Professional Documents
Culture Documents
, has kept
her healthy and active
over the span of her own
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If you remember the 1950s, Bonnie Prudden was a household
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line, read one of her many articles in Sports Illustrated, and at
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Bonnie Prudden:
Inspiring Health at Every Age
NHPC Staf
16 Summer 2011
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17 Summer 2011
1
PersPectives
Professions
for the
By field laws Professional regulatory grouP
Issue 10, summer 2011
JOINT SUBMISSIONS ON SANCTION: THE
HEARING TRIBUNALS ROLE
AYLA AKGUNGOR
Once a hearing tribunal has made a fnding of
unprofessional conduct, it is common practice
in many professions for the hearing tribunal
to be presented with a joint submission on
sanction. A joint submission on sanction sets
out a penalty (or penalties), which both the
investigated member and the College have
agreed constitutes a reasonable and appropriate
response to the unprofessional conduct.
A hearing tribunal always retains the discretion
to accept or reject a joint submission on sanction.
Generally speaking, the principle of deference
will apply and the hearing tribunal should accept
the joint submission on sanction unless it is of
the view that the penalty is unft, unreasonable
or is contrary to the public interest.
The principle of deference recognizes that joint
submissions on sanction are often the outcome
of an extended period of negotiations and
discussions where the parties have addressed
their minds to the issue of appropriate penalties.
In doing so, the parties have streamlined the
hearing process and saved time and resources.
Accordingly, the parties efforts in arriving at
a joint submission on sanction should not be
disregarded unless there are good and cogent
reasons for doing so. Recent decisions of the
courts have emphasized the importance of this
approach.
In Rault v. Law Society (Saskatchewan), 2009
SKCA 81, the College and the investigated
member made a joint submission that a lawyer
be permitted to resign in the face of discipline.
The hearing tribunal instead ordered that the
lawyer be disbarred and be ineligible to apply for
reinstatement for fve years. The Court of Appeal
reversed the sanction decision fnding that the
principles applied in criminal law with respect
to joint submissions on sentencing should also
be applied to professional disciplinary matters.
The Court noted that there are good public
policy reasons for the principle of deference
to joint submissions and concluded that if the
hearing tribunal was of the view that the joint
submission sanction was inappropriate, it had
a duty to give good or cogent reasons on why
the proposed sanctions were inappropriate;
not within the range of appropriate sanctions;
unft or unreasonable; or contrary to the public
interest.
similarly, in Pankiw v. Chiropractors
Association (Saskatchewan), 2009 SKQB 268,
the hearing tribunal rejected a joint submission
on sanction and imposed different penalties on
the investigated member. The court overturned
the sanctions imposed by the hearing tribunal
on the basis that it had not put its mind to or
concluded that the joint submission was unft,
unreasonable or not in the public interest. The
court then imposed the penalties set out in
the original joint submission on sanction. The
court noted that joint submissions are to be
encouraged not ignored. If they are ignored,
lengthy discipline hearings and increased
costs to be borne initially by members of the
profession and perhaps ultimately by the public
they serve will result.
In practice, if members of a hearing tribunal are
concerned that a joint submission on sanction is
unft, unreasonable or not in the public interest,
they should make their specifc concerns
known to the parties and provide them with an
opportunity to make further submissions, either
Continued on Page 4...
1
PersPectives
Professions
for the
By field laws Professional regulatory grouP
Issue 10, summer 2011
JOINT SUBMISSIONS ON SANCTION: THE
HEARING TRIBUNALS ROLE
AYLA AKGUNGOR
Once a hearing tribunal has made a fnding of
unprofessional conduct, it is common practice
in many professions for the hearing tribunal
to be presented with a joint submission on
sanction. A joint submission on sanction sets
out a penalty (or penalties), which both the
investigated member and the College have
agreed constitutes a reasonable and appropriate
response to the unprofessional conduct.
A hearing tribunal always retains the discretion
to accept or reject a joint submission on sanction.
Generally speaking, the principle of deference
will apply and the hearing tribunal should accept
the joint submission on sanction unless it is of
the view that the penalty is unft, unreasonable
or is contrary to the public interest.
The principle of deference recognizes that joint
submissions on sanction are often the outcome
of an extended period of negotiations and
discussions where the parties have addressed
their minds to the issue of appropriate penalties.
In doing so, the parties have streamlined the
hearing process and saved time and resources.
Accordingly, the parties efforts in arriving at
a joint submission on sanction should not be
disregarded unless there are good and cogent
reasons for doing so. Recent decisions of the
courts have emphasized the importance of this
approach.
In Rault v. Law Society (Saskatchewan), 2009
SKCA 81, the College and the investigated
member made a joint submission that a lawyer
be permitted to resign in the face of discipline.
The hearing tribunal instead ordered that the
lawyer be disbarred and be ineligible to apply for
reinstatement for fve years. The Court of Appeal
reversed the sanction decision fnding that the
principles applied in criminal law with respect
to joint submissions on sentencing should also
be applied to professional disciplinary matters.
The Court noted that there are good public
policy reasons for the principle of deference
to joint submissions and concluded that if the
hearing tribunal was of the view that the joint
submission sanction was inappropriate, it had
a duty to give good or cogent reasons on why
the proposed sanctions were inappropriate;
not within the range of appropriate sanctions;
unft or unreasonable; or contrary to the public
interest.
similarly, in Pankiw v. Chiropractors
Association (Saskatchewan), 2009 SKQB 268,
the hearing tribunal rejected a joint submission
on sanction and imposed different penalties on
the investigated member. The court overturned
the sanctions imposed by the hearing tribunal
on the basis that it had not put its mind to or
concluded that the joint submission was unft,
unreasonable or not in the public interest. The
court then imposed the penalties set out in
the original joint submission on sanction. The
court noted that joint submissions are to be
encouraged not ignored. If they are ignored,
lengthy discipline hearings and increased
costs to be borne initially by members of the
profession and perhaps ultimately by the public
they serve will result.
In practice, if members of a hearing tribunal are
concerned that a joint submission on sanction is
unft, unreasonable or not in the public interest,
they should make their specifc concerns
known to the parties and provide them with an
opportunity to make further submissions, either
Continued on Page 4...
O
nce a hearing tribunal has made a finding
of unprofessional conduct, it is common
practice in many professions for the
hearing tribunal to be presented with a joint
submission on sanction. A joint submission on
sanction sets out a penalty (or penalties), which
both the investigated member and the College have
agreed constitutes a reasonable and appropriate
response to the unprofessional conduct.
A hearing tribunal always retains the discretion
to accept or reject a joint submission on sanction.
Generally speaking, the principle of deference
will apply and the hearing tribunal should accept
the joint submission on sanction unless it is of
the view that the penalty is unfit, unreasonable
or is contrary to the public interest.
The principle of deference recognizes that joint
submissions on sanction are often the outcome of
an extended period of negotiations and discussions
where the parties have addressed their minds to
the issue of appropriate penalties. In doing so,
the parties have streamlined the hearing process
and saved time and resources. Accordingly, the
parties efforts in arriving at a joint submission
on sanction should not be disregarded unless
there are good and cogent reasons for doing so.
Recent decisions of the courts have emphasized
the importance of this approach.
In Rault v. Law Society (Saskatchewan), 2009
SKCA 81, the College and the investigated
member made a joint submission that a lawyer
be permitted to resign in the face of discipline.
The hearing tribunal instead ordered that the
lawyer be disbarred and be ineligible to apply for
reinstatement for five years. The Court of Appeal
reversed the sanction decision finding that the
principles applied in criminal law with respect
to joint submissions on sentencing should also
be applied to professional disciplinary matters.
The Court noted that there are good public
policy reasons for the principle of deference
to joint submissions and concluded that if the
hearing tribunal was of the view that the joint
submission sanction was inappropriate, it had
a duty to give good or cogent reasons on why
the proposed sanctions were inappropriate; not
within the range of appropriate sanctions; unfit or
unreasonable; or contrary to the public interest.
Similarly, in Pankiw v. Chiropractors
Association (Saskatchewan), 2009 SKQB 268,
the hearing tribunal rejected a joint submission
on sanction and imposed different penalties on
the investigated member. The court overturned
the sanctions imposed by the hearing tribunal
on the basis that it had not put its mind to or
concluded that the joint submission was unfit,
unreasonable or not in the public interest. The
court then imposed the penalties set out in
the original joint submission on sanction. The
court noted that joint submissions are to be
encouraged not ignored. If they are ignored,
lengthy discipline hearings and increased
costs to be borne initially by members of the
profession and perhaps ultimately by the public
they serve will result.
In practice, if members of a hearing tribunal are
concerned that a joint submission on sanction is
unfit, unreasonable or not in the public interest,
they should make their specific concerns
known to the parties and provide them with an
opportunity to make further submissions, either
orally before the hearing tribunal or by way of
written submissions. Only after the instigated
JOINT SUBMISSIONS ON SANCTION:
THE HEARING TRIBUNALS ROLE
18 Summer 2011
RECENT CASES OF INTEREST TO REGULATORS
member and the College have provided their
comments on the hearing tribunals concerns
with the joint submission should the hearing
tribunal proceed with making its ultimate
decision on sanction.
Indeed, as the case of Visconti v. College
of Physicians & Surgeons (Alberta), 2009
ABQB 742 demonstrates, this practice
should be followed at any point where the
hearing tribunal is considering varying from
the penalties proposed by the parties whether
or not the penalties were proposed by joint
sanction. In Visconti, the legislation provided
for an Investigating Committee to make
recommendations to the Council of the College
with respect to sanctions. Council imposed
sanctions over and above those recommended
by the Investigating Committee. Even though
there was no joint submission on sanction in
this case, the Court held that the investigated
member should have been advised that Council
was considering a higher penalty and been given
the opportunity to make submissions.
While it remains up to hearing tribunals to
determine whether they will accept joint
admissions on sanction, they must be mindful
of the public policy reasons for encouraging
joint submissions on sanction. In cases where
hearing tribunals choose to deviate from
joint submissions, they must be prepared to
set out in their written decisions cogent and
well-developed reasons for why the sanction
proposed by the parties was unfit, unreasonable,
not in the public interest or not within the range
of appropriate penalties for the unprofessional
conduct in question. s
Reasonable Apprehension of Bias
Lim v. Association of Professional Engineers of
Ontario, 2011 ONSC 106
A complaint against an engineer was referred to
a discipline hearing. The Manager of Legal and
Regulatory Affairs, who was the support staff
who assisted the discipline tribunal in its duties,
engaged in correspondence with the parties to
try to set a date for the hearing. Counsel for
the member indicated he had not received full
disclosure and therefore the proposed dates
would not work, but proposed some alternative
dates. The Manager sent a response by e-mail
indicating that the Chair of the Tribunal had an
obligation to the public to proceed expeditiously,
and that if assertions were made regarding the
lack of availability for a hearing, evidence would
have to be provided to support the assertions.
Further correspondence was exchanged between
the Manager and both counsel, in which the
Manager warned that threats and intimidation
would not be tolerated. The Manager threatened
to report members counsel to the Law Society,
and demanded an apology from counsel.
Counsel for the Association wrote stating that
she also thought the Managers communication
was inappropriate. The member then made
an application for further disclosure and also
argued that there was a reasonable apprehension
of bias. The Manager sought to be added as a
party to the application. The member hearing the
application refused to grant the Manager party
status. The Chair of the Tribunal subsequently
overturned the decision, and decided to add
the Manager of the Tribunal as a party, without
granting the parties an opportunity to make
submissions. The member sought a stay of the
hearing on the basis of reasonable apprehension
of bias. The Court granted the stay and
permanently quashed the proceedings.
Commentary: Tribunal staff, such as the
Hearings Director or persons acting in an
administrative capacity to assist discipline
tribunals in carrying out their functions must
not usurp the function of the discipline tribunal.
Tribunal staff can act as a conduit between the
parties and the discipline committee, but should
refrain from making any decisions on behalf
of the discipline committee, or appearing as if
they are controlling the process. Staff members
acting in this capacity should ensure that (a)
they do not communicate with the parties unless
they have directions to do so from the tribunal
or the Chair (b) they clearly indicate to the
parties that the correspondence is being sent
on behalf of the tribunal and (c) the tone and
content of the communications does not give
rise to a reasonable apprehension of bias.
2
RECENT CASES OF INTEREST TO REGULATORS
KATRINA HAYMOND
reasonable apprehension of bias
Lim v. Association of Professional Engineers of
Ontario, 2011 ONsC 106
A complaint against an engineer was referred to
a discipline hearing. The Manager of Legal and
Regulatory Affairs, who was the support staff
who assisted the discipline tribunal in its duties,
engaged in correspondence with the parties to
try to set a date for the hearing. Counsel for
the member indicated he had not received full
disclosure and therefore the proposed dates
would not work, but proposed some alternative
dates. The Manager sent a response by e-mail
indicating that the Chair of the Tribunal had an
obligation to the public to proceed expeditiously,
and that if assertions were made regarding the
lack of availability for a hearing, evidence would
have to be provided to support the assertions.
Further correspondence was exchanged
between the Manager and both counsel, in
which the Manager warned that threats and
intimidation would not be tolerated. The Manager
threatened to report members counsel to the
Law Society, and demanded an apology from
counsel. Counsel for the Association wrote
stating that she also thought the Managers
communication was inappropriate. The member
then made an application for further disclosure
and also argued that there was a reasonable
apprehension of bias. The Manager sought to
be added as a party to the application. The
member hearing the application refused to
grant the Manager party status. The Chair
of the Tribunal subsequently overturned the
decision, and decided to add the Manager of
the Tribunal as a party, without granting the
parties an opportunity to make submissions.
The member sought a stay of the hearing on
the basis of reasonable apprehension of bias.
The Court granted the stay and permanently
quashed the proceedings.
Commentary: Tribunal staff, such as the
Hearings Director or persons acting in an
administrative capacity to assist discipline
tribunals in carrying out their functions must
not usurp the function of the discipline tribunal.
Tribunal staff can act as a conduit between the
parties and the discipline committee, but should
refrain from making any decisions on behalf of
the discipline committee, or appearing as if they
are controlling the process. Staff members
acting in this capacity should ensure that
(a) they do not communicate with the parties
unless they have directions to do so from the
tribunal or the Chair (b) they clearly indicate to
the parties that the correspondence is being
sent on behalf of the tribunal and (c) the tone
and content of the communications does not
give rise to a reasonable apprehension of bias.
overlapping Jurisdiction
Nowoselsky v. College of Social Workers
Appeal Panel (Alberta), 2011 ABCA 58
A social worker was found guilty of a number
of allegations, including several boundary
violations with clients. The social worker
appealed to Council, which upheld the fndings,
and then to the Court of Appeal. The social
worker raised a number of grounds of appeal,
including that the same conduct was being dealt
with by the employer and was the subject of a
grievance pursuant to the governing collective
agreement. The social worker argued that he
was facing double jeopardy and the Hearing
Tribunal should not have proceeded in these
circumstances. The Court of Appeal rejected
this argument, confrming that in matters of
this nature, the employer could address the
conduct via the mechanisms in the collective
agreement, and the College could address the
conduct under the HPA.
Commentary: The fact that the employer is
addressing the subject matter of a complaint in
the employment context does not deprive the
regulatory body of jurisdiction to process the
complaint under its own governing jurisdiction.
Both the employer and the regulatory may have
a legitimate interest in addressing the conduct.
new evidence
Barrington v. Institute of Chartered Accountants
(Ontario), 2011 CarswellOnt 3623
Four accountants who worked at Deloitte were
involved in conducting an audit approving
the fnancial statements of a large company.
19 Summer 2011
Overlapping Juristiction
Nowoselsky v. College of Social Workers Appeal Panel (Alberta),
2011 ABCA 58
A social worker was found guilty of a number of allegations,
including several boundary violations with clients. The social
worker appealed to Council, which upheld the findings, and
then to the Court of Appeal. The social worker raised a number
of grounds of appeal, including that the same conduct was being
dealt with by the employer and was the subject of a grievance
pursuant to the governing collective agreement. The social worker
argued that he was facing double jeopardy and the Hearing
Tribunal should not have proceeded in these circumstances. The
Court of Appeal rejected this argument, confirming that in matters
of this nature, the employer could address the conduct via the
mechanisms in the collective agreement, and the College could
address the conduct under the HPA.
