art of reflexology vol.1

7/29/2019 Art of Reflexology Vol.1

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Appendix 2. Foot reflexology procedures

Reflexology sequence outline

The researcher follows Farnsworths method, taught to the researcher at the

Australian College of Tactile Therapies. This method is similar to Inghams method.

We will start at the right foot as follows:

Relaxing techniques

1. Ankle stretch under2. Ankle stretch over3. Ankle loosening4. Side to side5. Spinal stretch6. Metatarsal knead7. Diaphragm relaxer8. Toe rotation (Farnsworth, p 11-4)

Working the spine

1. Toe walk up sacral-coccyx zone


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Working the lungs

1. Diaphragm relaxer then toe walk from medial metatarsal upwards fromdiaphragm to base of toes

2. Do five plantar zones in between metatarsals, repeat other hand, back to startmetatarsal knead

3. Finger walk dorsal five zones in between metatarsals with thumb in fist medial tolateral

4. Change hands, repeat lateral to medial

Working the toes

1. Toe walk sideways over throat-thyroid reflex both ways2. Finger walk cervical while stretching toe with holding fingers3. Toe walk down large toe plantar side latched onto fingers, work medial to lateral

all toes latched onto fingers, work medial to lateral all toes to their roots

4. Repeat other coming back to start (use other hand)5. Hook in and back up on pituitary with medial thumb6. Working the brain7. Toe walk the ridge (eye and ear reflexes) both ways using lateral aspect or edge

of thumbs pulling down padding


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Working the digestive system

1. Toe walk waistline to diaphragm, cross hatch in both direction with foot indorsiflexion

2. Wring out with thumbs3. Toe walk waistline to heel line, cross hatch in both directions with foot in

dorsiflexion and wring out with thumb

4. Work the adrenal gland5. Work the ileocecal valve reflex hook in and back up right foot6. If on left foot cross hatch plantar heel zone working the sigmoid flexor three

ways with thumb then hook in and back up

7. Side to side relaxer (Farnsworth, p 11-5)

Working the lateral and medial heel areas

1. Finger walk lateral hip, knee, leg reflex zone2. Change hands and finger walk same reflex from dorsal side to plantar side3. Finger walk hip, sciatic reflex around external malleolus4. Change hands and finger walk same reflex going opposite direction underneath5. Change hands pin pointwith index finger rotate clockwise on lateral

reproductive reflex


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Details of each procedure are described below. Before using the procedures, the

reflexologist has to understand how to hold the clients foot and how to use thumb

and fingers effectively.

Basic holding technique

The heel of the holding hand will be placed firmly on the metatarsal pad of the foot

with the fingers relaxed over the toes and the thumb on the medial edge of the great

toe or the small toedrop the wrist slightly to relax the longitudinal tendon of the

foot, this gives you control over the foot and allows you to push the foot back or to

bring it forward using the natural spring of the ankle joint (Byers 2001, p 27).

Picture 1


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Basic thumb technique

The inside (medial) edge of the thumb is the used part, walk the thumb by

slightly bending and unbending the 1st

jointit will creep forward in this natural

positiontaking tiny biteslike a snail who leaves a steady, even trail (Byers

2001, pp 28-29).

Leverage

This technique helps you to put effective pressure on each area of the foot.

place the fingers of your working hand firmly underneath [each area] for

leverage in opposition to your thumb and do the walking motion with your thumb,

letting the fingers follow along as you move (Byers 2001, p 28).

Picture 3Basic thumb walking technique

Picture 2Position for the basic thumb technique

Inside medial


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Basic finger technique

The same as the thumb technique, taking creeping motions by smaller and smaller

bites and exerting a constant and steady forward pressurethe finger always moves in

a forward direction, never backwards or sidewaysthe index, third and fourth fingers

can walk individually or togetherwe use [this technique] to work certain areas

which could not be worked as effectively by using the thumbs (Byers 2001, p 30).

Hook-in, back-up technique or bumblebee action

Using the thumb techniquebend the 1st

joint of the thumb slightly and exert

pressure with the medial (inside) corner of the thumbon the reflex point, push in

and bend the thumb to approximately a 90angle as you drop the wrist(Byers

2001, p 31).

Picture 5Basic finger walking technique


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Pivot point technique

[This] technique is a valuable aid in working particularly tender areasuse the

basic holding position with the holding hand and flex the foot slowly onto the

thumb, flex several times; this gives increased pressure at the reflex point(Byers

2001, p 32).

Relaxing Techniques

Ankle stretch under

Support the right heel with the left hand with your thumb around the outside of the

ankle, just below the ankle bonegrasp the top of the foot in your other hand and

gently rotate it a few times in one direction, then a few in the other (Lidell 1984, p

137).

Picture 7Pivot point technique


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Ankle stretch over

Place the [right] hand with the fingers together over the dorsal side of the foot

with the webbing between the thumb and fingers over the ankle joint where the foot

is joined onto the leg; the rest of the fingers are wrapped around the leg, place the

heel of the[left] hand on the plantar surface of the footpush the foot back

firmly with the heel of the hand and let it return, in a slight oval motion, via its own

natural spring (Byers 2001, p 35).

Ankle loosening

Place the heel of the hands below the anklebone, one on the medial side and one on

the lateral side, then move the hands rapidly back and forth, the hands will be going

in the opposite direction from each other, the foot will shake from side to side

(Byers 2001, p 34).


