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iUCT 21 Principles and Practice of Complementary Therapies

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Therapy 1 - ACUPRESSURE

Concept Origins & Development (150 words minimum)

Acupressure is one of the oldest therapy and ancient form of massage. The first indication of this treatment method is evident in Traditional Chinese Medicine. According to history, Acupressure originated in China more than 5000 years ago. The concept of Acupressure is based on the theory of “qi” or “chi”, which means “breath” (Lee et al., 2021). Though, based on the medical point of view, Acupressure is based on the theory of life force or energetic force and flow within living things. After the spread of Buddhism across the world from China, Acupressure therapy started gaining popularity. According to many scholars, due to similarities in the treatment method, acupuncture is getting popular with the name Acupressure. According to many scholars, Indian Acupressure and Chinese acupuncture are very similar. Currently, Acupressure is used extensively in several East Asian countries as a martial art for healing and self-defence (chin na, tui na).

Nowadays, Acupressure is gaining popularity with the name of Tunia. The majority of acupuncturists trained in the United States receive training in Tuina, the most common type of Acupressure practised in China. Shen Tao, which employs highly light pressure applied just with the fingertips, is another kind, as is anma, a Japanese form that has evolved into a well-known form known as shiatsu.

Acupressure Point

(Figure 1: Acupressure Point)

Therapy Objectives (150 words minimum)

Benefits of Acupressure:

  1. It can help to minimise nausea and vomiting tendencies after surgery
  2. Acupressure can help to reduce pain caused due to invasive surgery or medical processes
  3. As per National Cancer Institute, Acupressure can help to reduce cancer-related nausea and fatigue
  4. According to many patients, Acupressure can also reduce pain, stress and level of anxiety

In Acupressure, applying pressure on acupuncture points can stimulate the body's energy flow (qi), which accelerates communication within the nervous system (Li et al., 2021). It can help improve the body's essential functions like digestion, metabolism, motor skill and sleeping. This is how Acupressure can bring back homeostasis.

The main point of Acupressure is LI-4, ren 12, ST36, and Sp 6. Acupressure, on this point, can improve digestion, influence the stomach and intestine and benefit digestive health (Dincer et al., 2021).

Poor diet plans, irregular sleeping habits, consumption of fast and junk food, work pressure, and poor work-personal life balance are the primary cause of anxiety and poor digestive health among today’s population. Acupressure can help to accelerate the flow of energy in the channels, which maintains acid reflux and improve indigestion and bloating.

Acupressure in Action

(Figure 2: Acupressure in Action)

Regulations & Legal Obligations (150 words minimum)

Code of conduct: According to the BAcC, the practitioners should maintain cleanliness, health and hygiene while applying pressure, along with maintaining the proper amount of pressure on the correct position of the patient’s body. If needles are used, that should be disposed of after single use

Professional standard: According to BAcC or British Acupressure Council, the practitioners should follow a code of practice, ethics and disciplinary processes while using or applying Acupressure to patients. Practitioners should manage the health and safety regulations of the patients as per the BAC (Chimote and Chimote, 2021).

For business needs, as per the legislation in the U.K. (England, Wales, Northern Ireland), the practitioner for Acupressure must register with the local authority and hold a registration certificate. For business purposes, the health care unit must register the name and business premises which should comply with the conditions like hygiene. Standard, store and dispose of needles, educational quality and level of effectiveness of the acupressure practitioner. The practitioner must have a special treatment licence that meets the Massage and special treatment licencing policies of the United Kingdom and local borrow. According to the Massage and special treatment licensing policy, the license for acupressure treatment will not be approved if the person is under 18 years old unless you are a qualified medical professional. The license should be renewable every year.

Training Required (150 words minimum)

Acupressure includes the same meridian pathways and pressure points as acupuncture. In training classes, the students should learn to use figures and pressure instead of using needles for treatment.

