Reflexology and Midwives of the Central Coast of New South Wales, Australia

Great article from the miwifery todat newsletter, from 2001!
Read here

Our hospital has 40 midwives trained in reflexology, a 40-hour certificate course on reflexology and uses in midwifery practice endorsed by our midwifery national body (ACMI). This accounts for one-quarter of the total midwifery staff.




Our teacher was Susanne Enzer, a retired midwife and reflexologist, originally from England and now living in Australia. Susanne facilitates seminars, workshops and the accredited course "Maternity Reflexology." She is also the co-author of "Maternity Reflexology: a guide for reflexologist" (1997) and author of "Reflexology: a tool for midwives" (2000).



Reflexology is a therapeutic system of pressure-oriented massage to feet, hands or ears in the belief that all organs and glands have corresponding reflex points to the body. Reflexology elicits painful or tender areas with actual or potential disorder. It is a gentle, nonthreatening, noninvasive effective therapy. It has the potential to balance and maintain equilibrium, relax and increase vitality, and balance energy and move blockages.



A complementary therapies working party (3 midwives, 1 pharmacist, 1 midwifery childbirth educator) forged a policy which has been accepted by the hospital ethics committee to practice reflexology at work.



We use reflexology in our antenatal clinics and midwife clinics for various discomforts of pregnancy like leg and ankle odema, constipation, anxiety, and prolonged pregnancy. In childbirth, reflexology is useful to help enhance contractions, increase relaxation, retained placenta. Postnatally, reflexology can assist after epidural, forcep or LSCS and urinary retention. Difficulties relating to breastfeeding can be helped with reflexology. Also, with exhaustion, postnatal depression. There are few contraindications- severe PE, APH, severe PPH.



We are conducting a randomised single-blind controlled trial on the effect of reflexology on foot and ankle oedema in late pregnancy (over 32 weeks pregnancy). All women who met the criteria and are attending the clinics are invited to participate in the trial. The women are randomised (after informed consent obtained) into one of the three groups: normal pregnancy visit (control), relaxation reflexology (placebo,) or lymphatic drainage reflexology (treatment). The sessions are 15-20 minutes at least once a week. The information gathered are pre- and post-treatment measurements of ankle and instep, and blood pressure.



The women answer a questionnaire at each session about comfort, changes in mood/feelings, and changes in relationship with midwife. The study commenced in August 1999 and is due for completion in August 2001. Unfortunately we will fall short of the 120 women needed as we have had only 80 women enrolled. The difficulty of the study is the midwives do not always have the time to give the reflexology as it is within work time and there is no research assistant.



In a separate part of the trial, 12 women were treated with lymphatic drainage reflexology and refused randomisation but wanted reflexology. The characteristics of the women were mostly primigravidas (91.6%), 24-39 years old (mean of 30 years), at 33-39 weeks gestation (mean of 37.5 weeks). The results show all measurements decreased after lymphatic drainage reflexology. The women's blood pressure decreased (42%), increased (21%) and/or remained unchanged (35%).



On a scale of 0 to 5, The women found a decrease in stress, tension, anxiety, pain, tiredness, discomfort and irritability. The majority felt "very relaxed" or "relaxed" during and after the reflexology. Most noticed a difference in their feet after the reflexology: "more movement," "not as tight," "less swelling." Additional comments made by the women included "more at ease with midwives," "feel better about myself," and "relaxed whole body."



Although this sample is small, the many midwives have had similar comments from women receiving reflexology. It demonstrates that reflexology has a place in midwifery practice.

- L.M.

Ορθοπεδική Ρεφλεξολογία - Orthopedic Reflexology

For information on Orthopedic Reflexology click here.

Because YOU, the (European, American, Canadian, Australian etc.) Reflexologist, spreads false and misleading "facts" on the history of Reflexology soon we might be "OUT OF WORK!".

"OUT OF WORK!", me? Neah, I doubt it! None the less...

Once again I have read an article on an exceptional buisness success associated with Reflexology - here -, this is the title:
Foot Massage Chain China Liangtse Said to Mull German IPO!!! Good for you Zhu! 

This is not the first time I have blogged about the inspiring success story of the man behind this success, Zhu Guofan - here. It seems  that once again he has been keeping himself busy in an even more positive way, read how he has gotten even more succesfull here Liangzi story.
In short,
"The franchised company now operates more than 700 outlets across China, employing more than 30,000 people." Reflexologists of course, or foot masseurs since they do foot massage!

The company has entered the European market with branches in Liangtse London UK and here, Berlin, Helsinki, Netherlands and more in the future are coming through their 100 centers in Europe Project, the price for Reflexology is 50min £ 59, preeeetty good!

So what is my point?

