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राखी का त्योहार कब शुरू हुआ यह कोई नहीं जानता। लेकिन भविष्य पुराण में वर्णन मिलता है कि देव और दानवों में जब युद्ध शुरू हुआ तब दानव हावी होते नज़र आने लगे। भगवान इन्द्र घबरा कर बृहस्पति के पास गये। वहां बैठी इन्द्र की पत्नी इंद्राणी सब सुन रही थी। उन्होंने रेशम का धागा मन्त्रों की शक्ति से पवित्र करके अपने पति के हाथ पर बाँध दिया। संयोग से वह श्रावण पूर्णिमा का दिन था। लोगों का विश्वास है कि इन्द्र इस लड़ाई में इसी धागे की मन्त्र शक्ति से ही विजयी हुए थे। उसी दिन से श्रावण पूर्णिमा के दिन यह धागा बाँधने की प्रथा चली आ रही है। यह धागा धन, शक्ति, हर्ष और विजय देने में पूरी तरह समर्थ माना जाता है।
स्कन्ध पुराण, पद्मपुराण और श्रीमद्भागवत में वामनावतार नामक कथा में रक्षाबन्धन का प्रसंग मिलता है। कथा कुछ इस प्रकार है- दानवेन्द्र राजा बलि ने जब 100 यज्ञ पूर्ण कर स्वर्ग का राज्य छीनने का प्रयत्न किया तो इन्द्र आदि देवताओं ने भगवान विष्णु से प्रार्थना की। तब भगवान वामन अवतार लेकर ब्राह्मण का वेष धारण कर राजा बलि से भिक्षा माँगने पहुँचे। गुरु के मना करने पर भी बलि ने तीन पग भूमि दान कर दी। भगवान ने तीन पग में सारा आकाश पाताल और धरती नापकर राजा बलि को रसातल में भेज दिया। इस प्रकार भगवान विष्णु द्वारा बलि राजा के अभिमान को चकनाचूर कर देने के कारण यह त्योहार बलेव नाम से भी प्रसिद्ध है। कहते हैं एक बार बाली रसातल में चला गया तब बलि ने अपनी भक्ति के बल से भगवान को रात-दिन अपने सामने रहने का वचन ले लिया। भगवान के घर न लौटने से परेशान लक्ष्मी जी को नारद जी ने एक उपाय बताया। उस उपाय का पालन करते हुए लक्ष्मी जी ने राजा बलि के पास जाकर उसे रक्षाबन्धन बांधकर अपना भाई बनाया और अपने पति भगवान बलि को अपने साथ ले आयीं। उस दिन श्रावण मास की पूर्णिमा तिथि थी। विष्णु पुराण के एक प्रसंग में कहा गया है कि श्रावण की पूर्णिमा के दिन भगवान विष्णु ने हयग्रीव के रूप में अवतार लेकर वेदों को ब्रह्मा के लिये फिर से प्राप्त किया था। हयग्रीव को विद्या और बुद्धि का प्रतीक माना जाता है।
राजपूत जब लड़ाई पर जाते थे तब महिलाएँ उनको माथे पर कुमकुम तिलक लगाने के साथ साथ हाथ में रेशमी धागा भी बाँधती थी। इस विश्वास के साथ कि यह धागा उन्हे विजयश्री के साथ वापस ले आयेगा। राखी के साथ एक और प्रसिद्ध कहानी जुड़ी हुई है। कहते हैं, मेवाड़ की रानी कर्मावती को बहादुरशाह द्वारा मेवाड़ पर हमला करने की पूर्व सूचना मिली। रानी लड़ऩे में असमर्थ थी अत: उसने मुगल बादशाह हुमायूँ को राखी भेज कर रक्षा की याचना की। हुमायूँ ने मुसलमान होते हुए भी राखी की लाज रखी और मेवाड़ पहुँच कर बहादुरशाह के विरूद्ध मेवाड़ की ओर से लड़ते हुए कर्मावती व उसके राज्य की रक्षा की। एक अन्य प्रसंगानुसार सिकन्दर की पत्नी ने अपने पति के हिन्दू शत्रु पुरूवास को राखी बाँधकर अपना मुँहबोला भाई बनाया और युद्ध के समय सिकन्दर को न मारने का वचन लिया। पुरूवास ने युद्ध के दौरान हाथ में बँधी राखी और अपनी बहन को दिये हुए वचन का सम्मान करते हुए सिकन्दर को जीवन-दान दिया।
महाभारत में भी इस बात का उल्लेख है कि जब ज्येष्ठ पाण्डव युधिष्ठिर ने भगवान कृष्ण से पूछा कि मैं सभी संकटों को कैसे पार कर सकता हूँ तब भगवान कृष्ण ने उनकी तथा उनकी सेना की रक्षा के लिये राखी का त्योहार मनाने की सलाह दी थी। उनका कहना था कि राखी के इस रेशमी धागे में वह शक्ति है जिससे आप हर आपत्ति से मुक्ति पा सकते हैं। इस समय द्रौपदी द्वारा कृष्ण को तथा कुन्ती द्वारा अभिमन्यु को राखी बाँधने के कई उल्लेख मिलते हैं। महाभारत में ही रक्षाबन्धन से सम्बन्धित कृष्ण और द्रौपदी का एक और वृत्तान्त भी मिलता है। जब कृष्ण ने सुदर्शन चक्र से शिशुपाल का वध किया तब उनकी तर्जनी में चोट आ गई। द्रौपदी ने उस समय अपनी साड़ी फाड़कर उनकी उँगली पर पट्टी बाँध दी। यह श्रावण मास की पूर्णिमा का दिन था। कृष्ण ने इस उपकार का बदला बाद में चीरहरण के समय उनकी साड़ी को बढ़ाकर चुकाया। कहते हैं परस्पर एक दूसरे की रक्षा और सहयोग की भावना रक्षाबन्धन के पर्व में यहीं से प्रारम्भ हुई , उत्तरांचल में इसे श्रावणी कहते हैं। इस दिन यजुर्वेदी द्विजों का उपकर्म होता है। उत्सर्जन, स्नान-विधि, ॠषि-तर्पणादि करके नवीन यज्ञोपवीत धारण किया जाता है। ब्राह्मणों का यह सर्वोपरि त्यौहार माना जाता है। वृत्तिवान् ब्राह्मण अपने यजमानों को यज्ञोपवीत तथा राखी देकर दक्षिणा लेते हैं।
अमरनाथ की अतिविख्यात धार्मिक यात्रा गुरु पूर्णिमा से प्रारम्भ होकर रक्षाबन्धन के दिन सम्पूर्ण होती है। कहते हैं इसी दिन यहाँ का हिमानी शिवलिंग भी अपने पूर्ण आकार को प्राप्त होता है। इस उपलक्ष्य में इस दिन अमरनाथ गुफा में प्रत्येक वर्ष मेले का आयोजन भी होता है।
महाराष्ट्र राज्य में यह त्योहार नारियल पूर्णिमा या श्रावणी के नाम से विख्यात है। इस दिन लोग नदी या समुद्र के तट पर जाकर अपने जनेऊ बदलते हैं और समुद्र की पूजा करते हैं। इस अवसर पर समुद्र के स्वामी वरुण देवता को प्रसन्न करने के लिये नारियल अर्पित करने की परम्परा भी है। यही कारण है कि इस एक दिन के लिये मुंबई के समुद्र तट नारियल के फलों से भर जाते हैं। राजस्थान में रामराखी और चूड़ाराखी या लूंबा बाँधने का रिवाज़ है। रामराखी सामान्य राखी से भिन्न होती है। इसमें लाल डोरे पर एक पीले छींटों वाला फुँदना लगा होता है। यह केवल भगवान को ही बाँधी जाती है। चूड़ा राखी भाभियों की चूड़ियों में बाँधी जाती है। जोधपुर में राखी के दिन केवल राखी ही नहीं बाँधी जाती, बल्कि दोपहर में पद्मसर और मिनकानाडी पर गोबर, मिट्टी और भस्मी से स्नान कर शरीर को शुद्ध किया जाता है। इसके बाद धर्म तथा वेदों के प्रवचनकर्त्ता अरुंधती, गणपति, दुर्गा, गोभिला तथा सप्तर्षियों के दर्भ के चट (पूजास्थल) बनाकर उनकी मन्त्रोच्चारण के साथ पूजा की जाती हैं। उनका तर्पण कर पितृॠण चुकाया जाता है। धार्मिक अनुष्ठान करने के बाद घर आकर हवन किया जाता है, वहीं रेशमी डोरे से राखी बनायी जाती है। राखी को कच्चे दूध से अभिमन्त्रित करते हैं और इसके बाद ही भोजन करने का प्रावधान है
तमिलनाडु, केरल, महाराष्ट्र और उड़ीसा के दक्षिण भारतीय ब्राह्मण इस पर्व को अवनि अवित्तम कहते हैं। यज्ञोपवीतधारी ब्राह्मणों के लिये यह दिन अत्यन्त महत्वपूर्ण है। इस दिन नदी या समुद्र के तट पर स्नान करने के बाद ऋषियों का तर्पण कर नया यज्ञोपवीत धारण किया जाता है। गये वर्ष के पुराने पापों को पुराने यज्ञोपवीत की भाँति त्याग देने और स्वच्छ नवीन यज्ञोपवीत की भाँति नया जीवन प्रारम्भ करने की प्रतिज्ञा ली जाती है। इस दिन यजुर्वेदीय ब्राह्मण 6 महीनों के लिये वेद का अध्ययन प्रारम्भ करते हैं। इस पर्व का एक नाम उपक्रमण भी है जिसका अर्थ है- नयी शुरुआत। व्रज में हरियाली तीज (श्रावण शुक्ल तृतीया) से श्रावणी पूर्णिमा तक समस्त मन्दिरों एवं घरों में ठाकुर झूले में विराजमान होते हैं। रक्षाबन्धन वाले दिन झूलन-दर्शन समाप्त होते हैं।
उत्तर प्रदेश :श्रावण मास की पूर्णिमा के दिन रक्षा बंधन का पर्व मनाया जाता है। रक्षा बंधन के अवसर पर बहिन अपना सम्पूर्ण प्यार रक्षा (राखी ) के रूप में अपने भाई की कलाई पर बांध कर उड़ेल देती है। भाई इस अवसर पर कुछ उपहार देकर भविष्य में संकट के समय सहायता देने का बचन देता है। प्रातः स्नानादि से निवृत्त होकर लड़कियाँ और महिलाएँ पूजा की थाली सजाती हैं। थाली में राखी के साथ रोली या हल्दी, चावल, दीपक, मिठाई और कुछ पैसे भी होते हैं। लड़के और पुरुष तैयार होकर टीका करवाने के लिये पूजा या किसी उपयुक्त स्थान पर बैठते हैं। पहले अभीष्ट देवता की पूजा की जाती है, इसके बाद रोली या हल्दी से भाई का टीका करके चावल को टीके पर लगाया जाता है और सिर पर छिड़का जाता है, उसकी आरती उतारी जाती है, दाहिनी कलाई पर राखी बाँधी जाती है और पैसों से न्यौछावर करके उन्हें गरीबों में बाँट दिया जाता है। भारत के अनेक प्रान्तों में भाई के कान के ऊपर भोजली या भुजरियाँ लगाने की प्रथा भी है। भाई बहन को उपहार या धन देता है। इस प्रकार रक्षाबन्धन के अनुष्ठान को पूरा करने के बाद ही भोजन किया जाता है। प्रत्येक पर्व की तरह उपहारों और खाने-पीने के विशेष पकवानों का महत्त्व रक्षाबन्धन में भी होता है। आमतौर पर दोपहर का भोजन महत्त्वपूर्ण होता है और रक्षाबन्धन का अनुष्ठान पूरा होने तक बहनों द्वारा व्रत रखने की भी परम्परा है। पुरोहित तथा आचार्य सुबह-सुबह यजमानों के घर पहुँचकर उन्हें राखी बाँधते हैं और बदले में धन, वस्त्र और भोजन आदि प्राप्त करते हैं। यह पर्व भारतीय समाज में इतनी व्यापकता और गहराई से समाया हुआ है ।
INDRA DEV AND RAKHI …
According to Bhavishya Purana, in the war between Gods and demons, Indra – the deity of sky, rains and thunderbolts – was disgraced by the powerful demon King Bali. Indra’s wife Sachi consulted Vishnu, who gave her a bracelet made of cotton thread, calling it holy. Sachi tied the holy thread around Indra wrist, blessed with her prayers for his well being and success. Indra successfully defeated the Bali and recovered Amaravati. This story inspired the protective power of holy thread. The story also suggests that the Raksha Bandhan thread in ancient India were amulets, used by women as prayers and to guard men going to war, and that these threads were not limited to sister-brother like relationships.
