TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICE GUIDELINE ON MALAY MASSAGE

Revised Edition, November 2009

2

First Edition, October 2007

Second Edition, November 2009

All rights reserved. No part of this book may be reproduced, stored, or transmitted in any form or by any means, electronic

or otherwise, including photocopying, recording, internet or any storage and retrieval system without prior written

permission from the publisher.

Published by: Traditional and Complementary Medicine Division

Ministry of Health Malaysia

ISNB 983 – 44754 – 4-4

Cover design by : Mohd Affendy Baharudin Traditional and Complementary Medicine Division

Ministry of Health Malaysia

2

Acknowledgements .............................................................................................................................i

1. Introductions ..............................................................................................................................1

2. Objectives ...................................................................................................................................2

3. Massage .....................................................................................................................................2

3.1 Malay Massage ....................................................................................................................2

3.2 Petua and Pantang Larang ...................................................................................................3

4. Procedures and Techniques .........................................................................................................4

5. Indications ..................................................................................................................................5

6. Contraindications and side effects ................................................................................................6

6.1 Contraindications.................................................................................................................6

6.2 Side effects of Massage Therapy ...........................................................................................6

7. Standard Of Practice....................................................................................................................7

7.1 Cleanliness ..........................................................................................................................7

7.2 Confidentiality .....................................................................................................................7

7.3 Respect ...............................................................................................................................7

7.4 Maintain professional distance ............................................................................................7

7.5 Personal Grooming ..............................................................................................................7

8. Terminology................................................................................................................................8

9. APPENDICES ...................................................................................................................................9

Appendix 1 : Types of Malay Massage.........................................................................................10

Appendix 2 : An Overview of Work Process for Malay traditional Masseur. .................................11

Appendix 3: Clerking Form .........................................................................................................12

Appendix 3: Clerking Form .....................................................................................................15

Appendix 3: Clerking Form .........................................................................................................15

Appendix 4: Screening Form.......................................................................................................18

Appendix 5: Consent Form .........................................................................................................20

Appendix 6 : Guide in Treatment Plan of Malay Massage for Chronic Pain and Post Stroke

Management ............................................................................................................................21

2

Diagram 1 : Massage Techniques /Strokes ..................................................................................22

Diagram 2: Hand Washing Techniques ........................................................................................24

10. REFERENCES ..........................................................................................................................25

11. Committee Members.............................................................................................................27

i

Acknowledgements

Special thanks to every individual and organizations that have in one way or another contributed

comments and advices during the preparation of the Traditional and Complementary Medicine

Practice Guidelines on Malay Massage.

1

1. Introductions

Traditional medicine is the knowledge, ski lls and practice of holistic health care,

recognized and accepted for its role in the maintenance of health and the treatment of

diseases. It is based on indigenous theories, beliefs and experiences that are handed

down from generation to generation1. Although modern medicine is widely spread,

traditional medicine still exists and widely used in many countries. Interest in traditional

medicine has increased over the last decade. People are now more prepared to look for

alternative approaches to maintain their health.

World Health Organization’s (WHO) traditional medicine programme was developed in

conjunction with the adoption of the health for all strategy and the primary health care

approach. The Regional Strategy for Traditional Medicine in Western Pacific Region

was prepared to help guide national governments, WHO and other partners in the

efforts to ensure the proper use of traditional medicine and its contribution for

maintaining health and fighting diseases in the Region. One of the strategies indicates

the need to promote public awareness and access to traditional medicine. It

recommends that government and non government organization should motivate

healers to cooperate and voluntarily share their healing knowledge and practices.

Access to traditional medicine through informed choice should be facilitated and mutual

understanding between practitioners of traditional and modern medicine should be

promoted.

In January 2006 ,the Malaysian Cabinet had approved the establishment of Traditional

and Complementary Medicine ( T&CM) unit in three hospitals, Kepala Batas Hospital in

Penang, Putrajaya Hospital in Federal Territory of Putrajaya and Sultan Ismail Hospital

in Johore. The implementation of the pioneer project is towards integrating traditional

and complementary medicine into the existing public healthcare delivery system..

To implement the services, the unit is provided with T&CM practice guidelines on the

three modalities of treatment.