Well it is not to deprive individuals of Oriental origin their right to honest work, it is more to secure the right of European, etc. of origin individuals to be able to work equally too our Oriental colleagues as Reflexologists. My interest is mostly for the Greek Reflexologists, especially since I have been a board member of the Hellenic Association of Reflexologists five years now and currently, president of HAR. Even more now with this global economic crisis, I am sick and tired of hearing our members difficulty in making a honest living by doing what they love and having invested-paid hard earned money to learn practise reflexology.

Do not feel sorry for the Greeks, this is not the case in Greece only, I know for a fact that this problem exists in most European countries, USA and Canada. I have seen in many countries ground level offices/workshops with high rent offering bodywork and/or reflexology. How many do you think out of 100 are owned by people not of Oriental heritage in Montreal, London lets say?
....
In England the English reflexologists rent space in offices ususally, why cannot they afford to rent a ground office with large windows on a busy street? 
- They do not want to. 
- They are not good enough reflexologists thus not making enough money to cut even or make a profit?
- People prefer the Asian practitioners to the English?
- They are humanitarians or believe in helping their fellow humans without getting paid.
- They are rich and do not need the money, or the success, or the satisfaction of living off something they love?
...and many other reasons possibly. 

Sure many factors will influence any endeavour but in our situation something very interesting is going on.

The problem and my point will become obvious with the following example, a quote in an article from The Observer UK, 25 November 2009.

"Over 5,000 years ago the Cherokee of North Africa practiced reflexology. Other ethnicities across China, India and Japan also practiced the art. Today the best reflexologists are said to be from China. There is no consensus on how it works."


So what's the problem? The problem is that in the past Reflexologists would make FALSE statements in their books, seminars, interviews etc. that Reflexology began 5.000 years ago in the Orient and this point is still going strong! 

Yeah yeah, I hear you saying here he goes again with his history, but....
It is a proven fact that this kind of (cultural) programming will have an effect on an individuals perception (client of Reflexology in our case) on how to choose a "compotent" Reflexologist, reference "Explain pain".

Published research has answered these questions, ...can you? And most importantly, why?:

- Where in Europe is homeopathy most succesfull?
- Under which circumstances is acupuncture most and least succesfull? 
(answers on the bottom picture)

My personal story - short!
One day in my office my aunt, who I am treating again after 2 years (succesfully the first time), for her stiff neck sees a Chinese being treated upon by me. Once he left she said "Spiros you must have become very good if the Chinese are coming to you to be relieved!" My office is doing good but her seeing the "Chinese man" made all the difference. Interesting, isn't it?

It makes sense for me now that when I visit London, New York, Montreal, Amsterdam I see many Chinese foot massage parlors - at ground level (high rent), but not one owned by a European Reflexologist. On the other hand I see Europeans doing mostly volunteer work, which is great, but it does not help you make a living, does it!

Of course we have to be good and continuously train to be competitive but...
STOP spreading false information about the history of Reflexology!
It is bad for buisness ....you fool! 


P.S. I honestly believe that, if ever, Liangzi offers a seminar I will attend, there must be lots to learn from his success, especially compared to so many over rated seminars on the market.
You can quote me, especially on the last remark. Spiros
P.S. 2 I wish our goverment here in Greece and especially the ministries of Civilization, Health and Tourism would follow this example  to create and promote a   health and well-being industry based on Hippocrates teachings. 

Same story two different publications, two different impressions and 1 question:"Where is the Heart Reflex?".

Lately amongst Reflexologists (also) growing attention has and will be given to the recent publication of a research paper titled:
"Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: A double-blind randomised controlled trial" - click to read abstract

This publication already has the attention of the media and we have found articles from two different sources.
1. Reflexology 'improves heart efficiency', claim researchers
2.Reflexology treatment affects heart functions

Just from reading the titles of the articles you could be able to guess which one is more favourable towards Reflexology than the other, can you?

If you guessed the 2nd one I say yes, in the 1st article we will read also the statement of an "old friend" of Reflexology, Edzard Ernst!

Reflexology,  is not cheap: a course of six to eight sessions can “easily be in excess of £400”, said the researchers.
Edzard Ernst, emeritus professor of complementary therapy at Exeter University, said the effect was "very small, not clinically relevant and probably a fluke due to multiple testing for statistical significance".
He added: "Before I believe these results, I want to see an independent replication."

Bottom line "Don't believe everything you read, question everything, especially me!"

Where is the heart reflex?

I, as an Orthopedic Reflexologist will question and speculate on everything, and I remember very well the differations of the heart reflex in many books I have read, I am sure many of you Reflexologists also! It seems though that this has been investigated on a more official level by the same reseachers at Stirling University, ....you are right, the same ones that have published the research article at the top!!!! What did they find? You can read (you must!) the abstract by clicking here: Reported treatment strategies for reflexology in cardiac patients and inconsistencies in the location of the heart reflex point: An online survey. or continue reading below the conclusion.

