, Randomized controlled trial
There are approximately 35.6 million people with dementia worldwide and, with the aging population, this number is expected to double every 20 years [1]. Whilst the majority of older people with dementia live in their own homes, and many developed countries are now prioritizing community- provided services in national policies and initiatives, a significant number still reside in long-term care (LTC) facilities [1]. Although inherently difficult to estimate, current data suggest that approximately 53% of people residing in Australian LTC facilities have dementia [2], while about two-thirds (64%) of people with dementia live in UK care homes [3].
Care staff working in LTC facilities are often under great physical and emotional demands. Research has shown that it is time-consuming to provide care for a person with de- mentia [4], and that many of the behavioral and psycho- logical symptoms of dementia, such as aggression, can lead to increased levels of stress and burnout [5], which can result in more negative attitudes and less empathy [6]. Such findings have worrying implications for the quality of care provided, particularly in terms of the increased risk of abuse and neglect [7,8]. However, there are also implications in relation to the recruitment and retention of staff, which continues to be a challenge for LTC facil- ities [9]. Specialized education and training of LTC staff is the likely means by which these issues will be addressed, and a recent report by the World Health Organization has advocated enhanced workforce education and training programmes on dementia and long-term care issues [1]. Effective interventions and techniques that moderate and reduce stress levels of care staff in the workplace should also play an important role.
Physiological models posit the particular effectiveness of massage therapy for inducing calming and reassuring sensations, with some evidence showing that an increased production of oxytocin positively mediates mood and social emotions [10]. Evidence from studies involving nurses, albeit limited by number and quality, suggest the potential stress alleviating effect of massage therapy when used in the clinical workplace. For example, a once-weekly 15-min back massage significantly reduced psychological symptoms
of anxiety in acute care hospital nurses [11]. A combin- ation of massage, relaxing music and aromatherapy was also shown to be effective in reducing anxiety for emer- gency nurses [12]. Similarly, a combination of tactile mas- sage and hypnosis helped reduce the stress and pain levels, and increase the work ability, of short-term emer- gency ward nurses [13]. Finally, a pilot study, involving healthcare workers at a LTC facility for adults with severe disabilities, found that a once-weekly 20-min massage ini- tially decreased pain severity, and showed some evidence of improving job satisfaction and morale [14]. There is an assumption that a reduction in staff stress will also influ- ence physiological measures such as blood pressure and heart rate.
When exploring the use of massage therapy in the LTC environment specifically, research has focused solely on the effect on residents with dementia. Whilst these studies have been criticized for poor methodological quality, they provide support for the positive effects of massage as a non-pharmacological intervention on agitated behaviors in this population [15]. To our knowledge, however, com- parable research has yet to be undertaken with LTC staff caring for a person with dementia. In light of this, the study described here was designed to assess the feasibility for conducting a larger, powered randomized controlled trial; and explore the potential of foot massage as a benefi- cial tool for the wellbeing of LTC staff providing care for people with dementia. A parallel group, randomized con- trolled trial was employed to ensure rigor, enable more valid and reliable conclusions to be drawn, and overcome methodological criticisms of previous research conducted in the field generally.
For the purposes of this pilot trial, it was hypothesized that when compared with the control group, participants receiving the foot massage would:
(1). demonstrate a greater reduction in negative mood as measured by the Profile of Mood States- Bipolar (POMS-Bipolar)
(2). demonstrate an increased state of relaxation, as measured by the physiologic parameters of blood pressure (BP)
Moyle et al. BMC Nursing 2013, 12:5
(3). demonstrate a reduction in anxiety, as measured by the Faces Anxiety Scale,
(4). report an increase in positive experiences of caring for a people with dementia, as measured by the Staff Experience of Working with Demented Residents’ Questionnaire (SEWDRQ).
The aims of this pilot trial were to: 1. assess the feasibility of the research design including recruitment of staff, the timing of the intervention and control sessions, and com- pletion rates; 2. compare the effect of foot massage versus a control activity of silent resting on LTC staff members’ BP (a physiological indicator of stress); anxiety; mood state; and experiences of working with people with de- mentia; and 3. review the trends in pre-post physiological measures to determine their use in a larger, powered randomized controlled trial.
This study was originally designed and conducted as a randomized controlled trial with cross-over, so that all participants experienced the foot massage intervention and silent resting control group. However, an unavoid- able change of location in which the intervention and control activities were administered occurred just after cross-over. Participants reported to the Project Manager (PM) a strong dislike for the new room (small with no windows), including some staff reporting feeling claus- trophobic, and initial inspection of results indicated a marked change in all outcome measures immediately after the room change. Because of this suspected extra- neous, stressful influence on care staff, it was considered inappropriate to analyze the data after cross-over. Thus, for the purposes of analyses and reporting, the study assumes a parallel group, randomized controlled trial design.
The study was granted ethical approval by the University Human Research Ethics Committee, and was verbally endorsed by senior management at the partner aged care organization and the nominated LTC facility.
One LTC facility, located in South-East Queensland (Australia), providing 105 beds for low (assisted), high (nursing home) and respite care to male and female residents, was nominated by the partner aged care organization as a suitable research site. This selection was based on the facility providing mainly high and dementia-specific care, and initial willingness from facil- ity managers and care staff to participate in the research.
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This study sought a sample of 20 LTC facility care staff. In the absence of a comparable study from which to cal- culate a sample size, this was considered sufficient for an exploration of the feasibility of the foot massage inter- vention and to provide initial pilot data. For convenience five participants who were available during the one-week period following the foot massage interview were asked to participate in a short individual qualitative interview.
The two Clinical Coordinators and the Director of Nursing at the LTC facility identified potential participants and provided them with informed consent materials so they could make a decision whether to participate. Formal enrolment into the research was based on the following inclusion criteria. The member of care staff:
1. providing direct care to residents (e.g., Registered Nurses (RNs), Enrolled Nurses (ENs), Personal Care Workers (PCWs), Assistants In Nursing (AINs))
2. regularly working ≥ two day-shifts a week
3. aged ≥ 18 years
4. willing and able to complete short, self-report scales
on aspects of their health, such as mood
5. willing to have their BP and anxiety measured after
each foot massage and silent resting activity
6. available for work at the facility for the duration of
the project, with no annual leave planned
7. providing written informed consent.
Staff were excluded from participating if they had evi- dence of skin infection or skin tears on one or both feet.
A member of the research team, who was blinded to the identity of eligible participants and not involved with data collection, used a computer program to undertake the permuted-block randomization process, with block sizes set at six. Participants were allocated to either the foot massage intervention or silent resting control group immediately after eligibility was determined and consent provided.
The foot massage intervention and silent resting control sessions were administered to participants individually, in a separate room with a closed door displaying a ‘Do not disturb’ sign. Each session lasted 10-min, and staff members could receive up to three sessions a week dur- ing their allocated shift, for four weeks. This meant that each participant could experience up to 12 sessions of either the intervention or control activity over the four- week study period (October- November 2011).
Treatment fidelity was upheld through: recruitment of two intervention Research Assistants (RA) who were prac- ticing massage therapists and had previously been trained in the foot massage technique for another research
Moyle et al. BMC Nursing 2013, 12:5
project; comprehensive training of intervention RAs in the implementation of foot massage and silent resting, and in measuring BP and anxiety; recruitment of a Project Manager (PM) to oversee the study; a standardized procedures manual detailing the protocol for both treat- ment and control; and spot-checks of data collection paperwork and the massage technique at regular intervals during the study period (checked by having the interven- tion RA give the foot massage to the trainer).
The intervention was a foot massage delivered by one of two RAs trained by an expert certified therapist in the massage technique. In each session, participants received a standardized five-minute massage on each foot (10-min in total), involving the application of light pressure with long, gliding, rhythmical strokes of the entire foot and ankle, and toe and ankle rotation, flexion and extension [16-19]. Unscented Sorbolene (8-10mls) was applied as a lubricant for the massage.
In the silent resting control sessions participants sat silently with their eyes closed and legs slightly elevated on a beanbag for 10-min. A trained RA stayed outside the room for the 10-min period. The purpose of the silent resting condition was to help isolate whether any observed effects were because of the foot massage specifically, or because the participant received special attention and had the opportunity to be away from the work environment for a quiet time.
Data collection
All participants were assessed on two self-report out- come measures at two main time-points during the study: pre-intervention (baseline) and post-intervention. The PM distributed the outcome measures to each par- ticipant, providing clear verbal and written instructions on how to complete each, and a contact number for any questions. Participants were asked to complete and re- turn the measures to a locked-box located in the LTC facility within one-week:
1. Profile of Mood States- Bipolar (POMS-Bipolar) [20]: a 72-item measure comprising six subscales measuring both positive and negative affects (‘agreeable-hostile’; ‘composed-anxious’; ‘clearheaded-confused’; ‘confident-unsure’; ‘elated- depressed’; and ‘energetic-tired’). Participants rate each item on a four-point scale that ranges from ‘0-much unlike this’ to ‘3-much like this’. Scores greater than 50 indicate more positive mood. This version of the POMS was chosen because of its ability to assess changes in mood in non-clinical situations produced by techniques such as massage [20]. The reliability of the measure and its subscales have been reported to be good, ranging from
α = 0.78 to 0.90 [21]. When used in this study, the
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internal consistency was excellent: α = 0.93 at both
pre- and post-intervention.
2. Staff Experience of Working with Demented Residents’
Questionnaire (SEWDRQ) [6]: a 21-item assessment of staff experiences and satisfaction, including their relationship with other staff and relatives of residents with dementia. In the original version, statements are scored on a scale from ‘0 – not at all’ to ‘4 – extremely’, with a total score and six sub-scores summated for the member of staff’s satisfaction with: ‘feedback’; ‘care organization’; ‘one’s own expectations’; ‘patient contact’; ‘expectation of others’; and ‘the environment’. In this study, as done previously [22], the instrument was modified to include culturally appropriate wording (i.e., ‘patient’ changed to ‘resident’). Higher scores indicate greater satisfaction. This modified version of the scale has good reported internal consistency (α = 0.80) [22], and this is confirmed in the current study (pre-intervention α = 0.93 and post- intervention α = 0.87).
In addition to these outcome measures, BP (systolic and diastolic – as a physiological indicator of stress), and a brief assessment of anxiety, were measured by a trained RA immediately before and after each session. BP was measured with a Digital Wrist Blood Pressure Monitor (model #6015) from American Diagnostic Corporation, America. Anxiety was measured using the Faces Anxiety Scale [23]: a validated scale [23] that asks participants to choose from five faces showing varying levels of anxiety.
A range of demographic information was also collected about each participant pre-intervention, including: age, gender, qualifications, role, length of time working in the facility, and number of hours worked.
Qualitative interviews with a subsample of five participants were undertaken post-intervention. As a mean to assess the feasibility of conducting a larger powered trial, the interviews were designed to assess participant’s perceptions of and reactions to the intervention, and their ideas for maximizing the efficacy of the intervention. These interviews sought to explore participants’ perceptions of: the intervention; timing of the intervention; practicalities of engaging staff in such an intervention; and suggestions for improvement.
Data analysis
All quantitative data were entered into PASW Statistics Version 20.0 (SPSS Inc., Chicago, IL, USA) for analysis. To confirm input accuracy, all entries were checked against source, and basic frequencies were run on all outcome measures and demographics to inspect the initial spread of responses, check for outliers and deter- mine the extent of missing data. The success of the
Moyle et al. BMC Nursing 2013, 12:5
randomization process was tested on the one pre- intervention variable (age) that permitted statistical analysis (because of the small sample size), via an inde- pendent samples t-test.
An Intention To Treat framework was applied to the analyses, so that all randomized participants were included and the small sample size preserved. Any missing values in the outcome variables were imputed with the respective series mean produced in PASW.
Total scores were computed for the POMS-Bipolar and SEWDRQ (the two self-report measures) at pre- and post- intervention respectively. Two, repeated measure ANOVAs were then undertaken to explore whether there were any differences in the measures when comparing foot massage versus silent resting (i.e., group differences). It was considered inappropriate to analyze the subscales of the POMS-Bipolar and SEWDRQ because excessive statistical analyses of the small sample size would likely increase the risk of a Type I error.
Change scores were calculated for BP (systolic and dia- stolic) and anxiety for each of the 12 foot massage or silent resting sessions (i.e., post- minus pre-intervention). An overall mean change score was then calculated for the foot massage and silent resting groups (i.e., sum of change scores divided by 12). Three, one-way ANOVAs were
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undertaken to explore differences in the physiological effect of foot massage versus silent resting (i.e., group differences) on participants’ BP and anxiety.