King Bali and Goddess Lakshmi
According to Bhagavata Purana and Vishnu Purana, after Vishnu won the three worlds from the demon King Bali, Bali asked Vishnu to stay with him in his palace, a request Vishnu granted. Vishnu’s wife, Goddess Lakshmi did not like the palace or his new found friendship with Bali, and preferred that her husband and she return to Vaikuntha. So she went to Bali, tied a rakhi and made him a brother to her. Bali asked her what gift she desired. Lakshmi asked that Vishnu be freed from the request that he live in Bali’s palace. Bali consented, as well accepted her as his sister.
Ganesha had two sons, Shubha and Labha. The two boys become frustrated that they have no sister to celebrate Raksha Bandhan with. They ask their father Ganesha for a sister, but to no avail. Finally, saint Narada appears who persuades Ganesha that a daughter will enrich him as well as his sons. Ganesha agreed, and created a daughter named Santoshi Maa by divine flames that emerged from Ganesh’s wives, Riddhi (Amazing) and Siddhi (Perfection). Thereafter, Shubha Labha (literally “Holy Profit”) had a sister named Santoshi Maa (literally “Goddess of Satisfaction”), to tie Rakhi over Raksha Bandhan.
Krishna and Draupadi
In the epic Mahabharat, Draupadi tied a rakhi on Krishna, while Kunti tied her rakhi on her grandson Abhimanyu, before the great war.
Yama and the Yamuna
According to another legend, Yama, the god of Death, had not visited his sister Yamuna for 12 years. Yamuna was sad and consulted Ganga. Ganga reminded Yama of his sister, upon which Yama visits her. Yamuna was overjoyed to see her brother, and prepared a bounty of food for Yama. The god Yama was delighted, and asked Yamuna what she wanted for a gift. She wished that he, her brother should return and see her again soon. Yama was moved by his sister’s love, agreed and to be able to see her again, and made river Yamuna immortal. This legend is the basis for a Raksha Bandhan-like festival called Bhai Duj in some parts of India, which also celebrates brother-sister love, but near Diwali.
Rakhi threads for sale in India
Raksha Bandhan is an ancient festival of the Indian subcontinent, and its history dates back thousands of years.
Alexander the Great and King Puru
According to one legendary narrative, when Alexander the Great invaded India in 326 BCE, Roxana (or Roshanak, his wife) sent a sacred thread to Porus, asking him not to harm her husband in battle. In accordance with tradition, Porus, the king of Kaikeya kingdom, gave full respect to the rakhi. In the Battle of the Hydaspes, when Porus saw the rakhi on his own wrist and restrained himself from attacking Alexander personally.
Rani Karnavati and Emperor Humayun
Another controversial historical account is that of Rani Karnavati of Chittor and Mughal Emperor Humayun, which dates to 1535 CE. When Rani Karnavati, the widowed queen of the king of Chittor, realised that she could not defend against the invasion by the Sultan of Gujarat, Bahadur Shah, she sent a rakhi to Emperor Humayun. The Emperor, according to one version of the story, set off with his troops to defend Chittor. He arrived too late, and Bahadur Shah had already captured the Rani’s fortress. Alternative accounts from the period, including those by historians in Humayun’s Mughal court, do not mention the rakhi episode and some historians have expressed skepticism whether it ever happened. Humayun’s own memoirs never mention this, and give different reasons for his war with Sultan Bahadur Shah of Gujarat in 1535.
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‘The Raki’ in ‘The Zenana’. by L. E. L.
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A child with cerebral palsy
Specialty Pediatrics, neurology, physiatry
Symptoms Poor coordination, stiff muscles, weak muscles, tremors
Complications Seizures, intellectual disability
Usual onset Early childhood
Causes Often unknown
Risk factors Preterm birth, being a twin, certain infections during pregnancy, difficult delivery
Diagnostic method Based on child’s development
Treatment Physical therapy, occupational therapy, speech therapy, external braces, orthopedic surgery
Medication Diazepam, baclofen, botulinum toxin
Frequency 2.1 per 1,000
Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. Signs and symptoms vary among people. Often, symptoms include poor coordination, stiff muscles, weak muscles and tremors. There may be problems with sensation, vision, hearing, swallowing and speaking. Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children of their age. Other symptoms include seizures and problems with thinking or reasoning, which each occur in about one third of people with CP. While symptoms may get more noticeable over the first few years of life, underlying problems do not worsen over time.
Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance and posture. Most often, the problems occur during pregnancy; however, they may also occur during childbirth or shortly after birth. Often, the cause is unknown. Risk factors include preterm birth, being a twin, certain infections during pregnancy such as toxoplasmosis or rubella, exposure to methylmercury during pregnancy, a difficult delivery and head trauma during the first few years of life, among others. About 2% of cases are believed to be due to an inherited genetic cause. A number of sub-types are classified based on the specific problems present. For example, those with stiff muscles have spastic cerebral palsy, those with poor coordination have ataxic cerebral palsy and those with writhing movements have athetoid cerebral palsy. Diagnosis is based on the child’s development over time. Blood tests and medical imaging may be used to rule out other possible causes.
CP is partly preventable through immunization of the mother and efforts to prevent head injuries in children such as through improved safety. There is no cure for CP; however, supportive treatments, medications and surgery may help many individuals. This may include physical therapy, occupational therapy and speech therapy. Medications such as diazepam, baclofen and botulinum toxin may help relax stiff muscles. Surgery may include lengthening muscles and cutting overly active nerves. Often, external braces and other assistive technology are helpful. Some affected children can achieve near normal adult lives with appropriate treatment. While alternative medicines are frequently used, there is no evidence to support their use.
Cerebral palsy is the most common movement disorder in children. It occurs in about 2.1 per 1,000 live births. Cerebral palsy has been documented throughout history, with the first known descriptions occurring in the work of Hippocrates in the 5th century BCE. Extensive study of the condition began in the 19th century by William John Little, after whom spastic diplegia was called “Little disease”. William Osler first named it “cerebral palsy” from the German zerebrale Kinderlähmung (cerebral child-paralysis). A number of potential treatments are being examined, including stem cell therapy. However, more research is required to determine if it is effective and safe.
Signs and symptoms
Cerebral palsy is defined as “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.” While movement problems are the central feature of CP, difficulties with thinking, learning, feeling, communication and behavior often co-occur, with 28% having epilepsy, 58% having difficulties with communication, at least 42% having problems with their vision, and 23–56% having learning disabilities. Muscle contractions in people with cerebral palsy are commonly thought to arise from overactivation.
Cerebral palsy is characterized by abnormal muscle tone, reflexes, or motor development and coordination. The neurological lesion is primary and permanent while orthopedic manifestations are secondary and progressive. In cerebral palsy unequal growth between muscle-tendon units and bone eventually leads to bone and joint deformities. At first deformities are dynamic. Over time, deformities tend to become static, and joint contractures develop. Deformities in general and static deformities in specific (joint contractures) cause increasing gait difficulties in the form of tip-toeing gait, due to tightness of the Achilles tendon, and scissoring gait, due to tightness of the hip adductors. These gait patterns are among the most common gait abnormalities in children with cerebral palsy. However, orthopaedic manifestations of cerebral palsy are diverse. The effects of cerebral palsy fall on a continuum of motor dysfunction, which may range from slight clumsiness at the mild end of the spectrum to impairments so severe that they render coordinated movement virtually impossible at the other end of the spectrum. Although most people with CP have problems with increased muscle tone, some have normal or low muscle tone. High muscle tone can either be due to spasticity or dystonia.
Babies born with severe cerebral palsy often have an irregular posture; their bodies may be either very floppy or very stiff. Birth defects, such as spinal curvature, a small jawbone, or a small head sometimes occur along with CP. Symptoms may appear or change as a child gets older. Babies born with cerebral palsy do not immediately present with symptoms.  Classically, CP becomes evident when the baby reaches the developmental stage at 6 to 9 months and is starting to mobilise, where preferential use of limbs, asymmetry, or gross motor developmental delay is seen.
Drooling is common among children with cerebral palsy, which can have a variety of impacts including social rejection, impaired speaking, damage to clothing and books, and mouth infections. It can additionally cause choking.
An average of 55.5% of people with cerebral palsy experience lower urinary tract symptoms, more commonly excessive storage issues than voiding issues. Those with voiding issues and pelvic floor overactivity can deteriorate as adults and experience upper urinary tract dysfunction.
Children with CP may also have sensory processing issues.`
Speech and language disorders are common in people with cerebral palsy. The incidence of dysarthria is estimated to range from 31% to 88%, and around a quarter of people with CP are non-verbal. Speech problems are associated with poor respiratory control, laryngeal and velopharyngeal dysfunction, and oral articulation disorders that are due to restricted movement in the oral-facial muscles. There are three major types of dysarthria in cerebral palsy: spastic, dyskinetic (athetosis), and ataxic.