Commentary: The fact that the employer is addressing the
subject matter of a complaint in the employment context does
not deprive the regulatory body of jurisdiction to process
the complaint under its own governing jurisdiction. Both the
employer and the regulatory may have a legitimate interest in
addressing the conduct.
New Evidence
Barrington v. Institute of Chartered Accountants (Ontario), 2011
Carswell Ont 3623
Four accountants who worked at Deloitte were involved in
conducting an audit approving the financial statements of a
large company. Under new management, serious financial
irregularities were discovered in the companys books.
Complaints were made against the four senior accountants who
were involved in the audit. The complaints alleged that they failed
to adhere to accounting and auditing standards. After a lengthy
discipline hearing, the accountants were found guilty of several
allegations. The Notice of Hearing alleged that the accountants
failed to comply with generally accepted accounting standards
(GAAP) and generally accepted auditing standards (GAAS)
and gave multiple particulars relating to those charges. During
the course of the hearing, evidence came to light that had not
been disclosed to the Institute during its investigation relating to
a dispute that the four accountants had with the company. The
dispute related to an inappropriate agreement that the company
had entered into that was affecting the validity of their financial
statements. Although the company advised the accountants that
it would cancel the agreement, the company failed to do so. The
Discipline Committee found three of the accountants guilty of the
specific allegations in the Notice of Hearing, concluding in part
that their failure to follow up regarding the cancellation of the
side agreement was a breach of the GAAP. They were ordered to
pay a large fine and the costs of the hearing.
The members appealed to the appeal tribunal, which upheld the
decision of the Discipline Committee. The accountants sought
judicial review, on the basis that there was a breach of fairness.
The court granted the application for judicial review in part,
quashing some of the findings, and overturning the costs order.
The members appealed the findings to the Court of Appeal, and
the Institute cross-appealed. The members raised several grounds
of appeal, including that they had inadequate notice of the
allegations and that the Discipline Committee failed to provide
adequate reasons. The Court of Appeal considered whether there
was a breach of fairness, given that the Notice of Hearing and
the particulars referenced therein did not specifically refer to the
side agreement that was referenced and material to the Discipline
Committees decision.
The Court of Appeal held that there was no breach of fairness to
the members, given that the side agreement was evidence that
had not specifically been disclosed to the investigators prior to
the hearing. It was raised by the accountants themselves during
the hearing, and should have been anticipated by them given that
they knew at least one witness would be testifying on the issue.
Moreover, it did not change the essential elements of the charges,
which were whether or not there was a breach of GAAP and
GAAS. Just because the prosecutor had a different theory of the
case did not prohibit the Discipline Committee from considering
the new evidence, since there are potentially different routes to
liability.
Commentary: Where new evidence arises during the course of
a hearing that is relevant to the charges, consideration of that
evidence will not always result in a breach of fairness. If the
member knew of the evidence, and the evidence is relevant to
the allegations in issue, the discipline tribunal may be able to
rely upon it notwithstanding the lack of specific notice. However,
the specific statutory provisions need to be considered. Many
statutes have a specific provision that allows a discipline tribunal
to consider new evidence that arises in the course of a hearing,
provided that notice is given and/or an adjournment is granted. If
new evidence does arise, in order to avoid allegations of a breach
of fairness, the hearing can be adjourned so that the member can
respond to the new evidence. Each situation should be carefully
assessed to determine the best course of action. s
4
These articles should not be interpreted as providing legal advice. Consult your legal
adviser before acting on any of the information contained in them. Questions, comments,
suggestions and address updates are most appreciated and should be directed to:
Katrina Haymond in Edmonton 780-423-9584
Lisa Gaunt in Calgary 403-260-8525
rePrintS
Professional organizations may reprint articles in their own newsletters provided credit
is given for the articles to Field Laws Professional Regulatory Group and the individual
author. Please send us a copy of the newsletter with the article.
disclaimer
edmonton
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PH 867 920 4542
www.fieldlaw.com
PersPectives for
the Professions
orally before the hearing tribunal or by way of written
submissions. Only after the investigated member and
the College have provided their comments on the hearing
tribunals concerns with the joint submission should the
hearing tribunal proceed with making its ultimate decision
on sanction.
Indeed, as the case of Visconti v. College of Physicians &
Surgeons (Alberta), 2009 ABQB 742 demonstrates, this
practice should be followed at any point where the hearing
tribunal is considering varying from the penalties proposed
by the parties whether or not the penalties were proposed
by joint sanction. In Visconti, the legislation provided for an
Investigating Committee to make recommendations to the
Council of the College with respect to sanctions. Council
imposed sanctions over and above those recommended by
the Investigating Committee. Even though there was no
joint submission on sanction in this case, the Court held that
the investigated member should have been advised that
Council was considering a higher penalty and been given
the opportunity to make submissions.
While it remains up to hearing tribunals to determine whether
they will accept joint submissions on sanction, they must be
mindful of the public policy reasons for encouraging joint
submissions on sanction. In cases where hearing tribunals
choose to deviate from joint submissions, they must be
prepared to set out in their written decisions cogent and
well-developed reasons for why the sanction proposed
by the parties was unft, unreasonable, not in the public
interest or not within the range of appropriate penalties for
the unprofessional conduct in question.
training dVd for hearing
tribunals is now available!
Over the past year, the lawyers at Field LLP had the
opportunity to work on an important and groundbreaking
project with the Alberta Federation of Regulated Health
Professions (AFRHP). The project resulted in the production
of a training DVD that will provide members of Hearing
Tribunals under the HPA with an overview of the discipline
process under the HPA and an introduction to some key
concepts that members need to be aware of. The DVD,
called Hearing Tribunal Essentials provides an overview
of basic administrative law principles, the professional
conduct process, contested and uncontested hearings,
key evidentiary rules, assessing credibility of witnesses,
imposing sanctions, and preparing reasons. The DVD also
includes a number of interesting demonstrations designed
to give new members a realistic snapshot of the hearing
process.
We appreciated the opportunity to collaborate on this
exciting project with the Steering Committee of the AFRHPs
Complaints Process Working Group, which included Kathy
Hilsenteger (ACDMTT), Sharlene Standing (CLPNA) and
Dr. Richard Spelliscy (CAP). If you want to obtain a copy of
the DVD, you can order it online at www.afrhp.org.
While the DVD provides general training, we anticipate that
many Colleges will still want individualized training for their
tribunals. Our Professional Regulatory Group will continue
to provide individualized and advanced training upon
request. Please contact Katrina Haymond at 423-9584 for
more information.
Joint Submissions
Continued from Page 1...
20 Summer 2011
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emy of trAditionAl cHineSe medicine, Active HeAltH group, Active releASe tecHnique, AfricAn toucH, AHern'S ScHool of mASSAge, AlBerni vAlley tHerApeuticS, AlBertA AromAtHerApy inStitute, AlBertA inStitute of mASSAge, AlBertA
mASSAge trAining, AlexAnder tecHnique, AlexAndriAn inStitute, Algonquin college of Applied ArtS & tecHnology, Allgemeinic KrAnKenHAuS WAndSBeK, AlliAnce deS mASSotHerApeuteS du queBec, AmAtSu trAining ScHool ltd., AmBi-
Antz, AmericAn inStitute of mASSAge tHerApy, AmericAn polArity tHerApy ASSociAtion, Arc inStitute, ArcHWAyS HeAling college, AromAtHerApy WHoliStic centre, AromAticA, Art of conSciouS toucH BodyWorK, ASiA-pAcific AromA-
tHerApy ltd., ASSociAtion deS mASSotHerApeuteS du queBec, ASSociAtion of mASSAge & BodyWorK profeSSionAlS, ASton pAtterning ASSociAtion, AtlAntic college of tHerApeutic mASSAge, AuStrAlASiAn college of nAturAl tHerApieS,
AuStrAliAn college of nAturAl medicine, AuStrAliAn government, AuStrAliAn inStitute of Applied ScienceS, AuStrAliAn inStitute of HoliStic medicine, BAlneA inStitute - ScHool of complimentAry tHerApieS, BAltimore ScHool of
mASSAge, BAncroft ScHool of mASSAge tHerApy, BAnning mASSAge ScHool, BArBArA BrennAn ScHool of HeAling, BeAr foot reflexology & trAditionAl tHAi mASSAge, Beijing univerSity of cHineSe medicine, BelAruSSiAn HeAltH vitAl
centre, Bellevue mASSAge ScHool, Blue Heron AcAdemy of HeAling ArtS And ScienceS, Body intelligence trAining, Body-mind connection, BodytAlK internAtionAl, Bonnie prudden myotHerApiStS, Boulder ScHool of mASSAge tHer-
Apy, BoWen college, BoWenWorK cAnAdA regiStry, BoWtecH, BriAn utting ScHool of mASSAge, BritiSH columBiA inStitute of HoliStic StudieS, cAlgAry college of HoliStic HeAltH And clinicS, cAlgAry college of trAditionAl cHineSe
medicine And Acupuncture, cAlming tHe oceAn, cAnAdiAn AcAdemy of nAturAl tHerApy, cAnAdiAn AcupreSSure college, cAnAdiAn ASSociAtion of SpeciAlized KineSiology, cAnAdiAn college of HeAltH ScienceS & tecHnology, cAnAdiAn
college of mASSAge & HydrotHerApy, cAnAdiAn college of mASSAge & WellneSS, cAnAdiAn college of Science And tecHnology, cAnAdiAn college of SHiAtSu tHerApy, cAnAdiAn educAtion centre of Beijing univerSity of cHineSe medicine,
cAnAdiAn HellerWorK ASSociAtion, cAnAdiAn inStitute of AlternAtive medicine, cAnAdiAn inStitute of Bio-field tHerApy, cAnAdiAn inStitute of nAturAl HeAltH And HeAling, cAnAdiAn inStitute of trAditionAl cHineSe medicine, cAnA-
diAn inStitute of WellneSS And SpA educAtion, cAnAdiAn nAtionAl ScHool of AromAtHerApy, cAnAdiAn ortHotHerApy college, cAnAdiAn pilAteS ASSociAtion, cAnAdiAn reflexology ScHool, cAnAdiAn ScHool of tHAi mASSAge, cAnAdiAn
ScHool of trAditionAl tHAi tHerApy, cAnAdiAn Society of teAcHerS of tHe AlexAnder tecHnique, cAnAdiAn tHerApeutic college, cAnAdiAn trAger ASSociAtion, cAnBerrA inStitute of tecHnology, cAnterBury college, cAreer cAnAdA
college, cAroline A. oWen, cArrington college, cASAromA WellneSS centre, cAScAdiA centre, cAyce/ reilly ScHool of mASSotHerApy, cdi college, centenniAl college of Applied ArtS & tecHnology (WArden WoodS cAmpuS), centre
de mASSotHerApie de queBec, cHAngcHun univerSity of cHineSe medicine, cHengdu univerSity of trAditionAl cHineSe medicine, cHiAng mAi SKill development centre, cHinA inStitute of Sport Science, cHoice college, cHongqing college
of trAditionAl cHineSe medicine, circle of life, ScHool of tHAi mASSAge And HeAltH, clASSicAl KineSiology inStitute, cleArHeArt BodyWorK ScHool, college And clinic of complementAry medicine, godelmAn, college BoreAl, college
of internAtionAl HoliStic StudieS, college of mASSAge tHerApiStS of ontArio, college of mASSAge tHerApy of BritiSH columBiA, college of medicAl intuition, college of nAturAl HeAling ArtS, college of nAturAl HeAltH cHoiceS,
college of tHe nortH AtlAntic, college pAuline gAgnon medecine AlternAtive, colorAdo inStitute of mASSAge tHerApy, comeniouS univerSity in BrAtiSlAvA, commiSSion on mASSAge tHerApy AccreditAtion, compucollege, connecticut
centre for mASSAge tHerApy, core inStitute ScHool of mASSAge tHerApy, crAniAl tHerApy centre, cv ScHool of continuing mASSAge educAtion, dAHAn inStitute of mASSAge StudieS, dAndong diet Service tecHnology ScHool, d'Arcy
lAne inStitute, deSert reSortS ScHool of SomAtHerApy, diAnne miller ScHool of pilAteS, dominion college of remediAl mASSAge, dr. vodder ScHool, eASt-WeSt college of HeAling ArtS, ecole de mASSAge profeSSionnel, ecole de
mASSAge profeSSionnel, ecole de mASSo-nAturo-KineSie, edmonton college of SWediSH relAxAtion mASSAge, edmonton puBlic ScHoolS, educAting HAndS ScHool of mASSAge, educAtionAl KineSiology foundAtion, elegAnce ScHool of
eStHeticS, elmcreSt college of Applied HeAltH ScienceS, empreSS Bridge college KineSiology college, energy medicine pArtnerSHipS, eSAlen inStitute, europeAn ScHool of SHiAtSu, evA HuSer ScHool, excellence in reflexology, felden-
KrAiS, firSt AffiliAted HoSpitAl of guAngxi trAditionAl cHineSe medicAl univerSity, firSt cAnAdiAn coSmeticiAn And HAir deSign AcAdemy, five elementS inStitute of trAditionAl cHineSe medicine, foldiScHule gmBH, footHillS college
of mASSAge tHerApy, from WitHin WellneSS centre, gAnSu college of trAditionAl cHineSe medicine, gold coASt trAining AcAdemy BurleigH HeAdS cAmpuS, golden needle Acupuncture, golden SciSSorS BeAuty & mASSAge ScHool,
good ScentS ScHool, grAnt mAceWAn univerSity ,grAnt mAceWAn univerSity, guAngxi trAditionAl cHineSe medicAl univerSity, guAngzHou univerSity of trAditionAl cHineSe medicine, guijeK inStitut queBecoiS pour lA SAnte inte-
grAle, guild for StructurAl integrAtion, HAle olA - A plAce of HeAling, HAndS on tHerApy ScHool of mASSAge, HAnne mArquArdt ScHool, HArBin SHengruntAng HeAltH tecHnology vocAtionAl trAining ScHool, HeAling BodyWorK
centre, HeAling co-op of SASKAtoon ltd., HeAling HAndS center, HeAling HAndS cHAir mASSAge, HeAling ScentS HoliStic clinic, HeAling toucH internAtionAl, HeAling your Soul mASSAge & WellneSS, HeAltH cAre AcupreSSure, HeAltH
centre "dAr" BulgAriA, HeArtWood inStitute, HeilongjiAng inStitute of trAditionAl cHineSe medicine, HellerWorK internAtionAl, HenAn trAditionAl cHineSe medicine univerSity, HoliStic unconventionAl medicine ScHool of nortHern
collAge,, HoloS univerSity grAduAte SeminAry, Hu Bei college of trAditionAl cHineSe medicine, HuA xiA Acupuncture And HerB college of cAnAdA, Hui zHou xu lAn BeAuty And HAir SKill trAining ScHool, Hurley/oSBorn prActitio-