All statistical tests were considered significant at the level p < 0.05. All statistical tests were undertaken as a means of showing trends in the pilot data and feasibility of the pre-post physiological measures. The qualitative interviews were transcribed verbatim and then analysed using a thematic approach. The transcripts were read several times by members of the team, and emerging issues were discussed and classified into themes. Results The recruitment of staff was successful, in that 19 members of LTC facility staff were formally enrolled into the research, randomized to intervention or control group, and analysed (see Figure 1). Random allocation to treat- ment group was considered successful, as there were no significant differences between groups in terms of age (p=0.50). There was 5.6% missing data in the study overall. Sample characteristics A profile of participant characteristics is displayed in Table 1. To summarise, all participants were female, Assessed for eligibility (n=21) Excluded (n=2) Did not meet inclusion criteria (n=2) Randomized (n=19) Allocated to Foot Massage Intervention (n=9) Received Intervention (n=9) Allocated to Silent Resting Control (n=10) Received control (n=10) Lost before final data collection (n=0) Lost before final data collection (n=0) Figure 1 Flow of participants through study. Analysed (n=19)  Moyle et al. BMC Nursing 2013, 12:5 Table 1 Sample characteristics Characteristic Qualifications (n=17) Role (n=19) Time employed at the facility (n=19) Existing health issues (n=19) Current medications (n=19) Smoking status (n=18) Page 6 of 9 n Notes. Total n=19; Participants could tick all that applied for: Qualifications; Existing Health Issues. ranging in age from 23–63 years, with a mean age of 49 (σ=11.437). The majority were AINs/PCWs (n=16), with a Certificate in Aged Care/Nursing (n=14). The length of time participants’ had been employed at the LTC facility ranged from less than 12 months to more than 10 years, with one to three years being the most common (n=7). Participants typically worked four, seven-hour shifts per week. For those allocated to foot massage, the number of sessions they received ranged from 8 to 12, with the average number received being 11. For those allocated to quiet presence, the number of sessions ranged from 7 to 12, and the average number of sessions received was 10. This confirms the feasibility of delivering 12 sessions in the time allocated. In terms of physical health: four participants had hypertension, for which they were taking medication; five had arthritis; four had depression (of which three were taking an antidepressant); three had anxiety; one had diabetes; and one a skin disorder. Five participants regularly took pain relief medication, and five were current smokers. Comparison of POMS-Bipolar and SEWDRQ, pre- and post- intervention The reduction in negative mood hypothesis was supported in this pilot study. A repeated measures ANOVA for POMS indicated there were no significant differences in the interaction between Time (pre/post) and Group (con- trol/intervention; p=0.666) or between the main effect of Time (p=0.875); there was however, a significant differ- ence between the main effect of Group (p=0.03). Given that the POM means were not significantly different between the groups at baseline (independent t-test, p=0.061), and there is a non significant Time effect, the significant group effect appears to be spurious either due to the small sample size and/or the appropriateness of using mood as an outcome measure (See Table 2). The hypothesis that LTC staff would be more satisfied in terms of their experiences of working with people with dementia, was not supported (p =0.06). A repeated measures ANOVA for SEWDRQ indicated there were no significant differences in the interaction between Time (pre/post) and Group (control/intervention; p=0.502), Sub-category Certificate in Aged Care/Nursing Diploma of Nursing Bachelor of Nursing Women’s Health Education Registered Nurse Enrolled Nurse Assistant In Nursing/Personal Care Worker <1 year 1-3 years 4-6 years 7-9 years ≥10 years Hypertension Arthritis Diabetes Skin disorder Depression Anxiety Blood pressure medication Antidepressants Pain relief medication Non-smoker 12 Current smoker 5 Previous smoker: quit in the last five years 1 14 2 2 1 2 1 16 3 7 3 4 2 4 5 1 1 4 3 4 3 5  Moyle et al. BMC Nursing 2013, 12:5 Page 7 of 9 Table 2 Repeated measure ANOVAs exploring group differences in mood state and experiences of working with people with dementia Dependent variable POMS-Bipolar SEWDRQ Total scores (σ) Effect of group Pre-intervention Post-intervention Foot massage 53.63 (7.49) 58.56 (10.75) Silent resting 47.11 (6.62) 49.48 (10.14) Overall 50.20 (7.61) 53.78 (11.15) Foot massage 53.91 (7.76) 56.11 (8.22) Silent resting 46.52 (5.02) 48.75 (6.89) Overall F-Value 50.02 5.59 (7.33) 52.24 4.24 (8.25) Significance (p=) 0.03* 0.06 Partial eta squared (η2) 0.25 0.20 Notes. Total n=19; Foot massage n=9; Silent resting n=10; *p<0.05; σ = Standard Deviation; POMS-Bipolar=Profile of Mood States- Bipolar; SEWDRQ=Staff Experience of Working with Demented Residents’ Questionnaire; Increases in POMS-Bipolar total scores indicate increased positive mood state; Increases in SEWDRQ total scores indicate greater satisfaction with working with people with dementia. between the main effect of Time (p=0.220), or between the main effect of Group (p=0.055). Given that the base- line SEWDRQ means were not significantly different be- tween the groups at baseline (independent t-test, p=0.075) these results indicate that the intervention had no signifi- cant effect on the mean SEWDRQ (See Table 2). Comparison of BP and anxiety immediately before and after intervention/control session The hypotheses of a reduction in stress, as measured by BP, and anxiety, as measured by the Faces Anxiety Scale, were supported in this pilot study. There were statistically significant differences in diastolic BP (F(1,17) = 4.79, p= 0.04, partial η2=0.22) and anxiety (F(1,17) = 7.31, p= 0.02, partial η2=0.31) according to group, with those receiving foot massage experiencing greater decreases than their silent resting counterparts (see Table 3). This suggests that foot massage was more effective than silent resting in immediately reducing anxiety and lowering diastolic BP. In terms of systolic BP, although both groups saw a non- significant reduction in mean change scores (p =0.60), this reduction was greatest for those in the silent resting con- trol group (See Table 3). The qualitative interviews found that all participants enjoyed engaging in the foot massage intervention; they described positive experiences of the massage, the break from work, and interactions with the massage staff. Participants reported feeling relaxed after the foot mas- sage and reported that the foot massage had some impact on their work. The impact included: less pain in their feet, feelings of relaxation, increased energy, and increased ability to manage work demands. Although the foot massage was reported as a positive experience taking staff away from their work to participate in the foot massage created feelings of guilt when leaving colleagues short staffed while they were away relaxing. Participants reported potential changes to the interven- tion and these included changes to the location of the massage, potentially the shoulders, hands or neck at alternate sessions to help with body movement; more pressure during the massage; or more time for the massage. Discussion This pilot trial demonstrated the feasibility of conducting a foot-massage intervention for staff working in LTC facil- ities. In terms of recruitment, although the facility was considered to be of an average size (105 beds), and the re- cruitment focused only on day shift staff, an adequate num- ber of staff were willing to be involved and, thus, our estimation of the number we could recruit from one facility was accurate. Recruitment was hampered only by the trial being undertaken in the pre-holiday period when there was Table 3 One-way ANOVAs exploring group differences in blood pressure and anxiety Dependent variable Systolic Blood Pressure Diastolic Blood Pressure Faces Anxiety Scale Mean change scores (σ) Effect of group Foot massage −5.10 (3.34) −5.06 (2.46) −0.72 (0.42) Silent resting −5.88 (2.97) −2.25 (3.05) −0.30 (0.24) Overall F-Value −5.51 0.29 (3.09) −3.58 4.79 (3.07) −0.50 7.31 (0.40) Significance (p=) 0.60 0.04* 0.02* Partial eta squared (η2) 0.02 0.22 0.30 Notes. Total n=19; Foot massage n=9; Silent resting n=10; *p<0.05; σ = Standard Deviation; Change scores were calculated for blood pressure (systolic and diastolic) and anxiety for each of the 12 ft massage or silent resting sessions (i.e., post- minus pre-intervention). An overall mean change score was then calculated for the foot massage and silent resting groups for each measure (i.e., sum of change scores divided by 12). Moyle et al. BMC Nursing 2013, 12:5 a large number of staff on leave. Challenges to the research design included the environmental limitations, and this demonstrates the importance of undertaking a relaxation intervention in a room where participants felt comfortable. Outcome measures were not problematic for participants to complete, however, the project manager had to remind participants to complete and return to the locked box. Whilst the generalizability of the study’s findings are hindered by the sample size and the characteristics of the sample, which included 19 women from one LTC facility, this pilot trial provides important initial data on the feasibility and potential efficacy of foot massage for LTC facility staff working with older people with demen- tia. Although there were trends indicating improvement in mood the appropriateness of using POMS-Bipolar or even measuring mood in general is questionable as mood may be too malleable to measure across time. In this research mood appears to have been heavily influenced by the physical demands of the LTC workplace, whereby participant’s reported feelings of guilt at experiencing a pleasurable experience, such as that experienced from the foot massage while others were busy in the workplace. Given the effects of the workplace, and poor physical health on mood, in future research the measurement of general wellbeing may be a more appropriate measure. The study found that members of LTC staff who received the foot massage intervention had significant decreases in diastolic BP and anxiety levels immediately after experiencing a session. These findings support those from previous massage studies involving hospital nurses and healthcare workers [11-14]. Building on these initial findings, a larger study is now needed. The non-significant trend for all participants to be less satisfied with working with residents with dementia after the study period, particularly after experiencing the foot massage intervention, was unexpected. It is possible that the opportunity for 10-min quiet, sitting-down time and, in the case of foot massage, soothing physical touch, gave care staff an opportunity to reflect on the physical and emotional demands of the job of caring for a person with dementia, and the high-stress nature and busyness of their work environment. The time away from their work may have also raised concerns of how they were going to ‘catch-up’ on the tasks they had been unable to complete whilst participating in the study. Such reflections may have then translated into reduced satisfaction scores on the SEWDRQ. Another explanation may center on the use of the instrument chosen to assess staff work experiences, the SEWDRQ. To date, there has been only limited investigation of the scale’s psychometric properties and performance within an Australian context. However, the reliability coefficients produced in this study, and in previous work undertaken by members of the research team [22], have been good to excellent, thus offering some Page 8 of 9 reassurance for suitability of the instrument. More work may be required, however, to validate this scale in an Australian setting. The general trend for systolic and diastolic BP to im- mediately decrease after an intervention or control ses- sion suggests that foot massage produced a physiological relaxation response. However, the fact that decreases in diastolic BP were most marked (and statistically signifi- cant), for the foot massage group, but that the decreases in systolic BP were most marked (but non-significant) for the silent resting group, makes interpretation diffi- cult. The research evidence on the effect of massage therapy on BP is somewhat conflicting [11,24], and the results from this pilot study reinforce the need for fur- ther exploration of whether BP is a useful and clinically meaningful indicator of the effectiveness of foot mas- sage. At this stage, the implications of effects identified in this study are unclear and raise doubts about the feasibility of using physiological measures, such as BP, as a pre-post measure in a short intervention such as a 10- min foot massage. Finally the qualitative interviews suggest the foot mas- sage was well tolerated and although taking staff away from their work resulted in some participants feeling guilty about taking time out, a 10-min foot massage was feasible during a working shift. Conclusions This pilot trial provides feasibility data for undertaking a larger, powered randomized controlled trial, and provides justification for the importance of environment in relax- ation interventions. A larger study is now needed to deter- mine, and isolate, the efficacy of foot massage for LTC staff. Abbreviations AIN: Assistant in nursing; BP: Blood pressure; CAM: Complementary and alternative medicine; EN: Enrolled nurse; LTC: Long-term care; PCW: Personal care worker; PM: Project manager; POMS-Bipolar: Profile of mood states- bipolar; RA: Research assistant; RN: Registered nurse; SEWDRQ: Staff experience of working with demented residents’ questionnaire. Competing interests The authors declare that they have no competing interests. Authors’ contributions WM conceived of the study and its design, oversaw and coordinated the research, trained RAs, and assisted in drafting the manuscript. AJ and MC equally contributed by providing methodological and statistical advice, and in drafting the manuscript. SOD assisted in overseeing the study at the research site, training RAs, providing statistical advice and in drafting the manuscript. JM provided methodological and statistical advice, and took the lead in drafting the manuscript. BS undertook the statistical analysis and assisted in drafting the analysis section of the manuscript. All authors read and approved the final manuscript. No writing assistance was utilized. Acknowledgements This study was wholly funded by the Dementia Collaborative Research Centre – Carers and Consumers, whose sole role was monetary and had no part in designing and undertaking the study, interpreting the findings, Moyle et al. BMC Nursing 2013, 12:5 drafting the manuscript, or in the decision to publish. The authors acknowledge support and contributions by Churches of Christ (Queensland), senior management at Lady Small Haven Aged Care Services, and all participating care staff. Specific thanks are also expressed to Ms. Chrystal Gray for her diligent work as PM, and to Ms. Nok Sritoomma for her expertise and time during the training of RAs in the foot massage intervention technique. Author details 1Research Centre for Clinical and Community Practice Innovation, Griffith University, 170 Kessels Road, Nathan, Queensland 4111. 2Griffith Health Institute, Griffith University, 170 Kessels Road, Nathan, Queensland 4111. 3NHMRC Centre of Research Excellence in Nursing Interventions for Hospital Patients, Griffith University, 170 Kessels Road, Nathan, Queensland 4111. 4Eskitis Institute of Cell and Molecular Therapies, Griffith University, Eskitis 2 Building N75 Brisbane Innovation Park, Don Young Road, Nathan, Queensland 4111. Received: 31 July 2012 Accepted: 11 February 2013 Published: 18 February 2013 References 1. World Health Organisation: Dementia: a public health priority. Switzerland: World Health Organisation; 2012. 2. Australian Institute of Health and Welfare: Dementia among aged care residents: first information from the Aged Care Funding Instrument. Canberra: Australian Institute of Health and Welfare; 2011. 3. Society A’s: Dementia 2007. London: Alzheimer’s Society; 2007. 4. Ory MG, Hoffman RR III, Yee JJ, Tennstedt S, Schulz R: Prevalence and impact of care giving: a detailed comparison between dementia and nondementia caregivers. Gerontologist 1999, 39:177–185. 5. Brodaty H, Draper B, Low LF: Nursing home staff attitudes towards residents with dementia: strain and satisfaction with work. J Adv Nurs 2003, 44:583–590. 6. Astrom S, Nilsson M, Norberg A, Sandman P-O, Winblad B: Staff burnout in dementia care: relations to empathy and attitudes. Int J Nurs Stud 1991, 28:65–75. 7. Goergen T: Stress, conflict, elder abuse and neglect in German nursing homes: a pilot study amongst professional caregivers. J Elder Abuse Negl 2001, 13:1–26. 8. von Dras DD, Flittner D, Malcore SA, Pouliot G: Workplace stress and ethical challenges experienced by nursing staff in a nursing home. Educ Gerontol 2009, 35:321–339. 9. Economics A: Nurses in residential aged care. Australia: The Australian Nursing Federation; 2009. 10. Uvnas-Moberg K: Oxytocin may mediate the effect of positive social interaction and emotions. Psychoneuroendocrinology 1998, 23:819–835. 11. Bost N, Wallis M: The effectiveness of a 15 min weekly massage in reducing physical and psychological stress in nurses. Aust J Adv Nurs 2006, 23:28–33. 12. Davis C, Cooke M, Holzhauser K, Jones M, Finucane J: The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses. AENJ 2005, 8:43–50. 13. Airosa F, Andersson SK, Falkenberg T, Forsberg C, Nordby-Hörnell E, Öhlén G, Sundberg T: Tactile massage and hypnosis as a health promotion for nurses in emergency care: a qualitative study. BMC Complement Altern Med 2011, 11:83. 14. Back C, Tam H, Lee E, Haraldsson B: The effects of employer-provided massage therapy on job satisfaction, workplace stress and pain and discomfort. Holist Nurs Pract 2009, 23:19–31. 15. Moyle W, Murfield J, O’Dwyer S, Van Wyk S: The effect of massage on agitated behaviours in older people with dementia: a literature review. J Clin Nurs 2012, 22:601–610. 16. Moyle W, Johnston A, O’Dwyer S: Exploring the effect of foot massage on agitated behaviours in older people with dementia: a pilot study. Australas J Ageing 2011, 30:159–161. 17. Nelson D: The power of human touch in alzheimer’s care. MTJ 2004, 43:82–92. 18. Sansome P, Schmitt L: Providing tender touch massage to elderly nursing home residents: a demonstration project. Geriatr Nurs 2000, 21:286–331. Page 9 of 9 19. Tuchtan V: The evidence for massage therapy. In Foundations of massage. 2nd edition. Edited by Tutchan C, Tutchan V, Stelfox D. Sydney: Churchill Livingstone; 2004. 20. Lorr M, McNair D: Profile of Mood States-Bipolar fom (POMS-BI). San Diego, CA: Educational and Industrial Testing Service; 1984:1988. 21. O’Halloran PD, Murphy GC, Webster KE: Reliability of the bipolar form of the profile of mood states using an alternative test protocol. Psychol Rep 2004, 95:459–463. 22. Moyle W, Murfield J, Griffiths S, Venturato L: Care staff attitudes and experiences of working with older people with dementia. Australas J Ageing 2011, 30:186–190. 23. McKinley S, Coote K, Stein-Parbury J: Development and testing of a faces scale for the assessment of anxiety in critically ill patients. J Adv Nurs 2003, 41:73–79. 24. Delaney JP, Leong KS, Watkins A, Brodie D: The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects. J Adv Nurs 2002, 37:364–371. doi:10.1186/1472-6955-12-5 Cite this article as: Moyle et al.: The effect of foot massage on long-term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial. BMC Nursing 2013 12:5. Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color figure charges • Immediate publication on acceptance • Inclusion in PubMed, CAS, Scopus and Google Scholar • Research which is freely available for redistribution