Early use of augmentative and alternative communication systems may assist the child in developing spoken language skills. Overall language delay is associated with problems of cognition, deafness, and learned helplessness. Children with cerebral palsy are at risk of learned helplessness and becoming passive communicators, initiating little communication. Early intervention with this clientele, and their parents, often targets situations in which children communicate with others so that they learn that they can control people and objects in their environment through this communication, including making choices, decisions, and mistakes.
For bones to attain their normal shape and size, they require the stresses from normal musculature. People with cerebral palsy are at risk of low bone mineral density. The shafts of the bones are often thin (gracile), and become thinner during growth. When compared to these thin shafts (diaphyses), the centres (metaphyses) often appear quite enlarged (ballooning). Due to more than normal joint compression caused by muscular imbalances, articular cartilage may atrophy,:46 leading to narrowed joint spaces. Depending on the degree of spasticity, a person with CP may exhibit a variety of angular joint deformities. Because vertebral bodies need vertical gravitational loading forces to develop properly, spasticity and an abnormal gait can hinder proper or full bone and skeletal development. People with CP tend to be shorter in height than the average person because their bones are not allowed to grow to their full potential. Sometimes bones grow to different lengths, so the person may have one leg longer than the other.
Children with CP are prone to low trauma fractures, particularly children with higher GMFCS levels who cannot walk. This further affects a child’s mobility, strength, experience of pain, and can lead to missed schooling or child abuse suspicions. These children generally have fractures in the legs, whereas non-affected children mostly fracture their arms in the context of sporting activities.
Hip dislocation and ankle equinus or planter flexion deformity are the two most common deformities among children with cerebral palsy. Additionally, flexion deformity of the hip and knee can occur. Besides, torsional deformities of long bones such as the femur and tibia are encountered among others. Children may develop scoliosis before the age of 10 – estimated prevalence of scoliosis in children with CP is between 21% and 64%. Higher levels of impairment on the GMFCS are associated with scoliosis and hip dislocation. Scoliosis can be corrected with surgery, but CP makes surgical complications more likely, even with improved techniques. Hip migration can be managed by soft tissue procedures such as adductor musculature release. Advanced degrees of hip migration or dislocation can be managed by more extensive procedures such as femoral and pelvic corrective osteotomies. Both soft tissue and bony procedures aim at prevention of hip dislocation in the early phases or aim at hip containment and restoration of anatomy in the late phases of disease. Equinus deformity is managed by conservative methods especially when dynamic. If fixed/static deformity ensues surgery may become mandatory.
Growth spurts during puberty can make walking more difficult.
Pain and sleep
Pain is common and may result from the inherent deficits associated with the condition, along with the numerous procedures children typically face. When children with cerebral palsy are in pain, they experience worse muscle spasms. Pain is associated with tight or shortened muscles, abnormal posture, stiff joints, unsuitable orthosis, etc. Hip migration or dislocation is a recognizable source of pain in CP children and especially in the adolescent population. Nevertheless, the adequate scoring and scaling of pain in CP children remains challenging. There is also a high likelihood of chronic sleep disorders secondary to both physical and environmental factors. Children with cerebral palsy have significantly higher rates of sleep disturbance than typically developing children. Babies with cerebral palsy who have stiffness issues might cry more and be harder to put to sleep than non-disabled babies, or “floppy” babies might be lethargic. Chronic pain is under-recognized in children with cerebral palsy, even though 3 out of 4 children with cerebral palsy experience pain.
Due to sensory and motor impairments, those with CP may have difficulty preparing food, holding utensils, or chewing and swallowing. An infant with CP may not be able to suck, swallow or chew. Gastro-oesophageal reflux is common in children with CP. Children with CP may have too little or too much sensitivity around and in the mouth. Poor balance when sitting, lack of control of the head, mouth and trunk, not being able to bend the hips enough to allow the arms to stretch forward to reach and grasp food or utensils, and lack of hand-eye coordination can make self-feeding difficult. Feeding difficulties are related to higher GMFCS levels. Dental problems can also contribute to difficulties with eating. Pneumonia is also common where eating difficulties exist, caused by undetected aspiration of food or liquids. Fine finger dexterity, like that needed for picking up a utensil, is more frequently impaired than gross manual dexterity, like that needed for spooning food onto a plate.[non-primary source needed] Grip strength impairments are less common.[non-primary source needed]
Children with severe cerebral palsy, particularly with oropharyngeal issues, are at risk of undernutrition. Triceps skin fold tests have been found to be a very reliable indicator of malnutrition in children with cerebral palsy.
Associated disorders include “intellectual disabilities, seizures, muscle contractures, abnormal gait, osteoporosis, communication disorders, malnutrition, sleep disorders, and mental health disorders, such as depression and anxiety”. In addition to these, “functional gastrointestinal abnormalities contributing to bowel obstruction, vomiting, and constipation” may also arise. Adults with cerebral palsy may suffer from “ischemic heart disease, cerebrovascular disease, cancer, and trauma” more so than a non-affected population. Obesity in people with cerebral palsy or a more severe Gross Motor Function Classification System assessment in particular are considered risk factors for multimorbidity. Other medical issues can be mistaken for being symptoms of cerebral palsy, and so may not be treated correctly.
Related conditions can include apraxia, dysarthria or other communication disorders, sensory impairments, urinary incontinence, fecal incontinence, or behavioural disorders.
Seizure management is more difficult in people with CP as seizures often last longer.
The associated disorders that co-occur with cerebral palsy may be more disabling than the motor function problems.
refer to caption
Micrograph showing a fetal (placental) vein thrombosis, in a case of fetal thrombotic vasculopathy. This is associated with cerebral palsy and is suggestive of a hypercoagulable state as the underlying cause.
Cerebral palsy is due to abnormal development or damage occurring to the developing brain. This damage can occur during pregnancy, delivery, the first month of life, or less commonly in early childhood. Structural problems in the brain are seen in 80% of cases, most commonly within the white matter. More than three-quarters of cases are believed to result from issues that occur during pregnancy. Most children who are born with cerebral palsy have more than one risk factor associated with CP.
While in certain cases there is no identifiable cause, typical causes include problems in intrauterine development (e.g. exposure to radiation, infection, fetal growth restriction), hypoxia of the brain (thrombotic events, placental conditions), birth trauma during labor and delivery, and complications around birth or during childhood.
In Africa birth asphyxia, high bilirubin levels, and infections in newborns of the central nervous system are main cause. Many cases of CP in Africa could be prevented with better resources available.
Between 40% and 50% of all children who develop cerebral palsy were born prematurely. Most of these cases (75-90%) are believed due to issues that occur around the time of birth, often just after birth. Multiple-birth infants are also more likely than single-birth infants to have CP. They are also more likely to be born with a low birth weight.
In those who are born with a weight between 1 kg and 1.5 kg CP occurs in 6%. Among those born before 28 weeks of gestation it occurs in 11%. Genetic factors are believed to play an important role in prematurity and cerebral palsy generally. While in those who are born between 34 and 37 weeks the risk is 0.4% (three times normal).
In babies that are born at term risk factors include problems with the placenta, birth defects, low birth weight, breathing meconium into the lungs, a delivery requiring either the use of instruments or an emergency Caesarean section, birth asphyxia, seizures just after birth, respiratory distress syndrome, low blood sugar, and infections in the baby.
As of 2013, it was unclear how much of a role birth asphyxia plays as a cause. It is unclear if the size of the placenta plays a role.As of 2015 it is evident that in advantaged countries, most cases of cerebral palsy in term or near-term neonates have explanations other than asphyxia.
Autosomal recessive inheritance pattern.
About 2% of all CP cases are inherited, with glutamate decarboxylase-1 being one of the possible enzymes involved. Most inherited cases are autosomal recessive.
After birth, other causes include toxins, severe jaundice, lead poisoning, physical brain injury, stroke, abusive head trauma, incidents involving hypoxia to the brain (such as near drowning), and encephalitis or meningitis.
Infections in the mother, even those not easily detected, can triple the risk of the child developing cerebral palsy . Infections of the fetal membranes known as chorioamnionitis increases the risk.
Intrauterine and neonatal insults (many of which are infectious) increase the risk.
It has been hypothesised that some cases of cerebral palsy are caused by the death in very early pregnancy of an identical twin.
Rh blood type incompatibility can cause the mother’s immune system to attack the baby’s red blood cells.
The diagnosis of cerebral palsy has historically rested on the person’s history and physical examination. A general movements assessment, which involves measuring movements that occur spontaneously among those less than four months of age, appears most accurate. Children who are more severely affected are more likely to be noticed and diagnosed earlier. Abnormal muscle tone, delayed motor development and persistence of primitive reflexes are the main early symptoms of CP. Symptoms and diagnosis typically occur by the age of 2, although persons with milder forms of cerebral palsy may be over the age of 5, if not in adulthood, when finally diagnosed. It is a developmental disability.
Once a person is diagnosed with cerebral palsy, further diagnostic tests are optional. Neuroimaging with CT or MRI is warranted when the cause of a person’s cerebral palsy has not been established. An MRI is preferred over CT, due to diagnostic yield and safety. When abnormal, the neuroimaging study can suggest the timing of the initial damage. The CT or MRI is also capable of revealing treatable conditions, such as hydrocephalus, porencephaly, arteriovenous malformation, subdural hematomas and hygromas, and a vermian tumour (which a few studies suggest are present 5–22% of the time). Furthermore, an abnormal neuroimaging study indicates a high likelihood of associated conditions, such as epilepsy and intellectual disability. There is a small risk associated with sedating children in facilitate a clear MRI.
The age when CP is diagnosed is important, but medical professionals disagree over the best age to make the diagnosis. The earlier CP is diagnosed correctly, the better the opportunities are to provide the child with physical and educational help, but there might be a greater chance of confusing CP with another problem, especially if the child is 18 months of age or younger. Infants may have temporary problems with muscle tone or control that can be confused with CP, which is permanent. A metabolism disorder or tumors in the nervous system may appear to be CP; metabolic disorders, in particular, can produce brain problems that look like CP on an MRI. Disorders that deteriorate the white matter in the brain and problems that cause spasms and weakness in the legs, may be mistaken for CP if they first appear early in life. However, these disorders get worse over time, and CP does not (although it may change in character). In infancy it may not be possible to tell the difference between them. In the UK, not being able to sit independently by the age of 8 months is regarded as a clinical sign for further monitoring. Fragile X syndrome (a cause of autism and intellectual disability) and general intellectual disability must also be ruled out. Cerebral palsy specialist John McLaughlin recommends waiting until the child is 36 months of age before making a diagnosis, because by that age, motor capacity is easier to assess.
