Clinical Speciality - 1 ,under the subject of Advanced Nursing Practice..F.Y Msc Nursing Student (IKDRC COLLEGE OF NURSING, AHEMEDABAD)

1. Alternative
modalities of Care
Presented BY:
Ms. Jalpa Patel
F.Y. Msc Nursing

2. Definition:
 Alternative/Complementary modalities have
been defined as treatment techniques whose
goals are to evoke healing, taking into account
the body-mind-spirit connection of every
individual (Dossey, 1995).
 It is a group of diverse medical and health care
system, practices, therapies and procedures
that are not presently considered to be part of
conventional medicine.

3.  Then, ‘alternative’ medicine means practices
and healing techniques that are not generally
taught in medical schools, thus alternating with
prevailing view.
 The technique that replaces the allopathic
medical care.
 The word ‘complementary’ gained popularity
in the field conveying the idea that the
modalities or techniques could be used to
complement and enhance the biomedical
treatments.

4.  The technique that are used in addition to the
conventional medicine.
 Nursing, however, is a holistic approach at its
essence. Likely, it is because nursing is a
holistic discipline that nurses have
demonstrated great enthusiasm for the
techniques and modalities associated with the
field of complementary and alternative care as
these techniques assist nurses to address the
physical, mental, emotional, and spiritual
dimensions of care.

5. Reasons to use alternative
therapies:
 Poor prognosis
 Focus of care is comfort not cure
 Desire to be more active in one’s own health
care
 Reduce side effects of treatment
 Reduce side effects of disease
 Desire to cover all the options
 Suggestions be family, friends and society

6.  Philosophical or cultural orientation
 Less expensive than conventional medicine
 Easier access to health food stores than
physician
 Dissatisfaction with or loss of trust in
conventional medicine
 Desire to treat the disease in a natural way
 Decrease the feelings of hopelessness and
helplessness
 Improve the immune system
 Improve the quality of life


7. Classification of ACT
1. Alternative medical system: A complete
system of theory and practice that evolved
independently of biomedical approach.
 Like:
 traditional Chinese medicine, homeopathic
medicine, naturopathic medicine, native
American medicine)

8. 2. Mind body interventions: uses a variety of
techniques to enhance the influence of the
mind and body’s intimate connections.
 Like:
 meditation, focused breathing, progressive
muscle relaxation, guided imagery, creative
visualization, hypnosis, biofeedback, music
therapy, and art therapy.

9. 3. Biologically based therapies: uses practices
and products which are completely natural and
biological.
Like:. nutrition and special diets (e.g. megavitamins,
metabolic therapies )
4. Manipulative and body based methods:
methods which involve the manipulation and
movement of the body.
Like: massage, aromatherapy, reflexology,
acupressure, shiatsu, polarity, chiropractic
medicine, yoga and exercise

10. 5. Energy therapies: focuses on the energy
within and outside the body.
Like :
Reiki,
therapeutic touch
6. Others :
counseling
group therapy
prayer
spirituality.

11. 1.ALTERNATIVE MEDICINE
SYSTEM:
 A common feature across the alternative
medicine system is an emphasis on working
with internal natural forces to achieve a
harmonic state of mind and body which can
promote a sense of well being and comfort.

12. TCM view the people as ecosystem in
miniature. Diagnosis is based on examination of
the person’s complexion, tongue, radial pulse
and detection of scent in the body, and the
treatment is geared towards correcting the
imbalance and is given with acupuncture and
herbal therapy.
a) Traditional Chinese
medicine:

13. b) Ayurvedic medicine :
 Comes from the Sanskrit word ayur (life) and
Veda (knowledge). It considers the disease
results from the accumulation of toxin in the
body and an imbalance of emotions. It
prescribes individualized diets, detoxification,
cleansing from orifices, meditation and yoga.

14. c) Homeopathic medicine:
 The treatment is based on the principle, “Like
cures like”. Homeopathic medicine are taking
original substance from plants, animals and
minerals and highly diluting them. It is believed
that body’s own healing ability is stimulated by
these medicines. They are sold over the
counter without prescription. They are so light
that they are considered to have very less side
effects.

15. d) Naturopathic medicine:
 It cures the disease by harnessing the body’s
own natural healing powers. Rejecting synthetic
drugs and invasive procedures, it stresses the
restorative powers of nature. It takes seriously
the motto, “First, do no harm.” It relies on
natural healing approaches such as herbs,
nutrition, and movement and manipulation of the
body.