2

2. Objectives

The objective are to promote the highest standards in the practice of the Malay

Massage modalities of treatment and to ensure public safety.

3. Massage

Massage has been categorized under the Manipulative and Body Base Method

according to National Center for Complementary and Alternative Medicine, National

Institute of Health, United State of America. Massage has shown to improve the

circulation, relieving many common muscle aches and pains, boosting immunity and

promoting an overall sense of well being2.

Massage may be used as primary therapeutic intervention or as an adjunct to other

therapeutic techniques3. The mode of action4,5 are by : (1) mobilization of inter-tissue

fluids, (2) reduction or modification of edema, (3) increase of local blood flow, (4)

decrease of muscle soreness and stiffness, (5) moderation of pain, (6) facilitation of

relaxation, and (7) prevention or elimination of adhesions .

3.1 Malay Massage

The Malay massage is a mixture of kneading, stroking and pressing with hands

(Diagram 1: Massage Techniques / Strokes). The massage strokes are done depending

on the masseur’s judgment of one’s body need, and selected natural plants or herbal

oils are applied during the massage6,7. It also sometimes accompanied with special

pray incantations and take home advise in form of post massage work out/ exercises8,9.

Malay massage is divided into two types of massage based on their purpose; wellness

and therapeutic massage. For the purpose of wellness, the massage helps in reducing

anxiety, improving sleeps, in boosting immunity of the body10 and in reducing stress.

3

Massage that fall into this categories includes relaxation massage (urutan merehatkan

badan), rejuvenating massage ( urutan penyegaran badan) and Improve blood

circulation massage (urutan melancarkan peredaran darah).

Therapeutic massage on the other hand helps to improve the condition of a particular

illness and in reducing severity of pain. Common illness that benefit from such massage

includes sprains and low back pain. Therapeutic massages are specified into massage

of nerve ailments, joints ailments, sprains, muscle ailments and others. (Appendix I:

Types of Malay Massage)

3.2 Petua and Pantang Larang

a. Take a light meal before massage treatment.

Before Malay massage procedure: every patient is advised to have light meals / breakfast as a fasting patient may be at

risk of fainting episodes or hypoglycaemia. Too heavy a meal may also lead to ineffective massage.

b. Shower / Bath

If patient needed to take a bath, please do so after 1 hour

completed Malay massage procedure.

c. Rest

Rest at least for 1 hour after completed massage.

d. Rehydrates

Patient are encourage to drink lots of warm plain water to rehydrate themselves after massage. This is to prevent

muscle soreness that occur post massage.

4

4. Procedures and Techniques

Massage treatment takes a variety of forms and may last between 15 to

90 minutes. (15-45 minutes for chronic pain and 60-90 minutes for post stroke

cases)

Treatment starts with a case history, assessment on the client’s condition

and the indications for massage11 (Please refer appendix 2: Work Process for

Malay traditional Masseur). During clerking for the case history and doing the

assessment for suitability for massage, the practitioner/masseur are required to

document all findings in the clerking form .(Appendix 3: Borang Penilaian Urutan

Melayu).Additional information can be obtain in the screening form if so required

(Appendix 4 : Screening Form). During the assessment, if the client is not

suitable for the treatment, advice to seek appropriate medical treatment should

be given.(please refer Section 6 : Contraindications for Massage)

Before starting any procedures or treatment, practitioner are required to

explain the procedures to the patient prior signing the consent form( Appendix 5 :

Consent Form For Malay Massage). All procedures are also required to be

documented in patient’s record. Malay massage treatment session ends with

counseling and advises regarding dietary intakes and exercise technique for

patient to continue at home. The number and frequency of follow up visit for

Malay massage treatment are catered according to individual bases (Appendix 6:

Guide in Treatment Plan of Malay Massage for Chronic Pain and Post Stroke

Management). However, any adverse event or side effect that occurs must be

reported and documented in appropriate form for further action.

In the unit, to preserve the authenticity of Malay massage technique, all Malay

massage are done on a raised floor that made of wood known as pangkin (figure

1).The patient is dressed appropriately to respect their privacy. Part of Malay

massage techniques are shown in Diagram 1: Massage Techniques/Strokes.

All type of massage oil being used must be registered with the Ministry of Health,

Malaysia. Any oils that contain methlysalicylate are prohibited.