CP is classified by the types of motor impairment of the limbs or organs, and by restrictions to the activities an affected person may perform. The Gross Motor Function Classification System-Expanded and Revised and the Manual Ability Classification System are used to describe mobility and manual dexterity in people with cerebral palsy, and recently the Communication Function Classification System, and the Eating and Drinking Ability Classification System have been proposed to describe those functions. There are three main CP classifications by motor impairment: spastic, ataxic, and athetoid/dyskinetic. Additionally, there is a mixed type that shows a combination of features of the other types. These classifications reflect the areas of the brain that are damaged.
Cerebral palsy is also classified according to the topographic distribution of muscle spasticity. This method classifies children as diplegic, (bilateral involvement with leg involvement greater than arm involvement), hemiplegic (unilateral involvement), or quadriplegic (bilateral involvement with arm involvement equal to or greater than leg involvement).
Main article: Spastic cerebral palsy
Spastic cerebral palsy, or cerebral palsy where spasticity (muscle tightness) is the exclusive or almost exclusive impairment present, is by far the most common type of overall cerebral palsy, occurring in upwards of 70% of all cases. People with this type of CP are hypertonic and have what is essentially a neuromuscular mobility impairment (rather than hypotonia or paralysis) stemming from an upper motor neuron lesion in the brain as well as the corticospinal tract or the motor cortex. This damage impairs the ability of some nerve receptors in the spine to receive gamma-Aminobutyric acid properly, leading to hypertonia in the muscles signaled by those damaged nerves.
As compared to other types of CP, and especially as compared to hypotonic or paralytic mobility disabilities, spastic CP is typically more easily manageable by the person affected, and medical treatment can be pursued on a multitude of orthopedic and neurological fronts throughout life. In any form of spastic CP, clonus of the affected limb(s) may sometimes result, as well as muscle spasms resulting from the pain or stress of the tightness experienced. The spasticity can and usually does lead to a very early onset of muscle stress symptoms like arthritis and tendinitis, especially in ambulatory individuals in their mid-20s and early-30s. Occupational therapy and physical therapy regimens of assisted stretching, strengthening, functional tasks, or targeted physical activity and exercise are usually the chief ways to keep spastic CP well-managed. If the spasticity is too much for the person to handle, other remedies may be considered, such as antispasmodic medications, botulinum toxin, baclofen, or even a neurosurgery known as a selective dorsal rhizotomy (which eliminates the spasticity by reducing the excitatory neural response in the nerves causing it).
Main article: Ataxic cerebral palsy
Ataxic cerebral palsy is observed in approximately 5-10% of all cases of cerebral palsy, making it the least frequent form of cerebral palsy. Ataxic cerebral palsy is caused by damage to cerebellar structures. Because of the damage to the cerebellum, which is essential for coordinating muscle movements and balance, patients with ataxic cerebral palsy experience problems in coordination, specifically in their arms, legs, and trunk. Ataxic cerebral palsy is known to decrease muscle tone. The most common manifestation of ataxic cerebral palsy is intention (action) tremor, which is especially apparent when carrying out precise movements, such as tying shoe laces or writing with a pencil. This symptom gets progressively worse as the movement persists, making the hand shake. As the hand gets closer to accomplishing the intended task, the trembling intensifies, which makes it even more difficult to complete.
Main article: Athetoid cerebral palsy
Athetoid cerebral palsy or dyskinetic cerebral palsy (sometimes abbreviated ADCP) is primarily associated with damage to the basal ganglia in the form of lesions that occur during brain development due to bilirubin encephalopathy and hypoxic-ischemic brain injury. ADCP is characterized by both hypertonia and hypotonia, due to the affected individual’s inability to control muscle tone. Clinical diagnosis of ADCP typically occurs within 18 months of birth and is primarily based upon motor function and neuroimaging techniques. Athetoid dyskinetic cerebral palsy is a non-spastic, extrapyramidal form of cerebral palsy. Dyskinetic cerebral palsy can be divided into two different groups; choreoathetoid and dystonic. Choreo-athetotic CP is characterized by involuntary movements most predominantly found in the face and extremities. Dystonic ADCP is characterized by slow, strong contractions, which may occur locally or encompass the whole body.
Mixed cerebral palsy has symptoms of athetoid, ataxic and spastic CP appearing simultaneously, each to varying degrees, and both with and without symptoms of each. Mixed CP is the most difficult to treat as it is extremely heterogeneous and sometimes unpredictable in its symptoms and development over the lifespan.
Because the causes of CP are varied, a broad range of preventative interventions have been investigated.
Electronic fetal monitoring has not helped to prevent CP, and in 2014 the American College of Obstetricians and Gynecologists, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and the Society of Obstetricians and Gynaecologists of Canada have acknowledged that there are no long-term benefits of electronic fetal monitoring. Prior to this, electronic fetal monitoring was widely used to prop up obstetric litigation.
In those at risk of an early delivery, magnesium sulphate appears to decrease the risk of cerebral palsy. It is unclear if it helps those who are born at term. In those at high risk of preterm labor a review found that moderate to severe CP was reduced by the administration of magnesium sulphate, and that adverse effects on the babies from the magnesium sulphate were not significant. Mothers who received magnesium sulphate could experience side effects such as respiratory depression and nausea. However, guidelines for the use of magnesium sulfate in mothers at risk of preterm labour are not strongly adhered to. Caffeine is used to treat apnea of prematurity and reduces the risk of cerebral palsy in premature babies, but there are also concerns of long term negative effects. A moderate quality level of evidence indicates that giving women antibiotics during preterm labor before her membranes have ruptured (water is not yet not broken) may increase the risk of cerebral palsy for the child. Additionally, for preterm babies for whom there is a chance of fetal compromise, allowing the birth to proceed rather than trying to delay the birth may lead to an increased risk of cerebral palsy in the child. Corticosteroids are sometimes taken by pregnant women expecting a preterm birth to provide neuroprotection to their baby. Taking corticosteroids during pregnancy is shown to have no significant correlation with developing cerebral palsy in preterm births.
Cooling high-risk full-term babies shortly after birth may reduce disability, but this may only be useful for some forms of the brain damage that causes CP.
A girl wearing leg braces walks towards a woman in a gym, with a treadmill visible in the background.
Researchers are developing an electrical stimulation device specifically for children with cerebral palsy, who have foot drop, which causes tripping when walking.
Main article: Management of cerebral palsy
Over time, the approach to CP management has shifted away from narrow attempts to fix individual physical problems – such as spasticity in a particular limb – to making such treatments part of a larger goal of maximizing the person’s independence and community engagement.:886 Much of childhood therapy is aimed at improving gait and walking. Approximately 60% of people with CP are able to walk independently or with aids at adulthood. However, the evidence base for the effectiveness of intervention programs reflecting the philosophy of independence has not yet caught up: effective interventions for body structures and functions have a strong evidence base, but evidence is lacking for effective interventions targeted toward participation, environment, or personal factors. There is also no good evidence to show that an intervention that is effective at the body-specific level will result in an improvement at the activity level, or vice versa. Although such cross-over benefit might happen, not enough high-quality studies have been done to demonstrate it.
Because cerebral palsy has “varying severity and complexity” across the lifespan, it can be considered a collection of conditions for management purposes. A multidisciplinary approach for cerebral palsy management is recommended, focusing on “maximising individual function, choice and independence” in line with the International Classification of Functioning, Disability and Health’s goals. The team may include a paediatrician, a health visitor, a social worker, a physiotherapist, an orthotist, a speech and language therapist, an occupational therapist, a teacher specialising in helping children with visual impairment, an educational psychologist, an orthopaedic surgeon, a neurologist and a neurosurgeon.
Various forms of therapy are available to people living with cerebral palsy as well as caregivers and parents. Treatment may include one or more of the following: physical therapy; occupational therapy; speech therapy; water therapy; drugs to control seizures, alleviate pain, or relax muscle spasms (e.g. benzodiazepines); surgery to correct anatomical abnormalities or release tight muscles; braces and other orthotic devices; rolling walkers; and communication aids such as computers with attached voice synthesisers. A Cochrane review published in 2004 found a trend toward benefit of speech and language therapy for children with cerebral palsy, but noted the need for high quality research. A 2013 systematic review found that many of the therapies used to treat CP have no good evidence base; the treatments with the best evidence are medications (anticonvulsants, botulinum toxin, bisphosphonates, diazepam), therapy (bimanual training, casting, constraint-induced movement therapy, context-focused therapy, fitness training, goal-directed training, hip surveillance, home programmes, occupational therapy after botulinum toxin, pressure care) and surgery. Surgical intervention in CP children mainly includes orthopaedic surgery and neurosurgery (selective dorsal rhizotomy).
CP is not a progressive disorder (meaning the brain damage does not worsen), but the symptoms can become more severe over time. A person with the disorder may improve somewhat during childhood if he or she receives extensive care, but once bones and musculature become more established, orthopedic surgery may be required. People with CP can have varying degrees of cognitive impairment or none whatsoever. The full intellectual potential of a child born with CP is often not known until the child starts school. People with CP are more likely to have learning disorders, but have normal intelligence. Intellectual level among people with CP varies from genius to intellectually disabled, as it does in the general population, and experts have stated that it is important not to underestimate the capabilities of a person with CP and to give them every opportunity to learn.
The ability to live independently with CP varies widely, depending partly on the severity of each person’s impairment and partly on the capability of each person to self-manage the logistics of life. Some individuals with CP require personal assistant services for all activities of daily living. Others only need assistance with certain activities, and still others do not require any physical assistance. But regardless of the severity of a person’s physical impairment, a person’s ability to live independently often depends primarily on the person’s capacity to manage the physical realities of his or her life autonomously. In some cases, people with CP recruit, hire, and manage a staff of personal care assistants (PCAs). PCAs facilitate the independence of their employers by assisting them with their daily personal needs in a way that allows them to maintain control over their lives.
Puberty in young adults with cerebral palsy may be precocious or delayed. Delayed puberty is thought to be a consequence of nutritional deficiencies. There is currently no evidence that CP affects fertility, although some of the secondary symptoms have been shown to affect sexual desire and performance. Adults with CP were less likely to get routine reproductive health screening as of 2005. Gynecological examinations may have to be performed under anesthesia due to spasticity, and equipment is often not accessible. Breast self-examination may be difficult, so partners or carers may have to perform it. Women with CP reported higher levels of spasticity and urinary incontinence during menstruation in a study. Men with CP have higher levels of cryptorchidism at the age of 21.
CP can significantly reduce a person’s life expectancy, depending on the severity of their condition and the quality of care they receive. 5-10% of children with CP die in childhood, particularly where seizures and intellectual disability also affect the child. The ability to ambulate, roll, and self-feed has been associated with increased life expectancy. While there is a lot of variation in how CP affects people, it has been found that “independent gross motor functional ability is a very strong determinant of life expectancy”. According to the Australian Bureau of Statistics, in 2014, 104 Australians died of cerebral palsy. The most common causes of death in CP are related to respiratory causes, but in middle age cardiovascular issues and neoplastic disorders become more prominent.