16.  A system of healing. Physical illness is
attributed to spiritual causes or spirit. The
healing involves activities that appease the
spirits, rid the individual of impurities and
restore them to a healthful, spiritually pure
state.
 The central figure in American Indian medicine
is the medicine man (healer, sorcerer, seer,
educator and priest), often called as Shaman.
Shaman and trained spiritual healers who seek
to drive the evil spirit out.
e) American Indian medicine:

17.  Shamanistic methods include
 Incantations
 Charms
 Prayers
 Dances
 Shaking a rattle
 Beating of drum
 Sucking to remove the disease

18. 2. MIND BODY
INTERVENTIONS:

19.  It is a complete system natural health care that
believes that the body has the ability to heal
itself.
 A mixture of natural modalities which may
include herbs, air, sunlight and hydrotherapy
etc.
 Aim of naturopathy is to make a person more
resilient and to enhance the immune system
stronger.
 The first stage is to prevent the development of
further development of disease through a

20. Three basic principles of
naturopathy are:
 The body has a natural drive to maintain the equilibrium,
symptoms of disease are viewed and indications that the
body is striving to heal it.
 The root cause of all diseases is the accumulation of waste
product and toxin due to lifestyle habits.
 The body contains the wisdom and power to heal itself,
provided serves to enhance its power.
 It includes:
 physiotherapy
 therapeutic exercises
 acupuncture
 hydrotherapy
 nutrition
 Herbal therapy etc.

21. Meditation:
 Self directed practice for relaxing the body and
calming the mind. State of consciousness in
which individual eliminates environmental
stimuli from awareness, producing a state of
relaxation and stress relief.
 Meditation evokes a restful state, lowers
oxygen consumption, a reduction in respiratory
rate and heart rate and subjective reports of
reduced anxiety.

22.  Various forms of meditation techniques are
there, but all of them can be grouped into two
which include mindfulness meditation and
concentrative meditation.

23. Indications for meditation;
 Anxiety or tension
 Chronic bereavement
 Chronic fatigue syndrome
 Drug abuse
 Irritability
 Hypertension
 Mild depression
 Low self esteem or self blame
 Sleep disorders
 Psychological disorders

24. Limitations:
 Some may have hypersensitivity to mediation and
require less time than average 15-20mts.
 Over meditation should be avoided
 Over meditation in a patient with history of
psychosis may precipitate psychoses episode.
 It augments the effect of certain medications so
precautions should be taken to alter the dose of
medicines.

25. Relaxation therapy:
 It is the releasing of physical and mental
tensions.
 Relaxation is the state of generalized
decreased cognitive, physiological or
behavioral arousal. The process of arousal
elongates the muscles, reduces the neural
impulses sent to brain and thus decreases the
activity of brain as well as other body systems.

26. Goal:
 the long term goal of relaxation therapy is for
the person to continually monitor himself for
indicators of tension and to consciously let go
and release the tension contained in various
parts of the body.

27. Types:
 Progressive relaxation: one learns to detect the
subtle localized sensations of muscle tension in
one muscle group and then multiple muscle
groups.
 Reduce mental activity is reduced by focusing on
muscle contraction and relaxation.
 Passive relaxation: involves teaching the
individual to relax muscles passively (without
contracting them).
 E.g. deep breathing.

28. Clinical applications of
relaxation therapy:
 lowering heart rate, HR,RR and muscle tension
 improving well being and reducing symptom
distress
 in combination with imagery, yoga etc known to
reduce pain, improve emotional wellbeing and
immune functions.

29. Limitations of relaxation therapy:

 fear of loss of control, feeling like they are floating
 “predormescent start” in beginning of the therapy
 In advance diseased patients relaxation therapy
would not be appropriate.

30. Music therapy:
 "Use of musical or rhythmic interventions
specifically selected by a music therapist to
accomplish the restoration, maintenance, or
improvement of social or emotional functioning,
mental processing, or physical health of an
older individual.”

31.  Many experts suggest that it is the rhythm of the
music or the beat that has the calming effect on us
although we may not be very conscious about it.
 Among the first stress-fighting changes that take
place when we hear a tune is an increase in deep
breathing. The body's production of serotonin also
accelerates.
 The Older Americans Act authorizes grants to states
to provide music therapy as a supportive service to
enable older persons to attain and maintain well-
being.

32. Imagery:
 Formation of mental concepts, figures and
ideas applied therapeutically to decrease
anxiety. Mental process and a variety of
procedures to encourage changes in attitudes,
behavior, or physiologic reactions.
 It is a process of incorporating the "power of the
mind" to assist the body to heal, maintain health
or relax by way of an inner communication
involving all senses, (i.e. visual, touch, smell,
sight, sound). It forms a balance between the
mind, body and spirit.

33.  It uses the conscious mind to create mental
images to evoke physical changes in the body,
improve sense of well being and enhance self
awareness. It is of two types:
 self directed ( individual creates his own mental
images)
 guided ( practitioner leads the individual through
the particular scenario)

34. Technique of guided imagery:
 A common guided imagery technique begins
with a general relaxation process asking the
person to slowly close their eyes and focus on
their breathing. They are encouraged to relax,
clear their mind, and surround themselves in
images that are peaceful and calm.
 Guided imagery may be practiced independently,
with a coach or with an audio or videotape.
 Guided imagery provides an opportunity for
people to directly focus on positive thoughts and
images, thus allowing a much welcomed
"temporary mental escape". People often call
imagery their "mini vacation in their mind."

35.  audio guidance
 visual guidance
 olfactory guidance

36. Clinical applications
 Control or relief of pain
 Decrease blood pressure
 Decrease blood glucose levels (Diabetes)
 Decrease allergy and respiratory symptoms
 Decrease the severity of headaches
 achieve calmness and serenity
 treatment of chronic conditions as asthma,
hypertension and GI disorders

37.  Limitations :of guided imagery
 Least clearly defined intervention, can range
from being highly structured to consisting of
day dreaming by the individual.