CONCLUSIONS:

Professional clarification around the heart reflex point location and further clinical research is urgently needed to establish the appropriateness of reflexology techniques for cardiac patients.



So it seems that the AoR with Stirling University agreed on a "large" zone and not on a pinpoint reflex as you will see in Fig. 1. of the research article (Photograph showing the tape applied to the subjects feet, along the shoulder girdle demarcation line.)

2nd Question? Do you see any obvious "anatomical reason" why the area above the demarcation line would have an affect on heart function - cardiac index, compared to let's say, ....the heel zone?

Personal comments: It would also be interesting to see what would happen if they would work only on the right foot?

Do not get me wrong, I love this research paper and congratulate the AoR, I just have many more questions.

And let us stop hassling each other with pinpoint reflexes, ok?

Ohhh! Here in Greece the Hellenic Association of Reflexologists had done some research on patients undergoing cardiac surgery, Reflexology interventions pre and post surgery, with great results, read-translate here.

Fharisto

Interventions for varicose veins and leg oedema in pregnancy.

Παρεμβάσεις για τη φλεβίτιδα και το οίδημα των κάτω άκρων κατά την εγκυμοσύνη  (Αναθεώρηση)

This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library

2008, Issue 4 Published by JohnWiley & Sons, Ltd

Read the full Review here.
Διαβάστε όλη την αναθεώρηση εδώ. 

Authors’ conclusions

Rutosides appear to help relieve the symptoms of varicose veins in late pregnancy. However, this finding is based on one small study (69 women) and there are not enough

data presented in the study to assess its safety in pregnancy. It therefore cannot be routinely recommended.

Reflexology appears to help improve symptoms for women with leg oedema, but again this is based on one small study (43 women).

External compression stockings do not appear to have any advantages in reducing oedema.

Are there trigger points on the feet? If YES, could this be why Reflexology works?

 

In the Orhtopedic Reflexology approach the feet muscles and the way to "approach -treat" them according to Hippocrates "law" on rubbing is fundamental!

Could the "diffuse noxious inhibitory control" theory answer on the given effectiveness of Reflexology?

"By the way Hippocrates was the first to describe this!!!!!"

The following article does not discuss Reflexology nor trigger points on the feet specifacally, none the less, it gives a solid basis to speculate, the "Orthopedic Reflexology" way!

I will comment (in red) to assist readers interested in Reflexology.

(click for full article)

Myofascial trigger points: the current evidence

from the original paper:

12. How do these treatments work?

Given that dry needling appears to be as effective as local anaesthetic, but has no convincing benefit over placebo treatment, the mechanism of action of all of these therapies remains to be clarified. The placebo treatments used have varied, but all have still involved the application of a penetrative or non - penetrative but nonetheless noxious stimulus to the skin. (reflexology can be a noxious stimulus) 

Central opioid release is thought to produce a global reduction in pain perception by gating spinal cord pain impulse transmission. This is known as diffuse noxious inhibitory control. Reversal of local anaesthetic-induced analgesia has been observed with the administration of an opioid antagonist (Fine et al., 1988). This implicates the endogenous opioid system, which acts to produce hypoalgesia at a spinal cord level, to at least a partial extent in the reduction of pain seen with this therapy.

This is the system implicated in the production of a runners’high (Koltyn, 2002), and it has been suggested to be important in production of the placebo effect (Grevert et al.,1983).

Beyond these suppositions, there is little hard evidence to date on the mechanisms of action of any of the therapies discussed. It is a notoriously hard area to research due to the interactions of so many systems on both a regional and whole-body level. Stress and the sympathetic nervous system have been shown to increase pain perception, but the effect of these treatments on this system has not been conclusively evaluated. (Reflexology is thought to act on the ANS)

13. Conclusions

Although trigger point related pain is widely recognised by health professionals, reliable clinical evaluation and imaging for diagnosis still eludes us. Many treatments in widespread use are poorly validated and not necessarily more effective than placebo. The application of a noxious stimulus may be the key to obtaining improvements in pain

perception. Less stimulatory interventions, such as laser and ultrasound, have not convincingly been shown to be beneficial. Most stimulatory interventions are able to induce subjective improvements in pain scores, if not objectively measurable improvement. Stretch, TENS(1), injection therapies, and dry needling have all shown benefit. Unfortunately, we have extremely limited data comparing results between different therapeutic approaches, in particular, invasive versus non-invasive from which to draw clinical conclusions.

Studies of invasive treatment utilising a placebo intervention have not found the active treatments to be any more effective. Importantly, the placebo interventions used are themselves, stimulatory. The amount of stimulation required to induce analgesia is currently unknown. Despite EMG evidence of changes in the regions of trigger points, muscle penetration does not seem to be necessary to produce an analgesic effect. The evidence is trending towards the magnitude of the effect being consistent regardless of the therapy chosen, or the depth of needle penetration, as long as some counter-stimulation is involved. The relative contributions of local tissue effects and central pain modulation to these clinical improvements require further investigation.

