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Animal-assisted therapies

Hippotherapy

Anthroposophical medicine

Description

Anthroposophical medicine was developed by the Austrian philosopher, Rudolph Steiner, the name derived from the Greek anthropos (human) and sophia (wisdom). It is based on the concept of body, mind and spirit/ego and encompasses the life-force/etheric body and the soul/astral body. Health equates to maintenance of equilibrium between the four parts, in conjunction with earth, water, fire and air and is dependent on the balance between catabolism (breakdown and use of energy) and anabolism (building and storing of energy). Anthroposophical medicine also recognizes three interconnected dynamic systems: the nervous system (spinal column, brain and nerves, responsible for thought and cognition), metabolic system (responsible for assimilation of nutrition, metabolism and movement of the limbs) and the rhythmic system (responsible for respiratory and circulatory systems, i.e. the rhythms of the body). The nervous and metabolic systems are polar opposites, while the rhythmic system maintains the balance between the two. Illness is viewed as a transformation, as part of the person’s destiny; failure to acknowledge this results in interference with the body/soul connection.

Anthroposophical medicine is normally practised by specially trained doctors and nurses and advocates a biodynamic, lacto-vegetarian diet, with unrefined carbohydrates. Foods are analogous with the human body; plant roots equate to the brain; stems/leaves equate to the rhythmic system; flowers/fruit equate to the metabolic system. Massage, hydrotherapy, eurhythmy, art, music therapy, homeopathic and herbal remedies are used as well as some conventional interventions. Consideration is given to seasonal and cosmic influences, i.e. solar, lunar and planetary influences, with treatments prescribed both for physical effects and as a catalyst in promoting the person’s life-force.

Bibliography

Arman M, Backman M. A longitudinal study on women’s experiences of life with breast cancer in anthroposophical (complementary) and conventional care. European Journal of Cancer Care. 2000;16(5):440-450.

Cysarz D, Heckmann C, Bettermann H, et al. Effects of an anthroposophical remedy on cardiorespiratory regulation. Alternative Therapies in Health and Medicine. 2002;8(6):78-83.

Ernst E. Anthroposophical medicine: a systematic review of randomised clinical trials. Wiener klinische Wochenschrift. 2004;116(4):128-130.

Fliostrup H, Swartz J, Bergstgrom A, et al. Allergic disease and sensitization in Steiner school children. Journal of Allergy and Clinical Immunology. 2006;117(1):59-66.

Grossarth-Maticek R, Kiene H, Baumgartner SM, et al. Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Alternative Therapies in Health and Medicine. 2001;7(3):57-66. 68–72

Hamre H, Becker-Witt C, Glockman A, et al. Anthroposophical therapies in chronic disease: the Anthroposophical Medicine Outcomes Study (AMOS). European Journal of Medical Research. 2004;9(7):351-360.

Hamre H, Fischer M, Heger M, et al. Anthroposophical vs. conventional therapy of acute respiratory and ear infections: a prospective outcomes study. Wiener klinische Wochenschrift. 2005;117(7–8):256-268.

Heusser P, Berger-Brauna S, Ziegler R. Palliative in-patient cancer treatment in an anthroposophical hospital: 1. Treatment patterns and compliance with anthroposophical medicine. Forschende Komplementärmedizin und Klassische Naturheilkunde. 2006;13(2):94-100.

Majorek M, Tüchelmann T, Heusser P. Therapeutic eurhythmy-movement therapy for children with attention deficit hyperactivity disorder (ADHD): a pilot study. Complementary Therapies in Nursing and Midwifery. 2004;10(1):46-53.

Van der Bie G, Huber M. Foundations of anthroposophical medicine: A training manual. Edinburgh: Floris Books; 2003.

Aromatherapy

Description

Aromatherapy is the therapeutic use of concentrated essential oils administered via the skin in massage, creams, gels and in water, via the respiratory tract in inhalations and vaporizers via mucous membranes, including rectally and vaginally, plus, occasionally gastrointestinally (aromatology). Therapeutic effects are thought to result from a combination of the chemical constituents, methods of administration and the effects of the aromas. The French chemist, Rene-Maurice Gattefosse (1881–1950) first used the term ‘aromatherapie’ and promoted essential oils as medical interventions after he burnt his hand in an accident and found that lavender oil relieved the pain and aided healing. The French surgeon Dr Jean Valnet (1920–1975) subsequently used essential oils effectively to treat wounded soldiers during the First World War and continued his research, teaching and practice almost until his death.

Essential oils are extracted most commonly by steam distillation, although other methods such as expression (for citrus essences) and solvent extraction (which produces an absolute) are also used. They contain hundreds of constituents with different therapeutic properties, grouped primarily into: alcohols (antiseptic, antiviral), aldehydes (antiseptic, sedative), coumarins (anticoagulant, hypotensive, phototoxic), esters (antifungal, antispasmodic, sedative), ketones (expectorant, mucolytic, analgesic, possibly emmenagogic), oxides (expectorant), terpenes – sub-divided into monoterpenes (antibacterial antiviral, analgesic), sesquiterpenes (antiinfective, antiinflammatory, antispasmodic) and diterpenes (antiinfective, expectorant), as well as phenols (antibacterial, stimulants) and some other constituents.

