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Have you ever come home from work or shopping after a long day on your feet, and all you wanted in life was to sit down and put them up? When you rested your feet on an ottoman, you immediately began to relax. The physiological reason you felt so much better was the slight widening of the peripheral capillary blood vessels in your feet-the natural response of relaxation. As the vessels opened up, more blood flowed to your feet, providing nutrients and oxygen. The foot pain and fatigue started to fade as the tissues were nourished. Ahhhh!
Use Your Mind to Increase Blood Flow and Foot Temp
A few years ago, researchers conducted a controlled study in which they taught diabetes patients with chronic foot ulcers how to relax and visualize warming their feet. The patients employed a standardized relaxation technique specifically designed to improve blood flow to the feet, guided by assisted temperature biofeedback.
After 12 weeks, 14 of 16 patients who practiced the relaxation intervention were completely healed of their foot ulcers, compared to seven of 16 patients in the control group who did not practice the relaxation. All members of both groups were receiving excellent wound care.
The findings were presented nationally and published in medical journals.
Based on this and other clinical work, Birgitta Rice, MS, RPh, CHES, developed the WarmFeet intervention. A Swedish ex-pat who works as a researcher, clinician, and certified health education specialist at the University of Minnesota Epidemiology Clinical Research Center, Rice devised the method as an "educational intervention"-to be used as a complementary therapy to standard medical therapies for foot and wound care.
Almost everyone is able to benefit from learning to relax with the WarmFeet technique. People who have poor circulation in the legs due to age, complications from diabetes, or arterial disease will show the most significant improvements. Rice, by the way, has lived with her own type 1 diabetes for nearly 50 years.
When developing her standardized relaxation technique, Rice turned to the natural phenomenon described above, in which the body widens the peripheral blood vessels as it relaxes. She added complementary mind-body techniques, such as visualization, to imagine comfort and warmth. Amazingly (or maybe not so amazingly-there is plenty of evidence of what the mind can do), this makes the feet feel even warmer. Because tissues and cells have memory, when you ask your feet to remember warmth-they will. The WarmFeet relaxation improves blood flow, thereby allowing a continuous supply of nutrients and oxygen to the feet.
Research Findings and Presentations
Rice's technique was tested in multi-site clinical trials at the University of Wisconsin. The medical outcomes were highly significant and positive for increased wound healing and pain relief. Of patients who practiced the technique, 87.5 percent completely healed their chronic ulcers, compared to 43.7 percent in the control group without the technique.
Rice has presented her findings nationally and published in medical journals, including Diabetes Care, DIABETES, The Journal of the American Podiatric Medical Association, The Diabetes Educator, and other consumer and professional magazines, such as Diabetes Health.
The Patient Experience
In clinical applications, ulcer healing has been the most significant result and pain relief a close second. Even after only a couple of weeks of daily relaxation, many patients have reported that their pain has subsided or even disappeared.
One patient, whom we'll call Mr. Smith, was scheduled for an amputation by his vascular surgeon. He went in to see his family doctor, Dr. Milton Seifert, MD, because of the excruciating pain in his feet. By then Smith was wheelchair-bound and had petechia, the precursor of gangrene in his feet. He said he could neither eat nor sleep because of the pain. Rice happened to be in the Minnesota clinic that day seeing other patients, so Dr. Seifert asked Smith if Rice could help him.
Rice trained Smith to improve the blood flow to his feet with the WarmFeet relaxation intervention. He did quite well for his condition, increasing his big toe temperature by 1.5 to 2 degrees Fahrenheit the very first time he tried the 16-minute relaxation technique. (The temperature was measured with a digital biofeedback thermometer.) Rice asked Smith to relax like this one or two times a day at home.
Two weeks later, Rice saw Mr. Smith when he returned to the clinic. He was actually standing up in the waiting room. He said that he could now both eat and sleep and that the day before he had walked in to a restaurant-something he had not been able to do for a long time. He continued to do well and recovered from the petechia.
Smith's surgery was put on hold, and he was allowed to go south for the winter, which was his deepest wish. Dr. Seifert instructed him to return promptly to Minnesota if his condition deteriorated. He returned in the spring and was still doing well, having practiced the WarmFeet relaxation regularly.
For his part, Dr. Seifert says that he is very impressed with Rice's methods. He confirms that Mr. Smith undeniably benefited from Rice's relaxation techniques. Rice demonstrated how she took the toe temperature, and Dr. Seifert said that from a medical point of view, he was pleased to see a clinical measurement-the two-degree increase in temperature-to confirm the beneficial effects. "It seems like everyone I refer to her does well with her methods," he says. A family physician, Dr. Seifert referred patients "whose pulses I couldn't feel, who had signs and symptoms of vascular disease, and who were also willing to put time and effort into practice relaxation. And they improved."
"I walked away thinking Rice's methods were a good thing," says Dr. Seifert. He adds, "Birgitta Rice is the kind of healthcare professional whose talents often go under-used because mainstream doctors don't know about them." He tried to work out a way to get Rice to work in his practice because she "had something to offer and is a great spirit." At the time, however, Rice's commitment to the Look AHEAD research study at the Epidemiology Clinical Research Center, University of Minnesota, meant that she had to decline the offer.
The WarmFeet Relaxation Intervention
Learning any new skill takes patience and practice. To maximize positive outcomes, it is very important to spend time daily learning this technique. You will have some success right away in improving blood flow and warming your feet, but practicing once or twice a day, 16 minutes at a time, allows you to really master the skill and get the full benefits. Assisted-temperature biofeedback (measuring skin temperature in hands or feet before and after relaxation) will show you if you are relaxing properly-if you are, your skin temperatures will increase. The feedback is very helpful when learning the technique.
Benefits from daily practice with the WarmFeet technique include:
1) Increased peripheral blood flow
2) Increased healing rate of foot ulcers
3) Reduced pain in legs and feet
4) Increased coping skills for life
"Continue this practice only as long as you want to enjoy increased circulation," Rice says with a smile.
The WarmFeet® Kit is available online at WarmFeetKit.com. It includes either a CD or an audio cassette with two tracks, one with instructions and the other with 16 minutes of guided relaxation, plus a personal alcohol skin thermometer for assisted biofeedback training. The cost is $22.95 for the CD version or $17.95 for the audio cassette, plus $3.50 for shipping and handling. (In Minnesota add 6.75% sales tax: $1.55 for the CD or $1.15 for the cassette.) To order by mail, send a check or money order with your name and address to:
Health Education for Life, 7412 Park View Dr., St. Paul, MN 55112.
You may email Birgitta Rice at firstname.lastname@example.org.
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.