ner'S ASSociAtion, ict KiKKAWA college, ict nortHumBerlAnd college, imKo Apleidingen AmerSfoort, in toucH trAining, inStitute for HumAniStic energy tHerApy, inStitute for tHerApeutic toucH, inStitute of AromAtHerApy, inStitute
of Scientific medicAl intuition, inStitute of tHAi mASSAge, inStitute of trAditionAl HerBAl medicine And AromAtHerApy, integrAtive yogA tHerApy, internAtionAl AcAdemy of eStHeticS, internAtionAl AcAdemy of mASSAge, internAtionAl
AcAdemy of nAturAl HeAltH ScienceS, internAtionAl certified AromAtHerApy inStitute, internAtionAl council for AquAtic tHerApy And reHABilitAtion, internAtionAl inStitute of reflexology, internAtionAl loving toucH foundAtion,
internAtionAl orgAnizAtion for SHAntAlA mASSAge, internAtionAl profeSSionAl ScHool of BodyWorK, internAtionAl ScHool of mASSAge tHerApy, internAtionAl ScHool of SHiAtSu, internAtionAl SivAnAndA yogA vedAntA centre, inter-
nAtionAl tHerApy exAminAtion council, internAtionAl trAining mASSAge, intuition By deSign, irene'S myomASSology inStitute, iSrAel AcAdemy of mASSAge, ivAno-frAnKivSK'S regionAl committee of tHe red croSS Society, jApAn SHi-
AtSu college, jiAngxi univerSity of trAditionAl cHineSe medicine, jin SHin do foundAtion, joHn BArneS myofASciAl releASe treAtment center, journey WitHin HoliStic Study And retreAt centre, joyeSSence AromAtHerApy centre, KA-
runA college, Kine-concept inStitute, KineSiology college of cAnAdA, KoKoro do jo ,KootenAy ScHool of reBAlAncing, KripAlu center for yogA And HeAltH, KripAlu center for yogA And HeAltH, KundAlini reSeArcH inStitute, KyBAlion
BfS fur mASSAge und pHySiotHerApie, lAKelAnd college, lAmBton college, lAngArA college, lAStone tHerApy ,lAyden'S HerBAl And tHerApy centre, le centre pSycHo-corporel, letHBridge college, leyline centre for SpirituAl
prActice, liAoling province city of fuSHun fu KAng yuAn mASSAge trAining ScHool, liAoning college of trAditionAl cHineSe medicine, lindSey HopKinS tecHnicAl educAtion centre, living eArtH ScHool of nAturAl tHerApieS, lomilomi
SomAtic HeAling centre inc., lotuS centre, lotuS pAlm ScHool, louiSiAnA inStitute of mASSAge tHerApy, lympHologic mediziniScHe WeiterBildungS gmBH, m.H. vicArS ScHool of mASSAge tHerApy , mAKAmi college, mAnitoBA mAS-
SAge And reflexology ASSociAtion (mmrA), mArcHAnd inStitute of Sport And deep tiSSue mASSAge, mASSAge- BAeder- und eleKtrotHerApieScHule, mASSAge tHerApy college of cAnAdA, mASSAge tHerApy college of mAnitoBA, mASSAge
tHerApy inStitute (SoutH AfricA), mASSAge tHerApy inStitute of colorAdo, mASSAge-ScHule WormS/inStitute for pHySiotHerApy And mASSAge tHerApy, mASter yogA AcAdemy, mASterS college of HoliStic StudieS, mAui ScHool of
tHerApeutic mASSAge, mcKAy mASSAge & HydrotHerApy progrAm, medicAl ScHool qindAo univerSity, medicine HAt college, medix ScHool, melBourne college of nAturAl medicine, meridiAn centre, metro community college,
mettA in motion, micHigAn ScHool of myomASSology, milne inStitute, miniStry of puBlic HeAltH of uKrAine, miSSiSSAugA ScHool of AromAtHerApy, moldovA repuBlicAn centre of medicAl SociAl reHABilitAtion, moreAu inStitute of
nAturAl HeAling, morquito rAncH AromAtHerApy, moScoW regionAl StAte inStitute, motHer And BABy WellneSS, mount royAl univerSity, myotHerApy college of utAH - ScHool of mASSAge tHerApy And BodyWorK, myotHerApy in-
Stitute of mASSAge, nAnjing univerSity of trAditionAl cHineSe medicine, nAtionAl AcAdemy of mASSAge tHerApy And HeAling ScienceS, nAtionAl certificAtion BoArd for tHerApeutic mASSAge And BodyWorK, nAtionAl HoliStic inStitute,
nAtionAl inStitute of mASSotHerApy, nAture cAre college, nAture'S WAy HerBAl HeAltH inStitute, nevAdA cAreer AcAdemy, neW center for WHoliStic HeAltH educAtion And reSeArcH, neW center for WHoliStic HeAltH educAtion And
reSeArcH, neW mexico AcAdemy of HeAling ArtS, neW mexico ScHool of nAturAl tHerApeuticS, neW yorK college of HeAltH profeSSionS, neWfoundlAnd And lABrAdor mASSAge tHerApiStS' BoArd, nortHern ArizonA mASSAge tHerA-
py inStitute, nortHern inStitute of mASSAge tHerApy, nortHern inStitute of mASSAge tHerApy (englAnd), nortHWeSt HellerWorK, nortHWeStern ScHool of mASSAge, nortHWeStern ScHool of mASSAge, nortHWeStern ScHool of
mASSAge, nortHWeStern ScHool of mASSAge, nuAd Bo rArn inStitute of tHAi mASSAge, oceAn BotAnicAlS eSSentiAl oilS, oceAn Stone tHerApy, oceAn Stone tHerApy, oHASHi inStitute, oKAnAgAn vAlley college of mASSAge tHerApy,
old medicine HoSpitAl ScHool of tHAi mASSAge, onSen internAtionAl, ontArio college of HeAltH & tecHnology, ontArio college of reflexology, ortHoBionomy ASSociAtion of cAnAdA, ortHopAedic inStitute, pAcific inStitute of Aro-
mAtHerApy, pAcific inStitute of reflexology, pAlAcKy univerSity, fAculty of pHySicAl culture, pcu college of HoliStic medicine, peng jiu ling qi gong HeAltH centre, pHillipS ScHool of mASSAge, pHuSSApA tHAi mASSAge ScHool,
pHySicAlmind inStitute, pHySiologic inStitute, pHySiotHerApy ScHool, poleStAr pilAteS, polyvAlente pierre-dupuy, prAirie mASSAge, profeSSionAl inStitute of mASSAge And fitneSS, profeSSionAl inStitute of mASSAge tHerApy, profeS-
SionAl inStitute of mASSAge tHerApy (cAlgAry cAmpuS), protege ScHool, pyrAmid yogA centre, quAntum toucH, quinteSSence AromAticS, rAinStAr univerSity, reflexology ASSociAtion of cAnAdA, reHABilitAtionS und AuSBildungSSte-
Atte feur mASSAge, reidmAn internAtionAl college for complementAry medicine, reidmAn internAtionAl college for complementAry medicine, relAx - u, relAx StAtion ScHool of mASSAge tHerApy, relAx to tHe mAx, remington college,
rocKy mountAin AcAdemy, rocKy mountAin HoliStic centre, rolf inStitute, rolfing guild, roSen inStitute, royAl AcupreSSure Society ScHool & clinic, royAl AeStHetic tHerApy internAtionAl college, royAl inStitute of Science And
mAnAgement, ruSSiAn militAry medicAl AcAdemy, SAcred divA HeAling centre for Women, SAcredASiA ScHool of Ancient tHAi mASSAge, SASKAtcHeWAn inStitute of Applied ScienceS And tecHnology, SASKAtcHeWAn SHiAtSu tHerApiStS
ASSociAtion, SASKAtoon SHiAtSu centre, SAult college of Applied ArtS & tecHnology, ScHool of HeAltH ScienceS, ScentS of comfort, ScHool for pHySicAl tHerApy At tHe BAltic SeA clinic, ScHool of effective reflexology, ScHool of
HeAling ArtS, ScHool of mASSAge tHerApy And AdvAnced trigger point, ScHool of SpA tHerApieS, ScottiSH ScHool of profeSSionAl mASSAge, ScuolA di eSteticA modernA, SeAted AcupreSSure tHerApy trAining, SHAndong univerSity of
tcm, SHAngHAi univerSity of tcm, SHAnxi trAditionAl cHineSe medicine college, SHeridAn college inStitute of tecHnology & AdvAnced leArning, SHiAtSu AcAdemy of toKyo, SHiAtSu ScHool freiBurg, SHiAtSu ScHool of cAnAdA, Sir
SAnford fleming college, SmitH mountAin lAKe inStitute of HigHer HeAling,SnoWlion center ScHool, SomAticS inStitute ScHool of mASSAge, SoutH AuStrAliAn HeAltH educAtion centre, SoutHern AlBertA inStitute of mASSAge,
SoutHern cAliforniA univerSity of HeAltH ScienceS, SoutHWind jAde, SpA lunA, Spectrum centre ScHool of mASSAge, Sprott-SHAW community college, St. joHn neuromuSculAr pAin relief inStitute, StAte vocAtionAl ScHool for
pHySiotHerApy At WurzBurg univerSity, Still point yogA ScHool, Stone tHerApy ScHool, Stott internAtionAl certificAtion centre, Stott'S pilAteS, SunriSe trAditionAl tHAi mASSAge, SunSHine mASSAge ScHool, SutHerlAnd-cHAn
ScHool, SWediSH inStitute - college of HeAltH ScienceS, tAoye trAditionAl cHineSe medicine And mASSAge inStitute, tHAi mASSAge ScHool of tHAilAnd, tHAi mASSAge toronto ScHool And mASSAge centre, tHAi mASSAge trAining centre,
tHAi trAditionAl medicine development centre, tiAnjin mASSAge tHerApiSt ScHool, tiltAn college, toKyo HeAltH inStitute, toronto ScHool of BuSineSS, toronto ScHool of tHAi mASSAge, toucH of grAy, toucHpoint inStitute of reflex-
ology And KineStHeticS, trAger cAnAdA, trAining in poWer, trAnSformAtionAl ArtS college, tri-StAr pAcific internAtionAl leArning And development centre, ulmKolleg - germAny, uncommon ScentS, univerSAl college of leArning,
univerSAl college of reflexology, univerSity of WeSt BoHemiA - pilSen college, upledger inStitute, uS cAreer inStitute, utAH college of mASSAge tHerApy, utopiA AcAdemy, vAncouver reflexology centre, vAncouver ScHool of
BodyWorK And mASSAge, volgogrAdSKiy medicAl univerSity, WAt pHo trAditionAl medicAl ScHool, Wellington college of remediAl mASSAge tHerApy, WellpArK college of nAturAl tHerApieS, WellSpringS college of mASSAge tHer-
Apy And eStHeticS, WeSt coASt college of mASSAge tHerApy, WeSt coASt college of mASSAge tHerApy (neW WeStminSter cAmpuS), WeSt coASt inStitute of AromAtHerApy inc., WeSt coASt KineSiologyinStitute,WeSt SicHuAn vocA-
tionAl ScHool, WeStern college of remediAl mASSAge,WeStern inStitute of AromAtHerApy, WeStervelt college, WHiStler ScHool of mASSAge And SpA ServiceS, WHiStler tHerApeutic centre, WHite river ScHool of mASSAge, Wild roSe
college of nAturAl HeAling, WindSong ScHool of HeAling, World of AromAtHerApy, WuHAn inStitute of pHySicAl educAtion, yogA AlliAnce (uS), yogA ASSociAtion of AlBertA, yogA in tHe rocKieS, yogA Studio college of cAnAdA,
yogAdotcAlm, zcd - odenSe/odenSe zonecollege, zeemAnS, zen SHiAtSu clinic And ScHool, zenergy BodyWorK And WellneSS, zHAn jiAng SHen mei occupAtion And tecH. ScHool.
NHPC RECOGNIZES MORE THAN
500 PROGRAMS INTERNATIONALLY
and the list keeps growing.
21 Summer 2011
Subhead Makami College:
One of Over 500 School Programs Recognized by the NHPC
W
hen the Pavkovic family opened Makami College in
Edmonton, Alberta, in 2001, they were united by their
simple desire to help people achieve their dreams.
When asked how Makami got off the ground, Marija Pavkovic-
Tovossi, Managing Director of Makami says, It just fit. We had
a lot of professionals that we networked with like chiropractors,
physiotherapists, and massage therapists that had been working in
the industry for over 20 years. We just went to all of them, and it
just happened. We were able to work together, doors opened, and
we were able to create something that is really changing peoples
lives. We like to see people get educated in order to change the
lives of their families.
All four members of the Packovic family are heavily involved
with the day-to-day operations at Makami College. Ljubica is the
Director of Operations and Department Head for the Massage
Therapy program, her husband Dragan is the Finance Director
and Construction Manager, their daughter Marija is the Managing
Director, and their son Vladimir is the Marketing Director.
Ljubica Pavkovic has a nursing background in Yugoslavia. She
is also a Massage Therapist, Holistic Practitioner, and holds
certification in numerous specializations in energy work and
massage therapy. Speaking with her daughter Marija, it is clear
that Ljubicas thirst
for knowledge
combined with her
love of teaching
and strong belief in
inclusivity has led
to her being a big
inspiration to the
students, because
they see where
shes come from
and what shes
achieved.
The Pavkovic family had overcome their own challenges before
realizing their dreams and starting their family business. When
they first moved to Canada from former Yugoslavia in 1987
none of them spoke any English, and because of that they faced
immense difficulty in getting settled here. Makami College,
which started as a small school with only 12 students in their
first year, has grown to having 30 employees and more than 350
students enrolled last year. Against all odds, the Pavkovic family
was able to overcome language and cultural barriers to create a
successful business in Canada.
They now encourage others to do the same by training them to
be Massage Therapists with solid business skills. Because they
know first-hand how difficult it can be to solidify a new career,
the Pavkovic family has designed the Makami program to be as
inclusive as possible regardless of a students limitations. One of our
part time students one time was a blind man, and he is an amazing
Massage Therapist, but hes blind. So no other school would even
take him in, but we had a special instructor work with him through
the whole process. And now he is an amazing therapist. I think we
try to give everybody a chance and an opportunity, because if this is
their dream then we want to help them achieve it.
Makami College is on NHPCs list of over 500 recognized
school programs. For more information about this school, visit
www.makamicollege.com
Are you an NHPC Recognized Program? Want to see your
school program featured in the next issue of Connections?
Contact Jasmine by email; Jbischoff@nhpcanada.org or by
phoning 1-888-711-7701 ext. 230
left to right: Vladimir Pavkovic, Marija Pavkovic-Tovissi,
Dragan Pavkovic, Ljubica Pavkovic
201-611 9th St. East
off Broadway, Saskatoon
Local, Convenient
Affordable
Oils, Linens, Tables,
Accessories... and More
382-4673 or 1-866-478-4998
Contact: Pam Fichtner RMT or Dale Jack
Tues. & Thurs. 1pm to 5pm or by appointment
www.saskmassage.ca
22 Summer 2011
CONTINUING EDUCATION
http://conted.mtroyal.ca/healthhumanservice
Information: 403.440.6867 or cehealth@mtroyal.ca
Reveal a
new you
Addiction Studies
Body Talk Access
Bowen Therapy
Energy Therapy
Feng Shui
Healing Touch
Massage Therapy
Medical Terminology
Mindfulness-Based Stress
Reduction
Personal Fitness Trainer
Reiki
Shiatsu Therapy
Spa Therapy
Yoga Therapy
23 Summer 2011
32 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
C. M. hughes, phD,isalecturerintheSchoolofHealth
Sciences,UniversityofUlster,NorthernIreland,United
Kingdom.s. Krirsnakriengkrai, phD,isalecturerinthe
DepartmentofPhysiotherapy,FacultyofHealthScience,
SrinakharinwirotUniversity,Bangkok,Thailand.s. Kumar, MD,
Mphil,isalecturerintheDepartmentofCommunityMedicine,
TeerthankarMahaveerMedicalCollege&ResearchCentre,
Moradabad,UttarPradesh,India.s. M. McDonough, phD,isa
professorattheHealthandRehabilitationSciencesResearch
Institute,SchoolofHealthSciences,UniversityofUlster.
Correspondingauthor:C.M.Hughes,PhD
E-mailaddress:CM.Hughes@ulster.ac.uk
R
efexology is an ancient treatment based on the the-
ory that all the body structures are interlinked with
specifc refex points on the hands and feet.
1,2
The
purpose of treatment is to normalize the bodys
function, break down tension, alleviate stress, and
improve nerve function and blood supply throughout the body.
3,4
Evidence suggests that refexology has an effect on physio-
logical outcomes. Frankel found that refexology increased sinus
arrhythmia, indicating a higher synchronization between heart
rate (HR) and respiration, and reduced baroreceptor refex sensi-
tivity
5
; therefore, refexology helps patients maintain blood pres-
sure (BP) homeostasis by creating changes in autonomic outfow.
zhen et al
found that refexology stimulation could increase the
complexity of HR variability signal, indicating an increase the
vagal activity.