5

Figure 1 : Pangkin

5. Indications

Massage is administrated as an complementary to other therapy, medical or

rehabilitation therapy and in some cases it is only carried out with the approval of

a medical practitioner.

Application of massage can be categories to different types of conditions11.

a) For generalized constitutional disorder, massage helps to enhances the

elimination of toxin and waste products. This achieve by systemic effect

where massage enhance the circulation systems particularly the venous

return and of the lymph. It also has indirect effect to the autonomic nervous

system which in turn improves the production of glandular secretions and

organ functions. Massage also has a localized effect where promote muscle

relaxation for the patient ; example Stroke patient8 , edema.

b) Acts on reflex zones , whether these areas arise from either direct referred

pain relating to the organ or indirect tissue changes example tension

headaches

c) Helps to alleviate some of the symptoms associate with the disease ;

example Low back pain12 , Chronic pain13 ,Anxiety and Depression.

6

6. Contraindications and side effects

Massage is contraindicated when it could cause worsening of a particular condition,

unwanted tissue destruction, or spread of disease14. A very small numbers of serious

injuries have been reported, and most occurred because caution were not followed or

massage was given by a person who was not properly trained.

6.1 Contraindications

Acute Infections

Acute Inflamations Trauma

Bacterial and fungal infections

- Athlete’s foot - Cellulitis - Ringworm

- Impetigo - Abscesse

Fever

Toxaemia (septicaemia) Viral infections Measles

Areas affected by herpes zoster (shingles)

Gout

Infective arthritis Ulcerative colitis Appendicitis

Open wounds

Bone fracture Bony avulsion

Vascular Disease

Others

Aneurysm Varicose veins Venous thrombosis Portal hypertension

Impaired blood supply to a tissue Weakness in the wall of the blood vessels as in haemophilia, Acute strains, Suspicious lumps or growth Osteoporosis

6.2 Side effects of Massage Therapy15

Massage therapies are not totally devoid of side effects. Below are some of side

effects that might occur post massage procedures. The incidence of adverse events is unknown,

but probably low16.

a. Temporary pain or discomfort

b. Bruising

c. Swelling

d. Allergic reactions of massage oils

7

7. Standard Of Practice

All Malay massage therapists must adhere to following standard of practice when

conducting massage.

7.1 Cleanliness

A therapist must always maintain his / her cleanliness and also the surrounding

environment. It involves good technique of hand washing prior to massage treatment.

(See Diagram 2: Hand Washing Procedure)

7.2 Confidentiality

Every part of patient’s body must be treated as confidential information. Therefore

therapist cannot divulge the identity of patient nor any deformities of the patient to any

third party.

7.3 Respect

A therapist must respect the patient’s body and maintain its privacy. When conducting a

massage treatment, any parts of the patient’s body that are not involved during the

procedure, must be covered to protect privacy and to respect patient’s dignity.

7.4 Maintain professional distance

A therapist should not unload their own personal problems to the patient.

7.5 Personal Grooming

- A therapist must wear clean and suitable clothes for massage.

- A therapist must give undivided attention during massage

- A therapist will not wear any jewelry during massage session that hinder

massage procedure

7.6 A therapist should not used sharp pointed object as a tool for massage.

7.7 Only the same gender massage therapist wi ll conduct the session onto the same

gender client. If otherwise, a chaperone is required throughout the session.

8

8. Terminology

Malay terminology Translation

Simpul Biawak,

Tarik mengkarung

Ular ular

Anak anjing tegang

Muscle spasm,

Muscle cramp

Angin Sakit

Angin Bengkak

Pecah angin

Inflamation

Urat lari

Urat terseliuh

Sprain

Semut semut

Cucuk cucuk

Kebas

Tebal kulit

Numbness

9

9. APPENDICES

Appendix 1 : Types of Malay Massage

References:

Traditional Malay Massage; Syed Mahdi Syed Fouzi Barakbah. Paper Presentation. First Asia Pacific Traditional and Complementary Medicine Conference, Malaysia 2008

11

Appendix 2 : An Overview of Work Process for Malay traditional Masseur.