38. Art therapy:
 A form of expressive therapy that uses art
materials, such as paints, chalk and markers.
 Based on the belief that the creative process of
art is both healing and life-enhancing.
 Helps the client to:
 Increase insight and judgment,
 Cope better with stress,
 Increase cognitive abilities,
 Have better relationships with family and
friends.

39. Goal :
 to improve or maintain mental health and
emotional well-being.
 Drawing, painting, sculpture and photography
are used.
 Therapist interpret the symbols and metaphors
form the creative work.
 “It’s not about being an artist, it’s about
using visual symbols to explore feeling and
emotions.....it’s about seeing feelings,
making them visible to yourself".

40. Uses
 For managers and staff under pressure
 For people who are generally stressed and
overworked
 For people with mental health problems
 For people with severe learning difficulties
 For children and young people who have
problems conforming in school and with personal
problems at home
 For people who feel they are problem free but
would like
the opportunity to explore issues within
themselves

41. Biofeedback:
 It helps the client to control the physiological functions that are
most difficult to control
 e.g. in stroke patients muscle recovery.
 It involves measuring a person’s bodily processes using
machinery that translates physiological functions into audio or
video signals conveying that information to him in a real time in
order to raise his awareness or conscience of the related
physiological functions.
 Parameters measured include HR, BP and oxygen saturation
etc. and skin temperature.
 Types of instrument used to do the measurement are:
 - EEG
 - ECG
 - EMG
 - Galvanic skin response training
 Uses in anxiety, migraine, raynaud’s syndrome and other GI

42. Laughter therapy:
 Types of therapy:
 Humor therapy (books, shows, movies, or
stories to encourage spontaneous discussion
of the patients own humorous experiences)
 Clown therapy (clowns perform personal
hygiene for others with the use of magic,
music, fun, joy)
 Laughter therapy (client's laughter triggers
are identified)

43.  How it works:
 By ensuring the inhalation of more oxygen, it
makes people feel better
 It decreases stress leading to lowered stiffness of
muscles - muscle relaxation
 gives a sense of well being because of release of
endorphins and neuropeptides
 very useful for patients of hypertension
 it also improves the immunity (increases level of
interferon)
 decreased incidences of cough and cold.

44. Laughter has innumerable other
benefits.
 It proves a potent anti-stress factor, decreases
asthmatic attacks, increases stamina, relives
arthritic pain, ensures good sleep and elevates
mood.
 Since the serotonin levels go up after laughter, it
is an effective antidote for depression too.
 Positive qualities are cultivated, thereby
removing negative emotions as jealousy, fear,
guilt and anger.

45. Hypnosis:
 Florida's "Hypnosis Law," defines hypnosis as
hypnotism, mesmerism, posthypnotic suggestion,
or any similar act or process which produces or is
intended to produce in any person any form of
induced sleep or trance in which the susceptibility
of the person's mind to suggestion or direction is
increased or is intended to be increased, where
such a condition is used or intended to be used in
the treatment of any human ill, disease, injury, or
for any other therapeutic purpose condition is used
or intended to be used in the treatment of any
human ill, disease, injury, or for any other
therapeutic purpose.

46.  All hypnosis is self hypnosis.
 It is important to identify this state, because it is
individual is typically more suggestible, or more
receptive to new ideas and initiation of new
behaviours.
 According to Erikson, “in hypnosis the limits of
one’s usual frame of reference and belief are
temporarily altered so that one can be receptive to
other patterns of association and modes of mental
functioning that are more conducive to problem
solving.”
 Has been shown to be helpful in the management

47.  Contraindicated in patient with cognitive
impairment.
 Hypnosis phases
 Preparation
 The first phase typically involves having the
subject sit or lie down and getting comfortable.
 Induction
 Induction takes the subject from normal
awareness to a state of enhanced relaxation.

48.  Deepening
 The deepening phase takes the subject from a
very relaxed state into the fully "hypnotized"
state, where conscious thinking is minimized
 Awakening
 The awakening phase is when the subject is
taken out of the hypnotic state. If the session is
to try to alleviate insomnia, then the subject is
encouraged to sleep, otherwise the subject is
brought back to a state of awareness with the
conscious mind fully reengaged.