6
When people are under stress, autonomic nervous system
(ANS) disturbances are induced, which consist of suppressed
vagal and/or enhanced sympathetic functions. The observed
effects of refexology on the ANS therefore may help explain why
refexology has been shown to reduce anxiety and stress in cancer
patients,
7
women with depression,
8
dementia patients,
9
and in
the working population.
10
Mental stress may be induced under experimental condi-
tions, provoking sympathoexcitatory responses following emo-
tional or behavioral challenges.
11
The Stroop color word test
12,13
and a mental arithmetic test
14,15
have been widely used as tools for
TheEffectofRefexologyontheAutonomicNervous
SysteminHealthyAdults:AFeasibilityStudy
C. M. Hughes, PhD; S. krirsnakriengkrai, PhD; S. kumar, MD, MPhil; S. M. McDonough, PhD
original research
Background Refexology has been shown to reduce anxiety and
stress in various populations. The mechanism by which this
occurs may be in modulating autonomic nervous system (ANS)
function; however; there is limited evidence available in the area.
PrimaryStudyObjective The aim of the study was to inves-
tigate the feasibility of using an experimental model to deter-
mine the physiological effect of refexology on stress.
Methods/Design A feasibility study to assess an experimen-
tal study design to compare the effect of refexology and control
interventions on heart rate (HR) and blood pressure (BP) fol-
lowing mental stress tests.
Setting The Health and Rehabilitation Science Research Institute
at the University of Ulster, Northern Ireland, United kingdom.
Participants Twenty-six healthy volunteers.
Intervention Mental stress was induced before and after inter-
vention. Participants in the refexology group received 20 min-
utes of refexology, and the control group received 20 minutes of
relaxation with a therapist holding each participants feet.
Primary Outcome Measures The outcome measures, HR
and BP, were measured throughout mental stress testing,
intervention, and a second period of mental stress testing fol-
lowing intervention.
Results The study design was considered feasible. There were
signifcant reductions in systolic blood pressure (SBP) (22%; P=
.03) and in diastolic blood pressure (DBP) (26%; P= .01) during
mental stress following refexology compared to the stress
period prior to intervention. In contrast, there was a 10% reduc-
tion in SBP (P =.03) but a 5% increase in DBP (P =.67) during
the period of mental stress following the control intervention
compared to results obtained during mental stress prior to this
intervention. However, there were no signifcant differences
between refexology and control groups.
Conclusion This study has demonstrated the feasibility of
conducting an experimental study on the effect of refexology in
stress using BP as the primary outcome measure. Results from
such a study would address the lack of high-quality evidence for
the physiological effects of refexology. (AlternTherHealthMed.
2011;17(3):32-37.)
32 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
C. M. hughes, phD,isalecturerintheSchoolofHealth
Sciences,UniversityofUlster,NorthernIreland,United
Kingdom.s. Krirsnakriengkrai, phD,isalecturerinthe
DepartmentofPhysiotherapy,FacultyofHealthScience,
SrinakharinwirotUniversity,Bangkok,Thailand.s. Kumar, MD,
Mphil,isalecturerintheDepartmentofCommunityMedicine,
TeerthankarMahaveerMedicalCollege&ResearchCentre,
Moradabad,UttarPradesh,India.s. M. McDonough, phD,isa
professorattheHealthandRehabilitationSciencesResearch
Institute,SchoolofHealthSciences,UniversityofUlster.
Correspondingauthor:C.M.Hughes,PhD
E-mailaddress:CM.Hughes@ulster.ac.uk
R
efexology is an ancient treatment based on the the-
ory that all the body structures are interlinked with
specifc refex points on the hands and feet.
1,2
The
purpose of treatment is to normalize the bodys
function, break down tension, alleviate stress, and
improve nerve function and blood supply throughout the body.
3,4
Evidence suggests that refexology has an effect on physio-
logical outcomes. Frankel found that refexology increased sinus
arrhythmia, indicating a higher synchronization between heart
rate (HR) and respiration, and reduced baroreceptor refex sensi-
tivity
5
; therefore, refexology helps patients maintain blood pres-
sure (BP) homeostasis by creating changes in autonomic outfow.
zhen et al
found that refexology stimulation could increase the
complexity of HR variability signal, indicating an increase the
vagal activity.
6
When people are under stress, autonomic nervous system
(ANS) disturbances are induced, which consist of suppressed
vagal and/or enhanced sympathetic functions. The observed
effects of refexology on the ANS therefore may help explain why
refexology has been shown to reduce anxiety and stress in cancer
patients,
7
women with depression,
8
dementia patients,
9
and in
the working population.
10
Mental stress may be induced under experimental condi-
tions, provoking sympathoexcitatory responses following emo-
tional or behavioral challenges.
11
The Stroop color word test
12,13
and a mental arithmetic test
14,15
have been widely used as tools for
TheEffectofRefexologyontheAutonomicNervous
SysteminHealthyAdults:AFeasibilityStudy
C. M. Hughes, PhD; S. krirsnakriengkrai, PhD; S. kumar, MD, MPhil; S. M. McDonough, PhD
original research
Background Refexology has been shown to reduce anxiety and
stress in various populations. The mechanism by which this
occurs may be in modulating autonomic nervous system (ANS)
function; however; there is limited evidence available in the area.
PrimaryStudyObjective The aim of the study was to inves-
tigate the feasibility of using an experimental model to deter-
mine the physiological effect of refexology on stress.
Methods/Design A feasibility study to assess an experimen-
tal study design to compare the effect of refexology and control
interventions on heart rate (HR) and blood pressure (BP) fol-
lowing mental stress tests.
Setting The Health and Rehabilitation Science Research Institute
at the University of Ulster, Northern Ireland, United kingdom.
Participants Twenty-six healthy volunteers.
Intervention Mental stress was induced before and after inter-
vention. Participants in the refexology group received 20 min-
utes of refexology, and the control group received 20 minutes of
relaxation with a therapist holding each participants feet.
Primary Outcome Measures The outcome measures, HR
and BP, were measured throughout mental stress testing,
intervention, and a second period of mental stress testing fol-
lowing intervention.
Results The study design was considered feasible. There were
signifcant reductions in systolic blood pressure (SBP) (22%; P=
.03) and in diastolic blood pressure (DBP) (26%; P= .01) during
mental stress following refexology compared to the stress
period prior to intervention. In contrast, there was a 10% reduc-
tion in SBP (P =.03) but a 5% increase in DBP (P =.67) during
the period of mental stress following the control intervention
compared to results obtained during mental stress prior to this
intervention. However, there were no signifcant differences
between refexology and control groups.
Conclusion This study has demonstrated the feasibility of
conducting an experimental study on the effect of refexology in
stress using BP as the primary outcome measure. Results from
such a study would address the lack of high-quality evidence for
the physiological effects of refexology. (AlternTherHealthMed.
2011;17(3):32-37.)
32 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3
Refexology and the Autonomic Nervous System
C. M. hughes, phD,isalecturerintheSchoolofHealth
Sciences,UniversityofUlster,NorthernIreland,United
Kingdom.s. Krirsnakriengkrai, phD,isalecturerinthe
DepartmentofPhysiotherapy,FacultyofHealthScience,
SrinakharinwirotUniversity,Bangkok,Thailand.s. Kumar, MD,
Mphil,isalecturerintheDepartmentofCommunityMedicine,
TeerthankarMahaveerMedicalCollege&ResearchCentre,
Moradabad,UttarPradesh,India.s. M. McDonough, phD,isa
professorattheHealthandRehabilitationSciencesResearch
Institute,SchoolofHealthSciences,UniversityofUlster.
Correspondingauthor:C.M.Hughes,PhD
E-mailaddress:CM.Hughes@ulster.ac.uk
R
efexology is an ancient treatment based on the the-
ory that all the body structures are interlinked with
specifc refex points on the hands and feet.
1,2
The
purpose of treatment is to normalize the bodys
function, break down tension, alleviate stress, and
improve nerve function and blood supply throughout the body.
3,4
Evidence suggests that refexology has an effect on physio-
logical outcomes. Frankel found that refexology increased sinus
arrhythmia, indicating a higher synchronization between heart
rate (HR) and respiration, and reduced baroreceptor refex sensi-
tivity
5
; therefore, refexology helps patients maintain blood pres-
sure (BP) homeostasis by creating changes in autonomic outfow.
zhen et al
found that refexology stimulation could increase the
complexity of HR variability signal, indicating an increase the
vagal activity.
6
When people are under stress, autonomic nervous system
(ANS) disturbances are induced, which consist of suppressed
vagal and/or enhanced sympathetic functions. The observed
effects of refexology on the ANS therefore may help explain why
refexology has been shown to reduce anxiety and stress in cancer
patients,
7
women with depression,
8
dementia patients,
9
and in
the working population.
10
Mental stress may be induced under experimental condi-
tions, provoking sympathoexcitatory responses following emo-
tional or behavioral challenges.
11
The Stroop color word test
12,13
and a mental arithmetic test
14,15
have been widely used as tools for
TheEffectofRefexologyontheAutonomicNervous
SysteminHealthyAdults:AFeasibilityStudy
C. M. Hughes, PhD; S. krirsnakriengkrai, PhD; S. kumar, MD, MPhil; S. M. McDonough, PhD
original research
Background Refexology has been shown to reduce anxiety and
stress in various populations. The mechanism by which this
occurs may be in modulating autonomic nervous system (ANS)
function; however; there is limited evidence available in the area.
PrimaryStudyObjective The aim of the study was to inves-
tigate the feasibility of using an experimental model to deter-
mine the physiological effect of refexology on stress.
Methods/Design A feasibility study to assess an experimen-
tal study design to compare the effect of refexology and control
interventions on heart rate (HR) and blood pressure (BP) fol-
lowing mental stress tests.
Setting The Health and Rehabilitation Science Research Institute
at the University of Ulster, Northern Ireland, United kingdom.
Participants Twenty-six healthy volunteers.
Intervention Mental stress was induced before and after inter-
vention. Participants in the refexology group received 20 min-
utes of refexology, and the control group received 20 minutes of
relaxation with a therapist holding each participants feet.
Primary Outcome Measures The outcome measures, HR
and BP, were measured throughout mental stress testing,
intervention, and a second period of mental stress testing fol-
lowing intervention.
Results The study design was considered feasible. There were
signifcant reductions in systolic blood pressure (SBP) (22%; P=
.03) and in diastolic blood pressure (DBP) (26%; P= .01) during
mental stress following refexology compared to the stress
period prior to intervention. In contrast, there was a 10% reduc-
tion in SBP (P =.03) but a 5% increase in DBP (P =.67) during
the period of mental stress following the control intervention
compared to results obtained during mental stress prior to this
intervention. However, there were no signifcant differences
between refexology and control groups.
Conclusion This study has demonstrated the feasibility of
conducting an experimental study on the effect of refexology in
stress using BP as the primary outcome measure. Results from
such a study would address the lack of high-quality evidence for
the physiological effects of refexology. (AlternTherHealthMed.
2011;17(3):32-37.)
24 Summer 2011
ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 33
inducing these ANS responses. These studies have shown that
HR and BP increase using experimental mental stress models to
levels similar to those observed during a moderate walking
task
16,17
but below those associated with hypertensive risk. These
experimental models therefore may be used to simulate patho-
logical stress.
The aim of the current study was to investigate the feasibility
of using an experimental model to determine the physiological
effect of refexology on stress using mental stress tests in healthy
adults to induce ANS function. The feasibility of patient recruit-
ment and retention, logistics of intervention, outcome measure
sensitivity, and appropriateness of the control intervention for such
a study design was carried out. These data also will provide the
basis of a power analysis to determine numbers for a future trial.
MATERIALSANDMETHODS
Participants
This study was approved by the Research Ethics Committee
of the University of Ulster. Healthy adults aged between 18 and
45 years were recruited from within the university through e-mail
announcements and advertisements. Participants were excluded
if they had previously received refexology or had any condition
that might interfere with the outcome measurements such as
vascular, lymphatic, or skin conditions; diabetes; pregnancy; use
of a cardiac pacemaker; or current drug therapy to treat hyper-
tension. Potential participants were informed about the experi-
mental procedure and asked to give written informed consent.
The number of participants required for this study was calculat-
ed using power analysis from a similar study of acupuncture,
18
as
there were no similar studies on refexology in the literature. The
sample size from power analysis was 10 per group. The current
study recruited 25 participants who were randomly allocated
into either the refexology group or control group using comput-
er-generated numbers and sealed opaque envelopes. An indepen-
dent researcher who was otherwise uninvolved in the trial
performed randomization. Participants were asked to abstain
from smoking and drinking caffeine or alcohol for at least 6
hours prior to testing and to refrain from eating or performing
strenuous exercise during the preceding 2 hours.
Interventions
The refexology group received stimulation to refex points
associated with the organs that would be expected to induce a
physiological response in the ANS. These points included the
refex area for the peripheral nervous system, including the ANS,
which is responsible for the regulation of HR and BP; the central
nervous system, the brain and spinal cord, as these areas regulate
ANS function; the solar plexus, which within the theory of refex-
ology will calm and relax the entire nervous system; the heart, as
direct refexology stimulation to this point may affect the organ
(left foot only); the kidney, due to its role in the control of BP;
and the endocrine refex points such as the pituitary, thyroid,
and adrenal gland points, as the hormones released from these
glands aid in the regulation of HR and BP. These points were
selected using appropriate published charts and textbooks.
2,19
Pressure was applied to each of these points for 30 seconds at a
time on each of the feet for a total of 20 minutes. The refexology
intervention using grape-seed base oil was performed by one of
two qualifed refexologists with more than 10 years experience.
The control group did not receive refexology stimulation;
the refexologists simply rested each participants heels in the
palms of their hands for 20 minutes. The purpose of this inter-
vention was to control for the effects of relaxation, touch, and
patient-therapist interaction. All interventions were carried out
in the same room.
MentalStressProcedure
Two mental stress tests were employed to induce ANS
parameters within the participants; these were the Stroop color
word test and a mental arithmetic test. A pilot study carried out
prior to this experimental study indicated that both of these tests
increased HR and BP to a similar degree and could therefore be
used interchangeably. The experimental procedure required two
periods of induced stress to the ANS and therefore two separate
stress tests were used to reduce the possibility of accommodation.
The participant determined the order in which the stress tests
were applied by randomly selecting one of two envelopes that
contained the names of the two tests. The test that the participant
selected was used as the frst stress test during the experiment.
The Stroop color word test consisted of presenting color-
naming words, with each word printed in a color different from
its meaning; for example, the word red was printed in blue ink.
To perform the task, the participant had to say the names of the
color of the ink, not the color designated by the word.
20
The men-
tal arithmetic test was a verbal serial subtraction. The partici-
pants were instructed to verbally subtract 13 serially from 1079
for 4 minutes.
15
During the mental stress, the sound from a met-
ronome beating at 2 Hz (120 bpm) was used as a distraction
15
and to increase stress.
21
As sympathetic responses to mental
stress testing are strongly influenced by perception of task
diffculty,
22
each volunteer was asked to assess each mental stress
test, using a standard 5-point scale: not stressful, somewhat
stressful, stressful, very stressful, or very very stressful.
OutcomeMeasurements
HR, systolic blood pressure (SBP), and diastolic blood pres-
sure (DBP) were measured noninvasively using an automatic upper
arm blood pressure monitor (Omron M5-I, Gaiam Ltd, Louisville,
Colorado). All outcomes were measured every minute at baseline
and during interventions and mental stress tests (Figure 1).
ExperimentalProcedures
Participants were asked to lie in the supine position. The
blood pressure cuff was applied to the upper arm, and HR and
BP were recorded every minute throughout the experimental
period. After 5 minutes of baseline measurement, the participant
took part in a mental stress test (color word test or mental arith-
metic) for 4 minutes, followed by a 10-minute recovery period.
Refexology and the Autonomic Nervous System
25 Summer 2011
34 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
The intervention was then carried out for 20 minutes according
to group allocation. A second baseline was measured for 5 min-
utes after the intervention period, followed by a different mental
stress test (color word test or mental arithmetic) for 4 minutes
and another 5-minute recovery period (Figure 1).
18
The investiga-
tors who carried out the mental stress testing and who measured
the outcomes were blinded to treatment allocation.
