Relaxation Techniques and effects on Vital Signs

1. RelaxationTechniques and effects on Vital Signs Faculty Advisor: Elizabeth Kelley Buzbee, A.A.S., R.R.T., N.P.S.- R.C.P. Stephen Briggs S.R.T. Conchita Cameron, Dip. M (ITEC)., Dip. CA, Reiki Master, S.R.T. Vicki Lossow B.A.(Ed)., S.R.T. Rene Talley S.R.T. Kathleen White S.R.T.

2. Biological Question Does Reiki, meditation, and aromatherapy affect vital signs and the perception of well being on healthy adults?

3. Hypothesis The relaxation techniques of Reiki, meditation and aromatherapy will have positive effects on vital signs and perception of well being compared to placebo among healthy adults.

4. Background • Stress is a natural part of daily living and one of the biggest influences in our lives today. The pressures and demands of twentieth century lifestyle have contributed to ever increasing stress levels which have been linked as causative factors in conditions such as coronary heart disease (CAD), cancer (CA), digestive problems and late onset diabetes.1 ‘Fight or flight’ is the body’s natural spontaneous response to stressful situations. The sympathetic nervous system is induced by stress to secrete hormones such as adrenaline and epinephrine which physiologically cause pupil dilation vasoconstriction, bronchodilation, heightened muscle tension, hypertension, tachycardia and tachypnea. Although these responses are a natural survival reaction, repeated or prolonged stress can have a negative effect n health and feelings of well-being. • Aromatherapy is the ancient art of using essential oils for use in body massage. They are also for diluted topical use, compressing or inhalation. The ‘oils’ are the actually the distilled essences of aromatic flowers, trees, plants, and resins. Some of the essential oils are contraindicated for certain conditions but well administered aromatherapy oils are safe to use on the majority of the public. Although lavender is a popular oil used for stress, we will be testing the bronchodilatory and anxiety reducing properties of Frankincense (Boswelia carteri). Hospital clinical studies with lavender have shown positive changes in vital signs, pain, anxiety and well-being after aromatherapy treatments.2,3,4 • Meditation techniques focus on balancing the physical body and mind. It is believed these relaxation techniques originated in the Middle or Far East. A psycho physiological perspective of meditation is the ‘regulation of attention’.5 Biofeedback studies into relaxation techniques have shown improvements in many symptoms such as pain, anxiety, stress, depression, daily activities and blood pressure.6,7 • Reiki is a non-invasive and non-manipulative form of hands-on energy healing. Reiki originated in India and was rediscovered by Dr. Usui who traveled to Tibet in the late 1800’s and learned the ancient art from the Tibetan monks. Dr. Usui then took Reiki back to Japan where he attuned 14 people. A Healing Center in Hawaii was started in the 1930’s shortly before Dr. Usui’s death. Reiki is now practiced all over the world and is not associated with any type of religion. Reiki appears to improve vital signs, assist with pain management and alleviate emotional stress.8,9

5. Methodology • The participants will be given an explanation of the research being conducted and given the opportunity to ask questions. After obtaining informed consent, the test subjects will draw a participant number from a container that will be confidential to both subject and researcher. The participant will then draw from another container that contains equal numbers of each therapy. The subject will then be taken into a quiet area and seated in a chair. Probes for a three lead EKG will be placed on the subject’s chest and connected to the EKG machine, which will stay on the entire time. Baseline vital signs (heart rate, blood pressure measured by a cuff and respiratory rate) and peak flow will be obtained and recorded. The subject will then observe a stressful short video/slide show, after which all monitoring parameters will be repeated and recorded. The subject will then receive their randomly drawn therapy being either meditation, aromatherapy or Reiki or a placebo for six minutes. The control placebo will be given to every third participant of each therapy.

6. Methodology con’t • Meditation relaxation therapy, which will begin with the subject seated in a chair with both feet flat on the floor. The researcher will then ask the subject to close his/her eyes and place earphones over the subject’s ears. The subject will then be instructed to take three slow deep breaths with full inhalation and exhalation. The researcher will then turn on the recorder and play a six-minute relaxation tape. After the tape has completed, the researcher will remove the earphones and the subject is instructed to open his/her eyes. The researcher will then retake and record all monitoring parameters. The subject will be asked a short verbal questionnaire regarding their perception of well-being during this event. The subject will be thanked for his/her participation in the research. • Meditation relaxation placebo, those subjects that receive the placebo will be seated in a chair with both feet flat on the floor. The researcher will ask the subject to close his/her eyes and place earphones over the subject’s ears. The subject then will be instructed to take three slow deep breaths with full inhalation and exhalation. The subject will then sit quietly with the earphones on and no sound for six minutes. After six minutes, the researcher will remove the earphones and retake monitoring parameters. The subject will be asked a short verbal questionnaire regarding their perception of well-being during this event. The subject will be thanked for his/her participation in the research.