49.  Length of an induction:
 Progressive Relaxation (PR)
 Rapid Induction (RI)
 With fear removed, most individuals can be
deeply hypnotized in 5-10 seconds.
 Not all people can be hypnotized, but about
10% of people respond exceptionally well.
 Recent research suggests that highly
hypnotizable people have high sensory and
perceptual gating abilities that allow them to
block some stimuli from awareness (Barnier,

50.  Disinhibition leads the subject to performing acts that he
would normally consider socially unacceptable or simply
would not do.
 General effects:
 Focused attention: a state is very similar to other states
of extreme concentration, where a person becomes
oblivious to his or her surroundings while lost in
thought.
 Suggestibility:
 Depth of hypnosis:
 Pupillary reflex
 An objective sign of hypnosis can be observed by a
pupillary reflex test. The subjects' pupils are usually

51.  Hypnotherapy is a term to describe the use of hypnosis
in a therapeutic context.
 Cessation of smoking (often in a single session) and
 The aid of weight loss (body sculpting).
 Psychologists and psychiatrists use hypnosis
predominantly for the treatment of Dissociative
disorders,
 Phobias,
 Habit change,
 Dépression and
Applications

52.  Post-traumatic syndromes
 Medicine and dentistry
 Education
 Surgery
 Entertainment
 Self-hypnosis
 Hypnosis in which a person hypnotizes himself or
herself without the assistance of another person to
serve as the hypnotist
 Most often used to help the self-hypnotist stay on
a diet, overcome smoking or some other addiction,
or to generally boost the hypnotized person's self-

53.  Waking hypnosis
 Involves altering the behaviour of a subject by
suggestion without inducing a trance. Related
to the placebo effect, a subject becomes
subconsciously convinced that what they are
being told is inevitable reality, for example that
the air in the room will cause them to swallow.

54.  Post hypnotic suggestions:
 "a person can act, some time later, on a
suggestion seeded during the hypnotic
session. Post-hypnotic suggestions can last for
a long time. A hypnotherapist told one of his
patients, who was also a friend: 'When I touch
you on the finger you will immediately be
hypnotized.' Fourteen years later, at a dinner
party, he touched him deliberately on the finger
and his head fell back against the chair."
 Potential dangers

55. • "A hypnotized patient will respond to a suggestion
literally. A suggestion that requires conscious
interpretation can have undesirable effects."

56. 3. BIOLOGICALLY BASED
THERPIES:

57. BIOLOGICALLY BASED
THERPIES:
 Alternative treatments that use substances found in
nature, such as:
 Botanicals
 Animal-derived extracts
 Vitamins
 Minerals
 Fatty acids
 Amino acids
 Proteins
 Prebiotics and probiotics

58.  Herbalism
 A traditional medicinal or folk medicine
practice based on the use of plants and plant
extracts.
 Also called as herbal medicine, herbology, and
phytotherapy.
 A number of traditions dominate the practice
of herbal medicine.
 Homeopathy, Naturopathy
 The Ayurvedic medicine system from India
 Chinese herbal medicine

59.  Photochemical derived from plants:
 Alkaloids: dramatic effect of CNS (e.g. caffeine
provides a mild lift, Datura cause severe intoxication
and even death.
 Quinine from Chincona, Morphine and Codeine from
the Poppy, and Digoxin from the Foxglove.

 Some of uses of herbs as therapy:
 Herbal bath: with hot water disperse the qualities of
herbs.
 Herbal wrap: body is enveloped in warm linen sheets
which have been soaked in a special blend of herbs.
 Aloe vera: heals burns,wounds;stimulates cell
regeneration and has antifungal, antibacterial and
antiviral properties.

60.  Apitherapy:
 Medical use of honey bee products. This can include the
use of honey, pollen, propolis, royal jelly and bee venom
.
 Bee venom is the most commonly used product, in
treatment of:
 Arthritis, bursitis, tendonitis
 Autoimmune diseases
 Dissolving scar tissue (e.g. keloids), Herpes zoster
(shingles), etc

 Mode of action:
 Contains active component melittin, which has a
powerful anti-inflammatory action

61. Color therapy:
 Color is simply light of varying wavelengths
and, as such, is a form of energy that is used in
Color Therapy.
 Light energy (color) affects all living cells, so it
can have a profound and healing effect on all
creation, human or otherwise
 Each color has its own specific wavelength and
vibration. These wavelengths resonate with
energies in different areas of the body.

62.  Methods used are:
 The placing of color silks on the body
 The directing of colored light on to the body
 Solarized water
 Meditation with color
 Color breathing

 There are seven main energy centers (chakras) of the
body which resonate with the seven rainbow colors.
 Good health and well being is achieved by a balance of
all these energy chakras.
 An appropriate color is used to balance each chakra.

64. Flower therapy:
 Dilute flower infusions used to treat emotional
conditions
 It is believed that harmful emotions were the main
cause of disease
 Each negative emotion is associated with a particular
plant.
 Flower Remedies and Essences are liquid
preparations created by boiling parts of plants in spring
water or by placing the flowers onto the surface of
spring water and leaving them to infuse by natural
sunlight for a period of time.
 Some examples:
 Rose- Cools mind and body, satisfies those that crave
attention

65.  4. MANIPULATIVE AND BODY
BASED THERAPIES:

66. Acupunctur
 The term "acupuncture" describes a family of
procedures involving the stimulation of
anatomical points on the body using a variety
of techniques. Acupuncture is among the oldest
healing practices in the world.
 Is one of the key components of traditional
Chinese medicine.

67.  Concept: It is based on the concept that
disease results from disruption in the flow of qi
and imbalance in the forces of yin and yang.
 Qi: represents the body’s vital energy which
flow through meridian or channels, Life force
proposed to regulate a person's spiritual,
emotional, mental, and physical health and to
be influenced by the opposing forces of yin
and yang.