12

UNIT PERUBATAN TRADISIONAL DAN KOMPLEMENTARI

HOSPITAL _______________

KAD RAWATAN URUT MELAYU Pesakit Angin Ahmar

MAKLUMAT PESAKIT

Nama : No. KP : Umur :

Alamat : No. Pendaftaran :

Jantina :

Poskod : Negeri : No. Tel : Bangsa :

RUJUKAN DARI / KEPADA

Tanpa Rujukan

PENILAIAN TANDA VITAL SEBELUM RAWATAN

Tekanan Darah : mmHg Berat : kg Tinggi : Cm

Kadar Denyutan Nadi : persaat Suhu Badan : 0C Dextrose : mmol/L

Skala Kesakitan (Tandakan bulat

pada yang berkenaan)

0 1 2 3 4 5 6 7 8 9 10

Tidak

Sakit

Mengganggu

Tugas Harian

Tidak

Selesa Sakit

Sakit

Teruk

Sakit Tidak

Tertahan

SEJARAH PESAKIT

SEJARAH ANGIN AHMAR FAKTOR RISIKO Tandakan ( ⁄ ) mana yang berkenaan

Tarikh Serangan Sendiri Keluarga Sejarah Pengubatan

Serangan pertama Serangan angin ahmar

Serangan kedua

Darah Tinggi

Kencing Manis

Serangan seterusnya Serangan Jantung

Ciri-ciri / Lokasi Serangan Masalah Jantung Sila nyatakan :

Kanan Kiri Kolestrol Tinggi

Infact Tiada Pendarahan

Haemorrhage Pendarahan

Merokok Bekas Perokok

RAWATAN LAIN Tandakan ( ⁄ ) mana yang berkenaan

Rawatan Diterima Ya Tidak Sila nyatakan jenis rawatan/ubatan

Rehabilitasi Sila nyatakan di mana :

Rawatan Tradisional Lain

Ubat-ubatan Moden

Ubat-ubatan Herba

Appendix 3: Clerking Form

13

PENILAIAN PESAKIT

Jenis kelumpuhan : Seluruh badan Separuh badan Kiri Kanan

Lokasi ( site ): Huraian : Isikan nama bahagian yang

mengalami kelumpuhan . Samada bahagian Kiri atau Kanan. Anggota

yang sakit e.g Kaki, Bahu dll

Ciri-ciri kelumpuhan (Character)

Huraian: Isikan ciri yang dialami;e.g tidak

boleh mengerak anggota bahagian,kejang, keras

Ketidakupayaan (Disability) yang lain:

Huraian:

Isikan samada pesakit mengalami simptom yang lain e.g tidak boleh

bertutur , tidak boleh menelan air atau/dan makanan dll

Faktor yang menjadikan keadaan lebih buruk (Aggrevating

Factor) :

Faktor yang menambahbaikan keadaan (Relieving Factor) :

Kemajuan (Progression) :

Isikan perbandingan keadaan

pesakit dari tempoh kelumpuhan hingga hari ini.

CATATAN

14

PENILAIAN RAWATAN

Ulasan :

PLAN RAWATAN

Ulasan

Nama Pengamal Tanda tangan :

Tarikh:

15

UNIT PERUBATAN TRADISIONAL DAN KOMPLEMENTARI

HOSPITAL _______________

KAD RAWATAN URUT MELAYU Pesakit Kesakitan Kronik

MAKLUMAT PESAKIT

Nama : No. KP : Umur :

Alamat : No. Pendaftaran :

Jantina :

Poskod : Negeri : No. Tel : Bangsa :

RUJUKAN DARI / KEPADA Tanpa Rujukan

PENILAIAN TANDA VITAL SEBELUM RAWATAN

Tekanan Darah : mmHg Berat : kg Tinggi : Cm

Kadar Denyutan Nadi : persaat Suhu Badan : 0C Dextrose : mmol/L

Skala

Kesakitan (Tandakan bulat

pada yang berkenaan)

0 1 2 3 4 5 6 7 8 9 10

Tidak Sakit

Mengganggu Tugas Harian

Tidak Selesa

Sakit Sakit Teruk

Sakit Tidak

Tertahan

SEJARAH PESAKIT

SEJARAH TRAUMA FAKTOR RISIKO Tandakan ( ⁄ ) mana yang berkenaan

Sendiri Keluarga Sejarah Pengubatan

Serangan angin ahmar

Darah Tinggi

Kencing Manis

Serangan Jantung

Masalah Jantung Sila nyatakan :