7. Methodology con’t • Aromatherapy relaxation, will begin with the subject seated in a chair with both feet flat on the floor. The researcher will then ask the subject to close their eyes and take three slow deep breaths with full inhalation and exhalation. The researcher will then give the subject an unscented Kleenex tissue that has five drops of Frankincense (Boswelia carterii) essential oil on it to be inhaled for six minutes. After the six minutes of aromatherapy, the researcher will remove the tissue, have the subject open his/her eyes and retake monitoring parameters. The subject will be asked a short verbal questionnaire regarding their perception of well-being during this event. The subject will be thanked for his/her participation in the research. • Aromatherapy relaxation placebo, those subjects that receive the placebo will be seated in a chair with both feet flat on the floor. The researcher will then ask the subject to close his/her eyes and take three slow deep breaths with full inhalation and exhalation. The researcher will give the subject an unscented Kleenex tissue with five drops of the Winter Ivy essential oil. After six minutes, the researcher will remove the Kleenex tissue and have the subject open their eyes. All monitoring parameter will be retaken and recorded at this time. The subject will then be asked a short verbal questionnaire regarding their perception of well-being during this event. The subject will be thanked for his/her participation in the research.

8. Methodology con’t • Reiki relaxation therapy, will begin with the subject seated in a chair with both feet flat on the floor. The researcher will then ask the subject to close his/her eyes and then be instructed to take three slow deep breaths with full inhalation and exhalation. The researcher who is trained Reiki will give the subject six minutes of Reiki therapy using three positions to include the head, neck and heart The researcher will end the therapy by placing his/her hands on the subject’s shoulders. The subject will then be asked to open his/her eyes and monitoring parameters will be retaken and recorded.. The subject will be asked a short verbal questionnaire regarding their perception of well-being during this event. The subject will be thanked for his/her participation in the research. • Reiki relaxation placebo, those subjects that receive placebo Reiki therapy will be seated in a chair with both feet flat on the floor. The researcher will then ask the subject to close his/her eyes and take three slow deep breaths with full inhalation and exhalation. The placebo Reiki will then be done with just simple hand placement over the three positions to include the head, neck and heart. After six minutes of placebo Reiki, the researcher will place his/her hand on the subject’s shoulders. The subject will then be asked to open his/her eyes and all monitoring parameters will be retaken and recorded. The subject will then be asked a short questionnaire regarding their perception of well-being during this event. The subject will be thanked for his/her participation in the research

9. Abstract • Three different relaxation therapies were performed on 14 healthy individuals who varied in age, height, weight, and race. Each subject answered a pre therapy questionnaire which helped to determine their level of stress. This survey showed that 50% of these individuals felt that they were under stress before the therapy was performed. The questionnaire also showed that 50% of the subjects were currently overeating as a form of stress release, and 58% were having trouble sleeping. • After their therapy was concluded, the individuals were asked to fill out a post therapy questionnaire. Pre and post data was compared to determine if the subject felt the relaxation therapy helped improve their sense of well being or if they suffered any negative effects. Of the 14 subjects, 64% felt the therapy was beneficial to them, and of these, 57% would consider adopting relaxation therapy into their daily life. The remaining 36% said they may or may not have had a positive effect. Of these, 28% said they may have had a positive effect and would consider using a form of relaxation therapy in their daily life, while 14% said they were not interested in any type of relaxation technique at all.