68.  Yin and yang: The concept of two opposing
yet complementary forces described in
traditional Chinese medicine. Yin represents
cold, slow, or passive aspects of the person,
while yang represents hot, excited, or active
aspects.
 A major theory is that health is achieved through
balancing yin and yang and disease is caused by
an imbalance leading to a blockage in the flow of
qi.
 Technique of acupuncture: involves
penetrating the skin with thin, solid, metallic
needles that are manipulated by the hands or

69.  Mode of action: it is thought that acupuncture
needling releases endorphins and other
nerurotransmitters in the brain.

70.  Duration: Treatment may take place over a
period of several weeks or more.
 Uses: in vomiting and pain relief of cancer
patients.
 Risk and complications: Improper needle
placement, movement of the patient, or a defect
in the needle can cause soreness and pain during
treatment. Other complications are:
 Small bruises on the insertion site
 pneumothorax
 Infections and
 Punctured organs.

71.  Acupressure:
 It is pressing of the single point or specific points to
relieve pain and stress in a particular area of the
body.
 Concept: it is based on the same concept as that
of the acupuncture but unlike acupuncture,
acupressure does not involve the use of needles to
stimulate energy points along the meridians, but
employs pressure from the fingers and hands for
the same purpose. In stimulating the energy points
in this way, acupressure aims to remove energy
blocks which produce health problems.

72.  It is used as an adjunct therapy to either
acupuncture or massage.
 It promotes relaxation and comfort.
 Caution: should not be applied near areas of
fractures, broken bones or near blood clots,
wounds, sore and bruises

73. Massage therapy
 Acting and manipulating the patient's body soft
tissue - the skin, muscles, tendons, ligaments, and
fascia with pressure, tension, motion, or vibration
done manually or with mechanical aids.
 Used in
 Pain relief (e.g. back pain, headache)
 Reducing anxiety
 Depression and
 Temporarily reduction in blood pressure, heart rate,
and state anxiety etc.

74.  Encourage healing by
 Promoting the flow of blood and lymph,
 Relieving tension,
 Stimulating nerves, and
 Stretching and loosening muscles and connective tissue to
keep them elastic.
 Equipments used:
 Massage table
 Massage chair
 Massage oils: fractionated coconut oil, grape seed oil,
macadamia oil, sesame oil, pecan oil, and mustard oil.
Often uses olive oil as a base when used medicinally,
or almond oil when used as massage oil.

75. Massage methods:
 Ayurvedic Abhyanga massage: performed by one or
two therapists using a heated blend of herbal oils
that is believed to be based on the body's dosha.
The aim is to loosen the excess doshas through
techniques such as kneading, rubbing, and
squeezing.
 Bare foot deep tissues (can be used to sense and
manipulate tissue, release fascia, as well as search
for and attack trigger points).

76.  Bowen therapy: rolling type movement over
fascia, muscles, ligaments, tendons and joints.
It is said not to involve deep or prolonged
contact
 Breema: consists of rhythmical and gentle
leans and stretches while lying on the floor.

77. Alexander therapy:
 Alexander technique is actually a method
to relieve the pain and stress caused by
the way we have misused our body during
daily activities.
 The Alexander Technique, teaches people
to change dysfunctional movement
patterns by educating clients in how to
change their daily habits of movement and
posture to
 restore the correct relationship of head, neck,
and back
 promote proper balance, posture, and

78.  It assumes a connection between serious
physical problems and faulty posture in sitting,
standing, and moving.
 Through awareness, movement, and touch, the
modality aims to interrupt habitual patterns of
posture.
Three primary things to remember in daily
movements:
 Think of freeing the neck
 Allow the head go up and forward
 Let the back lengthen and widen.
 E.g. Sitting and Standing

79.  Correct Way – Think of the shoulder as going
away from each other. Feet must be firmly
planted on the floor with sufficient width apart
(normally hip width).
 Do not - fold or wrap your feet. Don’t arch the
back and do not lean.

80. Aromatherapy:
 Aroma - fragrance or smell; therapy –
treatment
 "It is a holistic treatment of caring for the body
with pleasant smelling botanical oils such as
rose, lemon, lavender and peppermint.
 Uses Volatile liquid plant materials, known as
essential oils (Essential oils are aromatic
essences extracted from plants, flowers, trees,
fruits, bark, grasses and seeds).

81. Modes of application:
 Skin application (bath, massage)
 Inhaled directly
 Diffused to scent an entire room
 Oral, rectal, vaginal interfaces
 Mode of action:
 When inhaled, stimulates the olfactory nerves.
 Direct pharmacological effect of oil used.
 Used: for the relief of pain, care for the skin,
alleviate tension and fatigue and invigorate the
entire body

82. Essential oils contain chemical
components that can exert specific effects
on the mind and body
 Name of the
chemical
component
 Properties of the
chemical
component
 Essential oils that
contain the
chemical
 Aldehydes  Anti-inflammatory,
calming, sedative
 lemon grass, lemon
balm,
 Alcohols  Bactericidal, stimulant,
energizing, vitalizing
 Rose, rosewood,
peppermint, myrtle,
tea tree, sandalwood,
 Ketones  Wound healing,
mucolytic
 Camphor, rosemary

83. Chiropractic:
 Combines the Greek words cheir (hand) and
praxis (action) to describe a treatment done by
hand.
 Hands-on therapy–especially adjustment of the
spine–is central to chiropractic care.
Misalignments of the spine can interfere with the
flow of energy needed to support health.
Focuses on the relationship between the body's
structure–mainly the spine–and its functioning.