Kolestrol Tinggi

Merokok Bekas Perokok

RAWATAN LAIN Tandakan ( ⁄ ) mana yang berkenaan

Rawatan Diterima Ya Tidak Sila nyatakan jenis rawatan/ubatan

Rehabilitasi Sila nyatakan di mana :

Rawatan Tradisional Lain

Ubat-ubatan Moden

Ubat-ubatan Herba

Appendix 3: Clerking Form

Appendix 3: Clerking Form

16

PENILAIAN PESAKIT

Lokasi ( site ):

Huraian : Isikan nama bahagian yang sakit. Samada

bahagian Kiri atau Kanan. Anggota yang sakit e.g Kaki, Bahu dll

Ciri-ciri kesakitan (character)

Huraian:

Isikan ciri kesakitan yang dialami;e.g cucuk,tarik,dll

Menjalar ( Radiate)

Huraian:

Isikan pergerakkan kesakitan yang dialami. Sebagai contoh bermula kesakitan

bermula di kaki kiri dan ianya dapat dirasakan/menjalar hingga ke paha kiri

Masa bermula Onset

Huraian: Isikan masa mulanya kesakitan itu

bermula e.g 3 bulan yang lepas , 6 bulan yang lepas

Perkembangan Progression

Huraian:

Isikan perbandingan keadaan kesakitan pesakit dari tempoh ia bermula hingga

hari ini.e.g kesakitan bertambah teruk dari boleh berjalan dulu tetapi sekarang

menggunakan bantuan untuk berjalan.

Tempoh Duration

Huraian:

Disini menjelaskan tempoh masa kesakitan apabila pesakit diserang kesakitannya.e.g

10 minit, 20 minit dll

Faktor yang menyebabkan keadaan kesakitan lebih teruk

(Aggrevating Factor) :

Faktor yang mengurangkan kesakitan

(Relieving Factor) :

Simptom yang berkaitan Associated symptoms

17

PENILAIAN RAWATAN

ULASAN

PLAN RAWATAN

Nama Pengamal : Tanda tangan

Tarikh:

18

KEMENTERIAN KESIHATAN MALAYSIA UNIT PERUBATAN TRADISIONAL DAN KOMPLEMENTARI

HOSPITAL ………………… BORANG SARINGAN (SCREENING FORM)

Nama :

No. K/Pengenalan R/N:

Alamat :

Tarikh lahir:

Jantina

Umur:

Tarikh: Masa

Diagnosa Pesakit (Patient’s Diagnosis):

Aduan Pesakit (Chief Complaints): Sejarah Perubatan yang lalu (Past medical history): - Darah Tinggi (Hypertension):

- Kencing Manis (Diabetes Mellitus): - Penyakit Jantung (Ischaemic Heart Disease):

-Sawan (Epilepsy): - Lelah ( Asthma): - Barah ( Cancer): - Lain-lain: …………

Sejarah pembedahan yang lalu (Past surgical history): …………………………………………………. ……………………………………………….. ………………………………………………… ………………………………………………….

. Keputusan Ujian jika ada (investigations results if available): Coagulation Profile: RBS: X Rays: Lain-lain :

Sejarah Pengambilan Ubat-ubatan (Medication History):

Alahan (Allergy)

Appendix 4: Screening Form

19

20

BORANG KEIZINAN URUTAN MELAYU Sila baca maklumat ini dengan teliti. Rujuk kepada pengamal anda jika terdapat perkara yang tidak anda pahami.

Apakah Urutan Melayu? Urutan Melayu adalah satu kaedah urutan yang unik kerana sentuhannya yang lembut,mantap dan tertumpu kepada penggunaan jari.

Urutan Melayu terbahagi kepada dua kategori, iaitu Urutan Kesihatan Badan (kesegaran) dan Urutan Perubatan

(terapeutik) Apakah urutan kesegaran? Urutan kesegaran adalah bertujuan pencegahan penyakit .

