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1. Pengantar Perawatan refleksi Perawatan Refleksi Presented by : dr. I ntan Rahmadani, Sp.KFR , MM, AIFO-K

2. Rules?! Toleransi terlambat 15 menit , jika lebih mendapat tugas tambahan Absen maksimal 3x Wajib menggunakan name tag selama kuliah Jika kelas online wajib on camera

3. CPMK Memahami konsep perawatan refleksi Menjelaskan Perawatan massage Menjelaskan Jenis-jenis pijat Menjelaskan Terapi aroma, terapi warna, terapi music Menjelaskan Latihan Fisik pada wanita sepanjang siklus kehidupan Menjelaskan Pijat pada bayi dan balita sehat dan sakit ringan Menjelaskan Pijat pada remaja /orang dewasa / menopause/ lansia / paliatif Menjelaskan pijat pada Ibu hamil dan bersalin normal dan patologi Menjelaskan pijat pada Ibu Nifas normal dan patologi Menjelaskan Bisnis plan bisnis perawatan refleksi dengan pemanfaatan teknologi

4. Perawatan refleksi ? Reflexology a system of massage used to relieve tension and treat illness, based on the theory that there are reflex points on the feet, hands, and head linked to every part of the body the scientific study of reflex action as it affects behavior ( O xford dictionaries)

5. Reflexology Reflexology is the systematic practice of applying some pressure to particular points on the feet and hands to impact on health of related parts of the body ( J Tradit Complement Med.  2017 Jul; 7(3): 327–331)

6. History Earliest discovery of reflexology was found in Egypt Other studies  from China for the last 5000 years At the late of 14th century  applied throughout the Europe  zone therapy Father of modern reflexology, Dr. William Fitzgerald (1872–1942) Eunice Ingham (1879–1974) with Dr. Riley in 1930’s  writing many books: “Stories the Feet Can Tell, Stories the Feet Have Told, and Stories the Feet Are Telling”

7. the mechanism of action Although there is still ambiguity, some theories have been proposed: The gate control theory of pain Neural impulse theory Increased secretion of endorphins and encephalins which assist relieving of pain Improved lymphatic nerve and blood flow and consequently increased excretion of toxins from the body

8. theories Energy theory advocates that body parts can communicate using electromagnetic fields The communication can be blocked based on the surrounding respectively Energy flow can be restored P athway which is blocked can be opened R eflexology can break up the lactic acid crystal that usually deposited in the feet and allow energy to flow efficiently

9. methods Ingham method  Pressure is applied by “ thumbwalking ” whereby the thumb (or finger) bends and straightens whilst maintaining a constant pressure across the area of the foot being worked Rwo Shur method  combines thumb-sliding and pressure techniques, incorporating the knuckles and sometimes small, wooden sticks

10. Benefits Free from any drugs and chemical Wide option for many health problems Its ability to reduce pain It helps body to maintain the dexterity and locomotion ability It promotes general sense of relaxation As a prevention from any illness It promotes recovery process from any injury particularly at any region at hands and feet

11. contraindications Pregnancy but only for the first trimester period Diarrhea and vomiting Localized skin disease at hand, feet, and ears Localized inflammation or swelling of the feet, hand, and ears Fever and any infectious diseases whether systemic or localized Continuing extreme negative reaction to reflexology

12. TECHNIQUES Basic heating movements Turn the feet : Thumb in the solar plexus area and rotate the foot, with the other hand make medium pressure in the area of the solar plexus. Tilt of the foot:  Thumb in the area of the solar plexus and tilt the foot forward and backwards, medium pressure in the area of the solar plexus. Rotation of the foot :  Thumbs on both sides of the foot and fingers on the back, move the thumbs around the sole of the foot with circular friction. Frictions:  One hand in the dorsal area and the other in the dorsal area, making friction from the toes towards the instep and towards the heel or in opposite directions. Soft friction Exploratory movements:  With the thumb frictions are held very slowly, the finger is projected in any area looking for some reflex zone. The finger should not be separated while the scan lasts

13. TECHNIQUES Circular manipulation: Plantar technique.  The tip of the fingers with which it works is usually used.  Soft circular massage (average pressure depends on the receiver). Vibratory manipulation in pincers and statics:  The lateral zone and the Achilles heel and some dorsal part are used. Spiral manipulation with stretching:  Stimulate the long currents. It is done with the right hand and the pulp of the fingers. They are ascending spiral movements in a clockwise direction and from the heel to the fingers

14. TECHNIQUES Stretching With a thumb and forefinger  a stretch is made to all the toes of the foot then turn them sideways starting from the little finger towards the big toe Plantar technique  [reaction, friction, pressure] the three contact points are gently punctured, then the friction is performed moderately smooth with index finger and heart, the direction from the heel, but only the lateral zones. It is finalized by rubbing with the middle finger at the base of the plantar junction of each finger

15. TECHNIQUES Manipulation of lateral pinching ( kembiki ) : Lateral muscles (index finger and thumb). It is used preferably in feet of soft constitution. Handling by strong frictions specific to the heel. Strong friction in the heel area with the bottom of the palm of the hand, fingers extended right hand and with the left gently hold the foot, frictions are from left to right. Karate hit manipulation:  Taking one foot with one hand, the other should be placed in karate punch position, but with fingers slightly apart to cushion the impact. When touching the foot, the hand must bounce to cushion the impact. 3rd finger manipulation:  This must be applied as a last technique. Fundamental objective: Finish and finish the treatment + Calm the reflex zone of the head

16. Possible reactions 1- Painless 2- Soft pain 3- Severe pain The  typical pain  of a reactive point or zone  is usually of the pungent type  only appreciable when pressed on it Y ou  usually feel some pimples under your fingers , you must memorize the area. Then the exploratory movement finished working on them

17. Effects Small stimuli: activate, favor and stimulate Great stimuli: inhibit, restrict or stop the pain Enormous stimuli: paralyze

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23. Reflexology during pregnancy for treatment of various physiological problems such as nausea and vomiting, constipation, edema, fatigue, headache and to help breastfeeding

24. Reflexology on Pain Intensity and Duration of Labor on Primiparas ( Iran Red Crescent Med J 2011; 13(7):475-479) reflexology can be useful to decrease the pain intensity as well as duration of labor For the reflexology session, thumb and index fingers were used to work on the feet. First mild massage was given on all feet and then pressure was applied on concerned and specified regions (1) Pituitary gland, in the centre of the thumb; 2) Solar plexus, almost four fingers width below the base of the fingers of the feet; 3) Lumbar and sacral spine and 4) Genital area, below the ankle) At a dilation of 4-5 cm (active phase), was performed for 20 minutes on each foot (total 40 minutes)

25. Thank You