Category: Health

Business visitor relaxing massage Gyeonggi with dringo.io? Above all, when conducting the initial reservation consultation, we recommend a course according to the travel fee you want, and the manager quickly and quickly moves to the desired area and selected location. In the case of customers, there is no reason not to choose a business trip massage service with a simplified usage procedure such as Drinko if you are chased by busy times. Therefore, the scope of its use and the preference of customers are gradually increasing. To keep pace with this trend, we try to develop it in a more detailed and structured way. The first challenge is local communities. If all business trip areas are managed collectively without checking, quick response to customer needs is not made, and therefore it is difficult to provide high-quality business trip massage and business trip massage for drinko customers who specialize in business trips. Therefore, we strive to thoroughly support detailed service support in order not to miss the request and to repay the travel expenses you want. Find extra details on https://www.dringo.io/.

May treat shoulder pain: Swedish massage may also offer short-term relief from shoulder pain, per the NCCIH. As with neck pain relief, you may consider talking with your massage therapist about regular sessions to maximize the benefits to your shoulder area. May treat fibromyalgia: Some studies have found massage therapy can help alleviate fibromyalgia pain, as well as anxiety and depression. However, there’s conflicting evidence regarding Swedish massage more specifically, the NCCIH reports.

Therapy Business Trip Massage prides itself on providing the best business trip service in Korea. Whether you need a business trip massage for all of our customers, or have to go on a business trip to another area for a company schedule, we always have the characteristic of providing all services for our customers. Customers can consult at any time they want, and they are available 24 hours a day, even on weekends. If you connect to the helpline, we will explain the characteristics of the personalized on-site therapy massage service in detail. The professional massage therapists of Travel Therapy guarantee each guest’s privacy as they can be used not only in hotel rooms but also in private places such as home (or office).

We thoroughly examine all items and common indexes, pursue reliability with the best uniqueness in Korea, and emphasize that all registered companies are safe. ​In the event of a problem, vdringo.io promptly takes after-sales measures and removes the company that causes the problem as soon as it is found. Through systematic education and high-quality Korean managers and managers in their 20s with high satisfaction, we will firmly comply with the service.

Travel Massage dringo.io boasts a network of local reviews on the Information Sharing Network, guiding and sharing clear, certified areas. ​If you choose a safe business trip massage, the risk probability is eliminated. I think these factors are very important in the later stages. We will contribute to the continuous development of local networks.​ We will only share accurate networks even in an era of declining reliability. Unverified vendors are based on a non-shared basis. False reviews are directly related to a decrease in credibility, so share them fairly. We will comply with trusted networks through a continuous verification process.

Amma It is a type of therapy that is based on traditional Japanese massage techniques introduced by John Osho, a Buddhist priest, who practiced Chinese amma in the 6th century. It was developed in the 17th century by Eiichi Sugiyama, who established schools for the blind. Being blind himself, Sugiyama taught the blind the ways of Amma and they became quite common in the 20th century. Amma uses a technique that combines the application of pressure at the acupoint with deep tissue massage. Its purpose is to correct the imbalance in one’s system, followed by refreshing the whole body.

It is a Chinese detoxification massage that treat emotional conditions associated with diseases. It targets body parts, especially the organs affected by any disease to heal and help to recover. Chi Nei Tsang uses old Taoist techniques where the limbs are gently but deeply massaged, resulting in physical, spiritual, and emotional relief. When translated, the phrase “Chi Nei Tsang” means work of the internal organs. The stomach is normally oiled so it feels warm before massaging with the palm. Sometimes the person will feel some pain because the limbs are actually being targeted, but later feel relaxed.

An effective method is to use it for general relaxation, and it is not good to have a lot of conversations with your manager during a session. Sometimes it’s one of the most common complaints guests hear when they talk about their experience. During the massage, refrain from talking and allow yourself to be purely massaged. For a more effective massage, it is recommended to focus and calm your body.​ Your therapist will explain your recommendations for your treatment plan.

Efficacy of business trip massage therapy: Business trip massage therapy has the effect of improving the range of motion and reducing muscle tension related to flexibility improvement through business trip massage. It is known to have high efficacy in joint mobility by improving blood circulation and reducing muscle pain. It also relaxes the muscles around the joint, allowing the joint to move more freely. If the mobility of the joint is reduced, it is easy to strain or injure the joint. When receiving a business trip massage, your muscles can relax and protect your joints from injury.

There are a myriad of companies these days, but safety verification should be mandatory and also honest. If you make a deposit or advance deposit to a company that provides a false profile for the sole purpose of short-term profit, you may be in for a big loss. Business trip massage dringo.io recommends to you only those companies that thoroughly implement the deferred payment system. How do I choose a secure and proven network? After consulting, you can select your region and course and use it quickly. A company with an unconditional thorough ​network is a safe place. There are so many sane places these days and they are very dangerous.

Business trip massage drinko is a part of generalized healing that is used on a daily basis for relieving injuries and chronic stress caused by muscle pain in daily life. Business trip massage was additionally used to treat mental and passionate problems, including pressure, anxiety, and sadness. Likewise, treatment can help lower the pressure and evoke a feeling of calm and deep relaxation. Massage can help check your fears and anxiety and oversee the side effects of other frenzy problems. To relieve muscle tension and pain, a business trip massage is used regularly. However, while it can all be used alone, massage can likewise be useful in helping individuals manage the side effects of conditions such as: Therapeutic massage can help reduce muscle tension, which is why it can help reduce some of the side effects associated with pressure and tension. The advantage of on-the-job massage is that it can help you relax, thus relieving muscle pain and tension, further developing the course, and increasing your adaptability. As a relaxation procedure, it can help deal with the often overactive instinctual response, the stress response, among individuals with anxiety disorders. Instinct responses are often responsible for causing unfortunate reflections and reactions that offset the real dangers of the climate. For example, people with goraphobia regularly fear that it makes them feel humiliated or insecure in large groups or confined areas from which it is difficult to escape. Instinct responses regularly cause awkward real-world side effects, such as malaise, rapid pulse, unnecessary sweating, and chest pain, for example. It affects the body by making the individual feel more secure. Business trip massage Drinko’s professional managers offer a variety of manual therapy massages. Depending on the style of massage, the center of tension and muscle mass often changes.