In training, the student will practice the different techniques of massages. In acupressure training sessions, students must acquire knowledge about how to interview the patient and indicate the health and symptoms. The student should also know about the different pressure points:

  1. Large intestine 4: soft web between thumb and forefinger
  2. Liver 3 (LR-3): located on the top of the foot (Chimote and Chimote, 2021)
  3. Spleen 6 (SP-6): three finger widths above the inner ankle bone

In the training session, the student will learn about acupuncture. In the U.K., only herbal products are used for clinical practice. The student will also learn about the Tui Na. the session is 1000 hours long practice-based learning course. The student must have to attend practical classes, which will be a minimum of 30 hours per week.

Key Aspects of Good Clinical Practice (150 words minimum)

  1. In order to develop treatment planning, the practitioner must know about the massage techniques, pressure points and use of figures to create pressure. To learn about these practices and information about Acupressure, the practitioner should take part in an Acupressure assessment session
  2. The practitioner should know the way of interacting with the patient. The practitioner should learn about the pain and symptoms of the patients. It helps practitioners to determine the massage or pressure point on the patient’s body with which the person can relieve the pain
  3. In the case of Acupressure, the practitioners can get patients through referrals from existing patients. Though in the U.K., Acupressure is considered one of the popular modes of treatment and people know about this treatment and get relief from pain with this treatment (Dincer et al., 2021).
  4. In Acupressure, the practitioner should ensure hygiene, clean and sanitise their hand, and possibly use gloves while giving treatment to the patients. Additionally, the hygiene of the clinic and the room should be maintained.
  5. In Acupressure, the patient will be fully clothed, and the practitioner should ask for consent before giving a massage.

Therapy 2 - ALEXANDER TECHNIQUE

Concept Origins & Development (150 words minimum)

The Alexander technique is one of the century-old body practices to develop body posture, well supported by scientific research. The Alexander technique was developed in 1890 by Frederick Matthias Alexander in Australia. Alexander was a young actor who faced severe voice problems, and doctors could not help to recover from his health problem. No major medical cause was there behind this problem, and it has been found that Alexander was doing wrong when he was acting, which increased the strain and misuse of his vocal organ (Chapman, 2019). He noticed that he tightened his neck and pulled his head down and back, which affected his vocal organ. Therefore he understands that body posture is the main reason for health issues, and he developed the Alexander technique. Alexander's technique is widely used in our society today to teach the correct posture and movement of the body to prevent health issues regarding strain and unhelpful habits.

One Alexander technique

(Figure 1: One Alexander technique)

Therapy Objectives (150 words minimum)

The potential benefits of Alexander's techniques are discussed below;

? The Alexander technique helps to improve the body posture to prevent health issues.

? This technique helps to reduce body pain and gives flexibility.

? The Alexander technique is also helpful in developing the body movement of people.

Alexander's technique is beneficial for improving body posture, relieving pain, dealing with stress, and developing body movement effectively. It is suitable to rectify the wrong body movement that can harm health (Kildow, 2018). This technique can also be used to understand the correct body posture and improve essential body functions that may help regain homeostasis.

Many clients use the Alexander technique instead of taking medicine for treatment, as it helps to improve body posture and movement without medical help and helps to manage stress. Poor diet is a significant reason for illness nowadays, and most people do not know the correct body posture, which can create essential health issues (Schulz, 2022). This technique does not manipulate the body; an only light touch is required to improve body posture and movement.

Alexander technique-lying down spiral

(Figure 2: Alexander technique-lying down spiral)

Regulations & Legal Obligations (150 words minimum)

The Alexander technique is not controlled or operated by any regulatory body or council, and no rules or regulations are available to maintain this technique. Three years of training are required to fulfil all the standard protocols of the Alexander technique. Based on the code of conduct, teachers should effectively maintain proper dignity, rules, regulation, and fundamental rights. Teachers need to have professional skills and maintain a proper attitude to teach proper Alexander techniques for people to develop their body posture and movement.

There is no need for any academic prerequisites; however, the applicant needs to have enough maturity and skill to be the primary qualification for participating in the training regarding the Alexander technique (Phelan, 2021). There are no laws regarding the Alexander technique. However, practitioners must maintain the NHS's fundamental protocols and instructions. Maintaining the relationship between head and body posture, proper sitting arrangement, and balance between body and mind is required to teach Alexander's technique.