84.  Is based on these key concepts:
 Body has a powerful self-healing ability
 Body's structure (primarily that of the spine) and
its function are closely related, and this
relationship affects health.
 Therapy aims to normalize this relationship
between structure and function and assist the
body as it heals.

85.  The goal is to increase the range and quality
of motion in the area being treated and to aid
in restoring health
 The aim of such treatment is to restore a full
range of movement to the joints of the spine,
relax and lengthen muscles, tendons and
ligaments and relieve pain.

86.  Chiropractors may combine the use of spinal
adjustments with several other treatments:
 Heat and ice
 Electrical stimulation
 Rest
 Rehabilitative exercise
 Counseling about diet
 Side effects
 Temporary headaches, Tiredness or Discomfort in
parts of the body.

87. Rolfing:
 Technique of deep massage intended to realign the
body by altering the length and tone of myofascial
tissue.
 Basis of practice is the belief that misalignment of
myofascial tissue may have detrimental effect on
person’s energy level, self image, muscular efficiency
and general health.
 Pressure is applied with the fingers, knuckles, and
elbows.
 The Rolfing practitioner endeavors to manipulate and
stretch the body's fascial tissues to reestablish proper
physical alignment of the head, torso, pelvis, legs,
and feet and
 To promote associated mental and emotional
balance.

88. Magnetic therapy:
 Based on the principle that the earth is
one big magnet and that all our bodies
are surrounded by magnetic waves
emanating from the earth and other
spatial bodies including the sun and
moon.
 This natural magnetism influences and
supports all forms of life.
 Disease is therefore caused by the
imbalance between the various electro-
magnetic forces present within our

89.  Thus strategic placement of magnets on
specific parts of the body can cure chronic
ailments that standard medicine might find
difficult to control

90. Hydrotherapy:
 Treatment of disease by the use of water.
Specifically a method of treatment that attempts
to cure all diseases by the external (bath) or
internal (colonic irrigation) use of much water.
 Water can be in the form of ice, vapor, or liquid.
 Can be hot or cold water which is used.

91. Types
 Packing
 Hot air baths (Saunas)
 General baths
 Local baths
 Compress
 Used in:
 Musculoskeletal disorders (arthritis, ankylosing
spondylitis).
 Spinal cord injuries and
 In patients suffering burns, spasticity, stroke or
paralysis

92. Mech. of action:
 Heat is soothing, easing muscle tension and
relieving pain. Heat also improves circulation.
 Cold can either be stimulating or soothing.

93.  Examples
 A warm bath is soothing to the nerves and
helpful for bladder and urinary problems, mild
colds, and low fevers. Adding herbs helps to
soften and moisturize, and can stimulate or
relax.
 An alternating hot and cold footbath is said to
promote circulation in the legs, help varicose
veins, insomnia, headache and high blood
pressure.

94. Polarity therapy:
 A holistic health system developed by
Randolph Stone
 Polarity Therapy is a comprehensive health
system involving energy-based bodywork, diet,
exercise and self-awareness.
 Human Energy Field is affected by touch, diet,
movement, sound, attitudes, relationships, life
experience, trauma and environmental factors.

95.  Works on many different levels, influencing the
nervous, musculoskeletal, cardiovascular,
respiratory, gynecological and digestive
systems, as well as mental and emotional
health

96. Reflexology:
 Practice of massaging, squeezing, or
pushing on parts of the feet, or sometimes
the hands and ears, with the goal of
encouraging a beneficial effect on other
parts of the body, or to improve general
health.
 Uses same points as that of acupressure, to
improve nerve stimulation and circulation.
 Reflexology evolved from acupressure
which was part of the ancient healing
methods used by Egypt, India and China.

97. Osteopathy:
 Therapeutic approach that uses all forms of medical
diagnosis and therapy but places greater emphasis on
the influence of the relationship between the organ and
musculoskeletal system than conventional medicine.
 Osteopathy is a way of detecting and treating
damaged parts of the body such as muscles,
ligaments, nerves and joints.
 An osteopath employs many manual therapies for the
treatment of:
 Neuromusculoskeletal pain syndromes (low back pain,
tension headache etc.)
 Alongside exercise and other rehabilitative techniques.
 Attempts to treat conditions such as asthma, middle
ear infections in children, menstrual pain, and

98. Shiatsu:
 Uses thumb pressure and work along the same
energy meridians as acupressure and
incorporates stretching.
 Diagnosis and Therapy combined” is the ability of
the practitioner to use his sensory organs (palms,
fingers, and thumbs) to detect irregularities, such
as stiffness of the surface of the body, and to
promptly correct or heal these problems.
 Used in anxiety, headache, premenstrual
syndrome etc.

