Special Groups of Patients

24 Special Groups of Patients


24.1 Chronically Sick and Bed-Ridden Patients


24.1.1 General Information


Reflexotherapy of the Feet (RTF) has proved its worth as a form of long-term, supplementary care for improving the quality of life, easing severe pain, and maintaining interpersonal contact.


Depending on the patient’s regenerative capacity, the basic functions of the intestine, kidneys, respiratory, and cardiovascular systems may be expected to improve.


In patients with impaired sensibilities of various kinds and origins, body awareness can be developed and promoted through conscious, watchful experiencing of the treated areas of the feet.


Many of these patients also suffer from very cold and lifeless feet and are grateful for human touch and an increased body temperature. It is often useful to instruct friends and relatives how to move and massage the patient’s feet. The application of a good skin oil or cream is always found to be particularly beneficial.


In patients suffering from chronic pain, harmonizing the autonomic nervous system by stabilizing grips is of major importance in breaking the spirals of tension, pain, and anxiety which are constantly re-establishing themselves.


Individual symptoms of pain can be recorded in a brief course of Treatment in Acute Situations (Chapter 16). In addition, the zones of the excretory and metabolic organs (intestine, urinary tract, lymphatic system including the spleen and thymus, nasopharyngeal cavity and lungs) and those of the endocrine system, tailored to the patient’s response, are tonified.


24.1.2 Special Chronic Diseases


Multiple Sclerosis

In patients in the early stages of the disease, we can usually perform an initial assessment which indicates the zones in need of treatment. If the disease is already more advanced, an initial assessment is of little use as impaired sensibilities, paresis (partial paralysis), and the restriction and slowing down of all movement prevent the finding of reliable information.


Practical Advice

Therapy focuses on the symptoms which have arisen as a result of cerebral and spinal impairment and afflict the patient the most. However, during the first few sessions the feet should be treated in their entirety, not according to specific stimuli, and in combination with ample stabilizing grips in order to obtain a better understanding of the patient’s current response.


In the acute phase it is preferable to perform stabilizing grips and to avoid strong stimuli. The symptomatic zones of the brain and the spinal column should be treated sensitively using the sedating grip, avoiding the application of excessive pressure.


Symptomatic relief can be expected in:


Evacuation of the bladder and intestine: Sometimes spontaneous evacuation occurs immediately after treatment, sometimes the function of these systems improves as a result of a longer course of treatment.


Within the urinary and the digestive tracts, the sphincters are treated using the sedating grip (neurovegetative balance).


Spastic paresis: The rules of first-aid treatment are applied in the zones of the partially or completely paralyzed spastic muscle groups, provided they can be treated as zones. As a result of relatively vigorous treatment with the sedating grip, the acute spasm is often increased slightly for a brief period, before entering a phase of distinct relaxation of the muscles and joints which lasts a few hours.


Difficulties in swallowing: First the sedating grip is applied gently, later the following zones can be gently tonified: ventral and dorsal neck region, above all, in the region of the larynx, as well as the diaphragm and pelvic floor (corresponding to the base of the mouth), gastrointestinal tract, and all sphincter zones, especially the anus. Treat the lateral lymphatics of the neck gently and carefully.


Stabilizing grips, above all of the solar plexus, should be frequently interspersed. Eutonic positions (Chapter 6) have proved particularly effective.


Geriatric Patients

There is often the misconception that ageing is synonymous with being ill. In therapeutic circles, however, we are confronted, almost without exception, with sick elderly people. RTF offers a wide range of possibilities for alleviating such people’s condition:


A frequent sense of isolation can be alleviated by the remedy of touch alone. Touching the feet, including in the form of neutral massage and footbaths, has a particularly powerful effect on the whole person and constitutes a kind of “care for one’s roots.” After all, there is an intrinsic “memory” in everyone’s feet documenting how they have literally carried the whole person through their life. For these reasons too, we have been training geriatric nurses for a long time.


As basic metabolic functions (both anabolic and catabolic) are naturally slower in the elderly, they can be supported by gently tonifying the zones of the brain, heart, respiration, digestion, kidneys, skin, immune and lymphatic systems.


Dehydration in the elderly, unfortunately often not sufficiently recognized, cannot be counteracted by RTF alone. First and foremost, fluid intake should be increased in this case.


Parkinson’s Disease

In these patients, nonspecific treatment of all zones is well suited; the brain and the spinal column (symptomatic zones) should be treated gently at first and they can gradually also be tonified if the patient responds positively. RTF of the lymphatic system has also proved effective (Chapter 10.8.4).


The following partial improvements can be expected:


The markedly slower muscle movements observed with hypokinetic symptoms, including those of the mimic musculature, become more pronounced and lively again.


The abrupt release of normal muscle tension, above all, during passive movements, known as the cogwheel phenomenon, may occur less often and/or in an attenuated form.


Rest tremor may diminish in extent and frequency.


Above all, mood lability, which is often significant, is stabilized.


Bechterew’s Disease (Ankylosing Spondylitis)

The treatment can be performed at any stage of the disease; even in the final stage it has a good palliative effect.