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Aug 29 2011

History Of Reflexology – Corrections

Published by under history,reflexology

By Master Helen Whysong
Chapter One – From ‘One Step Beyond, author Master Helen Whysong’
History of Reflexology

Many civilizations have practiced reflexology. Evidence of this has been documented on four continents: Asia, Europe, Africa, and North America. The most common theory is that the earliest form of reflexology originated in China, as mcuh as 5000 years ago. The early Taoists are credited with originating many Chinese health practices.

The Cherokee tribes of North America to this day practice a form of reflexology that they continue to pass from generation to generation.

Reflexology traveled across India, Japan, Asia, and China. Traditional East Asian foot reflexology is called Zoku Shin Do. This is the foot portion of the Japanese massage technique. The roots of Zoku Shin Do go back to ancient China and are over 5000 years old.

Many changes took place in zone therapy, or reflexology, as new knowledge was added. In China, reflexology reached a new level. The practice of acupressure using the fingers turned into the practice of acupuncture using needles. The study of the reflex points still existed, but the knowledge was linked or added to and taken in a new direction—the direction of meridians. The Chinese concept of meridian therapy is an important part of the foundation of reflexology.

There are many peoples and individuals who deserve credit for the development of reflexology. This timeline charts some of the salient contributions.

2500 BC Ancient Egypt. Evidence of the practice of reflexology has been found in anceint Egypt, dating as far back as 2500 BC. Alternative medicine procedures were commonly practiced. The Tomb of the Physician, Ankhmahor, is located in the necropolis (city of the dead) of Saqqara. Saqqara was a burial ground of Egyptian pharaohs for over a thousand years, from the time of the First dynasty, the earliest organization of the civilizations of the Upper and Lower Nile Valley, dating back to 2750 BC.