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Side-to-side (back and forth)

Place the center of the palms of the hands, one on the medial side on the 1st

metatarsal head and one on the lateral side on the 5th

metatarsal head, with the

fingers relaxed, and then move the hands rapidly back and forth (Byers 2001, p 33).

Spinal twist/stretch

Place the hands together with the palms facing down and index fingers touching

each other; the thumbs will also be down, with the foot tipped out, place the hands

as a unit firmly around the foot, with the webbing between the thumbs and fingers

placed in the spinal reflex area and the thumbs on the plantar surface of the foot, the

center of the two hands will be placed on or slightly above the pelvic guideline,

Picture 10

Sideto-side


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heel stationary and firm at all times, continue this process until the hand nearest the

toes is over the great toe (Byers 2001, p 34).

Metatarsal kneading

Place the fingers of the right hand (holding hand) on the dorsum of the foot from the

medial side, with the index finger placed just below the base of the toes and the

thumb in a vertical position resting in the medial edge of the footwith the left

hand make a fist with the flat part placed against the plantar surface of the foot

(metatarsal area) directly opposite the right hand, first push the fist against the

metatarsal pad, then knead with the holding hand release a little pressure with the

fistkeep both hands in contact with the foot at all times[and] repeat several

i ( 2001 33)

Picture 11Spinal twist


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Diaphragm/solar plexus tension relaxer

Starting on the medial side of the foot, place the slightly bent working thumb on the

base of the metatarsal head, grasp the foot at the base of the toes with the holding

hand, making sure the thumb and index finger are placed around the great toe; it is

important that the holding hand is placed squarely over the toes and not to the side,

lift the foot with the holding hand and then pull the metatarsals onto the thumb

(applying extra pressure with the thumb); the pressure of pulling fingers should be

on the dorsum of the foot at the base of the toes; when pulling the toes onto the

thumb the heel of the holding hand should come slightly away from the plantar

Picture 12Metatarsal kneading


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Toe rotation

Hold the base of the toe you wish to rotate firmly with the thumb and fingers of the

holding hand, the thumb on the plantar surface and the fingers on the dorsal surface,

take the thumb and 1st

two fingers of your working hand and place them over the toe

all the way to its base, with a slight lift, rotate each toe, first in one direction several

times, and repeat in the opposite direction (Byers 2001, p 37).

Picture 13Diaphragm/solar plexus relaxation technique


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Working the spinal reflex

Start by working the sacral/coccyx area, roll the thumb over the edge of the heel

(often a callused area) and walk up approximately one half inch towards the

legthen start by using the right thumb and begin to walk up the sacral/coccyx

reflex from the base of the heel to approximately the pelvic guideline or as far as the

hand can reach, repeat several times on a slightly different path, covering all sides of

the reflex and never losing contact with the foot, work the lumbar reflex by placing

the fingers over the top of the foot and the thumb remains approximately on the

pelvic guideline, walk up the lumbar reflex to the waistline guideline and then

continue walking the thoracic reflex until reaching the 7th

cervical reflex, located

below the base of the great toerepeat several timesuse the index finger when

working the cervical reflex for an extra fine treatment, start by supporting the foot

with the fingers of the left hand which are placed over the toes and hold the great

toe firmly with the thumb and index finger, the working hand then supports the foot

with the thumb and the 3rd

, 4th

and 5th

fingers while the index finger walks from the

base of the great toe to the base of the nail, repeat this several times[after that]

working down the spinal reflex by supporting the foot on the metatarsal pad with

the fingers pointing upwards and bent at the knuckle joints, use the thumb of the

working hand to walk all the way down the spinal reflex, repeat several times using

a slightly different path each time (Byers 2001, p 53-55).


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Cervica

T oracic

SacralCoccygeal

Picture 15Curves of the spine and foot

Cervical (7)

Thoracic (12)

Lumbar(5)

Lumbar


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Picture 17Working across the sacral~coccyx reflex

Picture 18Working up the sacral~coccyx reflex


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Lung reflex

First, work the plantar surface of the footuse the basic holding position, tilt the

foot slightly outwards and gently spread the toes, using the right thumb, apply the

basic thumb technique, work up the grooves formed by the bones between each toe,

starting with the groove between the great toe and the 2nd

toeseparate the great toe

and the 2nd

toe with the holding hand in order to open the grooves properly, after

Picture 21Working up the cervical reflex

Picture 22Working across the cervical reflex


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metatarsal padding of the foot, then place the thumb of the working hand on the

index finger of the holding hand for leverage and work down the dorsum of the foot

with the medial corner of the index finger, work in the groove between the great toe

and the 2nd

toe, making sure the fist is pushing the foot back as this will spread the

region while working, line up the 1st

knuckle of the fist with the groove you are

working, this enables the working finger to line up with that groove, work this area

several times and then move to the following grooves repeating this procedure with

each groove, change hands and repeat this procedure in the opposite direction

(Byers 2001, pp 102-103).