For many children with CP, parents are heavily involved in self-care activities. Self-care activities, such as bathing, dressing, grooming, can be difficult for children with CP as self-care depends primarily on use of the upper limbs. For those living with CP, impaired upper limb function affects almost 50% of children and is considered the main factor contributing to decreased activity and participation. As the hands are used for many self-care tasks, sensory and motor impairments of the hands make daily self-care more difficult.[non-primary source needed][non-primary source needed] Motor impairments cause more problems than sensory impairments.[non-primary source needed] The most common impairment is that of finger dexterity, which is the ability to manipulate small objects with the fingers.[non-primary source needed] Compared to other disabilities, people with cerebral palsy generally need more help in performing daily tasks.
The effects of sensory, motor and cognitive impairments affect self-care occupations in children with CP and productivity occupations. Productivity can include, but is not limited to, school, work, household chores or contributing to the community.
Play is included as a productive occupation as it is often the primary activity for children. If play becomes difficult due to a disability, like CP, this can cause problems for the child. These difficulties can affect a child’s self-esteem. In addition, the sensory and motor problems experienced by children with CP affect how the child interacts with their surroundings, including the environment and other people. Not only do physical limitations affect a child’s ability to play, the limitations perceived by the child’s caregivers and playmates also affect the child’s play activities. Some children with disabilities spend more time playing by themselves. When a disability prevents a child from playing, there may be social, emotional and psychological problems, which can lead to increased dependence on others, less motivation, and poor social skills.
In school, students are asked to complete many tasks and activities, many of which involve handwriting. Many children with CP have the capacity to learn and write in the school environment. However, students with CP may find it difficult to keep up with the handwriting demands of school and their writing may be difficult to read. In addition, writing may take longer and require greater effort on the student’s part. Factors linked to handwriting include postural stability, sensory and perceptual abilities of the hand, and writing tool pressure.
Speech impairments may be seen in children with CP depending on the severity of brain damage. Communication in a school setting is important because communicating with peers and teachers is very much a part of the “school experience” and enhances social interaction. Problems with language or motor dysfunction can lead to underestimating a student’s intelligence. In summary, children with CP may experience difficulties in school, such as difficulty with handwriting, carrying out school activities, communicating verbally and interacting socially.
Leisure activities can have several positive effects on physical health, mental health, life satisfaction and psychological growth for people with physical disabilities like CP. Common benefits identified are stress reduction, development of coping skills, companionship, enjoyment, relaxation and a positive effect on life satisfaction. In addition, for children with CP, leisure appears to enhance adjustment to living with a disability.
Leisure can be divided into structured (formal) and unstructured (informal) activities. Children and teens with CP engage in less habitual physical activity than their peers. Children with CP primarily engage in physical activity through therapies aimed at managing their CP, or through organized sport for people with disabilities. It is difficult to sustain behavioural change in terms of increasing physical activity of children with CP. Gender, manual dexterity, the child’s preferences, cognitive impairment and epilepsy were found to affect children’s leisure activities, with manual dexterity associated with more leisure activity. Although leisure is important for children with CP, they may have difficulties carrying out leisure activities due to social and physical barriers.
Participation and barriers
Participation is involvement in life situations and everyday activities. Participation includes self-care, productivity, and leisure. In fact, communication, mobility, education, home life, leisure and social relationships require participation, and indicate the extent to which children function in their environment. Barriers can exist on three levels: micro, meso and macro. First, the barriers at the micro level involve the person. Barriers at the micro level include the child’s physical limitations (motor, sensory and cognitive impairments) or their subjective feelings regarding their ability to participate. For example, the child may not participate in group activities due to lack of confidence. Second, barriers at the meso level include the family and community. These may include negative attitudes of people toward disability or lack of support within the family or in the community. One of the main reasons for this limited support appears to be the result of a lack of awareness and knowledge regarding the child’s ability to engage in activities despite his or her disability. Third, barriers at the macro level incorporate the systems and policies that are not in place or hinder children with CP. These may be environmental barriers to participation such as architectural barriers, lack of relevant assistive technology and transportation difficulties due to limited wheelchair access or public transit that can accommodate children with CP. For example, a building without an elevator can prevent the child from accessing higher floors.
A 2013 review stated that outcomes for adults with cerebral palsy without intellectual disability in the 2000s were that “60-80% completed high school, 14-25% completed college, up to 61% were living independently in the community, 25-55% were competitively employed, and 14-28% were involved in long term relationships with partners or had established families”. Adults with cerebral palsy may not seek physical therapy due to transport issues, financial restrictions and practitioners not feeling like they know enough about cerebral palsy to take people with CP on as clients.
A study in young adults (18-34) on transitioning to adulthood found that their concerns were physical health care and understanding their bodies, being able to navigate and use services and supports successfully, and dealing with prejudices. A feeling of being “thrust into adulthood” was common in the study.
Children with CP may not successfully transition into using adult services because they are not referred to one upon turning 18, and may decrease their use of services. Because children with cerebral palsy are often told that it is a non-progressive disease, they may be unprepared for the greater effects of the aging process as they head into their 30s. Young adults with cerebral palsy experience problems with aging that able-bodied adults experience “much later in life”.:42 25% or more adults with cerebral palsy who can walk experience increasing difficulties walking with age. Chronic disease risk, such as obesity, is also higher among adults with cerebral palsy than the general population. Common problems include increased pain, reduced flexibility, increased spasms and contractures, post-impairment syndrome, and increasing problems with balance. Increased fatigue is also a problem. When adulthood and cerebral palsy is discussed, as of 2011, it is not discussed in terms of the different stages of adulthood.
Like they did in childhood, adults with cerebral palsy experience psychosocial issues related to their CP, chiefly the need for social support, self-acceptance, and acceptance by others. Workplace accommodations may be needed to enhance continued employment for adults with CP as they age. Rehabilitation or social programs that include Salutogenesis may improve the coping potential of adults with CP as they age.
Cerebral palsy occurs in about 2.1 per 1000 live births. In those born at term rates are lower at 1 per 1000 live births. Rates appear to be similar in both the developing and developed world. Within a population it may occur more often in poorer people. The rate is higher in males than in females; in Europe it is 1.3 times more common in males. Variances in reported rates of incidence or prevalence across different geographical areas in industrialised countries are thought to be caused primarily by discrepancies in the criteria used for inclusion and exclusion. When such discrepancies are accounted for in comparing two or more registers of patients with cerebral palsy (for example, the extent to which children with mild cerebral palsy are included), prevalence rates converge toward the average rate of 2:1000.
There was a “moderate, but significant” rise in the prevalence of CP between the 1970s and 1990s. This is thought to be due to a rise in low birth weight of infants and the increased survival rate of these infants. The increased survival rate of infants with CP in the 1970s and 80s may be indirectly due to the disability rights movement challenging perspectives around the worth of infants with disability, as well as the Baby Doe Law.
As of 2005, advances in care of pregnant mothers and their babies has not resulted in a noticeable decrease in CP. This is generally attributed to medical advances in areas related to the care of premature babies (which results in a greater survival rate). Only the introduction of quality medical care to locations with less-than-adequate medical care has shown any decreases. The incidence of CP increases with premature or very low-weight babies regardless of the quality of care. As of 2016, there is a suggestion that both incidence and severity are slightly decreasing – more research is needed to find out if this is significant, and if so, which interventions are effective.
Prevalence of cerebral palsy is best calculated around the school entry age of about 6 years, the prevalence in the U.S. is estimated to be 2.4 out of 1000 children.
Cerebral palsy has affected humans since antiquity. A decorated grave marker dating from around the 15th to 14th century BCE shows a figure with one small leg and using a crutch, possibly due to cerebral palsy. The oldest likely physical evidence of the condition comes from the mummy of Siptah, an Egyptian Pharaoh who ruled from about 1196 to 1190 BCE and died at about 20 years of age. The presence of cerebral palsy has been suspected due to his deformed foot and hands.
The medical literature of the ancient Greeks discusses paralysis and weakness of the arms and legs; the modern word palsy comes from the Ancient Greek words παράλυση or πάρεση, meaning paralysis or paresis respectively. The works of the school of Hippocrates (460–c. 370 BCE), and the manuscript On the Sacred Disease in particular, describe a group of problems that matches up very well with the modern understanding of cerebral palsy. The Roman Emperor Claudius (10 BCE–54 CE) is suspected of having CP, as historical records describe him as having several physical problems in line with the condition. Medical historians have begun to suspect and find depictions of CP in much later art. Several paintings from the 16th century and later show individuals with problems consistent with it, such as Jusepe de Ribera’s 1642 painting The Clubfoot.
The modern understanding of CP as resulting from problems within the brain began in the early decades of the 1800s with a number of publications on brain abnormalities by Johann Christian Reil, Claude François Lallemand and Philippe Pinel. Later physicians used this research to connect problems in the brain with specific symptoms. The English surgeon William John Little (1810–1894) was the first person to study CP extensively. In his doctoral thesis he stated that CP was a result of a problem around the time of birth. He later identified a difficult delivery, a preterm birth and perinatal asphyxia in particular as risk factors. The spastic diplegia form of CP came to be known as Little’s disease. At around this time, a German surgeon was also working on cerebral palsy, and distinguished it from polio. In the 1880s British neurologist William Gowers built on Little’s work by linking paralysis in newborns to difficult births. He named the problem “birth palsy” and classified birth palsies into two types: peripheral and cerebral.
Working in Pennsylvania in the 1880s, Canadian-born physician William Osler (1849–1919) reviewed dozens of CP cases to further classify the disorders by the site of the problems on the body and by the underlying cause. Osler made further observations tying problems around the time of delivery with CP, and concluded that problems causing bleeding inside the brain were likely the root cause. Osler also suspected polioencephalitis as an infectious cause. Through the 1890s, scientists commonly confused CP with polio.
Before moving to psychiatry, Austrian neurologist Sigmund Freud (1856–1939) made further refinements to the classification of the disorder. He produced the system still being used today. Freud’s system divides the causes of the disorder into problems present at birth, problems that develop during birth, and problems after birth. Freud also made a rough correlation between the location of the problem inside the brain and the location of the affected limbs on the body, and documented the many kinds of movement disorders.
In the early 20th century, the attention of the medical community generally turned away from CP until orthopedic surgeon Winthrop Phelps became the first physician to treat the disorder. He viewed CP from a musculoskeletal perspective instead of a neurological one. Phelps developed surgical techniques for operating on the muscles to address issues such as spasticity and muscle rigidity. Hungarian physical rehabilitation practitioner András Pető developed a system to teach children with CP how to walk and perform other basic movements. Pető’s system became the foundation for conductive education, widely used for children with CP today. Through the remaining decades, physical therapy for CP has evolved, and has become a core component of the CP management program.
