ISSN-0976-0245 (Print) « ISSN-0976-5506 (Electronic) Volume 10 Number — May 2019 ong Bs my, 7 os “ona rows © Indian Journal of Public Health Research & Development An International Journal SCOPUS IJPHRD CITATION SCORE Indian Joumal of Public Health Research and Development Scopus coverage years: from 2010 to 2018 Publisher: R.K, Sharma, Institute of Medico-Legal Publications. ISSN:0976-0245E-ISSN; 0976-5506 Subject area: Medicine: Public ealth, Environmental and Occupational Health Cite Score 2017- 0.03 SUR 2017- 0.108 SNIP 2017- 0.047 Website: www.ijphrd.comReflexology: A Modality in Manipulative and Body Based Method Nor Dalila Mariean', Mohd Hafzal Abdul Halim', Mohad Anizu Mohd Nor’, Mohd Firdaus Mohd Nasir! ‘Faculty of Hospitality, Tourism and Wellness, University of Malaysia Kelantan; *Facully of Sport Science and Recreation, MARA University of Technology Malaysia ABSTRACT Reflexology is an ancient therapeutic treatment which activates the innate healing powers of the body by applying some pressure to the specific reflex points which are located on all part of the feet, hands, or cars. The popularity of reflexology therapy has increased in recent years as the public seck more holistic ‘ways to maintain good health and well-being. This paper reviews and summarizes the existing literature on reflexology focusing on principle, concept, current issues and scientific evidence. Databases of PubMed, Scopus, Science Direct, Google scholar as well as ProQuest were the sources used for findings the articles. Collectively, these reviews suggest a number of areas where reflexology may well be beneficial. Recent evidence suggests that reflexology is a simple, less expensive and non-invasive method that effective to regulate the autonomic nervous system activities, coordinates physiological responses, alleviates anxiety, and induces body relaxation. Keywords: complementary medicine; reflexology; review Introduction Complementary and Alternative Medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of biomedicine’, The acronym of CAM encompasses the wide array of therapeutic, diagnosis, treatment, and preventive disciplines, which complement ‘mainstream medicine by contributing to the diversifying of medical conceptual frameworks", Developed nations were used the term of CAM to refer a diverse group of health-related therapies and disciplines which are not considered to be part of mainstream medical care’ ‘National Centre for Complementary and Alternative Medicine (NCCAM) classified CAM into four domains namely natural products including, vitamins, herbs and supplements; mind-body medicine; manipulative and body-based practices; as well as other CAM practices such as traditional Chinese medicine, ayurvedic, and homeopathy’. Manipulative and body-based practices focus primarily on the body structures and systems, including the bones, joints, soft tissues, circulatory and lymphatic systems®. It may be performed as a part of other therapies of whole medical systems, including chiropractic medicine, osteopathic medicine, massage, reflexology, yoga, tai chi and naturopathic medicine’. In the form of the manipulative and body-based therapy, reflexology has been practiced for over 4,500 years’ Objective The major aim of the study was to review the existing literature on reflexology and compile the facts. Method The systematic search for relevant literature was performed using five databases including PubMed, Scopus, Science Direct, Google scholar and ProQuest. The basic search terms used included traditional medicine, complementary integrative medicine and reflexology in order to facilitate search of literature, In order to obtain the widest range of studies, ro limit was set for the date of publication. Only articles using English asa language of publication were included in the review. medicine, ‘What is Reflexology? Definition of Reflexology: Reflexology is a complex ‘massage intervention, based on the concept that specific areas of the feet, hands or ears which are called reflex points correspond to specific internal organs within the body”, Reflexology consists of identifying and treating energy imbalances in the body through massage of reflex points in specific areas". By applying pressure on these reflex areas, is thought to correspond to a map ofIndian Journal of Public Heath Research & Development. May 2019, Val.10,No.5 818 the whole body by stimulating the normal functions of slands, organs as well as parts of the body and finally ‘will encourage the body healing process" Origins of Reflexology: Reflexology is an_ ancient techniques of pressure have been practiced for thousands ofyears by many different cultures inthe different part of the world including China, Egypt, and India”. It widely through, although never proven, that the concepts of reflexology have its origins in China roughly 5,000 years ago based on the system of Chinese medicine" Some people believe that reflexology was developed in Egypt as early as 2330 BC and it believed to be used for ‘more than 4,500 years based on the pictograph evidence that was found in the tomb of Ankomohor, an Egyptian physician in Sagquara, Egypt’ The modem concept of reflexology was introduced to the United States in 1913 by Dr. William Fitzgerald who an ear, nose, and throat surgeon", He discovered the application of pressure to the tops of the fingers and the middle section of each finger could induee an anesthetic effect on the facial area”. The ideas were continues in the early 20* century through the work of individuals such as Dr. Joseph Riley, a physician, physiotherapist Eunice Ingham, and others, who added their own ideas to the simple ten zone concept. Applying zone therapy’s basie principles to the feet, they added four lateral lines and further detail to create a map on the feet showing which pressure points correspond to different parts of body". Reflexology Method: Two methods of reflexology that have been accepted intemationally are Ingham method and Rwo Shur method'’. The Rwo Shur method was developed in Taiwan by Father Joseph Eugster, a Swiss missionary", Father Josef’s method was popular amongst the Asian countries and successfully taught in more than 40 regions including Taiwan, China, Japan, Korea, ‘Singapore, Hong Kong and Malaysia" *. This method. can be quite painful to receive as it mainly concentrated to stimulate the body rather than relaxation! ‘The Ingham method of reflexology was invented in 1930 by Eunice Ingham is based on the energy zones of the feet and the rest of the body®, Ingham made the claim that the application of reflexology massage to reflex points on the feet increases blood supply to the corresponding mapped organs in the body”, The Ingham method was different with Rwo Shur method where it does not use any