Report on the Relaxation-WarmFeet®
Feedback Study
at Diabetes In Control
Birgitta
I. Rice, MS, RPh, CHES
The Relaxation – WarmFeet® feedback study was offered to
DiabetesInControl.com readers last year. Health professionals tested
a relaxation technique designed to improve blood flow to the feet. Their
clients included patients with limited peripheral circulation and leg
pain. Outcomes have been positive for pain relief and improvement of
neuropathic symptoms. Since this feedback study was offered over the
Internet, we had participants in the United States as well as internationally,
for example India and South Africa.
Method and results
To facilitate and strengthen the learning process, Assisted Thermal
Biofeedback was used in the relaxation training. Patients used a small
alcohol thermometer, which they attached to the fleshy side of the great
toe to measure skin temperature before and after relaxation. The process
of relaxation increases peripheral circulation, warming the tissues.
Patients were encouraged to imagine feeling the warmth and increase
on that feeling each time. They increased great toe temperature by 3
- 8 degrees F consistently. At home they relaxed 16 minutes a day and
kept a daily log of practice times and temperatures.
The most convincing clinical outcome was the 25-40% improvement in
neuropathic symptoms, specifically pain relief. Many patients reported
a comparatively rapid decrease in pain during the first two weeks of
treatment. Some patients reported that if they stopped using the WarmFeet®
technique, their symptoms and pain recurred within days. This is understandable,
of course, since the WarmFeet® therapy provided additional oxygen
and nutrients to the tissues in the feet, thus improving pain relief
and well-being.
Regarding patients
Most patients welcomed and accepted this complementary approach, being
grateful that no additional medications were necessary to get help.
Before initiating this form of therapy, proper counseling (answering
all the questions of patients) was done. When a patient becomes part
of or responsible for the outcome, it can present either positive or
negative reactions. For this reason it is of utmost value that the health
professional has an encouraging and hopeful attitude. This is of tremendous
value to this vulnerable population.
Some patients reported that the WarmFeet® therapy made them more
compliant with their medications, anti-diabetic, anti-hypertensive or
other prescribed care. This specific information is cited in the literature
as well. Many stress-relieving therapies promote a calmer outlook on
life and increased coping skills. For patients with diabetes, a decrease
in HbA1c values has also been shown with consistent stress management
(not measured in this feedback study).
Regarding health professionals
Many health professionals found that the patients they had hoped to
bring in to the study often did not fit the study intake criteria. If
the health professional was not part of a treatment team, but rather
a sole therapist, it became hard to replace that patient.
Health professionals who love their work display resourcefulness and
creativity in helping their patients. Because of this, having the knowledge
and access to many valuable therapies makes it easier to propose interventions
that fit each circumstance and patient. Many expressed appreciation
for being part of this study, and one of them said, “It has really
changed the way I treat my patients.”
Summary
Positive clinical outcomes from the Relaxation-WarmFeet® study were
1) distinct pain relief and 2) increased coping skills for patient participants.
When patients were asked what was the hardest part of the therapy, the
response was “to remember to sit down and relax”. This is
not a surprise. The same is true for other lifestyle or behavioral change
programs as well. With a dietary change, it is hard to remember what
to eat or not to eat. With a physical activity change, it is hard to
remember to exercise and it takes some time for change to show. However,
the WarmFeet® therapy provided measurable benefits such as pain
relief within a couple of weeks. The patient, taking on the responsibility
for his/her own well-being (by relaxing daily), also showed an encouraging
change in coping skills.
The WarmFeet® Kit which includes a guide to learn
to relax, an audio tape with instructions on one side and the Relaxation
technique on the other side, an alcohol thermometer for assisted thermal
biofeedback is now available at www.rx4betterhealth.com
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