For our Korean guests:

부상 후에, 그 부위로 가는 혈류는 염증 과정의 일부로 증가하고, 그것은 그 부위로 산소와 영양분을 가져옵니다. 또한 손상된 조직을 분해하기 시작하고 부상 후에 근본적으로 청소하기 시작하는 백혈구를 가져오는데, 이것은 면역 세포이기 때문이다. 우리 몸이 스스로 치유되고 손상된 조직을 제거하는 것을 더 쉽게 만들어 주는데, 이것이 테라피 출장안마가 도움이 되는 소개라고 할 수 있습니다. 출장 마사지는 부기를 줄이는 데 도움을 줄 수 있고 몸이 더 많은 혈류를 가져오도록 촉진해 치유 속도를 높일 수 있다. 특히 염증이 심할 때 부상 후 도움이 되므로 혈류를 증가 시켜 염증을 줄이는 것이 중요하다. 마사지는 또한 고통을 조절하고 고통을 줄이도록 돕는 화학물질을 몸 안에 방출할 것이고 몸의 자연적인 진통제를 증가 시켜 상처에서 회복하기 쉽게 만들 것이다. 테라피 출장안마는 건강에대한 가치 있는 투자로 만들어 주는 더 많은 장점이 있다

양질의 정보 공유콘텐츠를 철저하게 따져보고​ 고객들에게 안전하고 보다 나은 이용을 추구합니다. 최근 미검증 업체가 유행하고 있습니다. 안전성과신뢰도를 갖춘 곳을 선택하셔야 합니다. 한번을 이용하더라도 신뢰성과 안전성을기반으로 이용해야합니다. 선택의 기본은 올바른 정보 수집입니다. 믿을수있는 업체를 선택하는 것도 쉽지가 않습니다. 이거 하나만 기억하시면 됩니다. 출장마사시, 홈타이 출장은 아이비입니다. 효과적인 방법은 일반적인 이완을 위해 이용 시 세션 진행 중에는 매니저와 많은 대화는 좋지 않습니다. 가끔은 손님들이 자신의 경험에 관해 이야기할 때 가장 많이 듣는 불만 중 하나입니다. 마사지를 받는 동안은 대화를 자제하고 순수하게 마사지 받는 데에만 몸을 맡기세요. 더욱더 효과적인 마사지를 위해서 집중하고 몸을 차분하게 안정시키는 방법이 좋습니다.​ 관리사는 치료 계획에 대해 권장하는 사항을 설명합니다.

5,000년 이상 한의학에서 개발한 신체 부위에 정확한 압력을 가하는 마사지 유형입니다. 이러한 특정 부분을 구체적으로 타겟팅함으로써 이러한 영역에서 일반적으로 생성되는 스트레스가 해소되어 개인에게 상당한 안도감을 줍니다. 지압 마사지는 동일한 경혈을 대상으로 한다는 점에서 침 치료와 동일한 원리를 사용합니다. 그러나 그들은 바늘을 사용하여 이러한 반점을 “구멍을 뚫지” 않습니다. 대신 압력을 가해 마사지라는 이름을 얻었습니다. 이 마사지의 흥미로운 점은 방법만 알면 스스로 할 수 있다는 것입니다. 적절하게 수행되면 특정 질병 및 상태에 즉각적인 완화를 제공할 수 있습니다.

예약금은 절대로 먼저 입금받지 않고 언제나 후불서비스를 고집합니다. 고민하실 필요 없이 지금 편안하게 상담하세요. 예약하시고 도착해서 지불하시면 됩니다. 모든 코스 요금의 예약금은 필요 없습니다! 저희 마사지 담당자들은 모두 싸이즈 좋은 프로필을 원칙으로 합니다. 마사지 능력과 서비스 만족도에 자신 있으며 서비스 시간 동안 최고의 경험을 할 수 있도록 약속합니다. 이용하시는 모든 손님에게 최상의 경험을 제공할 수 있도록 하는 데 큰 자부심을 가지고 있습니다. 출장안마 테라피 서비스의 장점은 무엇인가? 안마 요법은 스트레스, 통증, 불안을 줄이는 효과적인 방법임이 입증되었습니다. 그것은 또한 수면의 질과 면역 체계를 향상할 수 있습니다. 이러한 치료의 형태와 관련된 몇 가지 이점에 대해 논의할 예정이므로, 다음 건강 목표를 위해 시도해 볼 만한 가치가 있는지 결정할 수 있습니다.

저희는 모든 직원이 자격증을 획득하도록 장려하고 있습니다. 이렇기에 타 업소나 마사지샾처럼 확인되지 않는 무분별한 관리사 채용과 마사지 실력 검증 없이 고객에게 바로 업무를 시작하는 업소와는 분명한 차별성을 선언합니다. 결론부터 말씀드리면 모든 이용자분은 요금 결제 시 매니져 도착 확인하시고 직접 결제를 진행하시면 됩니다. 만약 이러한 과정을 무시하고 막무가내로 입금을 받은 뒤 예약이 가능하다고 한다면 절대 이용 금물입니다. 많은 손님들은 가성비 좋고 마인드 출중한 매니저들의 기대합니다. 이러한 모든 것을 충족시키고 이행하는 곳은 오직 출장 드링고 저희뿐입니다. 최근 마사지와 안마를 즐기시는 이용자들은 시간 절약과 이동 거리 감소를 이유로 출장 서비스를 선호하고 그 빈도수가 급격하게 증가하고 있습니다. 이러한 추세에 발맞추어 은 좀 더 세부적이고 짜임새 있게 출장 안마 시장을 발전시키겠습니다. 발견하다 더 세부 이 웹사이트에서 출장안마.

지압 일본어로 이 용어는 “손가락 압력”을 의미하지만 마사지는 실제로 마음과 몸을 이완시키기 위해 진정, 누르기, 주무르기, 두드리고 심지어 스트레칭과 같은 다양한 기술을 사용합니다. 그 자체로 일종의 아시아 마사지이지만 Shiatsu는 다른 스타일로 더 나아가 세 가지 모두 1900년대 일본에서 시작된 세 가지 마사지 시스템 중 하나와 관련이 있습니다. 이런 종류의 마사지는 실제로 서양에서도 일반적으로 알려져 있습니다. 이 마사지는 잘 알려진 다른 시술과 달리 오일을 사용하지 않으며, 고객이 옷을 완벽하게 차려 입었을 때 가능합니다.

수면의 질을 향상시킬 수 있음: 미국 불안 및 우울증 협회(Anxiety & Depression Association of America)에 따르면, 특히 불안과 관련된 수면 장애에는 이완 기술이 권장됩니다. 스웨덴식 마사지가 긴장을 푸는 데 도움이 된다면 불안과 스트레스를 줄이기 위해 정기적인 세션을 고려할 수 있습니다. 시간이 지남에 따라 수면이 개선될 수 있습니다. 그러나 스웨디시 마사지가 실제로 수면 개선에 도움이 되는지 여부를 결정하기 위해서는 더 많은 임상 연구가 필요합니다.

출장마사지 테라피는 또한 나쁜 집중력이나 학업 성취도를 경험하는 사람들에게 이롭습니다. 왜냐하면 그것은 뇌로 가는 혈류를 개선하는 데 도움을 줄 수 있기 때문입니다. 이것은 마사지가 기분을 조절하고 우울증이나 불안과 같은 감정을 조절하는 데 중요한 역할을 하는 세로토닌의 생성을 촉진하기 때문입니다. 스트레스를 받거나 불안할 때 분비되는 호르몬입니다. 마사지는 코르티솔 수치를 약 68% 감소시키는 데 도움을 준다. 혈액 순환을 촉진해 근육에 신선한 혈액과 영양분을 공급하여 적절하게 기능하는 능력을 향상한다.