Apakah urutan terapeutik? Urutan terapeutik merupakan urutan untuk membantu meningkatkan proses penyembuhan dan mengurangkan

kesakitan yang dihadapi. Perkhidmatan Urutan Melayu di unit Perubatan Tradisional

dan Komplementari yang sediakan adalah :-

1. Urutan kesegaran dalam Penjagaan Ibu selepas Bersalin

2. Urutan terapeutik untuk kesakitan kronik 3. Urutan terapeutik untuk Angin Ahmar 4. Urutan terapeutik untuk Rawatan Perbidanan

Adakah terdapat maklumat-maklumat lain yang perlu dimaklumkan kepada pengamal? Selain daripada maklumat perubatan yang biasa, adalah amat

penting bagi anda memberitahu pengamal sekiranya anda mengalami masalah masalah berikut: ( Sila tanda (√ )yang berkaitan)

Ya Tidak

Penyakit darah beku di anggota kaki deep venous thrombosis

Kepatahan Tulang

Mengalami masalah pendarahan

Mengambil ubat pencairan darah” anticoagulants’ atau sebarang ubat-

ubatan.

Penyakit Osteoporosis

Masaalah kulit

Alahan kepada minyak

PERAKUAN KEIZINAN Saya faham bahawa saya boleh bertanya sebarang soalan berkenaan rawatan saya sebelum menandatangani borang ini. Saya juga

bebas untuk menarik balik keizinan yang saya berikan bagi memberhentikan penyertaan saya ke atas prosedur-prosedur ini pada

bila-b ila masa. Prosedur prosedur telah dijelaskan kepada saya dan saya faham atas penjelasan yang diberi. Den gan ini, saya

secara sukarelanya bersetuju untuk menjalan i prosedur-prosedur di atas. Saya juga memahami bahawa satu rekod perkh idmatan

kesihatan saya akan disimpan. Rekod ini adalah sulit dan t idak akan didedahkan kepada sesiapa melainkan sekira ianya diarahkan

oleh wakil saya, atau diri saya sendiri atau sebarang cara lain yang dibenarkan atau atas arahan mahkamah.

Tandatangan: ............................................................................ Tandatangan Saks i :.........................................

Nama Penuh: ............................................................................ Nama Saksi : .....................................................

No. Kad Pengenalan: ............................ ..................................... No Kad Pengenalan : ........................................

Tandatangan Pengamal: .......................................................................................................

Tarikh: .................................................................................................................................

UNIT PERUBATAN TRADISIONAL DAN

KOMPLEMENTARI

HOSPITAL …………………..

Appendix 5: Consent Form

21

Appendix 6 : Guide in Treatment Plan of Malay Massage for Chronic Pain and Post

Stroke Management17

Chronic Pain Post Stroke

Number of session 3 sessions 7 sessions

Breakdown of

sessions

3 session in a week

Can either be :

3 days in a row

Or

Alternate days

First week : 3 session s

Second week : 2 sessions

Third week : 2 sessions

Assessment

for effectiveness

Done at the third sessions Done at the seventh session

Maximum session

given in the unit

for cases

5 sessions 10 sessions

22

Diagram 1 : Massage Techniques /Strokes

23

24

Diagram 2: Hand Washing Techniques

Hand Washing Techniques

Palm to palm. Right palm over left hand and vise versa.

Palm to palm fingers interlaced. Back of finger to opposing palms with fingers

interlocked.

REFERENCES

1 2

3 4

Rotational rubbing of right thumb

clasped in left palm and vice versa.

Rotational rubbing, with clasped fingers

of right hand in left palm and vice versa.

5 6

25

10. REFERENCES

1. Western Pacific Region (WPRO), The Regional Strategy for Traditional Medicine in Western Pacific Region, Manila 2002.

2. Lena Posner, Guide to the benefit of massage (cited 2009 Nov 23).Available from http://www.redmoonmassagetherapycom/assest/docs/guide_01.pdf

3. Andrew Vickers, Catherine Zollman, Clinical review : ABC of Complementary Medicine :

Massage Therapist , BMJ : 319:1254-1257 ( 6 November)

4. Lynn Freeman ,Chapter 13 : Massage Therapy, Mosby’s Complementary & Alternative Medicine, A Research-Based Approach, second edition; pg : 389 -413.