Picture 24Working the lung/breast reflex (dorsal surface)

Picture 23Working the lung reflex


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Thyroid and parathyroid gland reflexes

Since the thyroid gland is located at the base of the neck area, the reflex area will be

located at the base of the great toe, to work this area effectivelyuse the thumb of

the holding hand to spread the great toe so that it may be worked on effectively by

the thumb of the working hand on those of the holding hand; using the basic thumb

technique, make several passes, walking across the base of the great toe from the

medial side to the lateral side, change hand and come back in the opposite direction

in the same manner; this, of course, is done in order to completely cover the

comparatively wide reflex area for the thyroid gland reflex; working several passes

in one direction and then changing hands to work in the opposite direction will give

you complete coverage of the thyroid reflex area; this will also include the

parathyroid gland reflex since they are buried in the thyroid gland (Byers 2001, p

145).


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Sinus reflexes

Starting on the right foot, use the right hand as the working hand and the left as the

supporting hand, place the fingers of the supporting hand horizontally across the

dorsal surface of the toes, with the index finger level with the tip of the toes, place

the fingers of the working hand over the outside of the supporting fingers; the first

two fingers of the working hand should be over the first two knuckles of the

supporting fingers for leverage, using the basic thumb technique and starting with

the great toe, work down the middle and lateral edge of each toe from its tip to its

base, the working hand and the holding hand move together as a unit as you move

from toe to toe; remember, the first fingers of the working hand should be over the

first two knuckles of the supporting fingerswork each toe several times and take

about 6 to 10 small bites down the toe, then change hands and repeat this process

with the left thumb, starting on the small toe, always work down the middle and

then the medial edge of each toe to its base(Byers 2001, pp 104-105).


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Pituitary gland reflex

To pinpoint the pituitary reflexalways look for the widest point on both sides of

the great toe and then draw an imaginary line from point to pointthe pituitary

reflex will be found at the midpoint of this hypothetical linethis midpoint should

be close to the center of the great toewhen working on the right foot that you use

the right hand, and on the left foot you use the left hand; the holding hand will be

used to support and protect the great toe, always cover the toes with the fingers of

the holding hand, use the fingers of the working hand for leverage; the leverage

fingers are always on the outside of the holding hand; this is done to prevent any

injury or unnecessary pain to the top of the great toealways use the medial corner

of the thumb of the working hand by utilizing the hook-in, back-up

techniqueremember the bumblebee who sits down and backs upmaking 3 or 4

working contacts with this area(Byers 2001, p 143).

Picture 30Locating the pituitary gland reflex


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Working the brain

Hold the right great toe with the thumb and index finger of the right hand, the 1st

joint of the index finger of the left hand will be resting on the tip of the thumb, this

stabilizes the index finger which is used to work across the tip of the great toe in a

rolling motion with the wrist, start with the lateral edge of the tip of the index finger

and rill across the tip of the great toe, pick up the index finger and move to where

Picture 31Working the pituitary gland reflex

starting position

Picture 32Working the pituitary gland reflex hook in,

back~up technique


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Eye and ear reflex

Start on the right foot with the right hand as the working hand, the fingers of the left

hand (holding hand) are placed on the dorsum of the foot opposite the thumbflat

against the metatarsal area along the plantar surface of the foot, place the right

thumb of the working hand on the ridge making sure to use the lateral edge of the

thumb, the ridge is formed where the base of the small toes meet the metatarsal

paddingthe thumb will walk from medial to lateral in a forward motion across this

ridge starting at the base of the second toe and continuing to the lateral edge of the

footthe walking motion must be one in which the thumb walks all the way across

the base of the small toes, is picked up, comes back and starts overwith the

f h h b d d d d h h l l i

Picture 33Working the brain reflex


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Stomach reflex

The largest part of the stomach reflex is going to be found on the left footlocated

below the diaphragm guideline of the foot and above the waistline guidelinestart

with the left hand on the left foot and work from the waistline guideline in a criss-

cross motion up to the diaphragm guideline and cover the entire region, use the

basic holding technique, then change hands and cone back in the opposite direction,

giving the criss-cross effect (Byers 2001, p 117).

Picture 34

Working the eye and ear reflex medial to lateral

Picture 35Working the eye and ear reflex lateral tomedial


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Liver reflex

The liver reflex is on the right footthe reflex area covers the space from the

waistline guideline to the diaphragm guideline from the medial to the lateral side of

the right footstart with the right hand and work the area towards the diaphragm

guideline using the basic holding techniquethen come back over the area, change

hands, and walk across the area in the opposite direction angling towards the

diaphragm guideline (Byers 2001, p 118).

Gallbladder reflex

Generally, the gallbladder reflex will be around the 3rd

or 4th

zone above the

waistline guideline approximately a third of the way to the diaphragm guideline;

simultaneously, while working the liver reflex you are going to be working the

gallbladder reflex, the gallbladder reflex can also be located on the dorsal surface of

the foot just opposite the reflex site on the plantar surface (Byers 2001, pp 118-119).


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Pancreas reflex

The reflex area for the pancreas is found on both feet, but mainly on the left foot

and is located slightly above the guideline to the waist to approximately half way to

the diaphragm guideline; to work this area, use the basic thumb technique with the

left hand, in tiny caterpillar bites, while using the basic holding technique with the

right hand; after several slow and complete passes from the medial to the lateral

side, change hands and work in the same manner from the other direction; on the

right foot the reflex will be slightly below the waistline guideline (Byers 2001, p

119).