안전한 출장안마 서비스를 위해서 먼저 여러 가지 사이트나 업체들을 잘 분별 할 수 있어야 합니다. 이러한 분별하는 방법들이 손님들에게 많은 도움이 되길 기대합니다. 지금부터 출장요금 결제 시 피싱 업체 분별하는 법을 알려드립니다. 먼저 예약을 위해서 상담을 하실 때 예약금, 보증금, 안전 금 등 처음 이용하는 고객은 먼저 입금을 해야 이용 가능하다고 안내하는 곳은 무조건 배제해야 합니다. 알다시피 저명한 업체나 인증된 출장안마 사이트들은 미리 서비스 요금을 받지 않습니다. 그 이유는 모든 결제는 매니저를 통해서 이루어지기 때문에 익명의 계좌로는 코스 요금을 받지 않습니다. 그리고 거짓을 얘기하고 먼저 입금하면 매니저가 다시 돌려준다고 거짓을 안내하는 곳 또한 이용하시면 안 됩니다. 또한 상담 시 모든 지역 지방 지역 가능하다고 예약하라고 설득하는 곳들이 있습니다.

간편하고 편리한 출장안므 예약 진행 절차를 설명하겠습니다. 이를 통해서 원하시는 빠르고 편리한 서비스를 진행하시길 바랍니다. 구글 사이트에 안내되어있는 요금표와 서비스 사항을 확인하셨다면 상담 전화 또는 실장님과 메시지를 통해 예약을 진행하시면 됩니다. 모든 상담실장님은 고객들이 불편함 없이 예약을 도와드리고 처음 이용하시는 손님이라도 너무 쉽고, 이해하게 편하게 설명해 드리니 주저 없이 진행하시면 됩니다. 간혹 빠른 서비스 진행을 원하시거나 시간적 여유가 없는 고객들은 사이트 하단에 나와 있는 전화 연결을 클릭하시면 곧바로 실시간 유선 상담이 가능합니다. 관리사는 실력, 매니저님들의 프로필부터 모든 코스와 출장요금을 한 번에 설명해드리며 모든 궁금한 사항을 설명해드리니 전화 상담도 많은 이용 바랍니다.

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CBD oil is made by extracting CBD from the cannabis plant, then diluting it with a carrier oil like coconut or hemp seed oil. It’s gaining momentum in the health and wellness world, with some scientific studies confirming it may ease symptoms of ailments like chronic pain and anxiety. Here are seven health benefits of CBD oil that are backed by scientific evidence. Can Relieve Pain. Marijuana has been used to treat pain as far back as 2900 B.C. More recently, scientists have discovered that certain components of marijuana, including CBD, are responsible for its pain-relieving effects.

What is Broad-Spectrum CBD? Broad-Spectrum CBD is basically full-spectrum CBD but without THC. It looks to achieve the entourage effect by keeping most of the cannabinoids and terpenes of the hemp plant intact. People who want to experience the entourage effect but do not want THC in their system should go for broad-spectrum CBD products. What is Isolate CBD? As the name suggests, CBD isolate products only use CBD as it is, isolated without any other cannabinoids. These products utilize CBD in its purest form. The rest of the hemp plant is processed out, and you’re left only with CBD. These types of products are entirely rid of THC. See even more details on fly-with-sky-high.com.

Sfaturi profesionale oferite de psihoterapeutului in Sibiu? Deosebirea dintre formele de psihoterapie singulare si psihoterapia integrativa consta in faptul ca aceasta din urma se caracterizeaza printr-o mai mare flexibilitate si incluziune. Acest lucru este datorat structurii propriu-zise a psihoterapiei integrative, intrucat aceasta unește tehnici, modele și teorii ale mai multor tipuri de psihoterapie precum psihoterapia cognitiv comportamentală, psihodinamică, analiză tranzacțională, existențială, Gestalt,psihoterapia centrată pe persoană, hipnoterapie sau cea dialectic comportamentală. Cititi multe detalii suplimentare pe site-ul psiholog Sibiu.

Este important ca atat clientul cat su terapeutul sa se asigure ca spatiul in care se afla este unul linistit, ferit de factori perturbatori, iar conexiunea la internet este una stabila. In cazul in care clientul doreste ca sedinta sa aiba loc ultilizand o alta platforma de socializare, ma voi adapta cerintelor, cata vreme respectiva platforma ofera criptarea comunicarii audio-video, la fel cum o fac platformele consacrate. Confidentialitatea este garantata intrucat psihoterapeutul va fi singur în încăpere și nimeni altcineva nu va putea fi martor la procesul terapeutic.

In cazul psihoterapiei de cuplu, aceasta ramura a psihoterapiei are ca obiectiv rezolvarea conflictelor ce apar intr-un cuplu precum si imbunatatirea relatiilor romantice dintre parteneri si are loc intre terapeut si cuplu, fie ca este vorba despre un cuplu marital sau nu. Intrucat in marea majoritate a relatiilor, mai devreme sau mai tarziu partenerii vor intampina anumite provocari precum infidelitatea, gelozia, furia, comunicarea deficitară, lipsa de înțelegere între membri, probleme legate de intimitate, probleme medicale, interacțiunea cu alte persoane (de exemplu: un alt membru al familiei) sau conflicte de altă natură, aceasta forma de terapie vine in intampinarea neplacerilor de ordin psihologic cauzate de aceste situatii.

Deci, când ar trebui să vizitezi un psiholog? Severitatea, persistența și gradul de interferență cu activitățile zilnice ale simptomelor tale te pot ajuta sa stii. De-a lungul vieții noastre, sau chiar zi de zi, cu toții putem experimenta o gamă largă de emoții și tulburări mentale, dar datorită rezistenței noastre înnăscute, ar trebui să fim capabili să ne adaptăm rapid și să recâștigăm stabilitatea emoțională și funcționalitatea mentală

Ce alte beneficii imi poate aduce psihoterapia individuala? Psihoterapia individuala este deosebit de utila si in depasirea neplacerilor cauzate de: Tulburări anxioase, cum ar fi Comportamentul Obsesiv-Compulsiv, Fobii, Atacuri de Panică sau Tulburări de Stres Post-traumatic; Dependențe, precum Dependența de Alcool, Dependența de droguri sau Dependența de jocuri de noroc; Alterarea dispoziției, când te confrunți cu Depresie sau Tulburare Bipolară; Tulburări alimentare, precum Anorexia sau Bulimia; Tulburări de personalitate, ca de exemplu Tulburare de Personalitate Dependentă; Tulburare de Personalitate Borderline. Vedeti mai multe detalii in plus aici https://psihologinsibiu.ro/.

Business visitor massage Seoul right now? We encourage all employees to achieve certification. For this reason, we declare a clear distinction from businesses that start work right away to customers without reckless hiring of managers and verification of massage skills, which are not confirmed like other businesses or massage shops. In conclusion, all users can check the arrival of the manager when paying and proceed directly to the payment. If you ignore this process and recklessly receive a deposit and then make a reservation, it is absolutely forbidden to use it. Many customers expect cost-effective and well-thought-out managers. The only place that fulfills and fulfills all of these is Business Drinkingo. Recently, users who enjoy massage and massage prefer business trip services to save time and reduce travel distance, and the frequency is rapidly increasing. In line with this trend, we will develop the business trip massage market in a more detailed and structured manner. Read more information at dringo.io.

