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Chapter 47: Complementary and Integrative Health (CIH) Approaches in Rehabilitation

Theresa D. Hernández; Birgitta Johansson

INTRODUCTION: OVERVIEW OF COMPLEMENTARY AND INTEGRATIVE HEALTH

Complementary and integrative health (cih) interventions, as operationalized by the National Center for Complementary and Integrative Health (NCCIH) and the Veteran Health Administration (VHA) (VHA Directive, 2017–1137), includes a diverse group of treatments, many of which are already in use by the public. The World Health Organization has noted that between 65% and 80% of the global population uses some form of alternative or complementary medicine.1 Oftentimes, such practices are combined with accepted Western medicine practices, and therefore the term “complementary” (as opposed to “alternative” in which the treatment replaces traditional allopathic medical management) has been used. A brief overview of such practices is provided in Table 47–1.

Table 47–1Overview of Complementary Health Interventions
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Table 47–1 Overview of Complementary Health Interventions
Mind-Body Practices
Acupuncture and acupressure A family of procedures involving stimulation of defined anatomic points, a component of the major Asian medical traditions; most common application involves the insertion and manipulation of thin metallic needles
Alexander technique A movement therapy that uses guidance and education to improve posture, movement, and efficient use of muscles for improvement of overall body functioning
Guided imagery The use of relaxation techniques followed by the visualization of images, usually calm and peaceful in nature, to invoke specific images to alter neurologic function or physiological states
Hypnosis The induction of an altered state of consciousness characterized by increased responsiveness to suggestion
Massage Manual therapies that manipulate muscle and connective tissues to promote muscle relaxation, healing, and sense of well-being
Meditation A group of practices, largely based in Eastern spiritual traditions, intended to focus or control attention and obtain greater awareness of the present moment, or mindfulness
Reflexology Manual stimulation of points on hands or feet that are believed to affect organ function
Rolfing/structural integration A manual therapy that attempts to realign the body by deep tissue manipulation of fascia
Spinal manipulation A range of manual techniques, employed by chiropractors and osteopaths, for adjustments of the spine to affect neuromuscular function and other health outcomes
Tai chi A mind-body practice originating in China that involves slow, gentle movements and sometimes is described as “moving meditation”
Therapeutic touch Secular version of the laying on of hands, described as “healing meditation”
Yoga An exercise practice, originally East Indian, that combines breathing exercises, physical postures, and meditation
Traditional Medical Systems
Ayurvedic medicine The major East Indian traditional medicine system; treatment includes meditation, diet, exercise, herbs, and elimination regimens (using emetics and diarrheals)
Curanderismo A spiritual healing tradition common in Latin American communities that uses ritual cleansing, herbs, and incantations
Native American medicine Diverse traditional systems that incorporate chanting, shaman healing ceremonies, herbs, laying on of hands, and smudging (ritual cleansing with smoke from sacred plants)
Siddha medicine An East Indian medical system prevalent among Tamil-speaking people
Tibetan medicine A medical system that uses diagnosis by pulse and urine examination; ...

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