BlindingStatus
For blinding purposes, all participants were informed that
they would receive one of two different forms of complementary
intervention. After completion of the experiment, all partici-
pants were asked to guess which interventions they received to
check for blinding status. The blinding index for each group was
calculated using the method demonstrated by Bang et al.
23
Confdence interval (CI) of a proportion was calculated accord-
ing to the method described by Newcombe,
24
which was available
online at http://faculty.vassar.edu/lowry/prop1.html.
DataAnalysis
Each outcome measurement was analyzed using Statistical
Package for Social Sciences (SPSS) version 11.5 for Windows
(SPSS, Chicago, Illinois). Data were checked for a normal distri-
bution using kolmogorov-Smirnov test. Baseline values were
averaged from the values of minute 4 and minute 5 at resting
baseline. Data were analyzed for differences from preceding
baseline, during intervention, and during the two periods of
mental stress testing. Analyses of variance with repeated mea-
sures were used to compare treatment effects and time and post
hoc comparisons, using Tukeys Honestly Signifcant Difference
test, were used for signifcant between-group and within-group
comparisons. The level of signifcance was set at 0.05.
RESULTS
CharacteristicsofSubjects
Twenty-six healthy volunteers responded to the advertise-
ments and e-mail recruitment. One of them was excluded due to
previous exposure to refexology. Twenty-fve participants were
randomly allocated into two groups. Seven males and six females
with a mean age of 27.08 6.32 years were allocated to the refex-
ology group. Six males and six females with a mean age of 26.76
5.53 years were allocated to the control group. There was no
signifcant difference in demographics between the groups (P >
.05). There were no dropouts during the study, and no adverse
effects were reported.
ExperimentalProflesofAllOutcomes
During the 4-minute periods of mental stress, HR, SBP, and
DBP were signifcantly increased (P<.05) relative to the baseline
(average of baseline minute 4 and minute 5). This increase was
greater during the frst phase of mental stress testing than the
second phase of mental stress testing that occurred after the
intervention. The profile for DBP obtained at each minute
throughout the experiment is shown in Figure 2. Profles for HR
and SBP were similar.
ComparisonoftheEffectsofRefexologyandControlon
ResponsestoMentalStress
The second baseline period was lower than the frst base-
line; therefore, comparison of the effects of refexology and con-
trol on responses to mental stress was analyzed using the change
in HR and BP from the preceding baseline (average values at
minute 4 and minute 5 baseline). The average changes in HR
and BP over the 4 minutes of induced stress from preceding
baseline are shown in Table 1. There were signifcant reductions
in SBP (22%; P = .03) and in DBP (26%; P = .01) during mental
stress following refexology compared to the stress period prior
to intervention. In contrast, there was a 10% reduction in SBP (P
= .03) but a 5% increase in DBP (P = .67) during the period of
mental stress following the control intervention compared to
results obtained during mental stress prior to this intervention.
However, there were no signifcant differences between refexol-
ogy and control groups.
ParticipantsPerceptionofTaskDiffcultyofMentalStress
There were no signifcant differences in perceived diffculty
between the two mental stress tasks or between the refexology
and control groups as to the perceived difficulty within each
stress task. The perceived diffculty values (meanSD) were 1.23
0.6 (refexology group) and 1.25 0.97 (control group) for the
color word test and 1.92 1.19 (refexology group) and 1.25
0.97 (control group) for the mental arithmetic test.
Mental Mental
Baseline Stress Recovery Intervention Baseline Stress Recovery
5 min 4 min 10 min 20 min 5 min 4 min 5 min
Color word test or
mental arithmetic
Color word test or
mental arithmetic
1. Reflexology to the
ANS-related points
2. Control-touch
HR and BP continuously recorded every minute
FIGURE 1 Experimental Protocol
Abbreviations: ANS, autonomic nervous system; HR, heart rate; BP, blood pressure.
26 Summer 2011
ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 35 Refexology and the Autonomic Nervous System
BlindingEffciency
Most of the participants allocated to receive reflexology
treatment (53.8%) said dont know when asked which experi-
mental group they were in, while most of the participants in the
control group (66.7%) guessed control (Table 2). The blinding
index was 0.15 (95% CI, 0.03-0.46) for the refexology group and
0.5 (95% CI, 0.22-0.78) for the control group.
PowerAnalysis
The current data were used to calculate the numbers required
to detect signifcant differences for DBP between groups. Using a
within-group standard deviation of 7.1, a minimum difference
between groups of 2.6, alpha of 0.05, and power at 90%, a total of
180 participants per group would be required to detect signifcant
changes between groups.
TABLE 1 Average Increase in Heart Rate and Blood Pressure During 4-minute Stress Test
Intervention Outcomes
AverageIncrease
FromBaseline
%ChangePreintervention
toPostintervention 95%CI
Refexology HR (BPM) Preintervention 10.79
Postintervention 8.54 20.8% decrease 1.2%-42.9%
SBP (mmHg) Preintervention 9.81
Postintervention 7.62 22.3% decrease 0.3%-45%
DBP (mmHg) Preintervention 8.31
Postintervention 6.16 25.9% decrease 2.1%-49.7%
Control HR (BPM) Preintervention 11.40
Postintervention 9.15 19.9% decrease 2.8%-42.3%
SBP (mmHg) Preintervention 8.58
Postintervention 7.75 9.7% decrease 7.1%-26.4%
DBP (mmHg) Preintervention 8.96
Postintervention 9.44 5.4% increase 7.4%-18.1%
The % change in HR and BP during the stress test following intervention as compared to the stress test prior to intervention is shown along with confdence intervals.
Abbreviations: CI, confdence interval; HR, heart rate; BPM, beats per minute; SBP, systolic blood pressure; DBP, diastolic blood pressure.
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Stress
Control
Stress
Reflexology DBP
90
85
80
75
70
65
60
Reflexology
r
e
s
t
3
r
e
s
t
1
r
e
s
t
5
s
t
r
e
s
s
2
s
t
r
e
s
s
4
r
e
c
o
v
2
r
e
c
o
v
4
r
e
c
o
v
6
r
e
c
o
v
8
r
e
c
o
v
1
0
c
a
m
2
c
a
m
4
c
a
m
6
c
a
m
8
c
a
m
1
0
c
a
m
1
2
c
a
m
1
4
c
a
m
1
6
c
a
m
1
8
c
a
m
2
0
r
e
s
t
2
r
e
s
t
4
s
t
r
e
s
s
1
s
t
r
e
s
s
3
r
e
c
o
v
1
r
e
c
o
v
3
r
e
c
o
v
5
Time (min)
FIGURE 2 Profles of Diastolic Blood Pressure Responses to Mental Stress and Refexology or Control Intervention
*Signifcant difference from baseline (average of min 4 and 5) at P < .05
27 Summer 2011
36 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
DISCUSSION
Results from this study indicate that a larger trial would
require 180 participants in each arm in order to have the required
power to demonstrate signifcant changes in DBP in participants
under stress following refexology. This study also demonstrated
the feasibility of conducting a methodologically rigorous control-
led study under experimental conditions using healthy volun-
teers. Recruitment was successful as the required numbers were
randomized into the study. HR, SBP, and DBP increased signif-
cantly from baseline during both of the mental stress indicating
that these tests are appropriate to use under experimental condi-
tions. In addition, all participants self-reported the level of per-
ceived task diffculty using the standard 5-point scale. There was
no difference between refexology and control group, which con-
frmed that the perceived task diffculty did not infuence the
results between groups.
The blinding index was calculated from the method demon-
strated by Bang et al,
23
which was scaled to an interval of 1 to 1, 1
being complete lack of blinding, 0 being consistent with perfect
blinding, and 1 indicating opposite guessing which may be relat-
ed to unblinding. From the results, the blinding index of the refex-
ology group was 0.15 (95% CI, 0.03-0.46) and the control was 0.5
(95% CI, 0.22-0.78), indicating that the blinding may not have been
completely successful for the control intervention. It is diffcult to
defne what an appropriate comparable intervention for refexolo-
gy studies would be. Many studies have demonstrated that sham
interventions produced some effect. Frankel used foot massage for
a comparable intervention to reflexology and found that there
were no signifcant differences between refexology and foot mas-
sage because the foot massage also induced some therapeutic
effects.
5
Hughes et al in a trial comparing refexology and foot mas-
sage on pain in people with multiple sclerosis also found signif-
cant pain reduction in both group.
25
It was suggested by this group
that sham foot massage might also stimulate the refex points asso-
ciated with refexology and therefore have some therapeutic effect.
In a review of studies published on reflexology, kunz and
kunz discuss the problem of fnding an appropriate control for
refexology trials.
26
The authors report 14 studies comparing refex-
ology to a sham refexology treatment (use of nonrelated points)
and 11 studies comparing refexology and foot massage for various
conditions. The results of these trials were mixed, leading to the
general conclusion that foot massage is not a reliable control pro-
cedure for refexology. Therefore for the present study, the control
intervention used a simple touch on the participants heels, which
did not stimulate and refex points. This form of control was suc-
cessful, because although there was some unblinding in this group,
the intervention did not attenuate HR and DBP responses during
mental stress. The study therefore effectively controlled for thera-
pist interaction and touch without the stimulation of refex points.
Refexology moderated BP as the increase in BP observed dur-
ing the frst period of stress testing was signifcantly reduced by
22% to 25% in this group, whereas a small reduction in SBP (10%)
and an increase of 5% in DBP were observed in the control group.
Similar results were reported by McVicar et al, who with a sample
size of 52 demonstrated reductions in SBP and pulse rate following
refexology.
27
However, as with the present study, McVicar et al did
not fnd any differences between intervention and control groups.
In McVicars study, participants received refexology for 60 min-
utes. In the current experimental study, the effect of 20 minutes of
refexology intervention was investigated. This methodology was
based on a previously published study by Middlekauff et al, who
demonstrated reduced BP following 20 minutes of acupuncture.
18
It may be that a longer treatment period in our experimental
design would produce stronger results and should therefore be
considered in any future investigation. Indeed, refexologists stress
the importance of treating a patient holistically with a full treat-
ment rather than limiting an intervention to specifc points for a
specifc condition.
28
kunz and kunz suggest that frequency and
duration of treatment may vary from condition to condition.
26
They reference multiple studies that demonstrate a reduction in
pain or anxiety following one short refexology session; however,
evidence suggests that other refexology treatments (such as for
asthma control or cholesterol reduction) require daily sessions of
40 to 50 minutes over several days to demonstrate any effect. In
addition, the pressure or intensity of the treatment may be a fac-
tor.
26
The McVicar study researchers applied only a light pressure,
27
as this group had previously demonstrated effectiveness of a light
pressure within a cancer patient population. It may be that a mod-
erate pressure is required for optimal stimulation of refex points,
although there is no robust evidence to support this.
26
Refexology has been shown to reduce anxiety and stress in
various populations.
7-10
The mechanism by which this occurs may
be in modulating ANS function.
5,6,27
The current study demon-
strates the feasibility of conducting experimental studies in the
area and indicates that BP may be modulated by refexology; how-
ever, further fully powered trials using suggested modifcations to
the protocol such as longer treatment time are required to confrm
these fndings.
TABLE 2 Blinding Index of Refexology and Control Group
Assignment
Response
Total BI 95%CI Complementarymedicine Control Dontknow
Refexology 4 (30.8%) 2 (15.4%) 7 (53.8%) 13 (100%) 0.15 0.03-0.46
Control 2 (16.7%) 8 (66.7%) 2 (16.7%) 12 (100%) 0.5 0.22-0.78
Total 6 10 9 25
Abbreviations: BI, blinding index; CI, confdence interval.
28 Summer 2011
ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 37 Refexology and the Autonomic Nervous System
CONCLUSION
This study has demonstrated the feasibility of conducting
an experimental study on the effect of refexology in stress using
BP as the primary outcome measure. Results from such a study
would address the lack of high-quality evidence for the physio-
logical effects of refexology.
Acknowledgments
We gratefully acknowledge Dr Jongbae Park for his guidance on the protocol for this study.
REFERENCES
1. Tiran D, Chummun H. The physiological basis of refexology and its use as a potential
diagnostic tool. ComplementTherClinPract. 2005;11(1):58-64.
2. Mackereth PA, Tiran D. ClinicalRefexology:AGuideforHealthProfessionals. Edinburgh,
Scotland: Churchill Livingstone; 2002.
3. Ernst E, Pittler MH, Wider B. The Desktop Guide to Complementary and Alternative
Medicine:AnEvidence-BasedApproach. 2nd ed. Philadelphia, PA: Mosby; 2006.
4. Dougans I. Reflexology: The 5 Elements and Their 12 Meridians. London, England:
Thorsons; 2005.
5. Frankel BS. The effect of refexology on baroreceptor refex sensitivity, blood pressure
and sinus arrhythmia. ComplTherMed. 1997;5(2):80-84.
6. zhen LP, Fatimah SN, Acharya R, Tam kD, Joseph kP. Study of heart rate variability
due to refexological stimulation. ClinAcupunctOrientMed. 2003;4(4):173-178.
7. Stephenson NL, Weinrich SP, Tavakoli AS. The effects of foot refexology on anxiety
and pain in patients with breast and lung cancer. OncolNursForum. 2000;27(1):67-72.
8. Lee YM. Effect of self-foot refexology massage on depression, stress responses and
immune functions of middle aged women [article in korean]. Taehan Kanho Hakhoe
Chi. 2006;36(1):179-188.
9. Hodgson NA, Andersen S. The clinical effcacy of refexology in nursing home resi-
dents with dementia. JAlternComplementMed. 2008;14(3):269-275.
10. Atkins RC, Harris P. Using refexology to manage stress in the workplace: a preliminary
study. ComplementTherClinPract. 2008;14(4):280-287.
11. Steptoe A, Vgele C. Methodology of mental stress testing in cardiovascular research.
Circulation. 1991;83(4 Suppl):II14-II24.
12. Teixeira-Silva F, Prado GB, Ribeiro LC, Leite JR. The anxiogenic video-recorded Stroop
Color-Word Test: psychological and physiological alterations and effects of diazepam.
PhysiolBehav. 2004;82(2-3):215-230.
13. Waters AJ, Sayette MA, Franken IHA, Schwartz JE. Generalizability of carry-over
effects in the emotional Stroop task. BehavResTher.2005;43(6):715-732.
14. Aboussafy D, Campbell TS, Lavoie k, Aboud FE, Ditto B. Airflow and autonomic
responses to stress and relaxation in asthma: the impact of stressor type. Int J
Psychophysiol. 2005;57(3):195-201.
15. Reims HM, Sevre k, Fossum E, Mellem H, Eide Ik, kjeldsen SE. Adrenaline during
mental stress in relations to ftness, metabolic risk factors and cardiovascular respons-
es in young men. BloodPress. 2005;14(4):217-226.
16. Graham RC, Smith NM, White CM. The reliability and validity of the physiological
cost index in healthy subjects while walking on 2 different tracks. Arch Phys Med
Rehabil. 2005;86(10):2041-2046.
17. Bhambhani Y, Maikala R. Gender differences during treadmill walking with graded loads:
biomechanical and physiological comparisons. EurJApplPhysiol. 2000;81(1-2):75-83.
18. Middlekauff HR, Yu JL, Hui k. Acupuncture effects on refex responses to mental stress
in humans. AmJPhysiolRegulIntegrCompPhysiol. 2001;280(5):R1462-R1468.
19. Norman L, Cowan T. TheRefexologyHandbook:ACompleteGuide. Bath, England: Bath
CPI; 1988.
20. Stroop JR. Studies of interference in serial verbal reactions. JExpPsychol. 1935;18:643-662.
21. Ross AE, Flaa A, Hieggen A, Reims H, Eide Ik, kjeldsen SE. Gender specifc sympa-
thetic and hemorrheological responses to mental stress in healthy young subjects.
ScandCardiovascJ. 2001;35(5):307-312.
22. Callister R, Suwarno NO, Seals DR. Sympathetic activity is infuenced by task diffculty
and stress perception during mental challenge in human. JPhysiol. 1992 Aug;454:373-387.
23. Bang H, Ni L, Davis CE. Assessment of blinding in clinical trials. Control Clin Trials.
2004;25(2):143-156.