Picture 41Working the gallbladder reflex (dorsal surface)

Picture 40Working the liver reflex


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Adrenal gland reflex

The adrenal gland reflexes are located in the area halfway between the waistline

guideline and the diaphragm guideline, on the medial side and next to the protruding

tendon; work the adrenal gland reflex by holding the foot with the heel of the

holding hand in the metatarsal padding and the thumb on the great toe, which, when

pushed back, extends the tendon for a landmark; use the right hand to work on the

right foot and the left hand for working on the left foot, using the basic thumb

technique, walk slowly from the waistline guideline toward the diaphragm

guideline; when approximately halfway up this area, you will find a very sensitive

area (adrenal gland reflex) on the medial side of the foot right next to the protruding

tendonyou may also use the pivot rotation technique to work this all important

reflexhold the thumb on the exact reflex area and then flex the foot back and forth

on the pivot of the thumb; be careful not to exert too much pressure initially, rather

work up to the desired pressure (Byers 2001, p 146).


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Small and large intestine reflexes

Start on the right foot with the left hand using the basic holding position, working

the area from the waistline guideline to the pelvic guideline for both the large and

small intestines, work across this area first with the right hand and then the left hand

with the basic thumb technique using the criss-cross method (Byers 2001, p 121).

Ileocecal valve reflex

The ileocecal valve reflex is always worked by using the hook-in, back-up

technique; this reflex area is found on the plantar surface-lateral side (little toe side)

of the right foot, below the waistline guideline. To locate this reflex, use the basic

holding technique with the right hand and use the left thumb as the working hand,

run the thumb down the lateral edge of the right foot between the waistline

guideline and the pelvic guideline into the deepest part of the curve which is about

halfway between the two guidelines; once located, place the thumb in a horizontal

position, roll it from the edge of the foot straight around into the reflex, make sure

the thumb is bent at the first joint and use the wrist to hook-in, back-up; this reflex

will be fairly close to the lateral edge of the foot on the plantar surface between the

4th

and 5th

zones (Byers 2001, p 121).


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Sigmoid colon reflex

The way to locate the sigmoid flexure, a pin-point reflex, is to begin on the medial

side of the left foot where the heel guideline and the spinal reflex intersectfrom

this point, angle down at approximately 45 to where the 3 zone line intersects that

angleuse the basic holding technique, tip the foot out with the right hand, the left

thumb will walk down the 45 angle from the pelvic guideline to where the lines

intersect (3 zone line) and apply the hook-in, back-up techniqueafter working

the whole line downward and using the left thumb for the hook-in, back-up

technique, change hands and place the heel of the left foot in the palm of the left

hand; tip the foot out in a comfortable position and put the fingers of the working

(right) hand around the ankle for leverage, making sure the index finger is placed

under the anklebone; this prevents contortion of the thumb joint; starting on the

medial point of the pelvic line, walk the thumb down at a 45 angle to this pin-point

reflex, stop, hook-in, back-up and then repeat the process several times(Byers

2001, pp 122-123).


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Pelvic reflex

Work the pelvic area by keeping the foot back and straight, using the basic holding

technique, place the thumb of the working hand on the heel for leverage, using all

fingers, work the entire pelvic area in many directions by changing the angle of the

wrist (Byers 2001, p 57).

Picture 50Working the sigmoid flexure

with the right hand, starting position

Picture 51Working the sigmoid flexure,

hook-in, back-up technique


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Knee/leg reflex

To work this reflex, the fingers can be used very effectively and thus save the thumb

form overuse, use the basic holding technique, place the fingers of the left hand on

the lateral edge of the dorsal surface and the thumb on the heel area for leverage,

walk the fingers in several directions by changing the angle of the wrist, use the

Picture 54Working the pelvic area using the

pivot rolling technique

Picture 53Working the pelvic area using

the pivot rolling technique


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Hip/sciatic reflex

Place the heel of the right foot on the 3rd

and 4th

fingers of the left hand with the

index finger resting underneath the lateral side of the anklebone and the thumb on

the bottom of the heel for leverage, place the holding hand on the metatarsal

padding, keeping the foot back and straight, walk with the index finger in a forward

motion angling at an approximately 45 angle into the anklebone, go approximately

one quarter to one half inch, stop, lift up, come back and start over, repeat this

process several times, change hands, then place the right heel on the palm of the

right hand with the 3rd

finger resting under the anklebone on the lateral side of the

foot, walk it toward you, about one quarter to one half inch, this time the left

Picture 55Working the knee reflex

Picture 56Working down the knee reflex


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The ovary and the testicle reflex

The ovary and the testicle reflex is found on the lateral side of the heel (little toe

side); find the high spot on the anklebone, square off the back of the heel and draw

an imaginary line; divide this line in half; this is where the ovary/testicle reflex is

found; it is best to use your left index finger on the right foot, place the finger on

this spot where the lines cross and use the slight circular motion, repeat this on the

Picture 57Working up the sciatic reflex

Picture 58Working downhip sciatic reflex


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The uterus or prostate reflex

The uterus or prostate reflex is located on the medial side (great toe side)

approximately halfway from the high spot on the anklebone to the back corner of

the heel at the base of the ridge of the tendon; to work this reflex on the right foot,

tip the foot out and support firmly with the holding hand, place the right hand a few

inches above the ankle, with the medial edge of the thumb on the inside of the ankle

between the bone and the Achilles tendon, walk the thumb down this groove

continue until you reach the high point of the ridge; this is the uterus/prostate reflex;

keep the thumb firmly on the reflex while rotating the foot in an outward direction,

k h i fi b i h l i f h kl j i hi fl i

Picture 59Working the ovaries/testes reflex


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Groin reflex

Picture 60Uterus/prostate reflex

Picture 61Working the uterus/prostate reflex

Picture 62Working the chronic prostate/uterus reflex


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The fallopian tube and the seminal duct reflex

To work this reflex, hold the foot back and straight, work with the index finger of

the right hand and walk from the medial side starting just under the anklebone to the

lateral side finishing just under the anklebone, take at least 20 to 25 bites, change

hands and walk from the lateral side to the medial side of the anklebone(Byers

2001, p 153).