In 1997, Robert Palisano et al. introduced the Gross Motor Function Classification System (GMFCS) as an improvement over the previous rough assessment of limitation as either mild, moderate or severe. The GMFCS grades limitation based on observed proficiency in specific basic mobility skills such as sitting, standing and walking, and takes into account the level of dependency on aids such as wheelchairs or walkers. The GMFCS was further revised and expanded in 2007. …. SOURCE WIKIPEDIA
how reiki the touch therapy help ……. with the help of reiki seassons stiff muscles get relaxed …mental and emotional balance going better by continuous treatments ,body mind and sprit co ordination get better and better ……hoping the best
all your sufferings ends now a new begining ahead ……
सभी दिव्यात्माओं सम्मान सहित आपसे अनुरोध है कि केरल के लिए प्रतिदिन
प्रातः 6 बजे
रेकी अवश्य करें ताकि इस प्राकृतिक आपदा से जल्द से जल्द छुटकारा मिल सके जान व माल की हानि कम से कम हो
रेकी नहीँ जानने बाले ईश्वर, अल्लाह,वाहेगुरु, जीसस से हाथ जोड़कर सबकी सलामती हेतु प्रार्थना करें ।
अपने इष्ट मित्रों रिस्तेदारों को भी प्रार्थना हेतु प्रेरित करें
यह पुण्य व शवाब का कार्य है
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विश्वास आपके मन का ही एक विचार है
जीवन का नियम विश्वास का नियम है
भूल कर भी उन लोगों, चीज़ो पर बिश्वास नहीं करे
जो आपको दुख दे सकती हैं।अपने आप को प्रोत्साहित करने की, सशक्त बनाने की, और समृद्ध बनाने बाली शक्ति पर विश्वास रखें।
आपके बिश्वास के अनुसार ही आपका मन कार्य करने की कला सीख जाएगा।बिश्वास ऐसी पूंजी है जिससे कि इसका सही तरीके से प्रयोग करने पर जीवन को नई दिशा मिल सकती है।
आपके पास मस्तिष्क है और आपको इसका प्रयोग कैसे करना है ये सीखना चाहिए।
डॉ अजय प्रताप सिंह
REIKIOM- Way of living, Healing of body, mind & soul.Change your destiny
REIKIOM transformed lives of billions of people so next is you, change your life and destiny now. We help humanity.Spread love unconditionally. Blessings
VARIOUS KNOWN METHOD OF ALTERNATIVE TREATMENT AND SPRITUAL METHOD NOW A DAYS >>>>>
This is known a list of alternative medicine, various unknown methods are available in the world this is the begning ………..go ahead
Alternative cancer treatments
Bach flower therapy
Blood irradiation therapies
Body-based manipulative therapies
Body work (alternative medicine) or Massage therapy
Chinese food therapy
Chinese martial arts
Chinese pulse diagnosis
Chromotherapy (color therapy, colorpuncture)
Colloidal silver therapy
Flower essence therapy
German New Medicine
Hair analysis (alternative medicine)
Template:Hyperbaric Oxygen Therapy
Manual lymphatic drainage
Meridian (Chinese medicine)
Bach flower therapy
“REIKI”….the touch therepy,sparsh chikitsa…….(the way of living and loving a prosperous life)…REIKIOM.COM
Rolfing Structural Integration
Spiritual mind treatment
T’ai chi ch’uan
Therapeutic horseback riding
Tibetan eye chart
Traditional Chinese medicine
History of traditional Chinese medicine
Traditional Korean medicine
Traditional Japanese medicine
Traditional Mongolian medicine
Traditional Tibetan medicine
Water cure (therapy)
Wellness (alternative medicine)
Ashtanga vinyasa yoga
Zang fu theory
sabhaar from wikipedia https://en.wikipedia.org/wiki/List_of_forms_of_alternative_medicine
Research conducted in the world by various scientist on “reiki” the touch therapy
There were 13 peer-reviewed studies published between 1998 and 2016 that met all of the
selection criteria. There were 4 randomized single-blind studies and 7 randomized double-blind studies with human participants, and 2 studies using
rats. The studies included both pilot studies and clinical trials, looking at both short-term and long-term application of Reiki.
To assist in the interpretation of these data, the selected studies can be grouped into 4 categories:
Physiological responses to Reiki
Use of Reiki as a complementary therapy for a chronic condition
Use of Reiki as a treatment for a chronic condition
Use of Reiki as a complementary therapy for an acute condition
Physiological Responses to Reiki
Witte and Dundes10 conducted a randomized, placebo-controlled pilot study using university student volunteers to measure objectively the effect of
Reiki on physical and mental relaxation. Reiki was provided by a Reiki I practitioner over a period of 20 minutes, involving 4 hand positions on head,
neck, and upper torso of a seated participant. Four treatment arms were used, each with 25 participants: Reiki, sham Reiki placebo, a control group
relaxing and listening to a meditation tape, and a control group listening to calming music. It was found that Reiki was more effective than placebo,
music, or meditation for inducing physical relaxation, but there was no difference between groups for mental relaxation.
Baldwin and Schwartz8 investigated whether application of Reiki could reduce the deleterious effects of noise-induced stress in rats. Loud noise can
cause damage to the tiny blood vessels in the mesentery of rats, so the extent of microvascular damage can provide a quantitative measure of the level
of stress experienced by the animals. The experiments involved 3 treatment arms: (1) noise + Reiki (n = 4), (2) noise + sham Reiki (n = 4), and (3)
noise-only control (n = 4). Reiki or sham Reiki were provided to the caged rats for 15 minutes per day over 21 days. The experiment was replicated 3
times, and then again using different Reiki practitioners. It was found that the extent of stress-associated microvascular damage for noise + Reiki
was significantly less than that for noise + sham Reiki or the noise-only control.
1. Lin V, Canaway R, Carter B. Interface, interaction and integration: how people with chronic disease in Australia manage CAM and conventional
medical services. Health Expect. 2015;18:2651–2665. [PMC free article] [PubMed]
2. Coleman J. The Effectiveness of Reiki Treatments: A Summary of Evidence-Based Research and Clinical Effectiveness (Submission on “The Effectiveness
of Reiki Treatments” to the Review of Australian Government Rebate on Private Health Insurance for Natural Therapies) Monbulk, Victoria, Australia:
Australian Reiki Connection Inc; 2013.
3. Burden B, Herron-Marx S, Clifford C. The increasing use of Reiki as a complementarytherapy in specialist palliative care. Int J Pall Nurs.
4. Miles P, True G. Reiki—review of a biofield therapy: history, theory, practice, and research. Altern Ther Health Med. 2003;9:62–72. [PubMed]
5. Lee MS, Pittler MH, Ernst E. Effects of reiki in clinical practice: a systematic review of randomised clinical trials. Int J Clin Pract.
6. vanderVaart S, Gijsen VM, de Wildt SN, Koren G. A systematic review of the therapeutic effects of Reiki. J Altern Complement Med. 2009;15:1157–
7. Baldwin AL, Vitale A, Brownell E, Scicinski J, Kearns M, Rand W. The Touchstone Process: an ongoing critical evaluation of Reiki in the scientific
literature. Holist Nurs Pract. 2010;24:260–276. [PubMed]
8. Baldwin AL, Schwartz GE. Personal interaction with a Reiki practitioner decreases noise-induced microvascular damage in an animal model. J Altern
Complement Med. 2006;12:15–22. [PubMed]
9. Baldwin AL, Wagers C, Schwartz GE. Reiki improves heart rate homeostasis in laboratory rats. J Altern Complement Med. 2008;14:417–422. [PubMed]
10. Witte D, Dundes L. Harnessing life energy or wishful thinking? Reiki, placebo reiki, meditation, and music. Altern Complement Ther. 2001;7:304–
11. Díaz-Rodríguez L, Arroyo-Morales M, Fernández-de-las-Peñas C, García-Lafuente F, García-Royo C, Tomás-Rojas I. Immediate effects of reiki on heart
rate variability, cortisol levels, and body temperature in health care professionals with burnout. Biol Res Nurs. 2011;13:376–382. [PubMed]
12. Salles LF, Vannucci L, Salles A, Silva MJPD. The effect of Reiki on blood hypertension. Acta Paulista de Enfermagem. 2014;27:479–484.
13. Dressen LJ, Singg S. Effects of Reiki on pain and selected affective and personality variables of chronically ill patients. Subtle Energies Energy
Med J Arch. 1998;9:51–82.
14. Catlin A, Taylor-Ford RL. Investigation of standard care versus sham Reiki placebo versus actual Reiki therapy to enhance comfort and well-being
in a chemotherapy infusion center. Oncol Nurs Forum. 2011;38:E212–E220. [PubMed]
15. Erdogan Z, Cinar S. The effect of Reiki on depression in elderly people living in nursing home. Indian J Tradit Knowledge. 2016;15:35–40.
16. Alarcão Z, Fonseca JR. The effect of Reiki therapy on quality of life of patients with blood cancer: results from a randomized controlled trial.
Eur J Integr Med. 2016;8:239–249.
17. Gillespie EA, Gillespie BW, Stevens MJ. Painful diabetic neuropathy: impact of an alternative approach. Diabetes Care. 2007;30:999–1001. [PubMed]
18. Assefi N, Bogart A, Goldberg J, Buchwald D. Reiki for the treatment of fibromyalgia: a randomized controlled trial. J Altern Complement Med.
2008;14:1115–1122. [PMC free article] [PubMed]
19. Bourque AL, Sullivan ME, Winter MR. Reiki as a pain management adjunct in screening colonoscopy. Gastroenterol Nurs. 2012;35:308–312. [PubMed]
20. Kundu A, Lin Y, Oron AP, Doorenbos AZ. Reiki therapy for postoperative oral pain in pediatric patients: pilot data from a double-blind, randomized
clinical trial. Complement Ther Clin Pract. 2014;20:21–25. [PMC free article] [PubMed]
21. Porges SW. Vagal tone: a physiologic marker of stress vulnerability. Pediatrics. 1992;90:498–504. [PubMed]
22. Thayer JF, Lane RD. A model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord. 2000;61:201–216. [PubMed]
23. Tracey KJ. Physiology and immunology of the cholinergic anti-inflammatory pathway. J Clin Invest. 2007;117:289–296. [PMC free article] [PubMed]
24. Koenig J, Falvay D, Clamor A, et al. Pneumogastric (vagus) nerve activity indexed by heart rate variability in chronic pain patients compared to
healthy controls: a systematic review and meta-analysis. Pain Physician. 2016;19:E55–E78. [PubMed]
25. Tracy LM, Ioannou L, Baker KS, Gibson SJ, Georgiou-Karistianis N, Giummarra MJ. Meta-analytic evidence for decreased heart rate variability in
chronic pain implicating parasympathetic nervous system dysregulation. Pain. 2016;157:7–29. [PubMed]
26. Kemp AH, Quintana DS. The relationship between mental and physical health: insights from the study of heart rate variability. Int J Psychophysiol.