The following symptomatic and functional relief can be sought and obtained for the patient:


It is possible, for example, to delay progressive skeletal and capsular ankylosis and to counteract the threat of complete immobility. Therefore, treatment of the zones of the spinal column and joints, including the pubic symphysis, sacroiliac joint, and sternum and their articulated connections with the thorax is paramount, initially with sedating grips and later possibly using gentle tonification.


As the normal function and movement of the thorax and abdominal organs is greatly restricted by incipient or existing thoracolumbar kyphosis, tonifying treatment of the heart, respiratory organs, and digestive tract is particularly useful and can provide marked relief.


A course of treatment of the lymphatic zones on the foot has also proved effective as it has a harmonizing effect on the emotional level of the person.


Eutonic grips and positions bring relief for hours.


Hemiplegia, Paraplegia, and Tetraplegia

What all patients with these conditions have in common is paralysis of areas of organs or parts of the body as a result of complete (-plegia) or partial (paresis) failure of the sensorimotor supply from the spinal cord or damage to the central nervous system (CNS). Usually, accidents or diseases of the CNS are the triggers for these diseases.



As normal sensation transmitted by the neural supply is partially or completely impaired in these patients, not only the feet, but all the paralyzed parts of the body should be touched as often as possible to stimulate and activate other, more subtle qualities of perception and to prevent the patient from rejecting, isolating, or becoming indifferent toward the impaired areas.


Practical Advice

In incomplete paraplegics, above all, the disturbing attendant symptoms of a lack of control of bladder and intestinal function must be treated by means of gentle tonifying of these groups of organs. Again and again during RTF, patients hear bowel sounds and feel peristaltic movements which may also result in the spontaneous evacuation of the bowels. Albeit with individually differing results, deliberate control of the evacuation of the bowels can be supported. Above all, chronic recurrent ascending urinary tract infections decline.


The area of the spinal column where the lesion occurred should first be treated gently with sedating grips (Chapter 16.3). Later, in accordance with the vegetative response, it can also be tonified, possibly even somewhat more vigorously. Treatment begins distal to the impaired zone, but also includes the proximal part of the spinal column extending beyond the lesion. Intense pain can often be relieved by this means.


Treatment of the heart and respiratory organs improves the circulation as far as the peripheral areas and can prevent bronchial and pulmonary infections at the same time.


Initially, it is preferable to begin treating patients afflicted by cerebrovascular accident (CVA: apoplexy, stroke) on the foot that is not affected by paralysis. Stimuli may also be cautiously applied to the paralyzed foot, but here the dose limit should be carefully observed in order to avoid additional spasms. Particular caution should be exercised when treating the head, representing the symptomatic zones, to avoid overreactions.


After one or two courses of RTF, patients with CVA usually show improvements in


basic functions of their metabolic and excretory organs,


verbal articulation, and


mobility of the paralyzed side of the body;


above all, their mood becomes more stable. Treatment is also indicated if a disease is long standing.


When treating patients with pareses or plegia, particular attention must be paid to the symptoms of the autonomic nervous system (Chapter 4.2) as these indicate the appropriate dose, especially as patients do not feel the therapeutic grips, as a result of the disease, and often think the therapist should treat them with firmer and more intense grips. Treatment should be interspersed with gentle tonifying of the solar plexus at repeated intervals.


By touching the paralyzed parts of the body, at the same time the therapist imparts the unspoken knowledge that the severe trauma involving the spinal column and head region always deeply affects the patient’s personality as well, regardless of whether they are aware of this or not.


The keen nature of emphatic touch on the sensorily impaired parts of the person thus has a special quality.


Cancer

In general, RTF is highly appreciated by patients with cancer as a reliable concomitant therapy.


As a result of our extensive experience, we advise that during chemotherapy or radiotherapy patients are treated nonspecifically, that is, with ample stabilizing grips and cautious, gentle grips in the zones of the heart, spinal column, lymphatic system, digestive tract, and endocrine system. Approximately 2 to 3 weeks after radiotherapy or chemotherapy has ended, stimuli can again be applied in the zones, depending on the response, more vigorously and with more emphasis on the organs. This primarily concerns the symptomatic zones, even if the organs have been surgically removed. From our observations, the patient’s physical and mental condition stabilizes faster than usual as a result of the additional offer of RTF. The patient’s quality of life improves within the framework of their overall condition.


Cancer patients in intense pain due to the severity of their disease respond to first-aid treatment in the symptomatic zone (Chapter 16) with a reduction of pain lasting several hours, and recover somewhat in a relatively undisturbed sleep phase.


24.1.3 Summary


Treating the chronically sick can be very exhausting, partly due to the physical strain, partly because of the absorption of subtle irritations and stresses, particularly because the fate of this person also touches and affects us emotionally.


We should therefore take care of ourselves and be sure to find enough time for recovery and relaxation. Washing our hands under running water, remaining adequately hydrated, and airing the room help to neutralize our own energy field.


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Nov 18, 2016 | Posted by in ORTHOPEDIC | Comments Off on Special Groups of Patients

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