Physiotherapy was depicted in a relief tomb in Saqqara, showing the massaging of a shoulder and a knee. Heliotherapy (exposure to ultraviolet sun rays) for pain relief was mentioned in the Ebers Papyrus. To relieve pain in any part of the body, the procedure was to anoint the body and expose it to the sun. Mud and clay therapy was described in this way: “Thou shalt do for it: rub her feet and legs with a mat [mud and clay] until she is well.” Hydrotherapy (treatment by water) was practiced in a sanatorium near Dendara temple, in chambers that were equipped with basins. Water was poured down over a statue, then flowed down a canal into the basins. In the tomb of Nenkh-Sekhmet, Chief of Physicians in the 5th dynasty, it was written: “Never did I do anything evil towards any person.”

A pictograph dating between 2500 – 2330 BC in the tomb of Ankmahor displays the operation of circumcisions. Some illustrate the care given to the hands and feet, and it has been suggested that they represent the manicure and pedicure. The translation in *** most reflexology books of the hieroglyphs states: “Don’t hurt them; and make it enjoyable for you, my dear.” Most reflexologists say that this is a reference to an early practice of reflexology, though this is questioned.

(*This is it! the picture in our reflexology books have a different translation than in the history books. The history book translation states; Make these give strength. Reply: I will do thy pleasure. and Do not cause pain to these. In the history books the practitioners have tools in their hands performing work on the feet. Dr. Fitzgerald used tools!!!)

(Because of copyright I was not permitted to include the picture so here is the information; The books is; The Tomb of Ankhm’hor at Saqqara by Alexander Badawy.)

(The history book translation doesn’t sound like a manicure but a physical help for the body??)

One of the temples built by Ramses II contains a carving of the victory at the battle of Kadesh. The carving includes a depiction of soldiers on the campaign having their feet tended to. Even today ancient footwork practice can be found in some remote Egyptian villages.

The Egyptian people were a giving civilization. The water from the Nile river would flood the gardens and produce rich black soil. As a result they had an abundance of crops of wheat, corn, figs, and other vegetables. The crops and fish from the streams were shared among all the people, even the laymen. The weather in Egypt was rainy, making the climate sticky and humid. The Egyptian people were clean-shaven, with little or no body hair; the ladies used to shave their heads and wear wigs that were worn up on the top of the head like a beehive. In these beehive hairstyles, they would put essential oils embedded in wax. As the wax warmed, it would melt and the fragrant essential oils would be released into the air. Jewelry was strung around the neck like a large collar, and bracelets were worn both on the forearm and the upper arm. Often Egyptian people wore no tops; they only wore their gold jewelry and a silk sheet that wrapped around certain parts of the body.

The Egyptians educated within their community, and they were a gifted community; they had the first dentist, wonderful architects, doctors and so on. If the head of the household was a dentist, you were trained to be a dentist; if a builder, the offspring became a builder. Egyptians were the first to use gold in tooth fillings. Most of our holistic arts come from Egypt: Cranial Sacral, Aromatherapy, Massage, and Reflexology.

Egyptian families all lived together: grandma, sisters, brothers, father, mother, and all their children. They were very family minded and took care of each other, marrying as teenagers. They married their servants, and mixed marriages with their own relations was common practice. Because of this early motherhood and inbreeding, bloodlines became weak. The death rate among children was high and lives were short by today’s standards.

The Egyptians were a rich people. Other peoples found out about this and wanted to trade services with them. Trade began spreading across the large expanses of water that protected the Egyptians and surrounded their homes. People were jealous of the riches in Egypt and started wars with them. The Egyptian warriors were very organized and they usually won their battles. They would fight with a great deal of forward planning. They would line their warriors up both in a line and several rows deep. The attackers could not get through them, and they would have their victory. Despite the wealth in the land, the Egyptian people remained very humble in their workmanship. They would use the old ways of gardening, without modern equipment. Even today they live very humbly.

Everyone has seen movies of the great tombs of Egypt. They would cover these tombs with pictures to honor their dead. One of these tombs is particularly important for our discovery of reflexology—the physician’s tomb, the tomb of Ankhmahor in Saqqara. There is a really nice book called The Tomb of Ankhmahor at Saqqara by Alexander Badawy that shows you the tomb’s pictographs, which include circumcision, childbirth, pharmacology, embalming, dentistry, and reflexology. Scenes like these were carved into the tomb wall not only to honor the physician but also for religious purposes. On the reflexology pictograph you will notice that it looks as though the therapist is holding a tool in his hand for working on the feet. Underneath the picture it is written, “Make these give strength, reply, ‘I will do thy pleasure,’ reply, ‘Do not cause pain to these.’ ”

475-221 BC In China, the Yellow Emperors of Internal Medicine identified 14 channels (meridians) within the human body, six of which travel to the foot. Meridians are energy pathways all over the body that link our internal organs with the other parts of our body. These energy channels are the pathways for the circulation of the vital life force, which the Chinese call chi and the Japanese ki. Chi is also referred to as “life force,” “vital force,” and “vital energy.” Although chi is necessary for the existence of life, it is not visible to the naked eye; it is more akin to the electrical energy in our body. Reflexology is very effective in stimulating and revitalizing this energy flow. As we practice our reflexology techniques, we stimulate the autonomic nervous system, which is linked to every organ, gland, and all parts of the anatomy. The Chinese theory is that there must be an open flow of chi to maintain good health.

60 BC Mark Anthony is noted in historical works to have worked on Cleopatra’s feet at dinner parties.

300-700 Age of the Mayans and the Incas. These high cultures developed reflexology to diagnose and treat many illnesses. The Mayans documented their findings by carving them into stone plaques. The altar at Copan has engravings with symbols encoded that only medicine men could understand.

790 Buddhas footprints are found in the Medicine Teacher Temple in Nara, Japan.

1292 Marco Polo, upon his return to Italy, may have introduced Chinese massage techniques to the West. Another possibility is that the Dominican and Franciscan missionaries brought this knowledge home sometime during the Middle or Dark ages of Europe, between 400-1400 AD.

1582 In Europe at this time, zone therapy was practiced in several countries. The first book found published on the subject was by Dr. Adamus and Dr. Atatis in 1582. In Leipzig, Dr. Ball writes a a book on the same subject.

1771 Johann August Unzer, a German physiologist, in his published work is the first to use the word “reflex” with reference to the body’s motor reactions.

1830 Neuro-vascular holding points are discovered in 1830 by Dr. Terrance Bennet, a chiropractor. He found these points mainly on the head, and deduced that they seemed to influence the flow of blood to specific organs and structures in the body.

1833 Marshall Hall, an English physiologist, in a study on the reflex function of the medulla oblongata and the spinal cord, uses the term “reflex action” and demonstrates the difference between unconscious reflexes and volitional acts.

1834 The Swedish doctor Pehr Henrik Ling notices that pains emanating from certain organs are reflected in certain areas of the skin, but with no direct relation to these organs. Other students followed this line of thought, including the English neurologist Sir Henry Head. The treatment zones that he discovered came to be known as “Heads zones”. Therapeutic anesthesia was born.

1870 Russian psychologists begin researching zone therapy. These include Ivan Pavlov and Vladimir Bektev, founder of the Russian Brain Institute.

1890 Sir Henry Head publishes his discoveries that the sensitive areas of the skin are connected through nerves to a diseased organ. “The bladder,” he wrote, “can be excited into action by stimulating the soles of the feet.”

1900 Dr. Alfons Cornelius in Germany improves his own health by reflex massage.

The year 1913 witnessed the rebirth of reflexology.

“Reflexology is Nature’s push-button secret for vibrant health, more dynamic living, abundant personal energy, and better living without pain. A scientific technique of massage that has a definite effect on the normal functioning of all parts of the body.” – Dr. William Fitzgerald, 1913

Dr. William Fitzgerald (b.1872 – d.1942) is known as the “Father of Zone Therapy.” He was the most forward thinking of medical men, who became a natural healer through the art of using pressure therapy to benefit and heal the human body. A graduate of the University of Vermont, he was for many years senior Ear, Nose and Throat Surgeon at St. Francis Hospital, Hartford, Connecticut. While working at his specialty, he observed that by applying pressure to certain parts of the body the patient would feel no pain, and he was able to do minor operations without using cocaine or any other local analgesic.

Dr. Fitzgerald is responsible for what we call zone therapy today. He devised the system of mapping the body into five zones on each side of a median line. These zones run the length of the body from the head to the feet.

It is by using this map of the body on the feet that we are now able to find the reflex points that mirror our entire body. Dr. Fitzgerald called these lines the “ten invisible currents of energy” through the body, and he demonstrated the correlation between the reflex points on the feet and areas in distant parts of the body. He showed how a pressure of between 2 and 10 pounds on a given finger or toe could alleviate pain anywhere in a corresponding zone in the body.

Dr. Fitzgerald showed that the upper and lower surfaces of the joints and side areas could all be pressed with good results. He also showed that each zone could be worked on a client’s hand or foot, because the zones run to both extremities. The zones pass through the body from front to back. Each zone represents or includes all the organs, muscles, and bones through which the respective zone line passes.

The distance between the area treated and the corresponding organ was of no importance, since the entire zone was being treated. When pain was relieved, the condition that produced the pain was generally relieved as well, and this led to the mapping out of these various areas and associated connections, and also to the conditions influenced through them. Dr. Fitzgerald would use rubber erasers for therapy bites, metal combs, elastic bands, pegs and percussion motors, and surgical clamps on reflex areas. He applied pressure over any bony eminences or upon the zones corresponding to the location of the injury. In the book Zone Therapy (1928), Dr. Benedict Lust M.D. wrote, “I have reason to believe that there are now upwards of five hundred physicians, osteopaths, and dentists using these methods every day, with complete satisfaction to themselves and their patients.”

Dr. Fitzgerald was responsible for the studies and practices of zone therapy. Zone therapy (as it was called) has been practiced and taught by some of the most noted doctors in America. Zone therapy was taught by Dr. Fitzgerald to many doctors and chiropractors. The chiropractors, impressed with what they saw and learned, taught it to others in their chiropractic schools. Dr. Joe Selby-Riley (M.D., M.S., D.O., N.D.) said, “The scope of the science of Zone Reflex [Reflexology] is almost unlimited. Great physicians who have investigated it fully made the claim that it is the greatest ally yet found to this work. Side by side with other great therapies, zone therapy will stand in the march of science and progress.”