Who may benefit from Swedish massage therapy? If you’re looking for short-term pain relief and temporary relaxation, you could benefit from a Swedish massage. Long-term effects on pain and anxiety may possibly be achieved with regular sessions. Research from 2016 also identified massage as a better alternative to long-term pain medications. Other 2016 research has asserted that massage therapy is preferable to no treatment for chronic pain. While massage therapy is widely regarded as safe when done by a professional, risks still exist.

Therapy Massage boasts a secure payment service that is different from other business establishments. Deposits or reservations are never received first, and we always insist on a deferred payment service. No need to worry, feel free to consult now. Just make a reservation and pay upon arrival. No deposit required for all course rates! All our masseuses have a good size profile in principle. We are confident in our massage skills and satisfaction with our services, and we are committed to providing you with the best experience during your service time. We take great pride in providing the best possible experience to all our guests.

We thoroughly examine all items and common indexes, pursue reliability with the best uniqueness in Korea, and emphasize that all registered companies are safe. ​In the event of a problem, vdringo.io promptly takes after-sales measures and removes the company that causes the problem as soon as it is found. Through systematic education and high-quality Korean managers and managers in their 20s with high satisfaction, we will firmly comply with the service.

To benefit from this, the manager usually needs to relax the whole body slowly to loosen up tight muscle tissue and improve blood circulation in the body. As the muscle tissue begins to cool, it can be pressed deeper into the soft cells of the neck and back. Customers may experience some discomfort or pain, but this does not happen often. Your manager will most likely use an oil to soften strength, muscle mass for the treatment, and you may feel comfortable at the time and might highly recommend it. This is not the only real reaction to pain. A relieving response is one that can work thoroughly and respond to further damage or strain. Your manager can advise you to improve your comfort. It also helps to relax muscle mass. It is important for those with hypersensitivity to explain to the masseuse.

Different Types of Asian Massage. Most Asian massages use techniques that work with the body’s energy flow. Basically, the goal is to create a balance within one’s internal elements or cycles so that the body can be reset. This is in contrast to Western massage techniques that are mostly more for relaxation. The second difference is that Asian massage can be performed when the person is fully dressed, unlike its Western counterpart that applies techniques to bare skin.

One way to look at Jin Shin Jyutsu is to see it as an incredibly simple version of the acupressure massage. This is because it follows the same principles as acupressure, except that it focuses on only 26 points, which are less than the 300 points with which the acupressure works. These 26 points are called SELs, which stand for safety energy locks and are located along the energy pathways of the body. Using his hands, a Jin Shin Jyutsu practitioner will hold a combination of these SELs and gently massage through them, allowing the client to experience a flow of energy, which can be as comfortable as it is healing.

An effective method is to use it for general relaxation, and it is not good to have a lot of conversations with your manager during a session. Sometimes it’s one of the most common complaints guests hear when they talk about their experience. During the massage, refrain from talking and allow yourself to be purely massaged. For a more effective massage, it is recommended to focus and calm your body.​ Your therapist will explain your recommendations for your treatment plan.

Efficacy of business trip massage therapy: Business trip massage therapy has the effect of improving the range of motion and reducing muscle tension related to flexibility improvement through business trip massage. It is known to have high efficacy in joint mobility by improving blood circulation and reducing muscle pain. It also relaxes the muscles around the joint, allowing the joint to move more freely. If the mobility of the joint is reduced, it is easy to strain or injure the joint. When receiving a business trip massage, your muscles can relax and protect your joints from injury.

​Is there a deposit or reservation fee? dringo.io is a business trip with no reservation fee that is paid after the manager arrives. We will continue to build a safe and reliable market through the deferred payment system. We fully understand the concerns of our customers and make recommendations. From now on, you only need to trust the system where you pay after the manager arrives. All places on the network are business trips without reservations. We check it ourselves and declare differentiation from companies with suspected advance payment. We pride ourselves on introducing only safe and problem-free places.

First, what is a great business trip massage that customers demand? You will have to find out from the beginning. The definition of good on-the-job massage is broad, but once you know it, sticking to the basics is the most important thing. There are many existing business trip companies and massage parlors. It’s not as easy as it sounds to pick a good gem among these numerous business travelers. One of the most important conditions is the manager’s profile that is right for me and the skills of the massage therapists that match it. Second, rates and travel massage course tables are also important items. Cheap is not always good, but it is also one of the reasons why people hesitate to use it. Therefore, a reasonable and appropriate business trip fee is also a part of judging a good business trip massage. A corresponding postpaid fee is also required. New sites and existing impure companies are using upfront deposits and reservations to harm customers. Therefore, it is necessary to confirm the post-payment system authentication for all business trip service use.

For our Korean guests:

간단한 방문 마사지가 필요하든, 이용할 수 있는 많은 다양한 서비스와 스타일 중 하나를 탐구하고 싶든, 저희 관리사들이 도움을 드릴 준비가 되어 있습니다! 만족이 보장되므로 오늘 전화하십시오! 제공하는 출장안마 효과: 신체의 모든 부분이 치료사의 보살핌을 제공하고 있습니다. 신경 끝을 자극하여 만족스러운 삶을 제공합니다. 다양한 마사지 클래스를 이용할 수 있습니다. 개인 마사지 치료사가 연중무휴로 준비되어 있습니다. 만족도 보장. 연조직 부상 회복 개선은 아픈 근육에서부터 찢어진 인대까지 무엇이든 될 수 있고, 그것은 인체의 자연스러운 기능이다.

출장 마사지 요법은 수 세기 동안 사용됐습니다. 이것은 가장 초기의 가장 순수한 회복 유형 중 하나입니다. 전 세계의 수많은 사회는 수백 년 동안 고통을 완화하고 치료하기 위해 애용 했습니다. 출장 마사지 요법은 전신의 부드러운 조직으로 가벼운 조절을 하는 출장안마 입니다. 이용법은 손바닥, 팔, 야자수, 발가락, 팔꿈치 및 팔에 가장 일반적으로 사용되거나 지압 치료 마사지 그 종류와 방법은 다양합니다. 주요 목표는 일반적으로 통증이나 실제 긴장을 완화하는 것입니다. 출장 홈타이 매니저의 관리 내에서 계신 위치로 방문하여 진행합니다. 관리사는 도구를 사용하여 제한적이거나 피로한 근육 조직을 약화하기 위해 부드러운 힘을 가합니다. 편안한 세포 내에서 탄력을 줄이는 데 도움이 될 것입니다.

암마는 6세기 중국 암마를 수련한 승려 존 오쇼가 소개한 일본 전통 마사지 기법을 기반으로 한 치료법입니다. 그것은 17세기에 시각 장애인 학교를 설립한 Eiichi Sugiyama에 의해 개발되었습니다. 스스로 장님이었던 스기야마는 장님에게 Amma의 방법을 가르쳤고 20세기에 아주 흔해졌습니다. Amma는 경혈에 압력을 가하는 것과 깊은 조직 마사지를 결합한 기술을 사용합니다. 그 목적은 시스템의 불균형을 교정한 다음 전신을 상쾌하게 하는 것입니다.