Picture 64

Working thegroin reflex lateral to medial

Picture 63 .

Working thegroin reflex medial to lateral


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Diaphragm-deep breathing

Place the ball of the thumbs in the center of the diaphragm/solar plexus reflex in

both feet at the same time, allowing the fingers to comfortably support the dorsum

of the foot, ask your client to take a deep breath and maintain it each time you press

on this reflex, push in to this reflex as they take a deep breath and maintain the

pressure while they hold their breath for a short time, as they slowly exhale, you

should slowly let up on the pressure about halfway, do this 4 or 5 times gradually

increasing the time you hold the pressure and they hold their breath, always

maintain about half the pressure while they slowly exhalethis technique is

generally reserved for the end of a session (Byers 2001, p 37).

Picture 66


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Appendix 3. Light foot massage procedures

Light foot massage sequence outline

In this research, light foot massage is used as placebo reflexology. Accordingly, it

avoids putting pressure on specific reflexology areas. The light foot massage

procedures are as follows:

1. Ankle stretch under2. Ankle stretch over3. Ankle loosening4. Side-to-side5. Spinal twist6. Metatarsal kneading7. Toe rotation8. Put oil on your hand and enfold foot9. Hand-over-hand circulation for the Achilles tendon10.Thumb stroking to the plantar surface of the foot11.Palm stroking to the plantar surface of the foot12.Stretching toes apart13.Pulling toes


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Enfolding foot

Place one of your hands on[the] sole and the other on the top of[the] foot

slide your hands in a warm enfolding stroke slowly along top and bottom until your

fingertips slide off the tips of[the] toes; repeat a few times (Thomas 1989, p

42).

Hand-over-hand circulation for the Achilles tendon

Lift[the] foot, and pull toward yourself with the flat part of each hand, press up

into the tendon as you pull; as you pull down with your hands, be sure the foot is

well supportedpull not slap at the tendon (Inkeles 1987, p 117).


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Thumb stroking to the plantar surface of the foot

The thumbs are placed at the base of the toes, the right at the inner border, the left at

the outer border of the plantar surface; the fingers rest lightly on the dorsum of the

foot; the thumbs stroke firmly in opposite directions from the borders of the foot,

passing in the center; the stroking progresses from the base of the toes to the

heelreturn to the starting position with a superficial stroke, do this movement two

times (Wood 1981, p 66).

Palm stroking to the planter surface of the foot

The left hand on the dorsum of the foot gives support; the ulnar border of the right

hand is placed firmly on the plantar surface at the base of the toes (the hand is in

supination); as the hand strokes firmly down to the heel with deep pressure, it is

pronated and made to fit well into the arch, finishing with the palm flat on the table;

do this movement four times (Wood 1981, p 66-67).


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Stretching toes apart

Hold two adjacent toes between the thumbs and fingers of your hands and slowly

pull them apart from each other, stretching the web of skinstretch all toes in this

way (Thomas 1989, p 89).

Stroking the toes

Anchor the middle of the foot with one hand, and pull up the sides of each toepull

rapidly, almost snapping your fingers off the tip of each toeput pressure on the

sides of the toe without actually pulling hard on the toe itself (Inkeles 1987, p 118).


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The toe press

To do this, you need to press almost straight down from the toes without bending

the whole foot back and flattening the arch[support] one hand below the

anklekeep your fingers together, and press down over[the] toes, bending them

all the way back to the point of resistance; as you press down on the toes, the foot

will arch gracefully under your fingers[hold the stretch for a few seconds, then

release] repeat this movement three times (Inkeles 1987, p 117).

Foot circulation

Cup your hands so they fit the contours of[the] footand press one down the foot

from the base of the toes to the calf above the ankle; you can go even higher if you

like; when you reach the top position, begin at the toes with your other hand

pressing up the same way; as the second hand begins to ascend, the first hand

returns to the starting position (Inkeles 1987, p 120).


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Appendix 4. Demographic data questionnaire

Number of questionnaire

Part I Demographic Data

Name

Contact

number

1. Gender male female

2. Age.years

3. Marital status single couple

divorced/separated/widowed

4. Education no formal primary school

secondary school university/college

5. Financial difficulty? no yes

6. Period of hypertension 1-5 years 6-10 years


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.. ..

.. ..

.. ..

8. Period of treatment for hypertension

1-5 years 6-10 years

10-15 years more than 15 years

9. Which of the following medical conditions have you had diagnosed by a doctor?

(please tick one or more boxes)

heart disease diabetes

stroke kidney disease

others.

none of the above

10. How often do you have/take

- Fat/salty foods never


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- Smoking no yes how many a day?................................

quit when.