The work was wonderful, and very effective for the client. The level of discomfort was at times unbearable, but the results were fantastic. The practitioner, however, found a flaw in these techniques. Not only was a treatment sometimes beyond a client’s comfort zone, but the client could watch the practitioner, then go home and copy the action the practitioner applied to them. Reflexology is easy to learn, so as the doctors and chiropractors worked on the clients, the clients worked on themselves, and thus would not have to come back as often, yet still get fantastic results. Over the years, however, zone therapy became less popular because of the pain level induced by the techniques used.

Here is a list of contemporaries of Dr. Fitzgerald who used zone therapy. This list gives some idea of the wide range of therapies that included zone therapy techniques.

• Dr. J. S. Selby-Riley, Washington D.C. (chiropractor)
• Dr. Edwin F. Bowers, M.D., Los Angeles CA, author of Zone Therapy, or Relieving Pain in the Home
• Dr. George Starr White, M.D.
• Dr. Benedict Lust, N.D., D.O., D.C., M.D. He was called the “Father of Naturopathy.” Dr. Lust was the founder and dean of the American School of Naturopathic, the American School of Chiropractic, and the New York School of Massage. He was also owner and director of the Youngborn Health Resort, which had locations in Butler, NJ and Tangerine, FL. Author of Universal Naturopathic Encyclopedia, he wrote an article on zone therapy entitled, “Relieving Pain and Sickness by Nerve Pressure.”
• Dr. R. T. H. Nesbitt, Waukegen, IL. Dr. Nesbitt was one of the physicians who used zone therapy for childbirth. He had very gratifying experiences with pressure analgesia.
• Dr. G. Murray Edwards, Denver, CO, also used zone therapy for childbirth. He replaced the use of chloroform with elastic bands, each an eighth of an inch wide, that he wrapped around each foot, one around the large toe at the first joint and one around the remaining toes.

1913 Dr. William Fitzgerald

1916 Dr. Joe Shelby-Riley, who ran a school of chiropractic in Washington D.C, and his wife, Elizabeth Ann Riley, were students of Dr. Fitzgerald. Dr. Shelby-Riley wrote twelve books on the subject of zone therapy. He also introduced the technique called “hookwork,” by which the fingers are hooked under the bones to work certain areas of the body in connection with zone therapy.

1917 Dr. Edwin F. Bowers, M.D., a well-known medical critic and writer in New York, heard of Dr. Fitzgerald and his work, and, after making his acquaintance, helped Dr. Fitzgerald to write down his findings. Together they published the book, Zone Therapy, Relieving Pain at Home. It was Dr. Bowers who coined the term “zone therapy.”

1917 V.M. Bechterev of Russia coined the term “reflexology.” He was a colleague of Pavlov.

1920 Harry Bond Bressler was a writer and graduate of the Shelby-Riley Chiropractic School. In his writings he altered the zones from five lines to four. It is important to be aware of his alteration, because early books on the subject of reflexology can provide conflicting information with regard to zone location.

1925 Eunice D. Ingham Stopfel (b.1889 – d.1974) was a massage therapist (*error in the reflexology books) and lecturer, and author of Stories the Feet Have Told Through Reflexology. She learned the technique of reflexology while working for many years under Dr. Shelby-Riley. Eunice Ingham became known as the “Mother of Reflexology.” She blazed the trail for further developments in reflexology, and the technique we use today, The Original Ingham Method, is named after her. Eunice Ingham’s nephew, Dwight C. Byer, now continues her work.

(*Reflexology books state that Eunice was a mere massage therapist, while in fact she was a Chiropractic. I interviewed her nephew Dwight C. Byers about 1997 and he stated that he had been going through his aunts belongings and ran across a diploma for her as a Chiropractor.)

1938 Dr. Fitzgerald discovers Mayan stone plaques that seem to pertain to foot reflexology. He and Eunice Ingham decode these plaques; other stone plaques detailing hand reflexology were too eroded to be deciphered (which may help explain the prominence of foot reflexology).

1966 Doreen E. Bayly was trained by Eunice Ingham in America. She is responsible for bring reflexology therapies to Great Britain (in 1966). Ms. Bayly is also the author of a book on reflexology.

1974 Publication of Zone Therapy by Anika Bergson and Vladimir Tuchack.

From the book: “Zone therapy systems are a boost to conventional curative methods as practiced by the medical profession, not something opposed to or at variance with its practice. The stark simplicity of these wonderful methods stands in direct and dramatic contrast to the very nature of disease and those stubborn and depressing psychological conditions which disease brings in its wake. Zone therapy systems cannot possibly be detrimental if followed correctly. They can be amazingly, miraculously effective.”

The authors go on to say that zone therapy has been practiced for some fifty years before the publication of this book.

1975 Mildred Carter, a student of Eunice Ingham, was author of the book Hand Reflexology: Key to Perfect Health. She calls reflexology “a form of western-type acupuncture. The body’s vital life force circulates along pathways, and we can tap into an estimated 800 points on the body. But we can work these reflex buttons that go to all the organs with the feet and hands.” Ms. Carter has passed on, but her family has a website with her tools and books for resale.

1976 Stephan Thomas Chang published the theory that the discovery of pressure points took place when wounded soldiers baffled the ancient Chinese physicians by claiming that symptoms of disease vanished after they had been hit by arrows or stones. The relationship of pressure to the various organs was developed by trial and error by other Asian peoples as well. The various schools of martial arts began using pressure points to disable opponents.

1979 Ed and Ellen Case of Los Angeles, CA, on a tour of Egypt with Dr. Gwendolyn Raines, brought back an ancient Egyptian papyrus scene depicting the treatment of hands and feet in 2500 B.C.

1981 Anna Kaye, noted for her seminars and workshops, was co-author with Don C. Matchan of the book Mirror of the Body. Anna Kaye was a student of Eunice Ingham, and a student of polarity of Randolph Stone, Ph.D. She was 74 years of age when this book was published.

1983 Jurgen Kaiser was author of the book Masseur and Medical Balneologist. After training in foot reflexology, Mr. Kaiser researched hand reflexology intensively and put the zones into a topographical order. He concluded that hand reflexology could achieve even better results than foot reflexology, and that since it was easier to use, it had greater potential for the lay person.

1983 Dwight C. Byers holds special training and seminars on the subject of reflexology, and is author of Better Health with Foot Reflexology.

1984 Hanne Marquardt is the author of Reflex Zone Therapy of the Feet. This was the first British publication on reflexology since Eunice Ingham’s books. Hanna has twenty-five years experience as nurse, midwife, ward sister, and tutor in England and South Africa. Mrs. Marquardt offers courses in the United Kingdom at: British School of Reflex Zone Therapy of the Feet, 87 Oakington Avenue, Wembley Park, London HA9 8HY England, UK.

1985 National Inquirer reports that Prince Charles is hooked on reflexology therapy, which involves clearing the body’s 10 vertical energy channels by massaging different areas of the feet.

1990 Helen Whysong studied with Carole Poore, a Nature Sunshine provider, in Phoenix AZ. Carole held classes on herbs, iridology, and reflexology in her home. At this time Helen had persistent ear aches in her right ear (it had been punctured when she was eleven years old), and the doctor had recommended surgery. Since she had no insurance she was administered reflexology treatments, and these treatments eliminated the pain and kept infection out of the ear. Since then Helen has had two surgeries—she still has the hole in her left ear—and reflexology is still working its magic. Helen’s first experiences with reflexology left a deep impression on her, but she did not know that their was proper training in this area until 1991.

1997 Newsweek reports that Princess Diana has foot reflexology three times a week.

1998 Ladies Home Journal reports that the Duchess of York, Sarah Ferguson, is a client of Joseph Corvo, practitioner of the “so-called discipline of zone therapy”. The treatment involves massaging fifteen specific nerve endings on the face, which are said to revitalize eleven areas of the body.

Other Sources on the History of Reflexology
International Federation of Reflexologists, from Reflexology – An International History www://

Reflexology: Art, Science and History by Christine Issel
New Frontier Publishing P.O. Box 246654, Sacramento, CA 95824

Hand Reflexology by Jurgen Kaiser, Alexander Scharmann, MD, Beate Poyck-Scharmann, MD, Sterling Publishing Co., Inc. New York

Master Helen Whysong has been teaching Reflexology since 1995, director of Arizona Institute of Reflexology & Clinic in Mesa Arizona since 2000, Author of S.O.A.P. notes for clinical reflexology book since 2003, now releasing books; One Step Beyond and Zonery and Reflexology. Practitioners since 1992. DVD long distance classes available this summer. Helen believes that Reflexology is the gift of love, in the art of healing mind, body and spirit one foot at a time. Blessings.

This article was posted by Helen Jeanne Whysong

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Dec 27 2009

You Could Use a Vibrating Foot Massager

Published by under Chinese Reflexology,reflexology

What do humans walk or run on? Yes, that’s right, feet! It’s our feet that help us to run, walk and achieve all the goals of our lives. And it’s the feet which hurt the most at the end of a long day! Earlier, our forefathers had people who pressed and massaged their feet. They had saunas and steam baths which helped in rejuvenating them. However, these days when a visit to a beauty parlor costs money and almost half your salary, people don’t really get time to take care of their feet. As a result, they have all sorts of problems from edema to varicose veins and painful soles. However, thanks to the increasing popularity of the vibrating foot massager, most people no longer are facing these leggy issues!

Here are some advantages of a vibrational massage:

* It helps in relaxing your feet and hence reducing your stress.
* Stiffness and the muscle tension is relieved.
* Its particularly useful in healing sprained ligaments, strained muscles and swelling.
* It also relieves muscle spasms and aids in enhancing flexibility and range of motion.
* It also helps in enhancing athletic performance.
* Helps in enhancing the blood circulation and lymph fluids movement.
* Since it aids in relieving stress, it also helps in reducing blood pressure.
* You get a relaxed state of mind and your immune system is strengthened.

There is vibration in every atom of the universe. Hence, a vibrating foot massager only helps in the synchronization of these vibrations and helping your muscles to achieve a complete state of harmony.

Find the perfect vibrating foot massager for you! Personal Foot Massager

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Nov 26 2009

Geriatric Massage – Part II: Modalities for Frail Elders

Discover six techniques that can safely be used on those who are experiencing the discomforts of aging, and find out five special precautions and contraindications to be aware of regarding this growing population.

by Linda Fehrs, LMT

Studies have shown that the lack of touch can lead to severe psychiatric or physical problems, and even death in infants. Among the elder population it can lead to depression, anxiety, low self-esteem and lethargy. Lack of caring touch can result in a diminishing quality of life for anyone. Babies cry out to us for touch, but the touch-deprived senior often remains silent. It is important for those in the bodyworking professions to reach out to those who perhaps need them the most.