Training Required (150 words minimum)

Practical training and theoretical training are both required for teaching the Alexander technique. The theoretical training is essential to understand the actual process of this technique, the background of this technique, and the impacts of this technique to improve body posture as well as movement. A 3 years study and training program is required to learn the Alexander technique appropriately (Schulz, 2022). Theoretical classes are also important for understanding the proper technique of Alexander to prevent health issues occurring from wrong body postures. Around 1500-1600 hours are required for an institution to provide a better training program to teach the exact Alexander technique. The Alexander technique mainly improves people's body posture and body movement and reduces the wrong body habit, indicating a person's continuous professional development (CPD).

Key Aspects of Good Clinical Practice (150 words minimum)

The client's information is required to offer an appropriate teaching process for developing body posture and reducing potential health issues. The information regarding the health issues, client's age, maturity level, and reason for the body stress is necessary to initiate the teaching process of the Alexander technique (Schulz, 2022). Teachers and trainers must consult with the client to gather all this information for teaching this technique.

Based on the U.K. Data Protection Act 2018, all the collected information needs to be protected within the organisations and only used for teaching purposes (gov. uk, 2021). It is important to secure all the sensitive information of clients as per the data protection rules effectively. All the information can be stored in a cloud-based storage system to reduce the chance of data vulnerability (Kildow, 2018). The healthcare professionals need to refer the patients to other professionals if the patient's health issue is critical. Maintaining proper hygiene is essential to offer a secure training process for learning this technique. A good client who benefited from learning the Alexander technique can give positive feedback about this technique.

Therapy 3 - Osteopathy

Concept Origins & Development (150 words minimum)

Osteopathy was founded by physician and surgeon Andrew Taylor Still in the late 1800s, when he was in Kirksville, Missouri. According to Still, every part of the body should work harmoniously to ensure health. In medical practice, Still always aims to identify the best possible way in which he can restore the optimum health of the body with minimal surgery and medicine. In this search, Still joined the Chicago College of Osteopathy in 1900. The practice of Osteopathy started in 1874 in the United States. Still made this process famous in the 19th century (Robin et al., 2021). He claimed that the illness of the human body is linked to the musculoskeletal system, and osteopathic manipulation can solve this problem. During that time, Still was restricted by society from practising this conventional treatment process. Though, when Still lost his wife and three daughters to spinal meningitis, he took the initiative to make Osteopathy prevalent in society over the orthodox medicinal practice. In the 20th century, Osteopathy started to gain popularity across the U.S. and became a legitimised medical treatment for any musculoskeletal problem or issue. Now, across the world, one of the best ways to treat joint pain or muscle pain is Osteopathy.

Osteopathy

(Figure 1: Osteopathy)

Therapy Objectives (150 words minimum)

Osteopathy is a medical process or mode of treatment that positively affects the circulatory, nervous and lymphatic systems. The benefit of osteopathic treatment are:

  1. It improves body function: mobility and flexibility (Frara et al., 2021)
  2. It provides relief to osteopathic pain and improves the sleeping pattern
  3. It increases the energy level and enhances balance by reducing stress levels and muscle tension

In Osteopathy, gentle and hands-on techniques are used to restore muscle function. Soft tissue stretching, cross fibre massage, pressure on the trigger point, and mild joint manipulation can improve joint movement and flexibility and bring homeostasis (Frara et al., 2021).

Osteopathy is a drug-free and non-invasive therapy that aims to maintain homeostasis in the body by maintaining and improving body flexibility, movement and mobility. Nowadays, excessive pressure from work, lack of exercise, and poor diet can lead people to suffer from arthritis, osteoarthritis, and knee pain after a certain age. With Osteopathy, with minimal medicine, people can get relief from a wide range of health conditions like:

  1. Arthritis
  2. Knee pain
  3. Headaches
  4. Tennis elbow pain
  5. Postural problem
  6. Elbow pain

Osteopathy in action

(Figure 2: Osteopathy in action)

Regulations & Legal Obligations (150 words minimum)

 For the osteopathy practice standard, the General Osteopathic Council, U.K., has set and monitored practice standards and offers guidance to osteopaths to ensure that every patient receives quality care. According to Osteopathic Practice Standards, the practitioner should keep patient data and information confidential (Osteopathy.org.uk. (2022). Through communication and patient partnership, the practitioners should inform the patient of the therapeutic process. The practitioner should communicate effectively with the patient to maintain an ethical relationship.