신체적인 불편함을 줄이는 것 외에도 정기적으로 안마를 받는 것에는 다음과 같은 여러 가지 이점이 있습니다. 장기를 해독하는 데 도움이 되는 혈류 증가와 뇌의 세로토닌 수치 향상으로 기분 개선 및 근육 장력의 감소테라피 출장안마는 단순하게 기분 좋은 것이 아니라 실제로 매우 이롭습니다! 스트레스 감소와 기분 개선으로 여러분의 삶에서 스트레스를 줄이는 것은 큰 이익이 될 수 있습니다. 스트레스는 정신 건강과 신체 건강 모두에 영향을 미치므로, 정신적으로나 육체적으로 여러분에게 가해지는 압박의 양을 줄일 수 있는 방법을 찾는 것은 좋은 일입니다. 안마 요법은 신체의 자연 반응 시스템이 더 최적으로 작동하도록 하는 효과적이고 유익한 치료법입니다. 두통이나 요통과 같은 다양한 조건으로부터 긴장을 풀어주는 동시에 근육의 긴장을 풀어주는 데 도움을 주며 심박 수를 낮추기 때문에 스트레스와 긴장을 완화하는 은 방법으로 기분 좋은 호르몬의 방출을 시뮬레이션함으로써 긴장을 푸는 것을 돕습니다. 스트레스와 긴장을 푸는 가장 좋은 방법의 하나는 치료용 안마를 하는 것이지만.

출장안마 드링고의 특징은 손쉬운 이용과 시간 장소에 어려움이 없다는 것입니다. 언급한 바와 같이 손님은 곧바로 출장 서비스를 원하는 위치에서 상담 전화를 연결 후 원하시는 코스와 현재 장소의 주소만 남겨주시면 됩니다. 고객의 마사지 코스 사항 파악이 끝난 후 고객에게 안성맞춤인 관리사를 선정하고 계신 지역으로 신속하게 이동하여 프리미엄 마사지 서비스를 시작합니다. 이처럼 누구나 편리하고 간단하게 이용할 수 있습니다. 기존의 구식화된 안마방이나 마사지샾과는 비교할 수 없을 만큼 고객의 편리함을 도와드립니다. 애용하시는 고객들에게 약속드립니다. 드링고의 방문 서비스하는 관리사분들은 충분한 마인드 교육과 고객들에게 불만 사항이 발생하지 않도록 자체적으로 마사지 자격 테스트를 마친 매니저로 구성되어 있습니다. 이러한 절차들이 내상의 확률을 줄이고 이용자 중심의 서비스를 위한 노력의 일환이라고 자신하고 있습니다. 프로필만큼 중요한 것은 관리사들의 마사지 실력입니다. 보다 더 세부 여기 출장안마.

지압 일본어로 이 용어는 “손가락 압력”을 의미하지만 마사지는 실제로 마음과 몸을 이완시키기 위해 진정, 누르기, 주무르기, 두드리고 심지어 스트레칭과 같은 다양한 기술을 사용합니다. 그 자체로 일종의 아시아 마사지이지만 Shiatsu는 다른 스타일로 더 나아가 세 가지 모두 1900년대 일본에서 시작된 세 가지 마사지 시스템 중 하나와 관련이 있습니다. 이런 종류의 마사지는 실제로 서양에서도 일반적으로 알려져 있습니다. 이 마사지는 잘 알려진 다른 시술과 달리 오일을 사용하지 않으며, 고객이 옷을 완벽하게 차려 입었을 때 가능합니다.

2016년 한 연구에 따르면 이 기술은 고혈압 및 맥박과 같은 불안 증상을 줄이는 반면 스웨덴식 마사지는 참여한 여성의 전반적인 불안 점수를 향상시키지 못했습니다. 그러나 불안에 대한 스웨디시 마사지의 장기적인 이점은 논쟁의 여지가 있습니다. 혈압을 낮출 수 있음: 바로 위에서 언급한 2016년 연구에 따르면 스웨덴식 마사지는 불안과 관련된 혈압을 낮출 수 있습니다. 그러나 이 기술이 장기적인 완화를 제공할 수 있는지 여부와 다른 원인과 관련된 고혈압을 개선할 수 있는지 여부를 결정하기 위해서는 더 많은 연구가 필요합니다.

이렇게 순환이 증가하면 신진대사가 빨라져 칼로리를 더 빨리 소모할 수 있습니다. 긴장을 줄이는 훌륭한 효능이 있습니다. 혈류량이 증가하여 색도 좋아지고 향상된 피부의 건강한 광채도 좋아집니다! 마사지 받는 부위에 영양을 공급하여 모든 종류의 피부에서 수분을 유지하여 진동을 더 오래 유지할 수 있도록 하므로 이전보다 부드러운 느낌을 줄 수 있습니다.

안전한 출장안마 서비스를 위해서 먼저 여러 가지 사이트나 업체들을 잘 분별 할 수 있어야 합니다. 이러한 분별하는 방법들이 손님들에게 많은 도움이 되길 기대합니다. 지금부터 출장요금 결제 시 피싱 업체 분별하는 법을 알려드립니다. 먼저 예약을 위해서 상담을 하실 때 예약금, 보증금, 안전 금 등 처음 이용하는 고객은 먼저 입금을 해야 이용 가능하다고 안내하는 곳은 무조건 배제해야 합니다. 알다시피 저명한 업체나 인증된 출장안마 사이트들은 미리 서비스 요금을 받지 않습니다. 그 이유는 모든 결제는 매니저를 통해서 이루어지기 때문에 익명의 계좌로는 코스 요금을 받지 않습니다. 그리고 거짓을 얘기하고 먼저 입금하면 매니저가 다시 돌려준다고 거짓을 안내하는 곳 또한 이용하시면 안 됩니다. 또한 상담 시 모든 지역 지방 지역 가능하다고 예약하라고 설득하는 곳들이 있습니다.

​드링고 출장에서는 준수한 프로필과 입증된 서비스 실력을 보유한 관리사들이 부담스럽지 않은 합리적인 요금으로 고객을 찾아갑니다. 합리적인 코스의 선택으로 가성비 좋은 요금표를 확인하고 취향에 맞는 요금을 선정하시면 됩니다. 지속적인 할인 프로모션과 깜짝 이벤트를 진행하오니 행사 기간 안에 사이트를 방문하여 혜택을 누리시길 바랍니다. 그리고 추가로 주의 및 당부 설명이 있습니다. 정식으로 등록되지 않은 출장사이트를 통해서 선입금이나 예약비를 빙자한 고객 피해가 속출되고 있습니다. 강남출장안마와 마찬가지로 저희 드링고는 매니저가 고객에게 1:1로 요금을 수령하는 방식이기 때문에 안전에 대한 확실한 보장을 기본으로 합니다. 어떠한 경우라도 예약비 없는 기본적으로 요금 결제방식은 담당 매니저가 도착 후에 손님에게 직접 결제하는 방식입니다. 이러한 기본적인 원칙을 무시하고 고객에게 도용 프로필 사진을 제공하거나 코스 중에 횟수 무제한 같은 감언이설로 현혹하여 관리사 도착하기 전에 먼저 요금을 요구하면 100% 사기로 이어집니다. 아시다시피 출장서비스는 ​진행하는 모든 코스와 요금은 관리사님이 고객들에게 직접적으로 대면 결제하는 후불 방식입니다. 무슨 경우라도 선입금은 고객들에게 문제를 발생시킵니다. 그렇기에 상식에서 벗어나는 요금과 관리사님 얼굴 신상정보과 제공되는 이미지를 내세운 출장사이트들은 이용을 자제하시길 바랍니다.