A frail elder would be defined as someone requiring assistance in taking care of every day needs such as dressing, bathing and eating. They may not be able to move around freely on their own, perhaps needing a walker or wheelchair to assist in mobility. Often they are living with family members or reside in some kind of assisted living facility.

For the very frail client, any vigorous or deep massage is generally contraindicated. But there are also many modalities with a lighter touch that provide similar health benefits, as well as offer comfort and compassion to the recipient. For many frail elders a typical Swedish massage may be too stimulating, and care needs to be taken regarding the use of techniques that might influence the effects of medication. They may be taking medication for blood pressure, a blood thinner, insulin for diabetes or undergoing a regimen of chemotherapy. A thorough intake and evaluation is important in determining what techniques will be most beneficial to your client.

Less Invasive, Yet Effective Techniques
1. Cranial Sacral Therapy – is a gentle, non-invasive technique that uses a light touch to encourage the healthy movement of cerebrospinal fluid. This method of bodywork is used to reduce the negative effects of stress, enhance overall health and improve resistance to disease. It has also been shown to reduce problems associated with pain as well as some neurological dysfunctions, because of its affect on the brain and spinal cord.

2. Lymphatic Drainage – is used to stimulate the movement of lymph, which in turn helps to rid the body of inflammatory and toxic material. This technique uses a rhythmic, light touch to enhance the body’s own gentle pumping action within the lymphatic system. Lymphatic drainage massage helps to enhance the immune system as well as to reduce pain.

3. Polarity Therapy – is a bodywork technique that is based on basic principles of energy. The body is gently manipulated to rebalance the negative and positive energies within the body. Polarity therapy also encourages living in harmony with nature and includes recommendations of improving ones diet and exercise.

4. Reflexology – is a modality originally based on an ancient Chinese therapy. It involves the application of pressure to specific areas in the foot, hands and ears, which correspond to various parts of the body. The applied pressure to these reflex zones in turn stimulates body organs and relieves areas of energetic congestion. Reflexology is used to reduce pain, increase relaxation and stimulate circulation of blood and lymphatic fluids, and has been found to be useful in stress related illness and emotional disorders. Reflexology can also be used in circumstances where areas of the body are traumatized or diseased to the extent that direct touch is contraindicated.

5. Shiatsu – a light compression technique, similar to acupressure, was developed in Japan and uses traditional acupuncture points which help to encourage the healthy flow of life energy as well as restore balance in the body. Shiatsu uses traditional five-element Chinese medicine, which shows a relationship between the earth’s natural rhythms and the human body. The technique produces a sense of relaxation while stimulating blood and lymphatic flow. In turn, this helps with pain relief and the strengthening of the body’s resistance to disease and discomfort.

6. Therapeutic Touch – is a non-invasive form of energy work based on ancient energy healing methods. Used mostly by nurses, it is also used by other bodywork professionals who are trained to feel or sense energy imbalances in the client. The therapist uses a light touch or holds the hand above the body, with the client generally seated. Therapeutic Touch has been used in a variety of medical situations, including the care of premature infants. It is known to induce a state of relaxation within minutes.

Five Precautions
1. Hot Stone Massage – it might seem gentle enough, but for those who are on certain pain medications, or who suffer from the effects of diabetes, they are less sensitive to heat and pain and may not be able to respond appropriately. Make sure you are well trained in this modality before using it on a frail or elderly client.

2. Accommodating Special Needs – whether the massage is conducted in your office, a client’s home, an assisted living facility, a hospital or hospice, care needs to be taken to accommodate the special needs of the individual. Preparation in the way of extra bolsters or pillows, a blanket for added warmth or lubricants for dry or fragile skin is very important.

3. Slower Mobility – depending on the modality or techniques used, you may want to limit the massage session to no more than a half hour, and allow extra time before and after the session to allow for slower mobility. Intake may take longer, your client may need more time to get undressed or there may be problems with mobility, getting on and off the table or in and out of the office.

4. Special Contraindications – would be to never work in an area that has received radiation therapy or that has a tumor.

5. The Usual Precautions Are Also Advices – such as avoiding black and blue areas, varicose or other distended veins, areas of recent surgery, rashes, etc. And if your client has a pacemaker or other implanted device, make sure you get an okay from his/her physician.

At any age massage therapy can be a benefit, but for the frail elderly it ameliorates some of the inevitable physical discomfort and pain that accompanies growing older. It helps us improve their mobility as well. Getting a regular massage helps in the emotional aspects of their lives as well. It has been shown to reduce the feelings of isolation, fear, anxiety and depression perhaps because it offers a gentle, nurturing touch to those who may live a life alone without close family or friends.

Consider providing your services as a massage therapist to nursing homes, assisted care facilities, hospitals and hospice programs. You will find it is rewarding in more ways than words can express.

Recommended Study:
Cranial Sacral Fundamentals
Healing Energy and Touch
Lymphatic Drainage Massage
Polarity Therapy
Shiatsu Anma Therapy


Catlin, LMT, Ann. “Serving Older Adults.” MJT Summer 2008: 111-121.

Finch, Mary Ann. Care Through Touch. New York: Continuum, 1999.

Nelson, MFA, CMT, Dawn. Compassionate Touch: Hands-On Caregiving for the Elderly, the Ill and the Dying. Barrytown, New York: Station Hill Press, Inc., 1994.

Nelson, Dawn. From the Heart Through the Hands: The Power of Touch in Caregiving. Forres, Scotland: Findhorn Press, 2001.

Rose, Mary Kathleen. “Comfort Touch: Nurturing Acupressure Massage for the Elderly and Ill.” December/January 2004. Associated Bodywork and Massage Professionals. 14 Oct 2008 .

Posted by Editors at 02:06 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute.

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Nov 10 2009

Carpal Tunnel and Reflexology

Published by under reflexology


Do you suffer from pain in your wrist, hands, arms or fingers? Could you describe this pain as “a tingling numbness feeling?”

Does this pain keep you from enjoying the things you need or want to do? It’s most likely you have developed “Carpal Tunnel Syndrome. “
Reflexology is a scientific art based on the premise that there are zones and reflex areas in the feet, hands, body and ears, which correspond to all organs, glands and systems of the body. The physical art of applying specific pressures using thumb, finger, and hand techniques result in physiological changes. Whysong Reflexology™ takes in the whole person, body, mind and spirit. Searching for the core issues to help release this restricting dis-ease.

When treating carpal tunnel with reflexology you work the feet, wrist, back, shoulders and neck area. Clients say they can feel a tingle release and go up there arm or down the arms from the neck.

During 1998, an estimated three of every 10,000 workers lost time from work because of carpal tunnel syndrome. Half of these workers missed more than 10 days of work.

The average lifetime cost of carpal tunnel syndrome, including medical bills and lost time from work, is estimated to be about $30,000 for each injured worker.

Reflexology combined with Asian study could pay an enormous part in discomfort of the wrist area. We have six meridians that run through our wrist. Each meridian has many points of action in it, but the main one is called a source point. This is an area that when touched, reflexed, massaged can adjust the whole meridian. These points are located on the brink of the wrist.

One of these meridians is the lung meridian. The source point Lung 9 the lung meridian is in the radial groove at the wrist fold. This is a good reflex location for wrist conditions, asthma, coughing, chest pain and the emotion of grief connected to the lung meridians. Lungs gather the heavenly chi in the course of the breath. Breathing is the first thing we do when we are born and the last thing we do before we die.

The Lung Meridian travel up from the chest area and along side of the thumb. Pain in the thumb could be a chi disorder, or due to lung involvement or/and due to the paired meridian the large intestine. Or in this area could be that of carpal tunnel and the Ulnar /Median nerve.

Flexibility – Theories
Keep your mind flexible and open to theory. The more theory the more chances at finding core issues to the problem area. Chose prevention before it’s too late.

You too can learn how to apply this technique. You don’t have to be a therapist to have an interest in helping yourself, loved ones and your friends. Class available on DVD distance training course that you can view and review until you are comfortable to apply it with the skills to make a difference.

Master Helen Whysong has been a therapist in good standing since 1992, she is the director of Whysong Reflexology a Distance Training Center in Mesa AZ since 2000, author of S.O.A.P. Notes for Clinical Reflexology, One Step Beyond, and more.

This article was posted by Helen Jeanne Whysong

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Nov 10 2009

Why People Should Buy Foot Massagers

Published by under reflexology

Why would you want to buy foot massagers? Most people feel that it’s really a waste of money, when you can avail the same benefits in a professional saloon. Well, if you are one of those who think that, then just think about how many times have you been to the saloon in the past month?

Most of us are constantly running around trying to get things done through out the day; we hardly get time! And when we do get time; we prefer to catch up on our beauty sleep rather than go to a saloon. So when do we really get a foot massage done? Almost never! As a result, we face problems like varicose veins, oedema and other problems in our old age.

When you buy foot massagers, you are actually investing in your future. Let’s have a look at the benefits:

* A good foot massage will enhance your blood circulation. This helps in eliminating the accumulated toxins in cells and increasing the flow of nutrients to the cell. As a result your feet will have no problems related to swelling and poor circulation.
* If you are a heart patient, then a relaxing foot massage can do wonders for your stress levels. Researches reveal that patients report a significant decrease in the stress levels after a foot massage.
* According to the principle of acupressure, there are some strategic points in the feet which can help in eliminating problems, pains and aches in other body parts.

These days a lot of research goes into the designing of most foot massagers. Hence when you buy foot massagers then you are actually getting scientifically designed equipment which can relieve your stress and make you feel young again. You can even multitask! While you read, watch a movie, or even talk on the phone your foot massager is happily massaging your troubles away!

If you have decided to buy a foot massager, you may be wondering which one is right for you. Well, there is one site I’ve found that can help. Visit Personal Foot Massager Review and read about the best 3 foot massagers out on the market!

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Jun 01 2009

Effective Pain Management Techniques

Pain management techniques are as diverse and far ranging as the areas of the body pain impacts. Massage represents the safest, most effective component of a multi-disciplinary approach to pain management. Discover the options available to your clients in addition to your valued services.

by Nicole Cutler, L.Ac.

Dealing with chronic pain is big business for healthcare practitioners in the 21st century. An April 2005 nationwide poll conducted by Stanford University Medical Center, ABC News and USA Today found that more than half of Americans suffer from chronic or recurrent pain, and of those surveyed, 25 percent reported back pain as a significant disability. This translates into more than 11 million Americans being significantly impaired by chronic and recurring pain, and more than 2.6 million being permanently disabled by back pain alone.

Time is repeatedly proving that chronic pain has the best outcome when a multi-disciplinary program is followed. This indicates that pain relief finds clients seeking treatment from a variety of sources. The installment of pain management centers across the country have tapped into this success by combining a facility with physicians, pharmacists, rheumatologists, physical therapists, acupuncturists, nutritionists, fitness trainers, chiropractors and of course, massage therapists. Massage therapists can further expound upon the multiple modality approach by utilizing an array of techniques to shift clients out of their pattern of chronic pain.