99. AYUSH:
 Ayurveda:
 Ayur = Life; Veda = Knowledge/wisdom
 Ayurveda: “the science of life”
 A system of medicine that originated in India
several thousand years ago.
 Two ancient books on palm leaves are first
books written for Ayurveda (i.e. Charak Samhita,
Charak susruta)
 Ayurveda and variations of it have also been
practiced for centuries in Pakistan, Nepal,
Bangladesh, Sri Lanka, and Tibet

100.  Aim is to integrate and balance the body,
mind, and spirit
 Philosophy is that people, their health, and
the universe are all related and health
problems can result when these relationships
are out of balance.
Herbs, metals, massage, and other products
and techniques are used with the intent of
cleansing the body and restoring balance.

101. Beliefs:
 Interconnectedness (among people, their health, and the
universe ):
 All the things are joined together
 Each human being has element that can be found in the
universe.
 All are born in a state of balance within themselves and in
relation to the universe.
Health will be good if one's interaction with the immediate
environment is effective.
 Constitution (Prakriti) and health:
 Three doshas control the constitution (i.e. vata, pitta, and
kapha )
 Each dosha is made up of one or two of the five basic
elements: space, air, fire, water, and earth.
 Each dosha has a particular relationship to body functions
 An imbalance in a dosha will produce symptoms that are

102. Vata dosha;
 Vata dosha: combination of the elements space and air.
 Most powerful dosha because it controls very basic
body processes such as cell division, the heart,
breathing, and the mind
 People with vata dosha are more susceptible to skin,
neurological and mental diseases.
Pitta dosha:
 Elements fire and water.
 Control hormones and the digestive system.
 Pitta is upset by, for example, eating spicy or sour food;
being angry, tired, or fearful; or spending too much time
in the sun.
 People with Pitta are more susceptible to heart

103. Kapha dosha:
 Elements water and earth
 Help to keep up strength and immunity and to
control growth
 Aggravated by, for example, sleeping during the
daytime, eating too many sweet foods
 People with kapha dosha are more susceptible
to gallbladder problems, stomach ulcers, and
respiratory illnesses such as asthma.

104. Treatment goals:
 Eliminate impurities (Panchkarma): focuses on
respiratory and digestive tract. (enema, fasting,
inhalers)
 Reduce symptoms: yoga, meditation, breathing
exercises etc., herbs with honey to improve digestion
and reduce fever.
 Reduce worry and increase harmony in the patient’s
life: yoga, meditation
 Eliminate both physical and psychological problems
Some examples of use of plants
 Spice turmeric is used in Rheumatoid arthritis,
Alzheimer’s disease and wound healing.
 A mixture (Arogyawardhini) of sulfur, iron, powdered
dried fruits, tree root, and other substances has been
used to treat problems of the liver.

105. Ayurveda colleges in INDIA:
 Total no. of Ayurvedic colleges – 196.
 Maximum no in Karnataka.
 Provides degree course in BAMS (bachelor of
Ayurvedic medicine and surgery).
 Total duration is 41/2 +1 yr internship.
Yoga:
 Derived from Sanskrit word: Yuj- to unite or to control.
 An Indian practice that includes postures (asana),
breathing exercises (pranayama), and cleansing
practices (kriyas)
 Yoga is an ancient Indian practice using physical
postures to obtain a harmony of mind, body and spirit.
 It is not a religion, but the discipline of breathing and
concentration during practice will bring tranquility and

106. How does it work?
 Increased oxygenation of the blood
 Muscle toning throughout the body
 A clearer and more relaxed mind
 Improved posture
 Improved circulation of blood and lymph
 Regulation of bodily functions
Goal of yoga:
 It range from improving health and fitness, to reaching
Moksha.
 Moksha: liberation from all worldly suffering and the cycle of
birth and death (Samsara) at which point there is a
realization of identity with the Supreme Brahman.
Main branches of Yoga:
 Hatha Yoga- Yoga of purifying physical and mind
 Karma Yoga- Yoga of action
 Jhana Yoga- Yoga of knowledge
 Bhakti Yoga- Yoga of devotion

107. Eight Limbs of yoga practice are:
 Yama
 Niyama
 Asna
 Pranama
 Pratyahara
 Dharna
 Dhyana
 Samadhi
 E.g. of asnas and how they help?
 Trikonasana: Stretches the spine, opens the torso, and
improves balance and concentration.

108. Unani medicine:
 It is influenced by Islam.
 It has a base of honey which is considered to
have healing properties and used in medicine
and food practiced in Islamic world.
 Based on theory of the presence of the
elements (in Unani, they are considered to be
fire, water, earth and air) in the human body.
 Pearls and metal are also used in making
medicines.

109. Unani colleges in INDIA:
 Total no. of unani colleges- 45
 Under graduation- 37
 Post graduation-08.
 Gives degree course in BUMS (bachelor of unani
medicine and surgery), duration is 41/2 yrs. +1 yr
internship.
 DELHI:
 AYURVEDA AND UNANI TIBBIA COLLEGE (karol
bagh). Seats-40
 FACULTY OF MEDICINE, JAMIA HAMDARD
NAGAR, ND. Seats- 50

110. Siddha medicine:
 Siddha means the “one who is accomplished”
or who has attained “siddhi”.
 Siddhi - the attainment of flawless identity
with Reality (Brahman); perfection of Spirit."
 Perfected masters, who have transcended the
ahamkara, are called as Siddha.
 Oldest medicine system in India.