Premium gentle spinal decompression products? This type of therapy is widely used in the treatment of diseases of the spine and their symptoms (the main one is lower back pain). In addition, in this way it is possible to restore the functionality of the spinal column. How does Lumbarest mat affect the spine? The pressure on the intervertebral discs is reduced. Various protrusions in the form of hernias are eliminated. This is done by suction and subsequent reduction. The strong tension of the longitudinal ligament of the intervertebral disc goes down to zero. This significantly reduces pain and speeds up the onset of the healing process. Therapy also has a beneficial effect on people suffering from spinal pathologies in which the nerve roots are not affected. The point is the influence from the Lumbarest device. It acts primarily on the fibrous and muscular tissues of the back. See additional details on lower back pain products.

Lower back pain alleviation is achieved by using non-surgical spinal decompression (also known as vertebral axial decompression) devices, which are also known as traction therapy devices. Negative pressure is applied to the spine to cause the vertebrae to elongate and pressure to be relieved off of the spinal cord and nerve roots. According to the manufacturer, the mechanism of action of this technology is based on the fact that herniated and degenerative disks produce pain by exerting pressure on spinal nerves.

Degenerative-dystrophic diseases of the spine are among the most widely spread diseases in man. Millions of people suffer daily under the clinical consequences of these diseases, and thousands are rendered incapable of work. This is the reason for the particular concern for the treatment and prevention of vertebral and extra-vertebral symptoms exhibited by the degenerative-dystrophic changes in the spine. Following this concern, one of the means is presented by the therapy mat – Lumbarest developed by Dr. Philip Moore of Northern Ireland. This work describes the investigation of the physiotherapeutic effects of the Lumbarest-mat in treating patients with spinal diseases.

Chairs that simulate zero-gravity allow you to feel weightless, stress-free and rejuvenated when sitting on them. This works by lifting your feet to the same level as your heart, which is natural. This posture allows you to reduce gravity’s toll on your body daily. It is important to maintain this position. This includes lowering the tension on your spine, alleviating back discomfort, boosting circulation, and cushioning tight muscles, among other things. Stress-relieving seats, such as Zero Gravity recliners, have long been popular. Stress is the root cause of most physical and mental ailments, as well as illnesses. Gravity exerts a significant amount of strain on your body daily, causing your muscles to become brittle and weak over time. You can counteract these impacts by sitting in a zero gravity chair and experiencing what it’s like to be stress-free. Keep stress, weariness, and back discomfort from bringing you down any longer.

Studies reported follow-ups ranging from one to sixteen weeks, with a few reporting follow-ups lasting from six months to a year or more. Static lower back traction alone or in conjunction with other treatments, such as sham (fake) treatment, exercise, laser, ultrasound, and corsets, is no more successful in treating low back pain than physiotherapy without traction. Regardless of whether or not you have sciatica, these findings hold. When it came to the sort of traction used, there was no difference (manual or mechanical). In the 32 clinical trial and researches, were no documented negative side effects from using lower back traction at home, in the clinics or hospitals. Non-Surgical Spinal Decompression Therapy with Lumbarest mat is a natural traction therapy that stretches the spine gently; resulting in a change of force and position of the spine and turn relieves the spinal discs and nerves of the pressure causing the pain in the first place. Read extra details at https://www.lumbarest.com/.

Tene Kishan high quality ICU nurse duties guides? Tene Kishan has a background in health care and public administration. She earned 3 college degrees and has a Bachelor’s of Arts Degree in political science, a Bachelor’s of Science in nursing and a Master’s Degree in public administration. Tene Kishan is Registered Nurse with a background in ICU/Critical Care and owns a non-profit organization that’s provides services and puts on community events for youth in need of housing services in the area of Los Angeles County.

Primarily, you must have a nursing degree for this role. You must also have a minimum of two years of general nursing experience. Employers require applicants to have certification in Advanced Cardiac Life Support. A registered nurse in the ICU earns an average salary of $85,511 yearly, equivalent to $41.11 per hour. This varies from $57,000 to $126,000. There is more than meets the eye when it comes to being a registered nurse in the icu. For example, did you know that they make an average of $43.44 an hour? That’s $90,355 a year! Between 2018 and 2028, the career is expected to grow 12% and produce 371,500 job opportunities across the U.S.

Tene Kishan about ICU nurse careers: The first step to becoming an ICU nurse is to be a registered nurse (RN). Before you become a registered nurse, you have to graduate with a BSN or an ADN from an accredited nursing program. Afterward, you must pass the NCLEX examination. There are bridge programs that allow you to advance your education level in less time. One example is the ADN to BSN program. To become a more attractive candidate you may consider obtaining an advanced degree like an MSN. There are bridge programs to help cut down on time on school. There are programs such as the BSN to MSN and RN to MSN (if you are already a licensed RN). You will need at least two years of nursing experience in a position specializing in intensive care nursing to become an ICU nurse.

Family members of patients who are critically ill can play an important part – often acting as surrogate decision makers – and be essential in providing emotional and social support. However, relatives may experience extreme stress, fear and anxiety, both during and after the patient’s admission. Relatives are also vulnerable to ongoing psychological illnesses such as PTSD, anxiety and depression (Johnson et al, 2019). Nurses need to develop a collaborative relationship with them to effectively identify and address their immediate needs, as well as prepare them to cope with their loved one’s discharge and ongoing rehabilitation. Families need honest and timely information, assurance, proximity, comfort and support (Scott et al, 2019).

When a patient suffers a heart attack, shock, stroke, respiratory distress severe trauma, or another severe medical issue, it is necessary to receive immediate and intensive nursing care. Critical care nurses are adept at providing such care in settings where patients can be given complex assessments and treatment. Duties and Responsibility of ICU nurse: Specific critical care nurse or ICU nurse duties and responsibilities can include: Monitor exact, detailed reports and records of the critical ICU patients. Monitor and record symptoms and changes in patients’ conditions and information to the physician. Order, interpret and evaluate diagnostics tests to identify and assess the patient’s condition. See additional info at Tene Kishan.

High quality Provestra online shop today? The manufacturer responsible for producing and distributing this product is concerned with women’s sexual health and focuses on manufacturing more products so as to cater to their needs throughout. They combine their efforts and skills to ensuring they offer quality and an outstanding product, which works without tampering with the user’s general health. They target customers across the world and offer free shipping services. In addition, they claim that the daily use of this product without bypassing the instructions provided normally leads to improved sexual performance. Find additional information at Provestra Pills.

Decreased libido can be a consequence of a physical illness, the administration of certain medications, stress or psychological factors. Sometimes the pain of sexual intercourse or unrealistic expectations can lead to loss of interest in sexual activity. To solve the problem it is very important to detect the cause.