There are three primary categories in which pain management focuses:
· Non-invasive, non-drug pain management
· Non-invasive, pharmacologic pain management
· Invasive pain management

Non-invasive, non-drug pain management
There is a wide variety of noninvasive non-drug pain management techniques available for treating chronic pain. A few of the most widely accepted in comprehensive pain management programs are the following:

· Exercise—physical exertion with the aim of training or improvement. This can include strength training, water therapy, flexion exercises and aerobic routines involving active, passive and resistive elements. Exercise is necessary for proper cardiovascular health, disc nutrition and musculoskeletal health.

· Manual techniques—manipulation of affected areas by means of chiropractic adjustments, osteopathy, massage therapy and other tactile applications. Manual techniques use physical touch to alter tissue morphology, structure and function. The primary goal is increasing local circulation through muscle/ joint elongation and oxygenation.

· Behavioral modification—use of behavioral methods to optimize patient responses to pain and painful stimuli. Cognitive therapy involves teaching the patient to alleviate pain with relaxation and coping techniques. Biofeedback involves the gradual alteration of neuromuscular signals for symptomatic improvement.

· Cutaneous stimulation —superficial heating or cooling of skin. These pain management methods include cold packs and hot packs, and yield the best results when used in conjunction with exercise and other circulatory methods.

· Electrotherapy —the most commonly known form of electrotherapy is transcutaneous electrical nerve stimulation (TENS). TENS therapy attempts to reduce pain by means of low-voltage electric stimulation that interacts with the sensory nervous system.

Non-invasive pharmacologic pain management

Pain relievers and related drugs are used at every stage of western medicine’s treatment for chronic pain. The most common noninvasive pharmacologic treatments for chronic back pain are:

· Analgesics—includes acetaminophen. Long-term use involves risk of kidney damage.

· Nonsteroidal anti-inflammatory agents (NSAIDs)—includes aspirin, ibuprofen, naproxen, and the controversial COX-2 inhibitors.

· Muscle relaxants—used to treat muscle spasms due to pain and protective mechanisms.

· Narcotic medications—most appropriate for acute or post-operative pain. Since the use of narcotics entails risk of habituation or addiction if not properly supervised, they are seldom used for chronic conditions.

· Antidepressants and anticonvulsants— primarily used to treat nerve pain. However, an increasing number of physicians are experimenting with their use for all kinds of chronic pain syndromes.

Determine how client medications influence massage with a comprehensive, easy to use reference chart.

Invasive pain management techniques

Invasive techniques in pain management involve invasion of instruments and devices into the body. In general, surgery is not included in pain management, so invasive pain management techniques typically are less traumatic to the body than surgery. Some of the most popular invasive pain management therapies include:

· Injections—direct delivery of steroids or anesthetic to nerve, joint or epidural space. Injections into the facet, peripheral nerve, trigger point and other locations are also known as “blocks”. These may provide relief of pain (often temporary) and can be used to confirm diagnosis.

· Prolotherapy—injection of a solution to stimulate blood circulation and ligament repair at the affected site.

· Surgically implanted electrotherapy devices—implantable spinal cord stimulators (SCS) and implantable peripheral nerve stimulators. This is essentially an internal TENS device.

· Implantable opioid infusion pumps—surgically implanted pumps that deliver opioid agents directly to an affected nerve. Typically a last resort, this technique carries a high risk of addiction.

· Radiofrequency radioablation—deadening of painful nerve via heat produced by a specialized device.

Massage Therapy’s Role

Massage therapy’s role in pain management can be substantial. Fitting into the safest category with the best long-term outcome, massage is an excellent, non-invasive, non-drug, pain management, manual technique. Analogous to the overall pain management approach of inter-disciplinary healing, the reliance on a variety of massage techniques will give your client the greatest chance for pain relief. In order to visualize this approach, begin by imagining a stream filled with debris that prevents water from flowing downstream. With the goal of increasing water flow, one could choose from the following strategies:

· Physically removing the debris
· Digging a trench around the debris to encourage flow
· Opening an upstream dam to naturally force the debris through
· Pulverizing the debris

A comprehensive approach to increase your success rate would be combining all of the above. A massage therapist can take advantage of this comprehensive approach by relying on a variety of massage techniques, such as Swedish massage, Reflexology, Neuromuscular Therapy, Myofascial Release, reiki, or acupressure. In addition to collaborating with other healthcare professionals, diversifying within one’s own field will amplify your effectiveness. When choosing to enter the ever-growing market of pain management, keep all of these integrative concepts in mind for the ultimate benefit to your clients and your practice.

Recommended Study:
Myofascial Release, Neuromuscular Therapy, Pharmacology for Massage, Reflexology, Shiatsu Anma Massage, and Swedish Massage for Professionals.

References:, Poll: Americans Searching for Pain Relief, Gary Langer, ABC News Internet Ventures, May 2005., Pain Management Techniques,, 2006.

Posted by Editors at 01:35 PM

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Mar 18 2009

Chromotherapy: A Fascinating Similarity to Polarity

Published by under reflexology,tai chi,Uncategorized

Polarity therapy has established itself as an effective system of alternative healthcare. Founded on similar physical concepts, adding chromotherapy to polarity-based bodywork is likely to enhance client results. What is chromotherapy?

by Nicole Cutler, L.Ac.

For centuries, a select group of alternative healthcare practitioners have known that colors can dramatically affect health, inner harmony and emotions. Although those trained within the conventional medical model may doubt the efficacy of color therapy, or chromotherapy, a surprising number of success stories have surfaced touting the ability of color to impact human health. As the science behind chromotherapy is uncovered, it is easy to recognize it’s parallel with polarity therapy. Since polarity therapy and chromotherapy are both deeply routed in the basic laws of vibrational physics, these two modalities make a logical union.

Based on the premise that different bands of the light spectrum produce different effects in the human body, chromotherapy is known as a vibrational healing modality. When color and light strike an individual, they influence that same vibration present in the body.

The set of frequencies related to musical notes demonstrates how the vibration of color can influence the human body. If two properly tuned guitars are in the same room and the G string is plucked on one guitar, the G string on the second guitar will also ring. This phenomenon occurs because the sound frequency of the G note travels across the room causing the resonant frequency of the G string on the second guitar to sound. Likewise, the body’s organs have their own resonant frequencies associated with each chakra and meridian. Well known to physicists, the electrically charged molecules composing living tissue is always vibrating. Thus, chromotherapy practitioners can tune their clients for optimal wellness by exposing chakras and meridians to the color needed.

Some of the properties of color that render it a potential healing tool include:

· A property of light, color is electromagnetic energy.

· Different colors of light have different wavelengths.

· The shorter the wavelength, like violet, the faster it vibrates; the longer the wavelength, like red, the slower it vibrates.

Creating resonance between the body’s vibrating electromagnetic particles and the desired color’s vibration helps chromotherapy recipients achieve a more healthful state.

Chromotherapy in Practice
Applying the principles of chromotherapy, a therapist can utilize light and color in various forms. Some of its more common applications include projecting colored light onto certain areas of the body, suggesting colored visualizations and incorporating various colored materials into a session. Each basic color used in chromotherapy is associated with a different chakra and relates to different physical and emotional issues:

· Red – Red stimulates brain wave activity, increases heart rate, respiration and blood pressure and excites the sexual glands. It energizes the first chakra located at the coccyx. Warming and energizing, red is appropriate for someone who is tired, cold and has poor circulation.

· Orange – The color of joy and wisdom, orange energizes the second chakra located at the sacrum. Regarded to stimulate the appetite, orange is beneficial for illnesses of the colon and digestion.

· Yellow – Related to the solar plexus chakra, yellow energizes, lifts the mood, improves memory and can improve digestion.

· Green – Affecting the heart chakra, green is calming to the central nervous system. A good color for cardiac conditions, high blood pressure and ulcers, green also benefits those suffering from depression and anxiety.

· Blue – The color of the throat chakra, blue is a good color choice to influence respiratory or throat difficulties. Calming and cooling, blue may help counteract hypertension.

· Indigo – Related to the brow chakra, indigo can improve problems with the sinuses and face. It has also been used to help heal burns and reduce pain.

· Violet – Associated with the crown chakra, violet is cleansing, strengthening and peaceful. Affecting the skeletal system, it is often used therapeutically to improve immunity, arthritis and relieve headaches.

Polarity Therapy
Polarity therapy is a natural health care system that is also based on the human energy field. Relying on the constant motion of molecules, polarity therapy is aimed at balancing the constant pulsation of energy between positive and negative poles. These poles create fields and energetic lines of force throughout the body. Dr. Randolph Stone, the founder of polarity therapy, explains that a disturbance in this energetic system causes a departure from good health.

By incorporating energy mapping of the five natural elements (Ether, Air, Fire, Water and Earth) and the seven primary energy centers or chakras, polarity therapy encourages each energetic field to achieve unrestricted, optimal vibration levels. A polarity practitioner adds their own energy to a disordered field, to create vibration in unison. Known in physics as a Bose-Einstein Condensate, creating vibratory unison allows a dysfunctional organ to work more effectively. Similar to understanding entropy in quantum physics, proponents of polarity therapy acknowledge that healing occurs as energetic order is restored to systems that had previously been disordered.

Polarity in Practice
Mostly using very gentle types of bipolar contact, polarity bodywork involves many techniques. Characteristic of polarity, bipolar contact is when a practitioner uses the fingers of both hands to energetically and functionally link related areas of the body for energy movement. Methods used include cranial holds, rocking movements, techniques similar to reflexology and some osteopathic and chiropractic influenced moves. However, polarity therapy always emphasizes energetic work over manipulation. Since forceful manipulations are not part of polarity therapy, it is suitable for elderly and frail clients.

Whether practicing polarity therapy or chromotherapy, bodyworkers have the opportunity to put their physics knowledge to good use. For a Western science trained, analytical mind, both modalities are logical ways to influence well-being. If proficient in both chromotherapy and polarity, practitioners can combine the two to increase the therapeutic effectiveness of their sessions.

Recommended Study:
Polarity Therapy

References:, Color Therapy – Chromotherapy, Phylameana lila Desy,, Inc., 2008.

Rowen, Robert Jay, MD, 9 Alternative Health Scams, Second Opinion Publishing Inc., Atlanta, Georgia, 2002., Color Therapy, Association Alternative Medicine, 2008., Polarity Therapy: An Introduction, Will Wilson, American Polarity Therapy Association, 2008.

Posted by Editors at 12:36 PM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute.