27. Appelhans BM, Luecken LJ. Heart rate variability as an index of regulated emotional responding. Rev Gen Psychol. 2006;10:229–239.
28. Kok BE, Fredrickson BL. Upward spirals of the heart: autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts
positive emotions and social connectedness. Biol Psychol. 2010;85:432–436. [PMC free article] [PubMed]
29. Busch V, Zeman F, Heckel A, Menne F, Ellrich J, Eichhammer P. The effect of transcutaneous vagus nerve stimulation on pain perception—an
experimental study. Brain Stimul. 2013;6:202–209. [PubMed]
30. Schlaepfer TE, Frick C, Zobel A, et al. Vagus nerve stimulation for depression: efficacy and safety in a European study. Psychol Med.
31. Klinkenberg S, Majoie HJM, Van der Heijden MMAA, Rijkers K, Leenen L, Aldenkamp AP. Vagus nerve stimulation has a positive effect on mood in
patients with refractory epilepsy. Clin Neurol Neurosurg. 2012;114:336–340. [PubMed]
32. Sasikala G. Effect of Reiki therapy on biophysiological and psychological status of patients after major surgical procedures: a pilot report.
Indian J Health Wellbeing. 2013;4:1011–1017.
33. Notte BB, Fazzini C, Mooney RA. Reiki’s effect on patients with total knee arthroplasty: a pilot study. Nursing. 2016;46:17–23. [PubMed]
34. Midilli TS, Eser I. Effects of Reiki on post-cesarean delivery pain, anxiety, and hemodynamic parameters: a randomized, controlled clinical trial.
Pain Manage Nurs. 2015;16:388–399. [PubMed]
35. Midilli TS, Gunduzoglu NC. Effects of Reiki on pain and vital signs when applied to the incision area of the body after cesarean section surgery:
a single-blinded, randomized, double-controlled study. Holist Nurs Pract. 2016;30:368–378. [PubMed]
Baldwin et al9 extended their earlier study to investigate whether Reiki can reduce the heart rate and blood pressure of noise-stressed rats. The rats
were fitted with implantable telemetric transmitters to provide accurate physiological data. The same procedure was used as before, with 3 rats in
each treatment arm and Reiki or sham Reiki provided for 15 minutes per day over 5 days. It was found that Reiki, but not sham Reiki, significantly
reduced both the average resting heart rate and the rise in heart rate produced by exposure of rats to loud noise. However, neither Reiki nor sham
Reiki significantly affected mean arterial pressure.
Díaz-Rodríguez et al11 employed a randomized, single-blind, placebo controlled, crossover design pilot study to investigate the physiological effects
of Reiki in health care professionals with burnout syndrome. The study involved 21 participants receiving either Reiki or sham Reiki placebo, with
heart rate variability, body temperature, salivary flow rate, and salivary cortisol levels measured both pre- and posttreatment. Reiki was provided by
a practitioner with 15 years of experience, involving a 30-minute session covering the head, eyes, ears, and chest. It was found that a single session
of Reiki increased heart rate variability and body temperature but not salivary cortisol levels, indicating that Reiki shifts the autonomic balance
toward parasympathetic dominance.
Salles et al12 investigated the effect of Reiki on abnormal blood pressure using a randomized, cross-sectional, descriptive, and double-blind clinical
trial. Hypertensive patients were randomized to 1 of 3 treatment arms: (1) Reiki (n = 22), (2) sham Reiki placebo (n = 22), or (3) rest control (n =
22). Reiki was provided as a single 20-minute session (no details provided). It was observed that blood pressure decreased in each of the 3 groups,
with statistically significant differences between each group. The Reiki group had the greatest reduction in blood pressure, followed by the placebo
and the control group.
All 5 of these studies provide evidence that Reiki is better than placebo for inducing a physically relaxed state. This appears to be an objective
fact, given that it has been replicated in both humans10 and rats.8 Physiological measurements indicate that Reiki is more effective than placebo in
reducing resting heart rate,9 increasing heart rate variability,11 and reducing blood pressure.12 These results indicate that Reiki is more effective
than placebo in activating the parasympathetic nervous system.
Reiki as a Complementary Therapy for Chronic Conditions
Dressen and Singg13 investigated the potential benefits of Reiki for patients with a variety of chronic illnesses. This randomized, single-blind,
placebo controlled pilot study involved 4 treatment arms: (1) Reiki (n = 30), (2) sham Reiki placebo (n = 30), (3) progressive muscle relaxation (n =
30), and (4) rest control (n = 30). Reiki was provided by 4 Reiki masters as 30-minute sessions covering the full body of a recumbent participant,
given 2 times per week for 5 weeks. It was found that Reiki was more effective than the other treatments for reducing pain, depression, and state
anxiety in chronically ill patients. Reiki was also found to cause desirable changes in personality, including reduced trait anxiety, enhancement of
self-esteem, a shift toward internal locus of control, and toward a realistic sense of personal control.
Catlin and Taylor-Ford14 investigated whether provision of Reiki therapy during outpatient chemotherapy is associated with increased comfort and
well-being. This was a double-blind, randomized clinical controlled trial with 3 treatment arms: (1) Reiki (n = 63), (2) sham Reiki placebo (n = 63),
and (3) standard care (n = 63). A Reiki master nurse provided a single Reiki session of 20 minutes duration (no details provided). It was found that
participants in both the Reiki and sham Reiki placebo groups showed improvement in pre- and postcomfort and well-being outcomes, while those in the
standard care groups showed no differences in well-being or comfort. The researchers concluded that Reiki was no better than sham Reiki and that the
attentive presence of a designated nurse at the bedside was more important for patient well-being and comfort than the delivery of Reiki.
Erdogan and Cinar15 evaluated the effect of Reiki on depression in elderly persons living in nursing homes using a randomized, single-blinded pilot
study with 3 treatment arms: (1) Reiki (n = 30), (2) sham Reiki placebo (n = 30), and (3) control (n = 30). Reiki was applied to the experimental
group by a Reiki master for 8 weeks, once a week for 45 to 60 minutes. Sham Reiki was applied by 4 nurses who did not have Reiki training but thought
that they were practicing Reiki. The control group had no intervention. The researchers observed a statistically significant decrease in depression
levels for the Reiki group on the 4th, 8th, and 12th weeks. No significant decrease in depression scores were found for the sham Reiki or control
groups. There was no significant difference in the depression scores between the sham reiki and control groups. This study indicated that Reiki might
be effective for reducing depression in elderly persons living in nursing homes.
Alarcão and Fonseca16 employed a randomized, double-blinded, placebo-controlled study with a cross-sectional design to investigate the effects of
Reiki on the quality of life of blood cancer patients. The study involved 2 treatment groups: (1) Reiki (n = 58) and (2) sham Reiki placebo (n = 42).
Reiki (by Reiki masters) or sham Reiki treatment was provided in 60-minute sessions, twice a week for 4 weeks. Patient responses were assessed using
the WHOQoL-Bref, an abbreviated generic Quality of Life Scale. It was found that the Reiki group showed significantly more improvements in the
general, physical, environmental, and social dimensions of the WHOQoL-Bref. They generally felt better about themselves, their physical condition, and
their relationships with their environment and other people.
Each of these studies investigated a particular aspect of how Reiki may be employed as a complementary therapy in the management of chronic
conditions. In 3 of these 4 studies, Reiki was applied repeatedly over an extended period, with 1 or 2 sessions per week over a period of up to 8
weeks. In these 3 studies, Reiki was found to be more effective than placebo, resulting in reduced anxiety13 and depression,15 and improved self-
esteem13 and quality of life.16
Only one of the studies did not find a significant difference between Reiki and placebo.14 Interestingly, this was the only study that utilized Reiki
as a one-off, short-duration intervention, to improve patient comfort and well-being during chemotherapy. Interpretation of this study outcome is
difficult because the trial did not include a “usual treatment” control, which would have provided insight into the sensitivity of the instruments
used to measure “comfort” and “well-being.”
Reiki as an Adjunctive Treatment for Chronic Conditions
Gillespie et al17 investigated the efficacy of Reiki for alleviating pain and for improving mobility and quality of life in patients with type 2
diabetes and painful diabetic neuropathy. This was a randomized, semidouble-blind, placebo-controlled, 12-week clinical trial involving 3 treatment
arms: (1) Reiki (n = 93), (2) sham Reiki placebo (n = 88), and (3) usual care control (n = 26). Reiki was provided by 2 experienced practitioners who
provided 2 sessions in the first week, followed by weekly sessions over 12 weeks. Patients were recumbent during each 25-minute session. The
researchers found that global pain scores and walking distance improved in both the Reiki and placebo groups. However, there were no significant
differences between groups at the final visit. The researchers noted that the pain scores were relatively low in all groups, with high variability,
which reduced the power to detect a statistically significant difference between treatments.
Assefi et al18 conducted a clinical trial to determine whether Reiki can be beneficial as an adjunctive treatment for fibromyalgia. The trial was
factorial designed, randomized, double-blinded, and sham-controlled, with 2 treatment arms: (1) Reiki (n = 25) and (2) sham Reiki placebo (n = 25).
Reiki was provided by 3 experienced Reiki masters using two 30-minute sessions weekly for 8 weeks to recumbent participants. The trial results showed
that neither of the treatments improved the pain, fatigue, well-being, or physical and mental functioning of patients with fibromyalgia. These
researchers concluded that adults with fibromyalgia are unlikely to benefit from Reiki.
Both of these studies evaluated the potential of Reiki to relieve the pain of painful diabetic neuropathy and fibromyalgia, which are difficult
conditions to manage with allopathic medicine. In the trial by Gillespie et al,17 both Reiki and placebo showed some promise for relieving the pain of
painful diabetic neuropathy, but the experiment did not have sufficient statistical power to detect a significant difference between treatments. In
the trial by Assefi et al,18 neither Reiki nor placebo was able to relieve the pain of fibromyalgia or the resulting fatigue and reduced well-being,
indicating that Reiki is not a potential cure for this recalcitrant and difficult condition.