The knowledge, skill and performance standard concerns the knowledge and skills of the osteopath. As per this standard., the practitioner must be a primary healthcare professional and should hold medical practice license issued by the U.K. government and NHS.

As per cpd, Osteopathy.org.uk, the osteopath should have knowledge about CPD.

As per the Professionalism standard, osteopaths must ensure the safety and ethics of the treatment while offering osteopathic treatment to the patient. The professional should also be respectful toward patients.

As per Safety and Quality in practice,  the professionals should ensure that the treatment they deliver is high-quality, ethical and safe and can provide effective results to the patient.

Training Required (150 words minimum)

There are more than 5000 osteopaths in the U.K. registered with the General Osteopathic Council. In the U.K., more than seven million consultations are provided by the GOC on Osteopathy across the U.K. The student must follow the Monitoring standards of education (Osteopathy.org.uk. (2022). A student, while taking the initiative to become an osteopath, must complete the CPD cycle. During the training period, the student

  1. Complete and record 90 hours of CPD training
  2. Should cover all 4 themes of osteopathic Practice standards
  3. Must do at least one objective activity
  4. Cover all communication and consent
  5. Take an active part in Peer Discussion Review

The CPD training session is three years long practice-based training program. During the training session, the student should learn about first aid medicine and essential treatment related to Osteopathy.

Key Aspects of Good Clinical Practice (150 words minimum)

  1. Case-based discussion- the osteopath must take part in the discussion of the real or imaginary case with colleagues and ask for feedback on the practice. Here the case can be like, one patient of a certain age suffering from Rheumatoid arthritis, joint pain, and fatigue. Now discussion will continue on how by applying non-medicine and invasive treatment, the osteopath can treat rheumatoid arthritis.
  2. During the treatment, the osteopath will share all the information and details about the medicine with the patient and maintain body posture while taking the treatment.
  3. According to the Data Protection Act, 2018,  the practitioner should maintain the confidentiality of patients’ data and information, and case reports.
  4.  The practitioner should also maintain health and hygiene while offering treatment to the patients and maintain clear and ethical communication with patients.

Therapy 4 - physiotherapy

Concept Origins & Development (150 words minimum)

A physiotherapy is a form of medical care that aims to improve a patient's mobility, function, and overall health. Physical rehabilitation, injury prevention, and health and fitness are all benefits of physiotherapy. The concept of physiotherapy originated way back in 460 BC; doctors like Hippocrates and Galenus are thought to have advocated massage, manual therapy methods, and hydrotherapy as a treatment for patients. Similar to latest advancements in physiotherapy, machines like the Gymnasticon were created to cure gout and related disorders by methodically exercising the joints after the establishment of orthopaedics in the seventeenth century (Tejera-Falcón et al., 2017). The Royal Central Institute of Gymnastics (RCIG), founded in 1813 by Per Henrik Ling, the "Father of Swedish Gymnastics," for massage, manipulation, and exercise, is credited as being the first organisation to practise true physiotherapy as a profession. The National Board of Health and Welfare of Sweden officially registered P.T.s in 1887. Other nations quickly followed. The Chartered Society of Physiotherapy was founded in 1894 by four nurses in Great Britain. The School of Physiotherapy at the University of Otago in New Zealand graduated in 1913, and so on.

Today, Physiotherapy is a popular type of therapy for mobility and function-related cure. In 2021, there were about 78,000 physiotherapists employed in U.K. (Grieve and Palmer., 2022)

Therapy Objectives (150 words minimum)

The core objective of the therapy of physiotherapy:

· To restore and enhance the function of multiple body systems

· To restore the movement or function when someone is affected due to illness, injury or disability

· To reduce or eliminate the pain by restoring joint and muscle functions

· To avoid surgery and also to make the patient body ready through pre-surgery physiotherapy

The overall goal of the physiotherapy approach is to assist patients in returning to their previous level of functioning while also promoting activities and lifestyle modifications that can help prevent subsequent injuries and enhance general health and well-being (Bervoets et al., 2015). Physiotherapy is frequently recommended to patients by primary care physicians as soon as a problem arises since it is viewed as a conservative method of issue management.