5. J Michael Wieting, DO, Med. Massage, Traction, and Manipulation. E medicine Article. July 2005.

6. Syed Mahdi Syed Fouzi Barakbah, Traditional Malay Massage ( Presentation) First Asia Pacific Traditional and Complementary Medicine Conference, Malaysia,4 – 6 Nov 2008

7. Haniza MA,Fariza F,Norlaili A, Norsuria AG; A qualitative study on urut Melayu –traditional Malay massage (paper submitted for publication to the Journal of Complementary and Alternative Medicine).

8. Md Khusairi Hj Salleh, Suatu Kajian Mengenai Prinsip , Kaedah & Cara : Urut Tradisional

Melayu , Darul Numan, Edisi Pertama, ms 40-69

9. Haliza Mohd Riji, Prinsip dan Amalan dalam perubatan melayu , Bab 5 : Prinsip and Amalan Rawatan : 137-183

10. Impact of a Massage Therapy Clinical Trial on Immune Status in Young Dominican Children

Infected with HIV-1;The Journal of Alternative and Complementary Medicine , Jul 2006, Vol. 12, No. 6 : 511 -516

11. Mario – Paul Cassar ,Handbook of Clinical Massage: A Complete Guide for Students and Practitioners, second edition 2004;Churchill Livingstone; pg 93 -168

12. Sylvia Carlson, Massage for Stroke Patients : what is a stroke and what role can massage therapy play in recovery process.Suite 101.com.Oct 2006.(cited 2009 April 22).Available from http://massagetherapy.suite101.com/article.cfm/massage_for_stroke_patients

13. Cherkin DC, Sherman KJ Deyo RA , et al, A Review of the evidence for the effectiveness,

safety and cost of acupuncture, massage therapy and spinal manipulation for back pain, Annals of Internal Medicine, 2003 , 138 (11) : 898 -907.

26

14. Jennie C.I. Tsao, Effectiveness of Massage Therapy for Chronic, Non – malignant Pain : A

Review. Evidence – based Complementary and Alternative Medicine, Feb 2007.

15. Jerilyn A. Cambron,DC, Phd;jeniffer Dexheimer, LMT; Patricia Coe, CMT; Randy Swenson,

MPHE,DC, University of Health Sciences , Side Effects of massage Therapy : a Pilot Study.

16. Ernst E, The Safety of Massage Therapy. Rheumatology (oxford)2003;42(9):1101-6

17. Traditional and Complementary Medicine Division, Ministry of Health Malaysia, Consensus Meeting on Improvement Strategy in Traditional and Complementary Medicine (T&CM) Services in Integrated Hospital with T&CM Practitioners, March 2009.

27

11. Committee Members Review and Improvement Strategies of Traditional and Complementary Medicine Practice Guideline Workshop For Malay Massage , 2008.(Working group) Dr Zalilah Abdullah Traditional and Complementary Medicine Division Ministry of Health Malaysia Md Bakri Hassan Physiotherapy Department Kepala Batas Hospital Mustaffa Sultan Physiotherapy Department Sultan Ismail Hospital Che Salasiah bt Abd Majid Qualified Nurse Traditional and Complementary Medicine Unit Kepala Batas Hospital

Pauziah Monil Traditional Malay Medicine Practitioner Traditional and Complementary Medicine Unit Putrajaya Hospital Yaacob Mohd Daud Traditional Malay Medicine Practitioner Traditional and Complementary Medicine Unit Putrajaya Hospital Kamarul Hj Abd. Rahman Traditional Malay Medicine Practitioner Traditional and Complementary Medicine Unit Kepala Batas Hospital Haslina Hashim Traditional Malay Medicine Practitioner Traditional and Complementary Medicine Unit Kepala Batas Hospital Robaieyah Ramlie Traditional Malay Medicine Practitioner Traditional and Complementary Medicine Unit Kepala Batas Hospital

Editorial Members For Traditional and Complementary Medicine Practice Guideline.

Dr Ramli Abd Ghani Director Traditional and Complementary Medicine Division Ministry of Health Malaysia Jaafar Lassa Senior Principal Assistant Director Traditional and Complementary Medicine Division Ministry of Health Malaysia

Dr Shamsaini Shamsuddin Senior Principal Assistant Director Traditional and Complementary Medicine Division Ministry of Health Malaysia Dr Fariza Dato’ Fadzil Principal Assistant Director Traditional and Complementary Medicine Division Ministry of Health Malaysia

28