24. Newcombe RG. Two-sided confdence intervals for the single proportion: comparison
of seven methods. StatMed. 1998;17(8):857-872.
25. Hughes CM, Smyth S, Lowe-Strong AS. Refexology for the treatment of pain in people
with multiple sclerosis: a double-blind randomised sham-controlled clinical trial. Mult
Scler. 2009;15(11):1329-1338.
26. kunz B, kunz k. Evidence-Based Refexology for Health Professionals and Researchers
[e-book]. London, Uk: Dorling kindersley; 2009. Available from: kindle books.
Accessed August 21, 2009.
27. McVicar AJ, Greenwood CR, Fewell F, DArcy V, Chandrasekharan S, Alldridge LC.
Evaluation of anxiety, salivary cortisol and melatonin secretion following refexology
treatment: a pilot study in healthy individuals. Complement Ther Clin Pract.
2007;13(3):137-145.
28. Quinn F, Baxter GD, Hughes CM. Complementary therapies in the management of low
back pain: a survey of refexologists. ComplementTherMed. 2007;16(1):9-14.
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29 Summer 2011
What is self-care?
Part 2 of 2
(continued from Summer 2011 issue)
Julie Barlow
Professor of Health Psychology, Coventry University
Effectiveness of the CDSMC
In the US, randomised controlled trials (RCT) have found the
CDSMC to be effective in improving self-efficacy, use of self-
management techniques, improving physical and psychological
health status, and reducing health care utilisation among
participants with arthritis, lung disease, heart disease and stroke
(Lorig et al. 1999). Griffiths, Foster, Ramsay et al. (2007)
reviewed four UK randomised controlled trials (RCTs) examining
the effectiveness of the CDSMC (Kennedy, Reeves, Bower
et al. 2007; Griffiths, Motlib, Azad et al. 2005) and the related
Arthritis Self-management Programme (ASMP) (Buszewicz,
Rait, Griffin et al. 2006; Barlow, Turner, & Wright 2000). The
ASMP is very similar to the CDSMC but has a focus on arthritis.
Griffiths et al. found that self-efficacy improved in all studies,
psychological distress improved in three studies (Kennedy et al.
2007; Buszewicz et al. 2006; Barlow et al. 2000) and generic
quality of life improved in one study (Kennedy et al. 2007) based
on intent-to-treat analysis. However, effect sizes were small to
moderate and healthcare utilisation remained unchanged. The
review focused on a limited range of outcomes and thus did
not report effectiveness for outcomes such as positive affect
(Barlow et al. 2000), energy (Kennedy et al. 2007), exercise and
relaxation (Kennedy et al. 2007, Barlow et al. 2000), cognitive
symptom management (Barlow et al. 2000; Kennedy et al. 2007)
and communication skills (Barlow et al. 2000). The study by
Kennedy, Reeves, Bower et al., (2007) was a national evaluation
of the CDSMC which also assessed cost-effectiveness showing
that the intervention produced a small reduction in costs. The
authors report that valuing a quality adjusted life year at 20,000
results in a 70% probability of the CDSMC being effective
leading to the conclusions that the CDSMC may be a cost-
effective alternative to usual care (Richardson, Kennedy, Reeves
et al., 2007). A related paper by Reeves, Kennedy, Fullwood et al.,
(2008) focused on predicting who benefited from the CDSMC,
and showed that participants with lower self-efficacy and health-
related quality of life at baseline had more positive outcomes as
did younger participants who benefited much more than their
older counterparts. The authors conclude that the CDSMC will
have positive outcomes in a wide variety of people although
it may be particularly beneficial for younger people and those
lacking in confidence or not coping well with their LTHC.
Two RCTs examined the effectiveness of the CDSMC focusing
on specific target groups (i.e. Myocardial Infarction (MI) patients
and people with multiple sclerosis). A RCT of the CDSMC
(Barlow, Turner, Edwards & Gilchrist, 2009), focused on people
with Multiple Sclerosis (MS) and recruited nationally. The
CDSMC was open to anyone with a LTHC, thus, participants
with MS learned alongside participants with conditions such
as asthma, diabetes or heart disease. Results showed that at
4-months, the CDSMC was effective in terms of self-efficacy
and depression and although effect sizes were small, these
improvements were maintained at 12-months. The study was
designed to examine the characteristics of people with MS who
had expressed an interest in the Course and received information
about it but then decided not to attend. This group of informed
non-attenders were invited to take part in the study and formed
a Comparison Group. Compared to the Intervention Group, the
informed non-attenders had longer disease duration, were less
anxious, experienced less psychological impact, and fatigue at
baseline. A nested qualitative study based on interviews (Barlow,
Turner & Edwards, 2009) revealed that MS participants compared
themselves to other CDSMC attendees with similar symptoms
(but not necessarily the same diagnosis) and drew inspiration
and hope from those perceived to be coping well. Thus, the use
of social comparisons across and within diagnostic groupings
can be beneficial, suggesting that generic self-management
interventions do not compromise the opportunity for making
relevant informative comparisons. Participants learned new
self-care techniques, such as goal setting, that were catalysts for
mastering new skills. Achieving small, realistic goals enhanced
self-efficacy and led to feelings of empowerment and positive
outlook. As in earlier studies, the self-care competencies gained
by participants were generalised to other situations not directly
connected to MS, such as parenting, social activities and work.
Equally, although participants felt more in control of their MS,
many reported that they had not learned any new information or
skills; rather the benefits of the CDSMC were viewed in terms of
reinforcing and honing existing competencies to further improve
quality of life. Importantly, participants had learned to manage
illness around their lives as opposed to managing their lives
around their illness.
The effectiveness of the CDSMC for MI patients was examined
in a RCT (n = 192, mean age 65.9 years and a median duration of
one year since the first MI) (Barlow, Turner & Gilchrist, 2009).
This study may be of particular interest to readers of this chapter
given that all participants had completed Cardiac Rehabilitation
within the previous two years. The CDSMC was run specifically
for the MI patients and was delivered by two lay tutors who
themselves had experienced an MI. Analysis revealed no
statistically significant differences between the groups although
a pattern of small improvements among the Intervention Group
on self-efficacy, anxiety, depression and cognitive symptom
management was observed. It should be noted that this sample
30 Summer 2011
comprised mainly men (72%) and duration since the first MI
was relatively short (i.e. median of one year), which contrasts
with most other studies of lay led self-management where the
majority of participants are women and mean disease duration
tends to be ten years or more. In addition, participants in this
study were relatively high in self-efficacy and self-management
competencies at the start of the study as may be expected among
MI patients who have recently completed cardiac rehabilitation.
Interviews with a sub-sample of intervention group participants
showed that they perceived an overlap between the CDSMC
and cardiac rehabilitation particularly around diet and exercise.
However, they viewed cardiac rehabilitation as being more about
instruction whereas the CDSMC was more about discussion,
mutual support, and goal setting.
Well, the rehab is different really because the rehab is
mainly exercising. The self-management course is the fact
that, basically youre coming back to setting yourself a goal
to do and get on with it.
The self-management course was better because you got to
talk to people about their problems. At the cardiac rehab, it
was nurses standing in front talking about things.
The action planning [on the CDSMC] made me get up and
do some exercise. I was going to ride my exercise bike which
Ive never got round to using. And I set myself a plan to do
5 minutes a day on that. And now I go out and for a walk ...
and I have joined an exercise class.
Participants positively reappraised their situation as being more
manageable and believed that there is life after a heart attack.
Some were coping better after the CDSMC as they now realised
that they were not on their own. A few participants felt that that
had not improved or got worse in terms of MI-related problems
but nonetheless they felt a bit more positive. It appears that there
are few additional benefits from CDSMC attendance for this
target group who had recently completed cardiac rehabilitation
and had comparatively short disease duration. Interestingly, the
proportion of women (28%) in this study was greater than the
proportion of women attending cardiac rehabilitation, which is
reported to be 11-20% of those eligible (Barber, Stommel, Kroll et
al., 2001). This suggests that shifting the focus from rehabilitation
to self-care may be more attractive to women.
Further examples of self-care approaches with a community
perspective
This section provides some examples of other approaches to
community self-care remaining with the topic of heart disease
as an exemplar. The Heart Manual is a facilitated, home-based,
6-week programme for post-MI patients and is set in a cognitive-
behavioural framework. The programme comprises written
materials, a workbook to record progress and 2 audio tapes. Topics
covered include simple exercises, pacing activities, advice about
risk factors and lifestyle change, relaxation, stress management
and vignettes of patients experiences. Trained healthcare
professionals work with patients and their carers over the course
of the programme. A RCT showed that the incidence of clinical
anxiety was reduced by 50% in the Heart Manual group compared
to a control group who received standard care, information about
MI and lifestyle change, and informal counselling (Lewin,
Robertson, Cay et al. 1992). Patients who were clinically anxious
or depressed at discharge from hospital showed the greatest
improvement. In addition, there was a reduction in GP visits in
the following 12 months and a reduction in admission to hospital
in the first 6 months following discharge. A later study by Linden,
(1995) reported similar findings although sample size was small.
A comparison between the Heart Manual and hospital-based CR
showed no clinically or statistically significant differences (Jolly,
Taylor, Lip et al. 2007). However, Heart Manual participants who
failed to adhere to exercise attributed their lack of motivation to
difficulties in exercising on their own at home suggesting that
some form of group support may have been beneficial. Further
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manuals have been developed for Coronary Artery Disease
and Revascularisation (see The Heart Manual, http://www.
theheartmanual.com).
Increasing and maintaining physical activity levels is one
important aspect of self-care included in Cardiac Rehabilitation
(CR). Following CR, maintenance of physical activity over time,
can be difficult. A range of interventions have been designed
and tested to help participants maintain physical activity over
time. Cognitive interventions are based on techniques such as
self-efficacy enhancement, management of barriers to physical
activity and problem solving. Behavioural interventions are
based on self-monitoring, prompting, goal setting and feedback
and some interventions use a combination of cognitive and
behavioural techniques. A systematic review of such interventions
following CR found that whereas cognitive interventions showed
inconsistent findings, behavioural and combination interventions
had consistent outcomes and positive findings.
Increasingly, electronic technology is being incorporated in to
self-care interventions. Such technology enables virtual on-line
communities to be formed with the aim of providing group support
in a similar manner to the face-to-face, group-based approach
discussed above (i.e. the CDSMC). The impact of adding on-line
community features to an internet -mediated walking program was
examined among people who were overweight or had coronary
artery disease or type II diabetes (Richardson , Buis, Janney et
al. 2010). An RCT showed that although there was no difference
in terms of increased daily step count, participant attrition was
reduced among the on-line group. In addition, participants with
low baseline social support made greater use of the on-line features
than those with high baseline social support. An alternative use of
technology is where data is transmitted via telephone lines thus
enabling electronic communication between individuals in their
own homes and their clinical team (i.e. telehealth). The influence
of telehealth on self-management was examined among patients
with heart failure (Dansky, Vasey & Bowles 2008). An RCT found
that self-management behaviours were predicted by confidence
and that participants using video-based telehealth demonstrated
greater gains in confidence compared with control participants
who received routine home visits only.
Further examples of self-care in rehabilitation can be found in
other chapters of this Encyclopedia covering conditions such as
asthma, chronic obstructive pulmonary disease, fibromyalgia,
and myalgic encephalomyelitis/chronic fatigue syndrome.
Conclusions
The terms self-care and self-management tend to be used
interchangeably. Self-care has been used to refer to specific
rehabilitation strategies such as a particular exercise regime for
a specific condition. However, broader definitions of self-care
include not only management of symptoms and treatment but
also management of psychosocial consequences and lifestyle
changes. There is an increasing range of interventions being
developed to enhance self-care using cognitive, behavioural,
or cognitive-behavioural frameworks. Given the importance of
social support for encouraging and maintaining behaviour change,
many interventions involve group support either in face-to-face
group settings or via on-line communities. The advent of generic
courses, such as the CDSMC, provides an additional resource for
those people who require additional support or further guidance in
techniques such as goal setting, communication with family and
healthcare professionals or managing psychosocial consequences
of their conditions.
References
The following References are from the What is Self Care article found on
pages 13, 14, 15:
Bandura A. 1977. Social learning theory. Englewood Cliffs (NJ): Prentice-Hall.
Barber K, Stommel M, Kroll J, et al. 2001. Cardiac rehabilitation for community-
based patients with myocardial infarction: Factors predicting discharge
recommendations and participation. Journal of Clinical Epidemiology 54:1025-
30.
Barlow J. 2001. How to use education as an intervention in osteoarthritis. Best
Practice & Research Clinical Rheumatology 15(4):545-58.
Barlow JH, Edwards R, Turner AP. 2009. The experience of attending a lay-led,
chronic disease self-management programme from the perspective of participants
with Multiple Sclerosis. Psychology & Health 24(10):1167-1181.
Barlow JH, Turner AP, Edwards R, Gilchrist M. 2009. A randomised controlled
trial of lay-led self-management for people with multiple sclerosis including a
comparison with those who chose not to attend the intervention. Patient Education
& Counseling 77:81-89. doi 10.1016/j.pec.2009.02.
Barlow JH, Turner AP, Gilchrist M. 2009. A randomised controlled trial of lay-
led self-management for Myocardial Infarction patients who have completed
cardiac rehabilitation. European Journal of Cardiovascular Nursing 8:293-301.
doi 10.1016/j.ejcnurse.2009.02.002.
Barlow JH, Turner AP, Wright CC. 2000. A randomised controlled study of the
Arthritis Self-Management Programme in the UK. Health Education Research
15(6):665-680.
Benz Scott LA, Ben-or K, Allen JK. 2002. Why are women missing from
outpatient cardiac rehabilitation programmes? A review of multi-level factors
affecting referral, enrolment and completion. Journal of Womens Health 11:772-
91.
32 Summer 2011
Bush D, Ziegelstein R, Tayback M, Richter D, Stevens S, Zahalsky H, Fauerbach
J 2001. Even minimal symptoms of depression increase mortality risk after acute
myocardial infarction. American Journal of Cardiology 88:337-341.
Buszewicz M, Rait G, Griffin M, Nazareth I, Patel A, Atkinson A, Barlow J
& Haines A. 2006. Self management of arthritis in primary care: randomised
controlled trial. BMJ 333(7574):879.
Bradley LA. 1989. Adherence with treatment regimens among adult rheumatoid
arthritis patients: current status and future directions. Arthritis Care and Research
2(3):S33-39.
Chase JA. 2011. Systematic Review of Physical Activity Intervention Studies
After Cardiac Rehabilitation. Journal of Cardiovascular Nursing. [Epub ahead of
print]
Clark NM, Becker MH, Janz NK, Lorig K, Roakowski W, Anderson L. 1991.
Self-management of chronic disease by older adults: A review and questions for
research. Journal of Aging and Health 3(1):3-27.
Coates VE, Boore JR. 1996. Knowledge and diabetes self-management. Patient
Education and Counseling 29:99-108.
Damen S, Mortelmans D, Van-Hove E. 2000. Self-help groups in Belgium: their
place in the care network. Sociology of Health & Illness 22(3):331-348.
Dansky KH, Vasey J, Bowles K. 2008. Use of telehealth by older adults to
manage heart failure. Research in Gerontological Nursing 1(1):25-32. doi:
10.3928/19404921-20080101-01.
Department of Health. 2005. Self-Care A Real Choice. DH: London. Online:
http://www.dh.gov.uk/SelfCare.
Department of Health. 2005. Supporting people with long term conditions: An
NHS and social care model to support local innovation and integration. DH:
London.
Deyo RA. 1982. Compliance with therapeutic regimens in arthritis: issues, current
status, and a future agenda. Seminars in Arthritis and Rheumatism 12(2):233-244.
Dickens C, McGowan L, Clark-Carter, D, Creed F. 2002. Depression in
rheumatoid arthritis: a systematic review of the literature with meta-analysis.
Psychosomatic Medicine 64(1):52-60.
Gibson P, Powell H, Coughlan J, et al. 2002. Limited (information only) patient
education programs for adults with asthma. Cochrane Database of Systematic
Reviews CD001005.
Griffiths C, Foster G, Ramsay J, Eldridge S & Taylor S. 2007. How effective are
expert patient (lay led) education programmes for chronic disease? BMJ, 334,
1254-1256.