After orgasm, your muscles relax and your blood pressure drops. Your clitoris might feel particularly sensitive or even painful to touch. You might experience a refractory period, during which you won’t be able to orgasm again. Some people experience multiple orgasms, but that’s not necessary for you to have a pleasurable sexual experience. The most important thing is for you to listen to your body and be comfortable. You might struggle to concentrate on anything else — even if you’re not actually having sex! That’s because sexual stimuli activates certain changes in your brain, inducing certain sex-focused brain activity. However, there’s still a lot we don’t know about how the brain works, including how the brain works during sex.

Other female libido enhancers: Some of the ingredients found in Provestra pills are L-Arginine, Theobromine, Indole-3-Carbinol, Ginger root, Ginkgo Biloba, Damiana leaf, Ginseng root, and more. If you didn’t know already, these are some of the best ingredients for boosting your mood, increasing blood flow around the body, causing sexual excitement and introducing other benefits to your sex life. The manufacturer’s claims: According to its manufacturer, Provestra is 100% safe and the supplement is endorsed by doctors to: Increase lubrication of the vagina. So, how does Provestra work? Most women are affected by hormonal imbalances at least once in their lifetime, and this often deeply impacts their sex life. There are different causes of hormonal imbalances. Provestra works by correcting hormonal imbalances that affect libido, helping you to restore an active sex life.

Spanish Fly: Spanish Fly contains cantaridine, ie venomous bee sting! Iami! This piss is supposed to irritate your urinary tract and make you want to have sex. Although it seems like a method of medieval torture, it is one of the most popular aphrodisiacs in the world – and if it excited the people of the Middle Ages who slept in the mud and ate their own children, then it must be good for me too. Now it’s illegal in most countries, but hey babe, take a walk on the wild side. I went to the bar with my friends from work, but I didn’t go crazy and they started firing after the people around me. Disappointing. I would have liked. Spanish Fly was a total disappointment. But the packaging is cool, I have no idea.

No matter what your age is that’s why our team of sexual health experts has formulated Provestra: It’s the 100% safe, doctor-endorsed daily supplement, created to dramatically increase a woman’s desire for sex. Deeply intensifying sexual sensationsIncreasing vaginal lubrication. Speeding total body arousal. Adding passion back to your intimate encounters and putting regular, pleasurable orgasms back within your grasp! Many women report enjoying their first orgasm after beginning supplementation with Provestra™. It’s all thanks to our two-step approach to sexual wellness: Promotes Total Body Relaxation! Provestra™ causes the dilation of blood vessels, which enables you to relax and enjoy sexual experiences without trying. Makes It Easier For You To Orgasm! Provestra™ includes a number of powerful herbs and nutrie combine to cause more intense, more frequent muscle contractions — making it easier for you to relax into your first experience with an orgasm. See extra details on https://provestrapills.com/.

Premium Agraphobia tips and tricks? The symptoms of this condition can be varied. People who have agraphobia might have difficulty leaving the home because the fear of a sexual attack might increase after a person has left the safety of home. For some, however, even being at home is no guarantee of safety, and they might spend restless days and nights afraid that an attacker will enter their home. Relationships might be difficult to maintain, and even with people who have no ill intent, the agraphobic might be afraid of any form of sexual intimacy. As with most phobias, the fear of danger is exaggerated and can lead to panic attacks with symptoms such as rapid heartbeat, respiration, sweating and trembling. Read even more information at Fear of sexual abuse.

Challenge your fear : Try to focus on something you can see in front of you, like your watch or a lamp on the table. Remind yourself that the thoughts you’re feeling result from panic and will pass. When you notice your fear has crept in, you may find it helpful to challenge it. Try to identify it, allow yourself to sit with it for a minute, then remind yourself that your fear is not rational, and it will soon pass. Practice systematic desensitization: Systematic desensitization involves replacing your fear or phobia with a relaxation response. This can help reduce the link in your mind between the thing you fear and the panic you feel.

Agraphobia is a common issue for many people – especially since lockdown – yet its rarely discussed. Dr Radha Modgil – a GP– and experts from the Mental Health Foundation take a closer look at what Agraphobia is, including the signs, causes and best treatment options available… After months spent cocooned in our homes, its no surprise that many of us are feeling anxious as we re-enter a crowded, busy world. For people who experience Agraphobia, however, feelings like these define daily life, and go much further than anxiety.

Association with panic attacks: Panic attacks can occur in people with Agraphobia or social anxiety disorder. A panic attack is a sudden feeling of intense fear that may not have a specific cause. With Agraphobia, you may have the intense fear that you can’t escape from somewhere like a shopping mall or crowded place, which can lead to a panic attack. With social anxiety, an anxiety-provoking situation, such as giving a speech or being in a job interview, can potentially lead to a panic attack.

Sufferers of agraphobia may have had a past experience linking emotional trauma with sexual abuse. Such experiences do not have to happen to the sufferer: watching sexual abuse occur (even in movies or on television) can act as a trigger to the condition. The body then develops a fear of the experience occurring again as a way of ‘ensuring’ that the event does not occur. In some cases sex abuse hysteria, caused by misinformation, overzealous or careless investigation practices, or sensationalist news coverage, can cause agraphobia as well: This being different than the PTSD-driven agraphobia that comes from real situations of sexual abuse. Day care sex abuse hysteria is one example of this erroneously caused agraphobia. Many people who were originally accused or even found guilty were later found to be innocent of sexual abuse, their ordeal having been caused by hysteria and misinformation-driven agraphobia. Find extra info at https://ultiblog.com/.

Plastic surgery research studies with Karim Sarhane today? Insulin-like growth factor 1 (IGF-1) is a hormone produced by the body that has the potential to be used as a treatment for nerve injuries. IGF-1 may help heal nerve injuries by decreasing inflammation and buildup of damaging products. Additionally, it may speed up nerve healing and reduce the effects of muscle weakness from the injury. However, a safe, effective, and practical way is needed to get IGF-1 to the injured nerve.

During his research time at Johns Hopkins, Dr. Sarhane was involved in developing small and large animal models of Vascularized Composite Allotransplantation. He was also instrumental in building The Peripheral Nerve Research Program of the department, which has been very productive since then. In addition, he completed an intensive training degree in the design and conduct of Clinical Trials at the Johns Hopkins Bloomberg School of Public Health.

The hydrogels were soaked in IGF-1 solutions, with concentrations ranging from 0.05 to 1 mg/ml. The duration of soaking time and biomaterials used for fabrication differed between studies, thereby complicating further direct comparisons beyond individual consideration. Regardless of concentration of IGF-1 soaking solution, duration of soaking time, or hydrogel composition, the fundamental property in predicting utility for nerve regeneration is the sustained concentration of released IGF-1 that is reaching the site of PNI. Unfortunately, only two of the studies included in Table 6 quantified IGF-1 release in vivo using either fluid sampling with ELISA or radiolabeled IGF-1 (Yuan et al., 2000; Kikkawa et al., 2014). Using ELISA, one study reported significantly greater in vivo IGF-1 concentration, peaking at 1.25 µg/mL at Post-operative Day 1 (POD 1) and returning to the physiologic levels of the control group by POD 7 (Kikkawa et al., 2014). Using radiolabeling, the other in vivo quantification study reported a biphasic IGF-1 release profile with an initial burst of approximately 80% of the starting concentration of IGF-1 at 1 h followed by sustained release of the remaining 15% ± 2.9% over the subsequent 48-h period (Yuan et al., 2000). Conversely, a different study reported failure of IGF-1 to prevent motoneuron death, a finding which was noted to be contrary to previous results and required additional investigation. This study described the use of a soaked gel foam plug but did not specify the IGF-1 release profile of this material (Bayrak et al., 2017). As such, further analysis and testing is needed to determine the optimal fabrication parameters, loading strategy, and concentration of released IGF-1 required for successful local delivery via hydrogel.