11. Levels of blood pressure, LDL cholesterol, and triglyceride

Date Blood pressure (mmHg)

before/after

LDL

cholesterol

(mg/dl)

Triglyceride

(mg/dl)

1

2

3

4

5

6

7

8


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F 1

FF

1.

2. .

3.

//

4.

/

5. ?

6. 1-5 6-10


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7. ?

/

.. ..

.. ..

.. ..

.. ..

.. ..

8.

1-5 6-10

10-15 15

9. F? (

)

/ (stroke)


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10. /?

- /


48/84

11. , F

( )

/

LDL

(/)

F

(/)

1

2

3

4

5

6

7

8


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Appendix 5. The World Health Organization quality of life

questionnaire: BREF

(English Thai version)

WHOQOL-BREF (English)

Your general quality of life

Please read each question, assess your feelings, and circle the number on the

scale for each question that gives the best answer for you.

1. How would you rate your quality of life? (Circle one number only)Very poor.1

Poor..2

Neither poor nor good..3

Good.4

Very good.5

2. How satisfied are you with your health? (Circle one number only)Very dissatisfied...1

Dissatisfied...2


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Please circle one number on each line.

Not

at all

A little A

moderate

amount

Very

much

An

extreme

amount

1. To what extent do you feel that

physical pain prevents you from

doing what you want to do?

1 2 3 4 5

2. How much do you need any

medical treatment to function in

your daily life?

1 2 3 4 5

3. How much do you enjoy life? 1 2 3 4 5

4. To what extent do you feel your

life to be meaningful?

1 2 3 4 5


Not

at all

A little A

moderate

Very

much

Extremely


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Not

at all

A little A

moderate

amount

Very

much

Extremely

2. How safe do you feel in

daily life?

1 2 3 4 5

3. How healthy is your

physical environment?

1 2 3 4 5


Not

at all

A little Moderately Mostly Completely

1. Do you have enough

energy for everyday life?

1 2 3 4 5

2. Are you able to accept

your bodily appearance?

1 2 3 4 5

3. Have you enough money

to meet your needs?

1 2 3 4 5

4. How available to you is 1 2 3 4 5


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Not

at all

A little moderately Mostly Completely

5. To what extent do you

have the opportunity for

leisure activities?

1 2 3 4 5

3. How well are you able to get around? (Circle one number only)Very dissatisfied...1

Dissatisfied...2

Neither satisfied nor dissatisfied..3

Satisfied4

Very satisfied5

The following questions ask you to say how good or satisfied you have felt

about various aspects of your life over the last two weeks.

Please circle one number on each line

Very Dissatisfied Neither Satisfied Very


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Very

dissatisfied

Dissatisfied Neither

satisfied

nor

dissatisfied

Satisfied Very

satisfied

2. How satisfied are you

with your ability to

perform your daily living

activities?

1 2 3 4 5


with your capacity to

work?

1 2 3 4 5


with yourself?

1 2 3 4 5


with your personal

relationships?

1 2 3 4 5


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Very

dissatisfied

Dissatisfied Neither Satisfied Very

satisfied


with the conditions of

your living place?

1 2 3 4 5


with your access to health

services?

1 2 3 4 5


with your transport?

1 2 3 4 5

The following question refers to how often you have felt or experienced certain

things in the last two weeks.

4. How often do you have negative feelings such as a blue mood, despair,anxiety, depression? (Circle one number only)

Never.1

Seldom..2

Quite often 3

(WHOQOL BREF)


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(WHOQOL-BREF)

1

(G1)

1 2 3 4 5

2

(G2)

1 2 3 4 5

FFFFF

3

(F1.4

)

5 4 3 2 1

4

(F11.

4)

F

5 4 3 2 1

5

(F4.1

)

1 2 3 4 5

6

(F24.

2)

1 2 3 4 5

7

(F5.3

)

1 2 3 4 5


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FFFF

F

F

10

(F2.1)

1 2 3 4 5

11

(F7.1)

1 2 3 4 5

12

(F18.1)

1 2 3 4 5

13

(F20.

1)

1 2 3 4 5

14

(F21.1)

1 2 3 4 5

FFFFFF

15

(F9.1)

1 2 3 4 5

(F6 3)


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(F6.3)

20

(F13.

3)

1 2 3 4 5

21

(F15.

3)

1 2 3 4 5

22

(F14.

4)

1 2 3 4 5

23

(F17.3)

1 2 3 4 5

24

(F19.

3)

1 2 3 4 5

25

(F23.3)

1 2 3 4 5

FFFFFFFF

26 5 4 3 2 1


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Appendix 6. Approvals, consent form and information sheets

(English and Thai)


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Approvals from Flinders Clinical Research Ethics Committee (FCREC)


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Approvals from Phramongkutklao Clinical Research Ethics Committee


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Consent form (English)

FLINDERS MEDICAL CENTRE

FLINDERS UNIVERSITY OF SOUTH AUSTRALIA

CONSENT TO PARTICIPATION IN RESEARCH

I, request and give consent to my

first or given names surname

involvement in the research project:

Effects of reflexology on reducing blood pressure in patients with hypertension

(short title of research project)

I acknowledge that the nature, purpose and contemplated effects of the research

project, especially

As far as they affect me have been fully explained to

mysatisfaction by and my consent is given

voluntarilyfirst or given names surname

I acknowledge that the detail(s) of the following procedure(s):

- Randomisation

- Complete QOL and demographic questionnaires.