Griffiths C, Motlib J, Azad A, Ramsay J, Eldridge S, Khanem R, Munni R, Garrett
M, Barlow J, Turner A, Feder G. 2005. Randomised controlled trial of a lay-led
self-management programme for Bangladeshi patients with chronic disease: A
randomised controlled trial. British Journal of General Practice 55:831-837.
Janssens A, van Doorn P, de Boer J, van der Meche F, Passchier J and Hintzen R.
2003. Impact of recently diagnosed multiple sclerosis on quality of life, anxiety and
depression of patients and partners. Acta Neurologica Scandinavica 108:389-395.
Jolly K, Taylor R, Lip GY, Greenfield S, Raftery J, Mant J, Lane D, Jones M,
Lee KW, Stevens A. 2007. The Birmingham Rehabilitation Uptake Maximisation
Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation
in a multi-ethnic population: cost-effectiveness and patient adherence. Health
Technology Assessment 11(35):1-118.
Kennedy A, Reeves D, Bower P, Lee V, Middleton E, Richardson G, Gardner C,
Gately C, Rogers A. 2007. The effectiveness and cost effectiveness of a national
lay-led self care support programme for patients with long-term conditions: a
pragmatic randomised controlled trial. Journal of Epidemiology and Community
Health 61(3):254-61.
Lewin B, Robertson IH, Cay EL, Irving JB, Campbell M. 1992. Effects of self-
help post-myocardial-infarction rehabilitation on psychological adjustment and
use of health services. Lancet 25;3398800.:1036-40.
Linden B. 1995. Evaluation of a home-based rehabilitation programme for
patients recovering from acute myocardial infarction. Intensive and Critical Care
Nursing 11(1):10-9.
Lorig K, Holman H. 1993. Arthritis self-management studies: a twelve-year
review. Health Education Quarterly 20(1):17-28.
Lorig K, Holman H. 2003. Self-management Education: History, definition,
outcomes and mechanisms. Annals of Behavioral Medicine 26(1):1-7.
Lorig K, Sobel D, Stewart A, Brown B, Bandura A, Ritter P, Gonzalez V, Laurent D,
Holman H. 1999. Evidence Suggesting That a Chronic Disease Self-Management
Program Can Improve Health Status While Reducing Hospitalization: A
Randomized Trial. Medical Care 37(1)5-14.
Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. 2007. Depression,
chronic diseases, and decrements in health: results from the World Health Surveys.
Lancet 370(9590):851-858.
National Health & Hospitals Reform Commission Final Report: A Healthier
Future for All Australians. June 2009.
Patten SB, Beck CA, Williams JV, Barbui C, Metz LM. 2003. Major depression in
multiple sclerosis: a population-based perspective. Neurology 61, 1524-7.
Reeves D, Kennedy A, Fullwood C, Bower P, Gardner C, Gately C, Lee V. 2008.
Predicting who will benefit from an Expert Patients Programme self-management
course. British Journal of General Practice 58(548):198-203.
Richardson CR, Buis LR, Janney AW, Goodrich DE, Sen A, Hess ML, Mehari
KS, Fortlage LA, Resnick PJ, Zikmund-Fisher BJ, Strecher VJ, Piette JD. 2010.
An online community improves adherence in an internet-mediated walking
program. Part 1: results of a randomized controlled trial. Journal of Medical
Internet Research 12(4):e71.
Richardson G, Kennedy A, Reeves D, Bower P, Lee V, Middleton E, Gardner C,
Gately C, Rogers A. 2008. Cost effectiveness of the Expert Patient Programme
(EPP) for patients with chronic conditions. Journal of Epidemiology and
Community Health 62:361-367.
Sheeran P, Abraham C. 1995. The Health Belief Model. In: M Connor, P Norman,
editors. Predicting Health Behaviour. United Kingdom: Open University Press.
p. 23-61.
Van Hecke A, Grypdonck M, Defloor T. 2009. A review of why patients with leg
ulcers do not adhere to treatment. Journal of Clinical Nursing 18(3):337-49.
Wallston KA. 1992. Hocus-Pocus, the focus isnt strictly on locus: Rotters social
learning theory modified for health. Cognitive Theory and Research 16(2):183-199.
World Health Organisation. 2009. Self-care in the Context of Primary Health
Care. Report of the Regional Consultation, Bangkok, Thailand.
33 Summer 2011
Course
Listings
To advertise, contact Nadine:
888-711-7701 or nnoseworthy@nhpcanada.org
Please note that not all courses listed are recognized by NHPC,
but may still be eligible for NHPC Continued Competency Credits.
For a complete list of recognized modalities and programs, as well as
additional course listings, please visit www.nhpcanada.org
Academy of Reflexology - Have Feet Will Travel
Specializing in Reflexology and Chair Massage, Private or Semi Private courses are available. If you have a
group out of town, give us a call; arrangements can be made for our feet to travel to you.
Training- Accredited with NHPC for Certification as well as Continued Competency Credits.
Contact: Debra Cookson Phone: 780-235-3720
Email: reflexacademy@yahoo.ca Website: www.reflexacademy.com
Thai Style Massage
LevelI - Mondays 8:30 am - 5:30 pm
September 26, 2011 - October17, 2011
Cost: 625.00 plus GST
Level II - Wednesday Oc 19-Saturday Oct.22, 2011 Inclusive 8:30 am - 5:30 pm
Cost: 625.00 plus GST
In order to receive a certificate in Thai Style massage you must successfully complete both levels I & II.
If booked and paid for together cost for both levels is 1100.00 plus GST
Thai Foot Reflexology/Massage
September 26 & 27, 2011 9am - 4pm
Cost: 325.00 plus GST
If taken with the Level I & 2 Thai Style Massage course - Thai Foot Reflexology/Massage
ONLY 295.00 plus gst
Professional Reflexology
Pure & Simple
A) Full Days - Sept. 28, 2011 - Oct 1, 2011
9 am -5 pm
Or
B) Evenings - 5 pm -9 pm
Oct 5/6, 12/13, 26/27 & Nov. 16 , 2011
Fees for Foot Reflexology Pure & simple by itself is:
Cost: 695.00 plus GST
Hand/ Ear and Facial Reflexology portions of the Professional course will be decided with student input.
Price for Professional Course:
Cost 1450.00 plus 250.00 administration fee plus GST.
34 Summer 2011
BACK to BASICS Anatomy,
Physiology, & Chemistry
Correspondence Program
LIVING ENERGY
Natural Health Studies
This program is designed to give students the basics of Anatomy, Physiology, and Chemistry especially in
relation to Nutrition. This course is divided up into Four Modules:
Module 1: Chemistry basics
Module 2: Introduction to Anatomy & Physiology.
Module 3 & 4: The body systems.
ALL students are required to be proficient in these subjects. Therefore the Back to Basics course is an
essential component to the Wholistic Nutrition Program, especially for those students with limited or no
prior learning in these subjects. Exemption from Back to Basics may be granted if proof of prior study
can be given; or if you are currently registered as a massage therapist.
COST: $190 (plus GST) PER module (or)
$650 (plus GST) if all 4 modules are purchased at once.
Contact: Living Energy for more details at (780) 892-3006 (local call from Edmonton),
or visit our website www.livingenergy.ca
Five Elements Acupressure
Program
PCTIA Registered
NHPC Recognized
JSDF Approved.
This stellar 325 hour diploma program is an ideal mix of distance learning, classroom training and
externship that allows the out-of-town learner to partake of training while continuing their employment
and living in their own community. Blends the theory of Worsley Five Elements, the acupressure
technique of Jin Shin Do, the theory of Chinese acupuncture, the approaches of Neurolinguistic
Programming and Hakomi along with other related therapies to provide the practitioner with the skills to
work effectively with wide range of symptoms and issues, presented by their clients.
Dates: Entry level points are:
1) Basic Jin Shin Do (September 26, 2011) or
2) Distance Learning (start today!)
Fee: $4,498.50 (instalment payments may be arranged)
Recognized: By NHPC
For information packages contact the Canadian Acupressure College, 1-877-909-2244, e-mail:
cai@islandnet.com, website: www.acupressureshiatsuschool.com, Applications and payment may be made
on-line with Visa, MasterCard or Amex.
Canadian
Reflexology
School
Are you ready to grow your practice and your bottom line?
Experience the CRS difference! At Canadian Reflexology School we offer the best of both worlds.
Using an ideal mix of home study for the theory component and a comprehensive classroom
handson for the practical component, we provide flexibility around your schedule
and have the perfect formula for success.
Our leading edge programs include:
Foot Reflexology
Hand Reflexology
Ear Reflexology
Our popular IN A BOX series
(Business tools designed to help you grow your business)
Canadian Reflexology School is dedicated to students embracing their goals
of working in the wellness industry. Programs are personalized, convenient,
staff supported and successfully takes you to your goals as easy as 1-2-3!
NHPC approved programs and recognized by the CMTBC
Request your Information Package Today!
Schedule a complimentary consultation call to answer your questions.
Alison Rippin, B.P.E., RCRT Owner Speaker at the NHPC 2011 April Conference
Phone: 250-727-3199 www.canadianreflexologyschool.com
35 Summer 2011
Rejuvenating Face
Massage Course
Through the Canadian Centre
of Indian Head Massage with
Debbie Boehlen
Courses are ongoing throughout Canada
This 2-day course teaches you the theoretical knowledge and techniques you will need to provide a
wonderfully relaxing Rejuvenating Face Massage treatment for your clients, friends and family.
Certification is available.
This course is eligible for Continued Competence Credits with the NHPC, and approved for CEUs/CECs
with RAC and numerous other Provincial Associations and Governing Bodies in your province. Please
check our website for details.
For course dates and locations please contact Debbie or visit our website:
www.indianheadmassagecanada.com
Tel: 905.714.0298
Email: debb@bell.net
The Practice-building
roadmap
90 days to success
Do nothing and attract all the clients you want
Presenter Patrick Hercus has had a full time practice in Spiritual Counselling since 1995.
For the last 13 years he has had a waiting list, with no advertising or networking.
This webinar will give therapists, practitioners and business people the skills and consciousness to easily
attract clients.
Learn why, when two people who have equal connections and education, one thrives and the other
doesn't.
Accessing your market is becoming more difficult and expensive. This course will lead you through
exercises to connect your passion and purpose so strongly that people are drawn to you.
Is it time for you to learn a new way to be successful?
Presenter Patrick Hercus has had a full time practice in Spiritual Counseling since 1995.
For the last 14 years he has had a waiting list, with no advertising or networking.
Contact: Patrick 1-888-300-7685
Website: www.goachieve.com (for further information and to register)
Hot Stone Massage: An
Ancient Healing Technique
for the Contemporary
Therapist
with
Sheryl Watson R.M.T.
Increase your massage practice by adding the ancient healing technique of hot stone massage. This 20
hour workshop with 10 independent practicums will incorporate the science of general hydrotherapy
principles, and the sacred art of applying a full body hot stone massage.
Friday, September 30, 2011 from 1:00 5:00
Saturday, October 1, and Sunday, October 2, 2011 from 9:00 6:00 each day
This workshop included a history of hot stone massage, benefits and properties of hot/cold stones,
general principles of geothermal hydrotherapy and corresponding indications, contra-indications, special
considerations and cautions, preparation for treatment, care and cleaning the stones, marketing strategies,
full body hot stone massage including vascular flushing, a spinal layout, chakra stones, revitalization
technique, facial and foot treatment.
Sheryl has been practicing massage therapy since 1995 and is currently a techniques instructor at
MacEwan College.
Pre-requisite: massage certificate.
Investment: $425.00 plus G.S.T.
Location: Edmonton
This workshop has been approved for 5 Continued Competency Credits with the N.H.P.C. and Provider
status has been approved. M.T.A.A. has approved this workshop for 20 primary continuing education
credits.
Sheryl Watson at (780)488-3482, or info@sacreddiva.ca
36 Summer 2011
Indian Head
Massage Course
Through the Canadian Centre of Indian Head Massage with Debbie Boehlen.
Courses are ongoing throughout Canada.
This weekend course will teach you all you need to be able to provide a wonderfully relaxing Indian Head
Massage treatment for your clients, friends and family. Certification is available.
This course is eligible for Continued Competence Credits with the NHPC, and approved for CEUs/CECs
with RAC and numerous other Provincial Associations and Governing Bodies in your province. Please
check our website for details.
For course dates and locations please contact Debbie or visit our website:
www.indianheadmassagecanada.com
Tel: 905.714.0298
email: debb@bell.net
Infant Massage Training (34 hours)
Dates: October 8 & 9, 2011 (Edmonton)
Investment: $390 +gst
Location: Canadian College of Massage & Wellness
West Edmonton at Wellness Within
Register: www.wellnesscollege.ca
780-489-7799 (Edmonton area)
1-877-489-7799 (Toll-free)
Description:
Canadian College of Massage & Wellness offers a unique and exciting Infant Massage class. Help mom,
help baby. Gain invaluable knowledge for all parents. In this 2-day training you will learn how to teach
Infant Massage classes and offer individual sessions to Parents, including:
Benefits
Contraindications and Guidelines
Infant Massage Techniques and Parent Routines
o Colic, Digestion & Teething
o Common Childhood Discomforts
o Massage and Stages of Growth
o Hydrotherapy Techniques
Attachment Parenting
Addressing Parent Concerns and Questions
Developing and Promoting your Class
*This course has been approved for CEUs as a Specialization course by the NHPC!
Jade Stone Massage
Two Day
Workshop
With Shelley Willis
By
Southwind Retreat and Spa
Experience the ancient healing power of Jade Stone Massage. The new Hot Stone massage treatment; Jade
massage is a therapeutic and lucrative addition to your treatments.
Jade Stone Benefits
*Promotes relaxation & vitality while releasing toxins and inflammation
*Fewer stones with alternating temperatures for deeper results
*Jade Stones are heated or chilled non-porous for easy cleaning
Workshop schedule visit www.southwindjade.com
Private workshops please inquire
To Register contact Shelley the jade diva
1-877-545-4433 / 250-390-0185 jadediva@shaw.ca
NHPC Credentialed for Massage Therapists, Accredited CEU'S & CCC
Shelley Killeen is an educator of Jade Stone Massage offering workshops, distributor of Southwind Jade
Massage Stones and owner/operator of Southwind Retreat & Spa located on Vancouver Island.
37 Summer 2011
Maternal Massage Training (34 hours)
Dates: November 12 & 13, 2011 (Edmonton)
Investment: $390 +gst
Location: Canadian College of Massage & Wellness
West Edmonton at Wellness Within
Register: www.wellnesscollege.ca
780-489-7799 (Edmonton area)
1-877-489-7799 (Toll-free)
Description:
Canadian College of Massage & Wellness brings you a comprehensive course on Pre & Postnatal Massage
for Massage Therapists. In this 2-day intensive training you will gain practical & hands-on knowledge in the
following:
Benefits of Maternal and Postpartum Massage
Contraindications and Guidelines to Maternal Massage
Special Circumstances
Emotional and Physical aspects of Pregnancy and Postpartum
Positioning, Supports and Materials
Techniques and the Stages of Pregnancy
Labour Massage
Postpartum Massage
After the weekend course, 10 practicum massages are required.
*This course has been approved for CEUs as a Specialization by NHPC & MTAA!
Advanced Muscle Therapy
Seminars
Cheryl Stephenson RMT, MSc., BPE
Red Deer, AB
Are you looking for continuing education seminars that will increase your confidence and competence as a
therapeutic massage professional? This advanced technique seminar series is value packed with the
practical skills you require to excel at your profession. Included is:
An integrative treatment approach that employs a variety of protocols including trigger point,
active release, myofascial release, and muscle energy techniques.
A comprehensive manual with illustrations and detailed technique descriptions.
Oct 21, 2011 Introduction to Therapeutic Techniques
Oct 22, 23 Advanced Techniques for Low Back & Hip
Nov 19, 20 Advanced Techniques for Neck & Upper Back
Dec 4 Pilates for Therapists
Jan 14, 15, 2012 Advanced Techniques for Shoulder/Rotator Cuff
Feb 4,5,6 Pelvic/Lumbar Dysfunction & Correction
Mar 17,18 Advanced Techniques: TopicTBA
Apr 21,22,23 Cervical & Thoracic Dysfunction and Correction
Advanced Technique seminars present an integrative treatment approach employing Trigger Point,
Active Release, Myofascial Release, and PNF stretching techniques.