111.  Medicine professed and practiced by siddhars
who wrote their recipes on Palm leaves.
 Mainly developed by the Dravidians.
 Still practiced in south India.
 Medicine is made of the parts of the plants
and trees such as leaves, bark, stem, root etc
 Metals like gold, silver and iron powder are
used.

112.  Mode of action:
 Revitalizes and rejuvenates the organs, the
dysfunction of which is causing the disease.
This brings back normal functioning of the
organs.
 Maintains the ratio of Vata, Pitta and Kapha.
 It works when Allopathy fails, e.g. in DM,
corrects the function of pancreas, stimulating
it to produce insulin in the natural way, which
in turn maintains the blood sugar level.

113. Siddha colleges in INDIA:
 Total no. of Siddha colleges- 7.
 No one in DELHI.
 BSMS( bachelor of Siddha medicine and
surgery),
 Under graduation
 Post graduation

114. Homeopathy
 Greek words homeo, meaning similar, and pathos,
meaning suffering or disease.
 Based on law of similars", (all effective drugs
produce symptoms in healthy individuals similar to
those of the diseases that they can treat).
 History:
 In the late 1700s, Samuel Hahnemann proposed a
new approach to treatment.

 Tested cinchona bark on himself and found the “law
of similars.”

115.  Key concepts
 Stimulate the body's defense mechanisms and
processes so as to prevent or treat illness.
 Giving very small doses of substances called
remedies that produce the similar symptoms of
illness in healthy people if they were given in larger
doses.
 Treatment in homeopathy is individualized (tailored
to each person).
 Preparation of remedies
 Dilution and succussion
 Centesimal or "C scale", diluting a substance 1 part in
a 100 of diluent at each stage.

116. Homeopathy colleges in INDIA:
 Total no of Colleges for BHMS (Bachelor of
homeopathic medicine and surgery) - 149.
 In DELHI: 3 colleges are there:
 GURU GOBIND SINGH INDRAPRASTHA
UNIVERSITY (diploma course in BHMS, duration is
3 yrs.)
 Dr.B.R. SUR HOMEOPATHY MEDICAL COLLEGE,
HOSPITAL AND RESEARCH CENTRE (degree
course in BHMS, duration is 41/2 yrs. + 1 yr.
Internship).
 NEHRU HOMEOPATHY MEDICAL COLLEGE AND
HOSPITAL (degree course in BHMS, duration 41/2

117. 4.ENERGY THERAPIES:
 Common assumptions/principles:
 Energy fields and currents exist everywhere in
nature.
 Energy systems function in their natural state.
 Energy flows smoothly without significant
blockage or fixation.
 Our physical, psychological and spiritual well-
being depends on the free and uninterrupted flow
of 'life energy' around the body
 When energy is unbalanced, blocked or fixed due
to stress or other factors, pain and disease arise.
 Energy therapies seek to find the blockages and
release energy to normal flow patterns, and to
maintain the Energy Field in an open, flexible

118. Reiki
 Derived Chinese word, rei- unseen or spiritual
and ki- life force or energy. (Universal life
energy)
 A form of spiritual practice.
 Derived from ancient Buddhist practices.
 Practitioner places his hands on or above the
body area and transfers, “universal life
energy” to the patient.

120. 5. Others:
1. Counselling
2. Grouptherapy
3. Prayer
4. Spirituality

121. NURSING AND ALTERNATIVE
MODALITIES OF CARE
 Nurses are in an excellent position to adopt
complementary/alternative modalities into
practice that addresses assessed client needs
and to use these techniques to achieve the
goals of nursing.

 Use of theory and nursing classification
systems help nurses and provide a context to
use these complementary/alternative
modalities professionally.

122. Nursing theory providing context
 Alternative/complementary modalities performed
from within a context of a nursing theory/model
take on meaning from within the theory.
 E.g. Roy adaptation model, deals with the
concept of focal, contextual and residual stimuli.
 Nurse working within the context of this, assesses
the stimuli and takes action to promote the client’s
adaptation in physiologic needs, self-concept, role
function, and relations of interdependence
nursing health and illness.

123.  With regard to contextual stimuli,
she uses Music therapy to
change the environment and
promote the client’s adaptation to
stressful situation.

124. Nursing taxonomy providing
the context
 Provide frameworks for naming and
documenting the phenomena of concern of
professional nursing.
 Use of CAM, this action becomes an identified
nursing intervention planned to address/remedy
a nursing problem or concern.
 E.g. fear related to undergoing medical
diagnostic procedures (concern), and use of
guided imagery becomes a useful nursing
intervention.

125.  Summary
 Definition
 Reason to use alternative therapies
 Classification
 Alternative medicines system
 Mind body intervention
 Biological based therapies
 Manipulative and body based
therapies
 Energy therapies
 Nursing and alternative modality of

126. THANK
YOU