- Have BP taken before and following reflexology or light foot massage.

- Undergo 30-50 minutes of reflexology or light foot massage twice a week for 4weeks.

- Have approximately 5 ml of blood drawn on two occasions.

has/have been explained to me including indications of risks; any discomfort involved;


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I acknowledge that I have been informed that should I receive an injury as a result oftaking part in this study, I may need to start legal action in order to receive

compensation.

I declare that I am over the age of 18 years.

Signature

of research

participant:

Date:

Signature of Witness:

Printed Name of Witness:

I, have described to

the research project and the nature and effects of the procedure(s) involved. In my opinion

he/she understands the explanation and has freely given his/her consent.

Signature: Date:

Status in project:

Consent form (Thai)


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F ( 4)

F

F

FF

FF

F

F F

FFF

F

FFF

F

F F

..................................................................................F


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(.......................................................................... )........................................................

.....................................................................................

(....................................................................... )

........................................................

FF

F....................................F

.....................................................................................

(..................................................................... )

........................................................

F

.................................................../

( )

........................................................


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Information sheets (English)


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Participant Information Sheet

Effects of foot reflexology on reducing blood pressure in patients with

hypertension

You are invited to take part in a study exploring the effect of foot reflexology on

reducing blood pressure. High blood pressure occurs in populations worldwide,

particularly in developing countries such as Thailand. High blood pressure can

contribute to heart disease, heart attacks, stroke and renal failure inducing death.

This study will explore the potential for reflexology to assist in the treatment of

patients with high blood pressure.

This is a research project, and you do not have to be involved. If you do not wish to

participate, your medical care will not be affected in any way.

If you choose to participate, you will be asked to read and sign a consent form to

confirm your commitment to being involved in the study. At the first day of trial,

you will be asked to answer some general questions about your living circumstances

and complete a quality of life questionnaire. This will take approximately 15

will be measured again. The levels of lipid in your blood (LDL cholesterol and


67/84

triglyceride) will be measured on the first day and the last day of treatment by

nurses staff at the medical-outpatient department. This means approximately 5 mls

of blood will be drawn each time. Risks associated with drawing blood include minor

pain, the possibility of bruising and rarely infection. On the last day of the trial, you

will be asked to complete the quality of life questionnaire again. The investigator

will pay the costs of lipid measurements.

Reflexology is not harmful therapy. However, it may rarely cause some

disadvantages. The side effects are thought to be caused by the bodys effort to

eliminate toxic substances. The symptoms are fever, rash, sweating, light diarrhoea

from more frequent bowel movement, flatulence, increase of urination with darker

and stronger smell, increase of mucus in the nose, mouth, and bronchials, disturbed

sleep, increase of vagina discharge, tiredness, headaches, depression, and worse

pre-symptoms.

Your participation in the study is entirely voluntary and you have the right to

withdraw from the study at any time. If you decide not to participate in this study or

if you withdraw from the study, you may do this freely without prejudice to any

treatment at Phramongkutklao Hospital.

All records containing personal information will remain confidential and no


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information that could lead to your identification will be released to anyone outside

the research team.

Should you require further details about the project, either before, during or after the

study, you may contact Ms Jeranut Somchock at this phone number: 09 2316898 or

this e-mail address:[email protected]

This study has been reviewed by the Flinders Clinical Research Ethics

Committee. Should you wish to discuss the project with someone not directly

involved, in particular in relation to matters concerning policies, your rights as

a participant, or should you wish to make a confidential complaint, you may

contact the Administrative Officer Research, Ms. CarolHakof, on (08) 8204

4507 or at the department of the ethical committes of Phramongkutklao

Hospital, on 02-2460 066 ext. 93681.

FLINDERS MEDICAL CENTRE

FLINDERS UNIVERSITY OF SOUTH AUSTRALIA


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FFF (3)

foot reflexology

F

F F F

FF F

FF

FFFFF F

F FF FF F

F

FFF

F

FF

FFFF


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FFFFFFFFFF

F F

F

FF

F F

FF

F

FF F 25F 5 F ..

2530 ( 2546).

,

F FF F (

F diastolic FF 130-150


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(stroke), ,

(Brien et al 1995, pp 37).

F 54.7

4.9 100,000 .. 2534 ( 2546).

FFFFFF

F

FF

.. 2546 F 50.3 351.8 .

FF 2536-2537 F 831

199 (Mathers and Penm 1999, p6).

FFF

FF

FF

fl l

foot reflexology


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F

foot reflexology light foot

massage

FFF- ( systolic FF 140

diastolic FF 90

) F(hyperlipidaemia)

- 18 F- - F

FF

- (thrombotic disease)- (ulcers), (foot infections), F

(foot surgery)


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F

128

F

F 2 4 8

F

FFF

FF 2 FF F 64 F F

light foot massage F light foot massage 30 2 4 FF foot reflexology

F foot reflexology 50 2

4 F

F

F F


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/FFF

F foot reflexology FF

FF

FF

foot reflexology FF , , ,

F, , ,

, ,

F, , ,

F (Dougans 2002, pp 125; Kowalak 2003, pp 285).

foot reflexology FF

F

- FF

FFFFF


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50

F F

F FF

FF

F FF

() 09 2316898

F

F () 09 2316898

FF FF

02 2460066 F 93681

Flinders, Australia (the Flinders Clinical Research


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Ethics Committee)