Regulations & Legal Obligations (150 words minimum)

In the U.K., a physiotherapist must register in HCPC (Health and Care Professions Council), and the registration must renew every two years; otherwise, it gets cancelled. The "HCPC's professional standards" must be met by every physiotherapist. The "Standards of proficiency - Physiotherapists" and the "Standards of conduct, performance, and ethics" outline them. Members of the CSP who are certified physiotherapists must follow the "Code of Professional Values and Behaviour." The Rules cover all areas of practice. Only Society members physiotherapists are permitted to use the designation "chartered physiotherapist."Training Required (The Chartered Society of Physiotherapy., 2022).

Further, physiotherapist also needs to follow the Data Protection Act 2018 guidelines regarding using and dealing with patient data and information. Additionally, if the physiotherapist keeps the records of the patients, he/she may have to register as a data user in the "Information Commissioner's Office" (Lawdonut.co.uk., 2022).

Training Required (150 words minimum)

To become a registered physiotherapist, there are several different routes. But the most convenient training and learning of physiotherapy are getting the BSc Degree Apprenticeship. This degree program enables the interested individuals to work as an apprentice within a physiotherapy setting along with a surd at the respective university under the BSc Physiotherapy programme. The course involves 1000 hours of practice-based learning. Besides that, apprentices typically require a minimum of 30 hours per week, including training time away from the workplace. The theoretical learning and practical training enable individuals to become efficient physiotherapists, and a degree or certificate is highly accepted in the HCPC (The Chartered Society of Physiotherapy., 2022). After the BSc degree, individuals can take the Masters's level degree courses such as Integrated Masters or Pre-registration Physiotherapy Doctorate to meet the high-level training and learning requirements. Moreover, physiotherapists needed to 30hours of formal CPD every year to renew their membership in CSP. 

Key Aspects of Good Clinical Practice (150 words minimum)

1. In order to develop the treatment planning, a physiotherapist needs to know the physical complaints of patients, their background, what increases or eases the pain, other medical or physical conditions, and so on. To get this information, a physiotherapist assessment session is a crucial clinical practice (Wright et al., 2018). 

2. Recoding patient information effectively is the next curial aspect of good clinical practice. The physiotherapist can take manual notes of the patient information and also note or record it, but taking the client's consent before recording is crucial under the Data Protection Act 2018. A further physiotherapist can store the information in files with the client's name so that the patient's information does not get mixed.

3. Individual physiotherapies or settings can get patients through referrals from already existing clients. Further, medicine doctors sometimes refer to physiotherapy (Tejera-Falcón et al., 2017).

4. Health and hygiene are crucial to maintaining while giving therapy. Physiotherapy needs physical contact, so the physiotherapist needs to ensure that hygiene matters.

5. As physiotherapy needs physical contact, asking the patient for consent is crucial to Good Clinical Practice.

6. Clearing the full fees of the therapist and referring to others can be seen as an example of client after-care

References

Bervoets, D.C., Luijsterburg, P.A., Alessie, J.J., Buijs, M.J. and Verhagen, A.P., (2015). Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. Journal of physiotherapy, 61(3), pp.106-116. https://www.sciencedirect.com/science/article/pii/S1836955315000582

Chapman, S., (2019). The Alexander technique in relation to practising, performing and teaching. Bulletin of the Transilvania University of Bra?ov. Series VIII: Performing Arts, pp.7-12.

Chimote, B.N. and Chimote, N.M., (2021). Fertility interventions ‘add-ons’ in clinical ART practice: ethical, moral and commercial considerations. Journal of Assisted Reproduction and Genetics, 38(10), pp.2579-2580.

Dincer, B., ?nangil, D., ?nangil, G., Bahçecik, N., Ayaz, E.Y., Arslano?lu, A., Keskinler, M.V., Kabuk, A. and Özkan, G., (2021). The effect of Acupressure on sleep quality of older people: A systematic review and meta-analysis of randomised controlled trials. Explore.