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Mar 08 2009

Stroke Rehabilitation: 3 Complementary Therapies

May is Stroke Awareness Month. This is a good time to learn how bodywork can play a valuable role in helping to prevent stroke in those who are most vulnerable, and help victims recover with dignity. Of the five million stroke survivors in the United States, more than three million have some resulting disability or degree of impairment. Discover three complementary therapies that have been shown to help in stroke recovery and rehabilitation.

by Linda Fehrs, LMT

Every 45 seconds someone in the U.S. has a stroke. It is the third leading cause of death behind heart disease and cancer and the number one cause of adult disability. Eighty percent of strokes are preventable, according to the American Stroke Association.

Depending on the severity, recovery can be long and difficult. A major stroke can result in a person being unable to walk or speak; a mild stroke makes recovery easier and resulting disabilities are barely noticeable. Quick intervention, within 48 hours, is most effective in reducing the negative impact of damage to the brain. Unless you work in a hospital setting this is difficult but, as doctors become aware of how massage helps, this may change.

The causes of stroke, or cerebrovascular accident (CVA), include:

· Cerebral thrombosis, which is caused by a clot lodged in a cerebral artery and accounts for about 88% of strokes.
· An embolism, similar to cerebral thrombosis, differs in origin. Inefficient pumping of the heart allows blood to thicken, forming clots in the left atrium, which then enter the bloodstream and, ultimately, the brain.
· Cerebral and subarachnoid hemorrhages are caused by ruptured blood vessels as a result of uncontrolled chronic hypertension, head trauma or malformed blood vessels, which produce tissue death in the brain.

The extent of damage depends on the part of the brain affected, how much of it and for how long. Motor damage can be seen in either partial or full paralysis on one side of the body (hemiplegia), a loss of language (aphasia), personality changes and/or loss of memory.

Massage therapists offer a first line of defense in helping to recognize the symptoms of stroke and later, during recovery, to reduce its effects.

If a client appears to have a sudden onset of numbness in one arm, speech is slurred or difficult to understand, if they cannot repeat a simple phrase, or their face appears to droop on one side, it is time to call 911.

Prompt intervention is the best treatment, including administration of anticoagulants for blood clot reduction, except in strokes caused by a hemorrhage. Massage would typically not be introduced into the recovery regimen for several weeks or months and requires approval from the attending physician.

Massage Reduces Anxiety and Pain
In a 2004 study, Hong Kong Polytechnic University, Department of Nursing and Wong Chuk Hang Hospital in Hung Hom, Lowloon, Hong Kong, found that slow-stroke massage on elderly stroke patients treated for anxiety and shoulder pain resulted in significantly lower pain, anxiety, blood pressure and heart rate. The subjects had an average age of 73 and received no other pain relief measures. They received ten minutes of slow-stroke massage prior to bedtime for seven days and an evaluation before receiving massage on the first day, again on the last day of the study, and three days after the sessions ended.

The authors, Esther Mok and Chin Pang Woo, wrote “the results of this study support the view that [slow-stroke back massage], as an alternative adjunct to pharmacological treatment, is a clinically effective nursing intervention for reducing anxiety and shoulder pain in elderly stroke patients.”

As the study indicates, slow-stroke massage reduces two of what may be the most important factors in stroke recovery – pain and anxiety. Deep or vigorous strokes are counterproductive and may cause more harm than good. Slow, soothing techniques and gentle stretching help with flexibility and proprioception.

3 Complementary Therapies for Stroke Rehabilitation
In addition to slow-stroke massage techniques, a client’s recovery may also be helped by the use of familiar complementary therapies such as reflexology, aromatherapy or shiatsu.

1. Reflexology might be used if Swedish massage is inappropriate. It gently helps the body recover from a stroke. Clients are helped without using techniques that increase blood flow, and contraindicated in someone with blood vessel weaknesses.

2. Aromatherapy is also helpful. Using an essential oil such as lavender helps relieve stress, while oils of rosemary and lemon may help circulation.

3. Another option is shiatsu. In Chinese medicine, chronic weakness of Qi blocks the blood flow to the brain, causing strokes. Shiatsu helps restore this flow, offering a session that is both rehabilitative and relaxing. Using points known as Four Gates (LI4 and LV3) relaxes tension in the head, reduces pain and calms the mind. GB20 improves circulation to the head, thus bringing much needed oxygen to the brain.

Documentation through accurate and thorough SOAP notes is an important factor in the treatment of stroke victims. You will most likely be working in conjunction with other health care professionals, and sharing the outcomes of your sessions provide important evidence of a client’s progress. While initial intake is important in determining the type of massage treatment, ongoing notes will record the client’s improvement, help to update the primary care physician and demonstrate how massage can be an effective and valuable tool in the rehabilitation of stroke survivors.

While there may be no definitive studies proving the efficacy of massage in preventing or reducing strokes, it has been shown to positively affect predictors such as improving circulation and lowering stress and blood pressure. The effects of stroke continue to be one of the most debilitating disability issues. Massage therapists may help prevent stroke in those who are most vulnerable, and help victims recover with dignity.

Recommended Study:
Aromatherapy Essentials
Ethical Case Management
Shiatsu Anma Therapy

Resources:, Ailments/Stroke, Hale Clinic, London, UK, 2008., Jacob, Dr. George, Alternative and Complementary Medicine for Stroke, 2008.

Massage Benefits Stroke Patients Study: Originally published in Complementary Therapies in Nursing & Midwifery, 2004, Vol. 10, pp. 209-216., Stroke Rehab – Part I, An Overview, April/May 2000, and Stroke Rehab – Part II, Coming Back, June/July 2000, Massage and Bodywork Magazine, Miesler, Dietrich, M.A., C.M.T., May is Stroke Awareness Month, National Stroke Association, 2008, The Practical Application of Meridian Style Acupuncture, Pirog, John E., Pacific View Press, Berkeley, C, 1996., Stroke Statistics, American Heart Association, 2008.

Posted by Editors at 09:29 AM

© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute.

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Feb 15 2009

Going Green: Eco-Friendly Massage

With just a few simple changes, discover more tips on how massage therapists can take better care of the earth and their clients.

by Linda Fehrs, LMT

As massage therapists, our clients often look to us for simple ways to improve and maintain their health. Massage therapy could be thought of as a collection of non-invasive, non-toxic techniques and tools that help to reduce blood pressure, increase circulation and improve muscle tone. Our needs as professionals are few. All that is required at the very basic level is a trained pair of hands and a body to work on. The next step up would perhaps include a good quality massage table, some clean sheets and safe, healthy lubricants. A good location, somewhere to set up, is of course also necessary. It doesn’t get much easier, or greener, than that.

As time goes on, though, we may develop some bad habits, or not look into newer, more environmentally friendly ways of doing things. Most, if not all, of us can do better. We can make our practices healthier for ourselves and for our clients and, in turn, help the earth.

Here are ten simple ways to make your home and your practice a place that is not only safe and healthy for you, but also has a positive effect on the environment.

1. Drive Less – If possible, use public transportation, or if your office is close enough, walk or ride a bicycle to your practice. You might want to consider the benefits of working out of your home and eliminate commuting all together. There are no motorized vehicles that are totally non-polluting. Even the newer hybrid cars use some gasoline, and a totally electric car still uses unhealthy materials to produce electricity and batteries.

2. Adjust Your Thermostat – By lowering your thermostat by a few degrees in the winter months and raising it in the summer, you will not only reduce the use of energy that is used to produce it, but could also see a savings of 25 to 30 percent on your heating and air-conditioning bills. Remember to lower your thermostat as well during times you are not using your office, such as overnight or while on vacation.

3. Switch to Compact Fluorescent Light Bulbs or LED’s (Light Emitting Diodes) – Consider using these instead of incandescent bulbs at your desk or in your waiting room. They last longer and are more efficient than incandescent bulbs, resulting in the use of between 30 and 75 percent less electricity. If you are concerned about the harshness of the light, soften it with warm colored lampshades. Also, remember to turn off any lights in unoccupied rooms.

4. Buy in Bulk – Purchasing often used items in larger containers will save on packaging as well as cost. Massage oils, lotions and creams can be bought in large quantity and your small bottles can be refilled.

5. Use Environmentally Friendly Cleaners – Massage offices need to be clean, but that doesn’t mean having to use harsh or toxic chemicals. Many stores now carry gentle but efficient cleaning products. Going back to basics is often the best and there are many books and websites offering easy recipes for creating your own cleaning materials.

6. Use Cloth Bags Instead of Paper or Plastic – Using and reusing cloth bags for shopping ends the debate on paper vs. plastic when it comes to groceries or other products you purchase. Cloth bags are stronger, usually hold more and nothing new is added to landfills.

7. Reduce, Reuse and Recycle – Reducing your consumption of one-use items such as disposable razors, plastic water bottles and overly packaged food, reusing what you already have on hand like glass containers, and recycling things made of paper, plastic and metal items helps to lighten the load on local landfills.

8. Visit Your Local Library – By taking advantage of the library you can reduce the number of magazines you buy or subscribe to and minimize the number of books you buy. This helps to save valuable trees, which in turn helps wildlife to survive.

9. Buy Organic – As much as possible eat organic food and use organic materials, such as oils and sheets in your practice. Crops grown using pesticides have been shown to have negative health effects including damage to the nervous system, cancer and birth defects. Growing crops organically decreases this risk not only for the consumer but also farmers and animals.

10. Support Local Vendors – By shopping locally, especially at farmer’s markets or small businesses, you help lower your own fuel consumption as well as reduce the amount of energy it takes to transport goods across the country. Shopping within your community also helps the local economy, providing jobs close to home and resulting in less gas consumption.

Every day, in both large and small ways, we can help to make our offices and homes more eco-friendly. Something as simple as using essential oils instead of commercial air fresheners can reduce allergic reactions and may even help to alleviate the symptoms of asthma or other respiratory problems. Walking short distances instead of driving not only reduces air pollution, but it also gives our body exercise, allows us to slow down and we may see the world around us in new ways.

Setting good examples and letting our clients know that we care about the environment shows we care about their health and safety as well.

Recommended Study:
Developing a Wellness Center


Bond, Annie, Home Enlightenment: Practical, Earth-Friendly Advice for Creating a Nurturing, Healthy, Toxin Free Home and Lifestyle, Rodale Books, September 2005., Green Living, Care2, 2008., Workplace Campaigns, EarthShare, Spring 2007., Pollution Prevention and Recycling, Environmental Protection Agency, 2008., Small Business, GreenBiz.Com, 2008., A Bright Idea: Eco Conscious Lighting, Blake Frino, Green This Life, December 2008., How Green is Your Massage Practice?, Karen Menehan, Massage Magazine, March 2008., Going Green, Elizabeth Barker, Massage Therapy Journal, Fall 2007.

Posted by Editors at 12:27 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute.

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