The choice of therapy can, therefore, be guided by patient specific criteria, the therapist’s experience and qualifications, and patient preference. The discomfort induced by the therapy, the likelihood of post-treatment soreness, and the current functional level of the patient are important to consider. (Put Reflexology on the patients list of treatments to choose") Dry needling may not be appropriate for someone with long standing chronic pain that is known to flare after deep massage treatment, but it may be the treatment of choice for an athlete with a regional pain that has not responded to previous soft tissue work. Needle phobias or other known adverse reactions will limit therapeutic choices.

Regardless of the treatment chosen, it is imperative to remember that trigger points are rarely an isolated phenomenon, and the key to successful long-term outcomes of any treatment regime is addressing the precipitating and predisposing factors for each particular patient. (Right up our "alley"!)

(1) ICCMR Congress May 2007The effects of reflexology on pain threshold and tolerance in an ice-pain experiment in healthy human subjects.C.A. Samuel & I.S. Ebenezer

Στα ΕΛΛΗΝΙΚΑ ΕΔΩ

"ANOVA showed that there was a significant increase in pain threshold of the subjects following reflexology when compared with sham TENS control data (F(1,9)=5.68, P<0.05).Thus, for example at 60 min, pain threshold increased from a control mean value (sham TENS) ± s.e. mean of 9.1 ± 1.4 s to 15.5 ± 2.1 s following reflexology (P<0.01). Similarly, there was a significant increase in pain tolerance (F(1,9) = 5.132, P<0.05). Thus, at 60 min, pain tolerance increased from a control mean value ± s.e. mean of 120.2 ± 37.9 s to 171.4 ± 42.0 s (P<0.02).
The results of this study show that reflexology increases both pain threshold and tolerance in human volunteers exposed to acute pain. These findings indicate the possibility of using reflexology in the management of pain."

Επίδραση της Ρεφλεξολογίας στον οξύ μετεγχειρητικό πόνο και άγχος σε ασθενείς με καρκίνο του πεπτικού σωλήνα!

From the Association of Reflexologists forum!
Reflexology Research from Cancer Nursing Journal

Effects of Reflexotherapy on Acute Postoperative Pain and Anxiety Among

Patients With Digestive Cancehttp://www.northeastintegrativemedicine.org/resources/ResearchReferences/Oncology/ReflexotherapyAcutePostoperativePain.pdf

Study on origin of meridians and collaterals through pain relieving effect of muscle regions

Study on origin of meridians and collaterals through pain relieving effect of muscle regions

Dong BQ, Li CR, Huang FY, Zhang SJ, Xue LG.

Source

College of Acupuncture and Massage, Liaoning University of TCM, Shenyang 110847, China. peterbaoqiang@sina.cn

Abstract

Through analysis on sequencing of meridians and their muscle regions, their pertaining organs,
running courses, linking and indications described in Zubi Shiyimai (Eleven Meridian of Foot and Hand), Yinyang Shiyimai (Eleven Meridian of Yinyang), Lingshu: Jingmai (Miraculous Pivot: Meridian) and Lingshu: Jinjing (Miraculous Pivot: Muscle Meridian), it is found that most of the indications of acupuncture in ancient time are symptoms of the muscle regions. 62.59% points of the national standard acupoints location close to tender points of the muscle regions, which indicates that the origin of early acupoints are tender points along the running courses of the muscle regions.

Thus, it is concluded that meridians and their muscle regions have the same origin, which provides new train of thinking for a better comprehension of origin of meridians and collaterals.

PMID:

21894695

[PubMed - indexed for MEDLINE]

Why most published research findings are false.

Why most published research findings are false. - όλο το άρθρο.

Ποιος είναι ο Έλληνας Ioannidis JP?

Source

Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. jioannid@cc.uoi.gr

Abstract

There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research.

Φροντίδα για τους "φροντιστές υγείας" στην Αγγλία!

Unpaid carers can relax and unwind full article.

Unpaid carers are getting a chance to "recharge their batteries" this month during a series of rest and relaxation sessions in Suffolk.

People caring for a family member or friend with an illness, health condition, addiction, or disability are being offered massages, reflexology and relaxation days thanks to United Response.

The London-based charity, which provides services for people with learning and physical disabilities and mental health needs, is holding the sessions in Suffolk in June and July.

The move is part of its Time For You project, which supports unpaid carers who do not regard themselves as carers and may be missing out on support.

"Caring for someone else can be incredibly demanding. Time for You recognises this and wants to offer people a little bit of help to recharge their batteries."