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Objectives At the end of this presentation, you will have the information needed to: • Describe 3 superficial reflex massage techniques • Explain the outcomes they produce • Know when to avoid them or modify their use • Begin manual practice Definitions • Superficial: pertaining to or situated near the surface • Reflex: an involuntary reaction in response to a stimulus applied to the periphery and transmitted to the nervous centers in the brain or spinal cord ©2009 LWW Reflex Effects of Massage • Are mediated by the nervous system • Peripheral receptors send impulses to centers in the brain or spinal cord, which then cause a local or systemic response. • E.g., stroking a person’s hand at the right rate and rhythm can cause drowsiness. Mechanical Effects of Massage • Are caused by physically moving tissues, by: – Compressing – Stretching – Shearing – Bending – Twisting • E.g., stretching scar tissue causes it to lengthen. Superficial Reflex Techniques • Engage the skin and affect level of arousal, autonomic balance, or perception of pain. • Include: – Static contact – Superficial stroking – Fine vibration Static Contact • Motionless contact of the therapist’s hands with the client’s body, performed with minimal force • The least mechanically forceful of the massage techniques • An important part of systems such as Therapeutic Touch, Reiki, and Polarity Therapy Static Contact: Outcomes and Uses • Increases rapport • Decreases anxiety, improves relaxation • Analgesia • May improve growth of premature infants • Is used to assist with client education • May affect client’s electromagnetic field Static Contact: Contraindications and Cautions • Contraindicated in areas of acute inflammation because of pain • Clients who have much pain or distress may not tolerate touch at all. • Be sensitive to the needs of frail, high-risk, or terminally ill clients. • Even though static contact causes minimal mechanical effects, it can give rise to complex physical and emotional responses, including touchtriggered memory. Performing Static Contact • Use a relaxed upright posture and fully relaxed hands. • Breathe using your diaphragm. • Encourage relaxation and diaphragmatic breathing in your client. • Observe client for signs of relaxation. • For a relaxation response, try applying static contact to the client’s occiput, sacrum, face, hands, or feet. Static Contact Applied to the Occiput Static Contact Used to Teach Breathing Superficial Stroking • Gliding over the client’s skin with minimal deformation of subcutaneous tissues • Usually applied unidirectionally over large areas of the client’s body • Often used at the beginning or end of a region or intervention Superficial Stroking: Outcomes and Uses • Reduces pain • Improves mood and reduces anxiety • Changes level of arousal (alertness) • Improves growth of premature infants • May alter level of neuromuscular tone Superficial Stroking: Contraindications and Cautions • Contraindicated in areas of acute inflammation because of pain • Clients who have much pain or distress may not tolerate touch at all. • Be sensitive to the needs of frail, high-risk, or terminally ill clients. • Recent myocardial infarction • With bypass surgery, wait 48 hours. • Ticklishness: use a broader contact, more lubricant, or more pressure Performing Sedative Stroking • Use: – Relaxed contact with the entire palmar surface – Slow, stable rate – Caudal direction (down limbs and back) Performing Stimulating Stroking • Use: – Fingertip contact – Fast irregular rate – Multidirectional strokes Superficial Stroking of the Face Superficial Palmar Stroking of the Back Fine Vibration • Fast oscillating or trembling movement produced on the client’s skin with minimal deformation of subcutaneous tissues • Manual technique is hard to perform long enough to be effective. • Perform using a machine that vibrates at 100 Hz Fine Vibration: Outcomes and Uses • Analgesia for both acute pain and chronic pain • Improves ability of clients with neurologic problems to perform exercise (through temporarily raised neuromuscular tone) Fine Vibration: Contraindications and Cautions • When pain is due to acute inflammation, the weight of a hand or of a machine may not be tolerated locally Performing Fine Vibration • Analgesia is much greater when: – Vibration is applied continuously for longer than 30 minutes – Rate is 100+ Hz • So use a machine! You can attach it to the client, freeing your hands to perform other manual techniques. Using a Fine Vibration Machine References • The references for the material in this PowerPoint presentation are found in Chapter 7: Superficial Reflex Techniques.