Dysfunction and Correction seminars employ Muscle Energy Technique (Onsen) protocols
designed to correct spinal imbalances
details @ www.perfectbalanceseminars.com
contact Cheryl@perfectbalanceseminars.com (403) 877-6058
38 Summer 2011
Reiki Divine Energy Program
with Master Teacher Wayne
RMT, RM, MHA, IS2, BA Rel
As an holistic non-religious healing modality, Reiki focuses on conducting Divine healing energy (Chi/Ki)
into a client thereby increasing the level of their own natural healing energy. This energy is used to heal any
issue on the physical, mental, emotional, and/or spiritual levels. Other therapeutic modalities become
"energized" and more effective. The therapist becomes truly holistic by offering a complete approach to
healing. All parties are blessed and feel an angelic peace afterward.
Students are qualified to apply Reiki therapy. Level completion certificates (5 credits) are given at the end
of each of four levels.
What:Divine Reiki Program (ongoing)
Class form: Group or Individual (custom times) -In person or long distance.
Who:.Master Teacher Wayne RMT, RM,
When:...Ongoing -starting November 1, 2009
Where:.Suite 205 5831 57St. Red Deer, Alberta (T4N 2L5)
Time:10:00 a.m. - 3:00 p.m.
Tuition..$125.00 per level -cash
Contact: Wayne at (403)347-0928 www.divinelightreikiandhealth.com Divine.Light.Health@gmail.com
Stability Ball Training
From Gaia Adventures
Stability ball exercise is one of the most effective means to rehab your patients. Its easy, for every body
type, and fun to use. Learn the very latest advancements and techniques in stability ball training during my
upcoming workshops.
Stability Ball Training is coming October 28, 29 in Vancouver, Nov 12, 13 in Winnipeg and Nov 26, 27 in
Edmonton (14 Primary Credits MTAM, MTAA, MTABC, NHPC)
Advanced Ball Training on October 30 in Vancouver, Nov 14 in Winnipeg, and Nov 28 in Edmonton (7
Primary Credits MTAM, MTAA, MTABC, NHPC)
Go to http:www/gaiaadventures.com/bodyball.html for information and to register online.
In these hands-on, fast-paced sessions, youll learn about "Core Activation Assessment and Training
Techniques", functional kinetics with the ball and how to use the stability ball to rehab shoulders, back and
correct posture.
2 day
Active Isolated
Stretching (AIS)
Stretch-for-Lifes Active Isolated Stretching, The Mattes Method 2 day seminars will teach you how to
expertly assist your clients active stretching movements.
Active Isolated Stretching is a rehabilitative form of active and assisted stretching techniques that will
help you reach optimal flexibility, improve ROM and correct postural imbalances. Register today classes
fill up quickly!
Upcoming courses in BC and Alberta:
Kamloops: January 14 & 15 (Sat/Sun) Canmore: January 25 & 26
(Wed/Thurs)
Cranbrook: February 18 & 19 (Sat/Sun) Edmonton: February 22 & 23
(Wed/Thurs)
Calgary: March 10 & 11 (Sat/Sun) Red Deer: March 24 & 25 (Sat/Sun)
Nanaimo: April 14 & 15 (Sat/Sun) Kelowna: May 16 & 17 (Sat/Sun)
Course Fee: $430.00 (includes course manual)
To register visit www.stretch-for-life.com
denise@stretch-for-life.com
NHPC credits = 10 MTAA credits = 18 CMTBC credits = 14 MTAS credits = 16 MTAM credits = 16
39 Summer 2011
Active Isolated
Stretching
(AIS)
Instructor:
Paul John Elliott,
LMT, Certified AIS Instructor, Advanced
AIS Practitioner
Active Isolated Stretching: the Mattes Method (AIS) is a cutting edge method of stretching used
by todays massage therapists, personal trainers, athletic therapists and fitness professionals.
Working with the bodys natural physiological makeup, this method of stretching improves circulation and
increases fascial elasticity, which helps eliminate physical pain and improve human performance.
AIS is an outstanding modality for improving posture, eliminating abnormal curvatures as well as restoring
proper body alignment and eliminating physical pain.
This 3-day course will empower you with stretching and myofascial protocols that will compliment your
current techniques and strategies.
Upcoming Dates:
Calgary ADVANCED AIS.
May 27, 28 and 29 Location: 400-7330 Fisher St. S.E. T2H 2H8.
Requires one Level 1 course certificate.
Register at: http://stretchingcanada.com/event/seminar/advanced-ais
Regina Level 1 AIS 3-day.
June 3, 4 and 5
Location: Holiday Inn Express and Suites Regina, Sk S4S 3R6.
Register at: http://stretchingcanada.com/event/seminar/regina-3-day
Langley Level 1 AIS 3-day
August 19, 20 and 21
Location: Langley Sportsplex Suite 3.
Register: Paul Turner at 3-peaks Kinesiology:1-778-298-3757 - threepeaks@shaw.ca
Langley ADVANCED AIS 3-day
August 19, 20 and 21
Location: Langley Sportsplex Suite 3.
Register: Paul Turner at 3-peaks Kinesiology:1-778-298-3757 - threepeaks@shaw.ca
Structural Myofascial Therapy
(SMFT)
Course Developer:
BetsyAnn Baron
Level 1: Connecting with Fascia
Taught by course developer BetsyAnn Baron
Kelowna, BC: Sept 30-Oct 2, 2011
Montreal, QC: Nov 4-6, 2011 (taught in French)
Edmonton, AB: Nov 18-20, 2011
Early Registration Cost: $525 (reg $625) - Register more than 30 days
Credits: NHPC = 15
Learn how to help your clients experience rejuvenation of injured tissue, increase in their range of
motion, deeper and easier breathing, improvement in posture, decrease of chronic pain and so much
more. We will focus on:
1. Myofascial full body protocol including anatomy/physiology
2. Postural Somatic Awareness (PSA) - a fantastic, subjective evaluation tool for you, the therapist, as well
as for your clients
3. Working within these 3 paradigms: palliative, corrective, integrative
Level 2: Creating Specificity
Kelowna, BC: Feb 17-19, 2012
Montreal, QC: Mar. 9-11, 2012 (taught in French)
Edmonton, AB: Mar. 23-25, 2012
Level 3: Delving Deeper
Kelowna, BC: Apr. 27-29, 2012
Montreal, QC: May 11-13, 2012 (taught in French)
Edmonton, AB: June 1-3, 2012
For more information or to register contact:
BetsyAnn Baron
514-577-5355
education@baronbodyworks.ca
40 Summer 2011
Back to Back Traditional
Study Retreats
on the Southeast Coast of India
From
Calming the Ocean
in combination with
The Healing Hands Center
& Wudang Wen Wu
Tui Na Massage and Healing Qi Gong
December 23 - 31, 2011
Must Register by November 15, 2011
Healing Qi Gong creates internal strength for a longer and healthier life, increasing overall power;
Tui Na Massage techniques focus on joint mobility for better circulation, which helps the body naturally
heal itself while loosening constrictive adhesions.
Honorary Doctor of Qi Gong David Wei creates a beautiful harmony between these healing practices for
effective, comprehensive treatments with priceless hand maintenance exercises.
8 - 12 Students $1,799 13 - 16 Students $1,699
Ancient Thai Massage, Yoga & Self-Healing
January 2 - 14, 2012
Must Register by November 30, 2011
Training provided by a Master of Ancient Thai Massage since 1990
Detoxify yourself physically, then emotionally with simple exercises
Strengthen your body and mind through daily strengthening yoga sets
During the two weeks you'll go through incredible life changing experiences
Awaken your healing energy through guided meditations and self-attunements
Learn the only form of Ancient Thai Massage that flows physically and energetically
The Ancient Massage, Ancient Stretches and Ancient Healing of Doctor Jivaka Kumarabhacca are a
powerful combination that will benefit any massage practitioner. To find this combination of traditional
practices in a single curriculum is rare.
8 - 12 Students $2,099 13 - 16 Students $1,999
Prices in Canadian Dollars, Based on double occupancy, add $350 for single occupancy
(includes taxes, tuition, accommodation, 3 meals/day, transportation to and from the Chennai airport)
Held at Cocoland, a resort in the middle of a coconut plantation three minutes from the beach.
Kristian Olsvik 780-701-9993 www.calmingtheocean.com info@calmingtheocean.com
STONE THERAPY SCHOOL
Course developer: NINA
GART
Level 1
Hot & Cold Stone Massage
3-day certification course
The Original Stone Therapy Training
Level I - Massage with Hot & Cold Stones
3-day intensive, instructional, hands-on course
Credits: NHPC 15
Pick up a stone from anywhere, look deep inside for captured within is the power to heal
2011 schedule:
AB
Calgary: Sep 30 Oct 2
Edmonton: Nov 4 6
Grande Prairie: Nov 18 20
SK
Saskatoon: Oct 17 - 19
Regina: Dec 2 - 4
BC
Vancouver: Oct 8 - 10
Nanaimo: Sep 16 - 18
Victoria: Sep 19 21
Main focus of the course is SAFETY:
. In depth Stone Therapy Procedures
. Bio Mechanics
. Safety principals in Stone Therapy
. Stones used, their qualities and care for stones
. Thermatherapy principles
. Indications, contraindications, benefits and so much more
Stone Therapy School offers courses since 1999 for massage therapists, energy and SPA professionals.
Ongoing classes in AB, SK, BC
CEUs: NHPC 15, MTAA 25, MTAS 21, CMTBC 21
To register: NINA GART 604-459-8646 nina@stonetherapyschool.com www.stonetherapyschool.com
41 Summer 2011
Unwind the Belly
with
Chi Nei Tsang
Workshops
Learn to Unwind The Belly with Chi Nei Tsang Workshops www.unwindthebelly.ca
Chi Nei Tsang (chee-nayt-song) is traditional Oriental Visceral bodywork. The three pillars of CNT are
breath work, applied qigong, and skilled gentle touch - all three are addressed in each exhilarating two day
module. Learn to work the body core without fear.
In Level 1A we learn the fundamentals necessary to do a safe powerful abdominal bodywork session.
Our primary focus is to open the channels of elimination the Metal organs - the skin, the lungs, and the
large intestine. We free the diaphragm & expand & relax the breath, and learn to open the 9 Wind Gates.
We root & ground with Earth Qigong, and build our life force (qi or chi), from the marrow out, with
Bone Breathing.
In Level 1B we become more assured and specific with the ancient abdominal touch techniques. We learn
powerful ways to work with and balance the Earth and Wood internal organs of the body. Our
anatomical knowledge grows. We learn to maintain our own health (& transform toxic energy) with the
Microcosmic Orbit and the Six Healing Sounds
Unwind the Belly with Chi Nei Tsang
The Fundamentals:
Part 1 - The Basics: Metal Organs (no prerequisite):
16-17 September 2011, Edmonton, AB (at the Providence Renewal Centre)
Part 2 - Wood And Earth Organs (prerequisite: Fundamentals Pt 1):
18-19 September 2011, Edmonton, AB (at the Providence Renewal Centre)
Global Body Attitude (prerequisite: Fundamentals Pt 1 & 2):
Part 1 - Fire Organs & Chasing Specific Winds
25-26 November 2011, Edmonton, AB (at the Providence Renewal Centre)
Part 2 Water Organs & Balancing Meridians
27-28 November 2011, Edmonton, AB (at the Providence Renewal Centre)
Visceral Anatomy: An East/ West Perspective
Dates TBA, December 2011, Vancouver, BC,
Qigong & Discharging for Healthcare Practitioners (no prerequisite):
Dates & Location TBA
Instructor: Peter TS Melnychuk, LMT
Certified CNT Instructor (since 2004) & Adv. Practitioner, CNT Institute (Oakland, CA)
Visceral Manipulation Practitioner & Certified Teaching Assistant (Barral Institute)
Online Info & Registration: detailed course descriptions & fees at www.unwindthebelly.ca
Contact & Registration: Laurelle at 780.428.5572 or info@unwindthebelly.ca
Please specify which class(es) you are interested in.
WHOLISTIC NUTRITION
Correspondence Program
LIVING ENERGY Natural
Health Studies
A 2-year-plus program designed for people who want to get a solid, working under-standing of nutrition
and how it relates to health and wellness, also for people wanting to further their career in the natural
health field.
This is an ongoing program, and students can start at any time. Level 1, Level 2, and Level 3 are totally via
correspondence; Level 4 (advanced nutrition) is a detailed hands-on five-day program.
COST: Levels 1-3 $750 each (plus GST)
Level 4 $800 (plus GST)
** Cost of course includes workbook, administration fees, tutorial support, and one exam for each level.
A discount is available if Levels 1-3 are purchased at the same time.
This program has affiliations with a number of organizations and colleges including Canadian Association
of Natural Nutritional Practitioners (CANNP). For detailed information contact Living Energy/Dr. Radka
Ruzicka HD(RHom), NNCP at (780) 892-3006 (local call from Edmonton), visit our website
www.livingenergy.ca
42 Summer 2011
Need space?
NHPCs Knowledge Center is taking bookings now.
For more information:
call 1 888 711 7701
or email jgabriel@nhpcanada.org
The Knowledge Center features:
Affordable rates
Member discounts
1600 square feet
Large windows overlooking downtown Edmonton
Kitchenette
Massage tables, projector, catering,
desks & chairs available
1
0
%
MEMBER
DISCOUNT
ON BOOKINGS
1
5
%
ADVERTISITNG
DISCOUNT
43 Summer 2011
I AM NHPC
One of the great benefits of being a
member of the NHPC is the associations insurance
program.
No other professional liability insurance policy
specific to your profession offers an occurrence
form policy with limits of $3,000,000 each claim and
$4,000,000 per policy period per individual.
ADDITIONAL BENEFITS
Instantrecognitionbymostinsurance
companies across Canada
Instant recognition as a competent professional
Massage Therapy Competency Assessment Process
A prior learning assessment process for 2200
hour competency equivalency recognition by the
insurance industry
Facilitates massage therapists moving into
regulated environments
Does not apply to Regulated MT Provinces
Visit www.nhpcanada.org or call 1-888-711-7701 for
more information.
Halifax, Nova Scotia
October 24
Toronto, Ontario
October 25
Winnipeg, Manitoba
October 26
Saskatoon, Saskatchewan
November 14
Regina, Saskatchewan
November 15
Calgary, Alberta
November 16
Edmonton, Alberta
November 17
Vancouver, British Columbia
December 5
Kelowna, British Columbia
December 6
Lethbridge, Alberta
December 7
The NHPC invites members
to attend a Connections Caf
in a city near you.
Connect with like minded healthcare professionals for a
powerful evening of networking and conversation.
Together we can strengthen our natural health community.
Join us.
Online registration opens mid September at nhpcanada.org
or call 18887117701 for more information.
natural health practitioners of canada association
association des praticiens de la sant naturelle du canada
2011 FALL
SCHEDULE
FREE REGISTRATION
7 - 9 pm
Locations TBA
Refreshments &
Snacks Provided
Halifax, Nova Scotia
October 24
Toronto, Ontario
October 25
Winnipeg, Manitoba
October 26
Saskatoon, Saskatchewan
November 14
Regina, Saskatchewan
November 15
Calgary, Alberta
November 16
Edmonton, Alberta
November 17
Vancouver, British Columbia
December 5
Kelowna, British Columbia
December 6
Lethbridge, Alberta
December 7
The NHPC invites members
to attend a Connections Caf
in a city near you.
Connect with like minded healthcare professionals for a
powerful evening of networking and conversation.
Together we can strengthen our natural health community.
Join us.
Online registration opens mid September at nhpcanada.org
or call 18887117701 for more information.
natural health practitioners of canada association
association des praticiens de la sant naturelle du canada
2011 FALL
SCHEDULE
FREE REGISTRATION
7 - 9 pm
Locations TBA
Refreshments &
Snacks Provided