tools or reflex stick in its practice™, ‘Theories of Reflexology: There is still obscurity regarding the action mechanism of reflexology therapy, nevertheless ithas certainly been shown to have profound physiological and psychology effects, Many theories have been used to make clear working system on this holistic therapy. Collectively, there are five theories that support the reflexology mechanism which gives impacts to the body health. Energy mechanisms theory advocating reflexology points are linked to intemal organs and structures by ‘energy channels which become blocked in the event of illness and which are re-opened through reflexology”. Daring physical suffering or discomfort caused by illness or injury, the human body do not function effectively because the body in imbalance state and consequently blocked the vital energy pathways Another theory of reflexology is neuromatrix theory which also known as gate control theory”. Reflexology is believed to reduce intensity of pain by transmitting afferent impulses and closing the neural gates in the dorsal hom of the spinal cord, therefore blocking pain transmission® *. Stimulation of the reflex points on the skin sends messages from these cells through nerve pathways to control centers inside the body, which send. other messages back to the muscles or internal organs”. ‘The next theory proposes that reflexology can break up the lactic acid crystal that usually deposited in the feet and therefore allow energy to flow efficiently”. It is ‘thought that lactic acid deposited as microcrystals in the fect are crushed by the application of pressure or massage which thereby allows for the free flow of energy. Reflexologists work with the concept that the sole of the foot is a map which represents the entire body’. By palpating the foot, it created a relaxing effect which contributes to relieve tension and stress, affecting the autonomic response, which, in tur, affects the endocrine, immune, and neuropeptide systems”. A theory also suggesting that reflexology is simply a ‘method of showing care and concer for patients. Reflex Area and Points: Foot reflexology involves stimulation of the particulars reflex point in the sole of the foot, which believed to be the nerve center of the body", There are more than 7000 nerve endings are present in each foot called reflexes’. However, in the oldest classic of the theory of Chinese traditional medicine, practitioner was found a total of 600 points comprise the body, with 66 points located in the feet, Figure | illustrates the base of the ankle and toes on the top of the foot with specific reflex points whereas Figure exhibits the sole with specific reflex points.S16 Indian Journal of Pubic Health Research de Development, May 2019, Vo. 10, No. 5 Eee Figure 1: The Base of the Ankle and Toes on the Top of the Foot with Specific Reflex Points Figure 2: The Sole with Specific Reflex Points -merging Reflexology Issues safety of Reflexology Practice: Reflexology should be avoided when it comes to the particular circumstances” Foot reflexology is discouraged in people with foot fractures, unhealed wounds, as well as active gout or osteoarthritis that affects the foot and ankle®. Women in carly pregnaney specifically during the first trimester or first three months of pregnancy also should not receive reflexology therapy”. Stimulation at the particular reflex points might induce the contractions and subsequent causes the premature delivery as well as the risk of miscarriage™. Since reflexology improves circulation, the ‘thrombosis and embolism patients should not be exercised ‘with this kind of therapy because it could potentially cause the movement of clot towards the heart or brain’ Quality Control of Reflexology: Conventional medicine is a highly regulated system in which those who practice it are consistent trained and accountable*, Patient who use biomedical services have clearly defined courts of appeal if they are dissatisfied or injured”. In contrast, the vast of field of complementary and alternative medicine including modality of reflexology is largely unregulated and practiced by practitioner who may be untrained and. dangerous". Therapists may display impressive diploma granted by unregulated, unrecognized and unaceredited insttutions™. ‘The Potential of Reflexology: Reflexology is a gentle remedy encourages the body work naturally to regenerate its own balance. can help both physically and emotional of an individual and bring relief a variety of acute and chronic condition”, Recent evidence suggests. that reflexology is a simple, less expensive and non-invasive ‘method that effective to regulate the autonomic nervous, system activities, coordinates physiological responses, alleviates anxiety, and induces relaxation* ™. Evidence Base of Reflexology: Even though reflexology has been used for a wide variety of conditions, specific medical claims should always support by sound evidence. There are few studies that evaluate the efficacy or effectiveness of reflexology therapy for various condition of health, The effectiveness of reffexology has been clinically reported in to inerease sleep quality and as well as the quality of life”; reducing fatigue and anxiety’; relieving pain; reducing menopausal symptom and idiopathic constipation‘ ©; as well as reduced stress? Conclusion Reflexology is being embraced in many countries of the world for its provision of enhanced health, ‘mental and physical relaxation coupled with its inherent simplicity and harmlessness. Recently, more scientific and clinical research has been conducted because of its positive effects in reducing and alleviating symptoms,Indian Journal of Public Heath Research & Development. May 2019, Val.10,No.5 $17 especially those associated with chronic conditions such as diabetes mellitus, hypertension and muscular illness. Acknowledgment This work was supported in part by the University of, Malaysia Kelantan under the Short Term Research Grant Scheme, R/SGIP/A11.00/01416A/001/2018/000479. The authors would like to acknowledge to Mr Mohamed. Farid A. Rahman for material support for this article. Ethical Clearance: This study has been approved by the ethics committee of the University of Malaysia Kelantan, Conflict of Interest: The authors have no conflicts of interest to declare, ‘Source of Funding: This study was financially supported by the authors. REFERENCES 1, Tabish SA. Complementary and Altemative Healthcare: Is it Evidence-Based? International Journal of Health Sciences. 2008; 2(1): v-ix. 2. Greco CM, Nakajima, Manzi S. Updated Review of Complementary and Alternative Medicine ‘Treatments for Systemic Lupus Erythematosus, Curr Rheumatol Rep. 2014; 15(11): 378, - Quinn F, Hughes CM, Baxter GD. 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