10. Discussion • Aroma therapy with the use of Frankinscense as the essential oil, proved to be somewhat effective in increasing the peak flow of the test subjects. The peak flow volume increased by 2.08 %, the difference of the before and after therapy. However, the respiratory rate decreased more significantly by 11.1 % overall. Analyzing the data, some subjects decreased their respiratory rate as much as 50% in the measurement during the therapy. This is evidence that the test subjects were taking slow, deep breaths. This proves that Frankinscense can be utilized as a natural bronchodilator. There was a slight increase in the heart rate as indicated by a 3.81% increase and blood pressure also increase both diatonically showing a 3.56% increase and systolic pressure increasing 4.14%. However, the percent change in the SPO2 was minimal with a small decrease of 0.41%. There is evidence that further investigation of Aromatherapy needs to be considered and continued as a viable relaxation program. • Reiki therapy produced different physiological effects with the same measurement parameters. The heart rate percentage for the test subjects group increased slightly by 4.27%. However, some individuals had a decrease in heart rate as much as 10.9%. The respiratory rates as a whole increased by 29%, the difference being between the pre and post therapy. However, individual test subjects showed significant decrease of 44.4%,in the respiratory rate during the Reiki treatment. Peak flows had a small increase in volume based on the pre and post measurements taken after the Reiki therapy. Individually, some test subject’s peak flows decreased by 8% while others had an increase of 14.2% in volume. Diastolic blood pressure in general decreased using the measurements of before and after Reiki therapy by 4.30% and systolically decreased by 2.85%. The Sp02 did not change significantly during or after the Reiki therapy with a total before and after decrease of 0.81%. • Meditation therapy demonstrated different physiological effects than the previous two therapies used in this study. The measurement parameters however did not change from the previous two therapies. Heart rate change based on the pre and post measurements increased by 6.92%. Individual test subjects however showed an even smaller increase in the heart rate during the meditation therapy of 5%. Peak flows did not significantly change for both the total as a group and individually. The change in peak flow was decreased by 0.5%, however, on some individual subjects there was an increase of 0.5%. Systolic blood pressure measurements dropped by 2.95%.,based on averages before and after treatment. Individually, some test subjects had a drop in systolic blood pressure of 4.76% based on their before and after therapy measurements. Diastolic blood pressure increased by 2.64%.

11. Effectson Heart Rates % Change based on averages of before and after therapy

12. Effects on Respiratory Rates % Change based on averages of before and after therapy

13. Effects on Blood Pressure % Change based on averages

15. Conclusion • The Aroma, Reiki and meditation therapy showed encouraging significant responses on the measured parameters of the test subjects. The greatest changes were noted during the therapy itself. Reiki and Aroma therapy had the greatest amount of individual change in measured parameters than meditation therapy demonstrated as indicated in the recorded measurements. The parameter measurements of the respiratory rates showed the greatest decrease with the use of Reiki therapy for some individual by as much as 44.4%. However, the respiratory rate change as a whole showed an increase of 29%. Meditation therapy demonstrated that it was more well known as a relaxation therapy technique however there was a larger percentage of test subjects that stated that they had a felt a response from Reiki compared to the other two methods of relaxation.

16. Limitations • Sample population was limited to college students and faculty and family members. • Study area was informal and may have incorporated mild interruptions that may have affected outcomes.

17. Recommendations • Perform further relaxation studies with a larger sample group. • Use a more formal setting when performing further clinical studies. • Extend research to include more detailed information regarding vital signs during therapy. • Allow longer time period for relaxation therapy.

18. Glossary • GLOSSARY • Adult Onset Diabetes -- the pancreas produces insulin at a higher than normal levels and the body develops resistance to insulin effects, therefore not enough insulin to meet metabolic needs. Obesity is the chief cause and factor. • Adrenaline – Epinephrine • Attune – (attuned) to adjust or accustom something to become receptive or responsive to something else. • Biofeedback - Involves the use of electronic devices to measure and report information of a person’s biological functions to include heart rate, blood pressure and muscle tension. • Bronchoconstriction – The act or process of decreasing the caliber of a bronchus. • Bronchodilation – The act or process of increasing the caliber of a bronchus. • CAD – Coronary artery disease condition in which blood supply to heart muscle is partially or completely blocked. • Cancer – A new and abnormal growth and disease the natural course of which is fatal • EKG - A measuring device that presents a representation of the electrical current moving through the heart during a heart beat • Emotional distress - A state of emotion or mental status that can participate or alter the • course of physical disease to include heart rate, blood pressure, sweating, sleep patterns, immunological system and the nervous system. Can cause physical symptoms and illness when no illness is present. • Epinephrine - A hormone secreted by the adrenal medulla that is released into the bloodstream in response to physical or mental stress, as from fear or injury. It initiates many bodily responses, including the stimulation of heart action and an increase in blood pressure, metabolic rate, and blood glucose concentration. • Also called adrenaline. • Energy healing – Focus on energy fields thought to exist in and around the body – the belief that life force or subtle energy resides in and around the body. • Essential oils – Constituting the necessary or inherent part of a thing. Giving substance necessary and peculiar qualities. (essential only). • Hypertension - Abnormally high blood pressure in the arteries regardless of cause. A state of physiological stress. • Relaxation -The state of being free from tension and anxiety • Stress - A state of mental or emotional strain or tension resulting from adverse or • tension resulting from adverse or demanding circumstances. • Tachycardia – Abnormally high heart rate. • Tachypnea- Abnormally high respiratory rates • Topical - The direct application of a substance to a part of the body commonly the skin. • Vasoconstriction – The diminution of the caliber of vessels, especially the constriction of arterioles leading to decreased blood flow to a body part. • Vital signs - The measurement of heart rate in beats per minute, respiratory rate in breaths per minute, blood pressure and peak flow.

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