Reiki as a Complementary Therapy in Acute Settings
Bourque et al19 undertook a randomized, double-blinded pilot study to determine whether the use of Reiki decreases the amount of analgesics
administered to patients undergoing screening colonoscopy. The trial included 3 treatment arms: (1) Reiki (n = 25), (2) sham Reiki placebo (n = 5),
and (3) retrospective chart review of prior patients as the control (n = 30). A Reiki master provided a 10-minute Reiki treatment simultaneously with
intravenous administration of midazolam (a sedative), prior to the colonoscopic procedure. During colonoscopy, meperidine (an analgesic) was
administered to the conscious patient, depending on the level of pain experienced. The trial results indicated no statistically significant difference
in meperidine administration between the patients in the control and Reiki groups. The researchers noted that the study would have been enhanced by
having a pain scale to determine the amount of meperidine to be administered to the patients. It was observed that patients displayed a calmer
demeanor after screening colonoscopy with Reiki.
Kundu et al20 investigated the potential benefits of Reiki as an adjuvant to opioid therapy for postoperative oral pain control in pediatric patients.
In this double-blind, randomized clinical trial, children aged 9 months to 4 years who were scheduled for elective dental work or for palatoplasty
surgery were randomly assigned to 1 of 2 groups: (1) preoperative Reiki (n = 20) or (2) preoperative sham Reiki control (n = 18). Reiki was provided
by a Reiki master for 20 to 30 minutes (details not provided). It was reported that there was no evidence of benefit from a single session of
preoperative Reiki in terms of reducing pain intensity, analgesic requirements, incidence of side effects, or perioperative family satisfaction.
In both of these trials, Reiki was not found to be more effective than placebo for reducing acute pain during medical procedures. In both cases,
however, it is unclear whether the design of the experiments provided sufficient statistical power to reach a firm conclusion. Bourque et al19 stated
that the experiment could have been improved by using a pain scale to help calibrate the amount of analgesic administered. Kundu et al20 used the
Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, which is appropriate for determining the dosage of postsurgery analgesic for young
children, but its statistical resolving power is not well defined.
This review identified 13 placebo-controlled studies of Reiki that included at least 20 participants in the Reiki treatment arm, of which 8 found that
Reiki was more effective than placebo.8–13,15,16 There were 4 studies that found no difference between Reiki and placebo, but this could be attributed
to a lack of statistical resolving power of the experiments.14,17,19,20 In one study in which Reiki was not better than placebo, involving patients
with fibromyalgia,18 neither Reiki nor the placebo had any beneficial effect.
Viewed collectively, these studies provide reasonably strong support for Reiki being more effective than placebo. Two of the studies were conducted
with rats and produced clear, objective evidence of a benefit of Reiki over placebo. This suggests that there is some merit to the claim that Reiki
“attunement” imparts an extra healing capacity to the recipient. Although there is currently no scientific explanation for this, the clinical trial
evidence is compelling. Further research is warranted to better understand this phenomenon.
Reiki has been shown to be better than placebo for inducing a state of relaxation.8,10 Physiologically, this means that Reiki is effective in
activating the parasympathetic nervous system, quantitatively measured as reduced heart rate,8 reduced blood pressure,12 and increased heart rate
variability.11 The parasympathetic nervous system is one branch of the autonomic nervous system, the other branch being the sympathetic nervous
system. In a healthy individual, the activity of the 2 branches can be rapidly modulated in response to changing environmental demands, but overall
are maintained in a state of dynamic balance, or homeostasis. This regulatory process is primarily mediated by the parasympathetic nervous system via
the vagus nerve.21
It is known that the vagus nerve plays a vital role in mediating the mutual interactions between the brain and the body. According to the
neurovisceral integration model,22 the vagus nerve plays a key role in processes that regulate the health of the body, including inflammatory
responses, glucose regulation, and hypothalamic-pituitary-adrenal function. In each of these processes, the regulatory role of the vagus nerve is
thought to be associated with its function as part of the “inflammatory reflex.”23
According to the polyvagal theory,21 the autonomic nervous system is the neurophysiological substrate for emotional expression and contingent social
behavior. The perception of pain, like other emotions, is an affective state that is governed by the autonomic nervous system. Chronic pain is
associated with dysregulation of the autonomic nervous system and reduced heart rate variability. Increased heart rate variability indicates a greater
capacity of the autonomic nervous system for affect regulation and reduced pain sensitivity.24,25
A compromised autonomic nervous system, as characterized by reduced heart rate variability, is associated with cognitive and affective dysregulation,
and psychological inflexibility, which are major psychological risk factors for psychopathologies such as chronic anxiety and depression.26
Conversely, increased heart rate variability is associated with better regulation of emotional responses, better coping strategies, more positive
emotions, and increased social connectedness, supporting an “upward spiral” in social and psychological well-being.27,28
Thus, the vagus nerve plays a vital role in mediating both physical and mental health. Artificial stimulation of the parasympathetic nervous system
via the vagus nerve has been shown to reduce the perception of pain,29 reduce depression,30 and improve mood and quality of life.31
For patients with chronic health conditions, Reiki has been found to be more effective than placebo for reducing pain and anxiety,13 depression,15 and
for improving self-esteem13 and quality of life.16 It seems likely that these effects are the result of Reiki’s ability to activate the
parasympathetic nervous system and increase heart rate variability, which can be understood in terms of the neurovisceral integration model22 and the
As a safe and gentle way to activate the parasympathetic nervous system via deep relaxation, Reiki has the potential to provide valuable support for a
broad range of chronic health conditions. Research to date does not suggest that Reiki can cure any health condition, so it is not appropriate to
regard Reiki as an alternative to allopathic medicine. Instead, Reiki should be regarded as a useful complement to conventional practices, especially
for chronic illnesses where the use of drugs offers little benefit.
Previous research has provided evidence to suggest that Reiki may be a useful complementary therapy in acute settings. For example, the effectiveness
of Reiki as an aid to recovery after major surgical procedures has been tested in an Indian hospital. Reiki was provided for 7 days after surgical
procedures such as laparotomy, gastrectomy, hysterectomy, cholecystectomy, mastectomy, and general abdominal surgeries. Reiki was found to improve the
vital signs (temperature, pulse, respiration, blood pressure, and pain), hence the prospects for better recovery and to reduce anxiety and
depression.32 Also, Reiki has been found to significantly reduce pain and the need for analgesics following total knee arthroscopy33 and delivery by
Caesarean section.34,35 Such results are potentially significant, because it has been shown that high preoperative anxiety and depression and its
persistence during the postoperative period leads to a higher morbidity and mortality rate. Reiki could potentially play a complementary role in acute
surgical procedures, to reduce the risk and cost of postoperative complications.32
However, in the 2 placebo-controlled trials considered in this review,19,20 Reiki was not found to be more effective than placebo for reducing acute
pain during medical procedures. A possible reason for this is that, in these 2 trials, Reiki was provided for a short period (10-30 minutes) prior to
the procedure. In contrast, in the trials that reported success, Reiki was provided for a number of days postprocedure, that is, for 2,34,35 3,33 or 7
No research has been conducted to evaluate the optimum duration of a Reiki session, or the optimum number of sessions that should be provided.
Typically, a Reiki practitioner would recommend the use of 3 sessions as a starting point, regarding more Reiki as being better than less. The optimum
amount is likely to be different for each condition, and possibly each person, so this could be a significant source of experimental variation that
has not yet been taken into account. Since Reiki has been shown to have a significant effect on measurable physiological variables such as heart rate
variability, it is recommended that research be undertaken to investigate whether the effect of Reiki on heart rate variability has only a transient
or lasting benefit, and whether multiple Reiki sessions over an extended period of time have a cumulative effect.
Reiki is a safe, gentle, and profoundly relaxing healing modality that can be practiced by anyone who has received an “attunement” from a Reiki
master. This review has found reasonably strong evidence for Reiki being more effective than placebo, suggesting that Reiki attunement leads to a
quantifiable increase in healing ability.
Reiki is better than placebo in activating the parasympathetic nervous system, as measured by reduced heart rate, reduced blood pressure, and
increased heart rate variability. For patients with chronic health conditions, Reiki has been found to be more effective than placebo for reducing
pain, anxiety, and depression, and for improving self-esteem and quality of life. According to the neurovisceral integration model and the polyvagal
theory, these effects are due to higher parasympathetic nervous system activity, mediated via the vagus nerve.
This understanding suggests that Reiki has the potential to provide valuable support for a broad range of chronic health conditions. However, there is
no justification to regard Reiki as a cure for any health condition. Instead, Reiki should be regarded as a complementary therapy that can be
implemented alongside all other medical and therapeutic techniques.
Further research is recommended to help optimize the application of Reiki for specific health conditions and to examine the benefits arising from
provision of multiple Reiki sessions over an extended period of time.
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divine reiki healers
दावानल /जंगल मे आग;
गर्मी से कुछ जगह high alert जारी किया गया है !
जीव जन्तुओं ,पेड़ पौधों तथा
जनमानस मे जान माल का नुकसान नहीँ हो या कम से कम हो
इसके लिए सभी दिव्य रेकी healers से अनुरोध है mother earth की विशेष healing आने वाले five days तक करें !
( powered by the divine H H paradise ,श्री ज्ञान सिंह , B .D .O .धर्मार्थ चिकित्सा सेवायें . )
नोट —-अगर आप रेकी नहीँ जानते तो आप केवल शाम 7 बजे से 8:00बजे तक आँख बँद करके 5 day तक ईश्वर से जीव जन्तुओं ,पौधों तथा सबके भले के लिए प्रार्थना अवश्य करे ! !बाद में सभी को धन्यवाद अवश्य दें !thanks
………डॉ अजय ममता सिंह
divine reiki healers 🙏🙏🙏🙏🙏🙏🙏🙏🙏
अभी हाल ही में आये आँधी तूफान से कई जगह तबाही का मंजर नज़र आया !
कुछ जगह high alert भी जारी किया गया है !
जनमानस मे जान माल का नुकसान नहीँ हो या कम से कम हो इसके लिए सभी दिव्य रेकी healers से अनुरोध है mother earth की विशेष healing आने वाले seven days tak करें !
( powered by the divine H H paradise ,श्री ज्ञान सिंह , B .D .O .धर्मार्थ चिकित्सा सेवायें . )
नोट —-अगर आप रेकी नहीँ जानते तो आप केवल सुबह 5:30 बजे से 6:00बजे तक आँख बँद करके 7day तक ईश्वर से सबके भले के लिए प्रार्थना अवश्य करे ! !बाद में सभी को धन्यवाद अवश्य दें !thanks
………डॉ अजय ममता सिंह
after some days of reiki ,
news अभी अभी
delhi ncr से तूफान का खतरा टला …..🙏🙏🙏🙏🙏🙏
हृदय तल से धन्यवाद
सभी दिव्य रेकी हेलेर्स का
तथा सभी सुधी मित्रों का जिन्होने हमारे साथ मानवता के लिए प्रार्थना मे सहयोग दिया !
डरे नहीँ डर नहीँ फैलायें
अलर्ट रहे सजग रहें उपाय करें !!!!