FFF

FF

FF

F F ,

F, , ,

F

FFFF

FF

Appendix 7. Tables

Table 1 Other co morbidities of the two study groups


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Table 1. Other co-morbidities of the two study groups

Medical Conditions Foot Reflexology Group

(n = 64)

Light Foot Massage Group

(n = 64)

Paralysis

Asthma

Bells palsy

Thyroid disease

Prostate enlargement/CA

TB lymph node

Hernia

CA breast/rectum

Abdominal aortic aneurysm

Psoriasis

Spondylosis or

Spondylolisthesis/with

Dysuria

Peptic ulcer

-

-

1.6

3.1

1.6

-

-

1.6

-

1.6

1.6

1.6

1.6

3.1

-

4.7

1.6

1.6

1.6

3.1

1.6

-

1.6

-

Table 2. Other medical treatments of the two study groups

Medical Treatments Foot Reflexology Group Light Foot Massage Group


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gy p

(n = 64)

g g p

(n = 64)

Peripheral vasodilators &

cerebral activators

Muscle relaxants

Anti-rheumatic, anti-

inflammatory analgesics

Oestrogens & progesterones &

related synthetic drugs

Antacids & antiulcerants

GIT regulators, antiflatulents &

anti-inflammatories

Gout preparations

Anti-depressants

Other agents affecting

metabolism

Agents affecting bone

metabolism

Minor tranquilisers

Vitamin B

Nootropics & neurotonics

Anti-asthmatic & COPD

preparations

1.6

-

9.4

1.6

12.5

9.4

3.1

1.6

-

1.6

3.1

7.8

6.3

1.6

3.1

4.7

7.8

1.6

10.9

3.1

4.7

3.1

1.6

3.1

4.7

4.7

1.6

-

Table 3. Other medical treatments of the two study groups (continued)

Medical treatments Foot Reflexology Group Light Foot Massage Group


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gy p

(n = 64)

g g p

(n = 64)

Thyroid preparations

Calcium/with vitamins

Anti-emetics & antivertigo drugs

Neurodegenerative disease drugs

Antihistamines & anti-allergics

Multivitamins

Cough & cold remedies

Analgesics & antipyretics,

anticonvulsants

Anti-anemics, pre & post natal

vitamins

Quinilones

Laxatives, purgatives

Cardiac drugs

Other drugs for genito-urinary

system

Vitamin E

Anticonvulsants

3.1

1.6

6.3

4.7

1.6

-

1.6

3.1

6.3

-

1.6

1.6

1.6

1.6

-

3.1

1.6

3.1

1.6

3.1

3.1

-

1.6

4.7

1.6

1.6

3.1

3.1

3.1

1.6

Table 4. Other medical treatments of the two study groups (continued)


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Medical treatments Foot Reflexology Group

(n = 64)

Light Foot Massage Group

(n = 64)

Androgens & related synthetic

drugs

Calcium carbonate or calciumacetate

Arthritis drugs

-

7.8

-

1.6

7.8

1.6

Appendix 8. Participants comments

Additional comments on each treatment from participants


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Additional comments on each treatment from participants

Comments Foot reflexology

n 54 (84.4%)

Light foot massage

n 48 (75%)

Satisfied with treatment Very much: 43 (67.2%)

Average: 11 (17.2%)

Very much: 42 (65.6%)

Average: 6 (9.4%)

Feel comfortable 22 (34.4%) 17 (26.6%)

Feel relaxed 15 (23.4%) 12 (18.75%)

Relieve fatigue, numbness,

cramp

15 (23.4%) 9 (14.1%)

Walk easier 6 (9.4%) 5 (7.8%)

Feel relaxed/light in feet 6 (9.4%) 1 (1.6%)

Want to have more of this

treatment in the hospital

5 (7.8%) 8 (12.5%)

Lower blood pressure 4 (6.25%) 5 (7.8%)

Sleep well 3 (4.7%) 5 (7.8%)

Like it very much 3 (4.7%) 0

Would like more time 2 (3.1%) 5 (7.8%)

Relieve stress 2 (3.1%) 1 (1.6%)

Additional comments on each treatment from participants (continue)


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n 54 (84.4%)

Light foot massage

n 48 (75%)

Brain relaxed 1 (1.6%) 0

Warmer feet 1 (1.6%) 0

More confident to go out 1 (1.6%) 0

Feel fresh 1 (1.6%) 2 (3.1%)

Relieve feet pain 1 (1.6%) 1 (1.6%)

Relieve feet oedema 1 (1.6%) 0

More sex ability 1 (1.6%) 0

Better than taking medicine 1 (1.6%) 1 (1.6%)

SBP increase 1 (1.6%) 0

Prefer harder 0 1 (1.6%)

More energy 0 1 (1.6%)

Heart beat regularly 0 1 (1.6%)

Dizziness disappeared 0 1 (1.6%)

M l l d 0 1 (1 6%)

Additional comments on each treatment from participants (continue)


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n 54 (84.4%)

Light foot massage

n 48 (75%)

Stronger urine colour and

odour

0 1 (1.6%)

Follow BP once a

month/every two months

0 1 (1.6%)

Light music 0 1 (1.6%)

Body massage 0 1 (1.6%)


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