Stroke is the condition where the blood supply to the brain is interrupted because of some reasons that may cause many health problems.27 It usually occurs due to blood vessels ruptures. Many patients have tried reflexology as the alternative therapy in order to recover from strokes. The practitioners believe that pressure that they exerted on a particular point on reflex areas may induce a positive outcome and physical changes to the body.28

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For theory session, the teaching includes principle of reflexology, physiological effect of reflexology, various reflex points of the feet, chart theory, zones and cross reflexes, relationship of reflex points to body organs, using reflexology for health and complementary treatment as well as contraindications to reflexology. On the other hand, for practical session, the teaching includes the methods to examine the feet, good hygiene practice, and arrangement of treatment sessions, treatment practicality, assessment and documentation of the client's treatment, consultation as well as individualization of client's conditions.15
Acupressure [from Latin acus "needle" (see acuity) + pressure (n.)[31]] is a technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in those meridians. Pressure may be applied by fingers, palm, elbow, toes or with various devices.
Earliest discovery of reflexology was found in Egypt based on the observation of daily life activities including the medical practices.1 Other studies have reported that reflexology emerges from China for the last 5000 years ago but there is no documentation found, so with the finding of hieroglyphic mural in the pyramid located in Saggara, reflexology is considered as a part of Egyptian culture from 2330 BC.3 At the late of 14th century, reflexology was already applied throughout the Europe with another name; zone therapy.9 Father of modern reflexology, Dr. William Fitzgerald (1872–1942) has discovered that zone therapy has been used by Aboriginal American.9 Jenny Wallace from North American Indians tribes used pressure at the feet as one of the sources of healing process.9 Fitzgerald study has brought reflexology practice to be widely used in the United States.3 The discovery of zone therapy was developed from the finding of pressure applied on many parts of body such as hands, nose, ears, and many more can relieve pain sensation.10 Dr. Joe Shelby Riley from Washington has conducted many studies of therapy including reflexology and has used this therapy for many years.9 Eunice Ingham (1879–1974) has worked together with Dr. Riley in 1930's as the therapist and work greatly to help people understand reflexology.8 She shared the technique of reflexology with others by writing many books such as “Stories the Feet Can Tell, Stories the Feet Have Told, and Stories the Feet Are Telling”.9 Reflexology has greater recognition after the emergence of another eminent woman in this therapy world with her book; “Helping Yourself with Foot Reflexology” which reached more than 500,000 copies sold.9
“Good pain” is at the heart of the pressure question: a strange, potent sensory paradox that many people actually seek out as the goal of therapy, consciously or unconciously. Either it isn’t literally painful (just intense), or it’s painful but desired anyway because of relief or belief: an actual biological relief or at least the belief that there is one. But it’s important to note that not all satisfying, relieving sensations are genuinely helpful (e.g. scratching a mosquito bite).
Pumping - The stroking movements in massage suck fluid through blood vessels and lymph vessels. By increasing the pressure in front of the stroke, a vacuum is created behind. This is especially important in tight or damaged muscle tissue as a tight muscle will squeeze blood out like a sponge, depriving the tissues of vital nutrients and energy to repair.
There is not necessarily a hard line between these two techniques, and many sessions often incorporate both depending on your needs. It is usually the case that not all the muscles in your body need deep tissue techniques applied. Rather than being overly concerned with choosing the “right” session, make sure you communicate to your therapist the goals for your session so that he or she can customize the right blend of techniques for you. One massage style is often the foundation of the session, with other techniques used as needed. Due to the slow pace of deep tissue massage it is necessary to schedule a 90-minute session if you would like your full body addressed. Use these guidelines for communication based on your primary goal for the session:
Currently, the learning centre which provides training for reflexology is very limited. Normally anyone interested to learn reflexology will learn about reflexology through apprenticeship. Recently, Stella In, a local Malaysia training centre offers certification of training in reflexology. This institute was established by the Ministry of Tourism Malaysia as one of the centres of excellent which offers spa therapy training, specifically for Malaysian, with full job guarantee at any officially approved spa organizations. This institute offers certified qualification of national/international diploma in reflexology foot massage course. Learning about the body zones, feet reflexes, and reflexology techniques which can improve blood circulation, removal of toxins from body, and help to increase the energy level are offered in this course. The teaching techniques include theory and practical.14
Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.
Aromatherapy is the use of essential oils to promote healing and a feeling of well being and relaxation in the recipient. The essential oils are extracted from the parts of herbs and plants and contain all the properties of the plants themselves. There are several ways of applying the oils, including adding the oils to your bath, or inhaling them, but the most popular and effective is through massage.
Swedish massage is the most popular type of massage in the United States. It involves the use of hands, forearms or elbows to manipulate the superficial layers of the muscles to improve mental and physical health. Active or passive movement of the joints may also be part of the massage. The benefits of Swedish massage include increased blood circulation, mental and physical relaxation , decreased stress and muscle tension, and improved range of motion.

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