Frara, S., Allora, A., di Filippo, L., Formenti, A.M., Loli, P., Polizzi, E., Tradati, D., Ulivieri, F.M. and Giustina, A., (2021). Osteopathy in mild adrenal Cushing’s syndrome and Cushing disease. Best Practice & Research Clinical Endocrinology & Metabolism, 35(2), p.101515.

gov.uk, (202), data protection regulation, Available at: https://www.gov.uk/government/publications/guide-to-the-general-data-protection-regulation [Accessed on: 25th August, 2022]

Grieve, R. and Palmer, S., (2022). Physiotherapy for plantar fasciitis: a UK-wide survey of current practice. Physiotherapy, 103(2), pp.193-200. https://uwe-repository.worktribe.com/OutputFile/886548

Kildow, E.S., (2018). The Alexander Technique, mindfulness, and wellness for performing arts students. In The Online Journal of the Practice/Production Symposium of the Mid America Theatre Conference (Vol. 7, pp. 1-22).

Lawdonut.co.uk. (2022). Physiotherapist legal issues. [online] Available at: <https://www.lawdonut.co.uk/business/sector-specific-law/physiotherapist-legal-issues> [Accessed 25 August 2022].

Lee, S.N., Kim, B. and Park, H., (2021). The effects of auricular Acupressure on stress, anxiety, and depression of outpatient nurses in South Korea. Complementary Therapies in Clinical Practice, 44, p.101447.

Li, T., Li, X., Huang, F., Tian, Q., Fan, Z.Y. and Wu, S., (2021). Clinical efficacy and safety of Acupressure on low back pain: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2021.

Osteopathy.org.uk. (2022). Training courses - General Osteopathic Council. [online] Available at: <https://www.osteopathy.org.uk/training-and-registering/becoming-an-osteopath/training-courses/> [Accessed 25 August 2022].

Phelan, L., (2021). Vocal Pedagogy and the Alexander Technique: a reflection. Revista de Investigación e Innovación en Ciencias de la Salud3(2), pp.128-135.

Robin, F., Cadiou, S., Albert, J.D., Bart, G., Coiffier, G. and Guggenbuhl, P., (2021). Methotrexate osteopathy: five cases and systematic literature review. Osteoporosis International32(2), pp.225-232.

Schulz, J., (2022). Risk, Resilience, and the Essential Experience of Being Seen: Helping Actors Move from Self-Care to Deep Freedom with the Alexander Technique. SDC Journal10(1), p.71.

Tejera-Falcón, E., Toledo-Martel, N.D.C., Sosa-Medina, F.M., Santana-Gonzalez, F., Quintana-de la Fe, M.D.P., Gallego-Izquierdo, T. and Pecos-Martín, D., (2017). Dry needling in a manual physiotherapy and therapeutic exercise protocol for patients with chronic mechanical shoulder pain of unspecific origin: a protocol for a randomised control trial. BMC Musculoskeletal Disorders, 18(1), pp.1-11. https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1746-3

The Chartered Society of Physiotherapy. (2022). Regulatory and professional requirements. [online] Available at: <https://www.csp.org.uk/networks/independent-practitioners/governance-support/regulatory-professional-requirements#:~:text=Regulation%3A%20Health%20and%20Care%20Professions%20Council%20(HCPC)&text=To%20work%20as%20a%20physiotherapist,you%20are%20being%20appropriately%20regulated.> [Accessed 25 August 2022].

The Chartered Society of Physiotherapy. (2022). Routes into physiotherapy. [online] Available at: <https://www.csp.org.uk/careers-jobs/become-physiotherapist/routes-physiotherapy> [Accessed 25 August 2022].

Wright, A., Moss, P., Dennis, D.M., Harrold, M., Levy, S., Furness, A.L. and Reubenson, A., (2018). The influence of a full-time, immersive simulation-based clinical placement on physiotherapy student confidence during the transition to clinical practice. Advances in simulation, 3(1), pp.1-10. https://link.springer.com/article/10.1186/s41077-018-0062-9

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