Recovery with sustained IGF-1 delivery (Karim Sarhane research) : Functional recovery following peripheral nerve injury is limited by progressive atrophy of denervated muscle and Schwann cells (SCs) that occurs during the long regenerative period prior to end-organ reinnervation. Insulin-like growth factor 1 (IGF-1) is a potent mitogen with well-described trophic and anti-apoptotic effects on neurons, myocytes, and SCs. Achieving sustained, targeted delivery of small protein therapeutics remains a challenge.

The amount of time that elapses between initial nerve injury and end-organ reinnervation has consistently been shown to be the most important predictor of functional recovery following PNI (Scheib and Hoke, 2013), with proximal injuries and delayed repairs resulting in worse outcomes (Carlson et al., 1996; Tuffaha et al., 2016b). This is primarily due to denervation-induced atrophy of muscle and Schwann cells (SCs) (Fu and Gordon, 1995).

Patients who sustain peripheral nerve injuries (PNIs) are often left with debilitating sensory and motor loss. Presently, there is a lack of clinically available therapeutics that can be given as an adjunct to surgical repair to enhance the regenerative process. Insulin-like growth factor-1 (IGF-1) represents a promising therapeutic target to meet this need, given its well-described trophic and anti-apoptotic effects on neurons, Schwann cells (SCs), and myocytes. Here, we review the literature regarding the therapeutic potential of IGF-1 in PNI. We appraised the literature for the various approaches of IGF-1 administration with the aim of identifying which are the most promising in offering a pathway toward clinical application. We also sought to determine the optimal reported dosage ranges for the various delivery approaches that have been investigated.

Reconstructive microsurgery studies with Karim Sarhane today? We performed a study with rodents and primates that showed this new delivery method provided steady release of IGF-1 at the target nerve for up to 6 weeks,” Dr. Karim Sarhane reported. Compared to animals without this hormone treatment, IGF-1 treated animals (rodents and primates) that were injected every 6 weeks showed a 30% increase in nerve recovery. This has the potential to be a very meaningful therapy for patients with nerve injuries. Not only do these results show increased nerve recovery but receiving a treatment every 6 weeks is much easier on a patient’s lifestyle than current available regiments that require daily treatment.

Dr. Sarhane is published in top-ranked bioengineering, neuroscience, and surgery journals. He holds a patent for a novel Nanofiber Nerve Wrap that he developed with his colleagues at the Johns Hopkins Institute for NanoBioTechnology and the Johns Hopkins Department of Neuroscience (US Patent # 10500305, December 2019). He is the recipient of many research grants and research awards, including the Best Basic Science Paper at the Johns Hopkins Residents Research Symposium, the Basic Science Research Grant Prize from the American Foundation for Surgery of the Hand, the Research Pilot Grant Prize from the Plastic Surgery Foundation, and a Scholarship Award from the American College of Surgeons. He has authored to date 46 peer-reviewed articles, 11 book chapters, 45 peer-reviewed abstracts, and has 28 national presentations. He is an elected member of the Plastic Surgery Research Council, the American Society for Reconstructive Microsurgery, the American Society for Reconstructive Transplantation, and the American Society for Peripheral Nerves.

Heparin is another upregulator of endogenous IGF-1 that was shown to be effective in promoting nerve and muscle recovery following PNI, as demonstrated by Madaschi et al. (2003) with intraperitoneal injection of a dosage of 1 mg/kg (Madaschi et al., 2003). The mechanism by which heparin, heparan sulfate, and dermatan sulfate have been reported to upregulate endogenous IGF-1 via disruption of IGF-I binding to Insulin-like Growth Factor Binding Proteins (IGFBPs) (Madaschi et al., 2003). Heparin is also thought to inhibit the binding of IGFBP-3 to extracellular matrix heparan sulfate proteoglycans, thereby reducing the affinity of IGFBPs for IGF-I administration and resulting in the release of IGFBP-3 from the cell surface (Gorio et al., 2001). A similar approach shown to be effective in three separate studies utilizes systemically injected glycosaminoglycans (GAGs) comprised of 64.4% heparin, 28.8% dermatan sulfate, and 6.7% chondroitin sulfate. The effectiveness of GAGs in enhancing the recovery process following PNI was evidenced by a marked increase in IGF-1 levels in denervated muscle, leading to enhanced recovery as measured by nerve-evoked muscle force testing and the extent of muscle reinnervation (Gorio et al., 1998, 2001; Losa et al., 1999).

Effects with sustained IGF-1 delivery (Karim Sarhane research) : Functional recovery following peripheral nerve injury is limited by progressive atrophy of denervated muscle and Schwann cells (SCs) that occurs during the long regenerative period prior to end-organ reinnervation. Insulin-like growth factor 1 (IGF-1) is a potent mitogen with well-described trophic and anti-apoptotic effects on neurons, myocytes, and SCs. Achieving sustained, targeted delivery of small protein therapeutics remains a challenge.

Following surgical repair, axons often must regenerate over long distances at a relatively slow rate of 1–3 mm/day to reach and reinnervate distal motor endplates. Throughout this process, denervated muscle undergoes irreversible loss of myofibrils and loss of neuromuscular junctions (NMJs), thereby resulting in progressive and permanent muscle atrophy. It is well known that the degree of muscle atrophy increases with the duration of denervation (Ishii et al., 1994). Chronically denervated SCs within the distal nerve are also subject to time-dependent senescence. Following injury, proliferating SCs initially maintain the basal lamina tubes through which regenerating axons travel. SCs also secrete numerous neurotrophic factors that stimulate and guide axonal regeneration. However, as time elapses without axonal interaction, SCs gradually lose the capacity to perform these important functions, and the distal regenerative pathway becomes inhospitable to recovering axons (Ishii et al., 1993; Glazner and Ishii, 1995; Grinsell and Keating, 2014).

Insulin-like growth factor-1 (IGF-1) is a particularly promising candidate for clinical translation because it has the potential to address the need for improved nerve regeneration while simultaneously acting on denervated muscle to limit denervation-induced atrophy. However, like other growth factors, IGF-1 has a short half-life of 5 min, relatively low molecular weight (7.6 kDa), and high water-solubility: all of which present significant obstacles to therapeutic delivery in a clinically practical fashion (Gold et al., 1995; Lee et al., 2003; Wood et al., 2009). Here, we present a comprehensive review of the literature describing the trophic effects of IGF-1 on neurons, myocytes, and SCs. We then critically evaluate the various therapeutic modalities used to upregulate endogenous IGF-1 or deliver exogenous IGF-1 in translational models of PNI, with a special emphasis on emerging bioengineered drug delivery systems. Lastly, we analyze the optimal dosage ranges identified for each mechanism of IGF-1 with the goal of further elucidating a model for future clinical translation.