Evidence

There is both clinical and non-clinical evidence that essential oils are antibacterial, antiviral and antifungal and trials have demonstrated their effectiveness in combating methicillin resistant staphylococcus aureus (MRSA) and other major infections. Clinical studies have demonstrated the value of aromatherapy for labour and other types of pain, reducing blood pressure, anxiety, depression and insomnia but whether this is due to the essential oil chemistry or the method of administration has not yet been adequately verified. Many of the aromatherapy trials have investigated the concept of aromatherapy as a treatment modality, irrespective of the individual oils used. The number of studies on specific essential oils varies, with some, such as tea tree, having vast amounts of evidence, while others which are less well known or less commonly used, have very little, if any, literature to support them. References to clinical research, as well as some case reports, have been included here, where available; readers interested in non-clinical investigations of specific oils are referred to the Journal of Essential Oil Research as one particularly good resource.

Safety:

Essential oils should be stored in dark bottles at a cool temperature, to avoid deterioration and be kept away from children. Some oils such as citrus oils will deteriorate more quickly than others and have a shelf-life of about 3–6 months; they should be stored in the refrigerator. In the UK, oils are not normally ingested as it is not possible to determine the site and rate of absorption, nor can the majority of UK aromatherapists obtain indemnity insurance cover for administration by mouth (although French doctors prescribe oils orally). Oils should not normally be applied neat to the skin, as dermal sensitivity may occur, but should be diluted in a carrier oil, such as grapeseed or sweet almond (although some individuals may also be sensitive to certain carrier oils, particularly sweet almond). Blended oils should be discarded after about 4 weeks as oxidation (deterioration) may chemically alter the oil and its therapeutic properties.

Some oils should be avoided by people with abnormalities of blood pressure, as certain essential oils are hypotensive, while others are hypertensive. If used in large doses, certain oils, notably the citrus oils, may cause photosensitivity in susceptible people and in those taking drugs with similar side-effects. There are many essential oils which should not be used by pregnant or lactating women, as the effects on the fetus and the mother’s systemic condition are unknown; it is advisable to avoid all essential oils in pregnancy unless recommended by a suitably trained practitioner. Many oils should be used with caution in small children under 12 years of age and should never be used on babies under 3 months, as the antibacterial properties may adversely affect ongoing maturation of the immune system.

Dosages should range from 0.5–1% for children; 1–2% during pregnancy, labour and lactation and for patients compromised by illness or debilitating conditions; the normal dose for healthy adults is up to 3% ( a total of 3 drops of essential oil in each 5 mL of carrier/base oil). Care should be taken if the individual is prescribed any medication since the metabolism of essential oils is precisely the same as for pharmacological drugs and there is a theoretical possibility of drug–oil interactions.

Bibliography

Bastard J, Tiran D. Aromatherapy and massage for antenatal anxiety: its effect on the fetus. Complementary Therapies in Clinical Practice. 2006;12(1):48-54.

Burns E, Zobbi V, Panzeri D, et al. Aromatherapy in childbirth: a pilot randomised controlled trial. British Journal of Obstetrics and Gynaecology. 2007;114(7):838-844.

Hadfield N. The role of aromatherapy massage in reducing anxiety in patients with malignant brain tumours. International Journal of Palliative Nursing. 2001;7(6):279-285.

Hur MH, Oh H, Lee MS, et al. Effects of aromatherapy massage on blood pressure and lipid profile in Korean climacteric women. International Journal of Neuroscience. 2007;117(9):1281-1287.

Fellowes D, Barnes K, Wilkinson S. Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database of Systematic Reviews. (2):2004. CD002287

Kim JT, Ren CJ, Fielding GA, et al. Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding. Obstetric Surgery. 2007;17(7):920-925.

Kyle G. Evaluating the effectiveness of aromatherapy in reducing levels of anxiety in palliative care patients: results of a pilot study. Complementary Therapies in Clinical Practice. 2006;12(2):148-155.

Lee CO. Clinical aromatherapy Part II: Safe guidelines for integration into clinical practice. Clinical Journal of Oncology Nursing. 2003;7(5):597-598.

Lin PW, Chan WC, Ng BF, et al. Efficacy of aromatherapy (Lavandula angustifolia) as an intervention for agitated behaviours in Chinese older persons with dementia: a cross-over randomized trial. International Journal of Geriatric Psychiatry. 2007;22(5):405-410.

Lis-Balchin M. Possible health and safety problems in the use of novel plant essential oils and extracts in aromatherapy. Journal of the Royal Society of Health. 1999;4:240-243.

Lis-Balchin M. Aromatherapy science: a guide for healthcare professionals. London: Pharmaceutical Press; 2006.

Tiran D. Clinical Aromatherapy for Pregnancy and Childbirth, 2nd edn. Edinburgh: Churchill Livingstone; 2004.

Wilkinson SM, Love SB, Westcombe AM, et al. Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. Journal of Clinical Oncology. 2007;25(5):532-539.

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