Canadian Health and Care mall: Important information about diabetes


Diabetes is a metabolic disorder with hyperglycemia either due to an absolute or relative deficiency of insulin secretion or reduction in the biologic effectiveness of insulin or both. The abnormalities in diabetics’ mellitus contribute to cellular events that cause atherosclerosis and subsequently increase the risk of cardiovascular events. The oxidative stress biomarker myeloperoxidase (MPO) enhances cardiovascular risk prediction. Serum malandialdehyde (MDA) level was significantly higher in patients with diabetes for more than 5 years and in the presence of diabetic complications (both microvascular and macrovascular).

Risk of cardiovascular disease (CVD) increased significantly with increasing total cholesterol (TC) and low-density lipoproteins cholesterol (LDL-C). Type 2 diabetic patients are more prone to develop cardiovascular complications. Atherogenic index of plasma (AIP) is the new marker of atherogenicity, since the AIP is related directly to the atherosclerotic risk.

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The levels of MPO, MDA and AIP in these patients help to detect cardiovascular complications, and early interventions can be done to prevent future development of cardiovascular complications.

MPO (EC a member of the heme peroxidase superfamily is a tetrameric hemoprotein (MW 144,000 Da) consisting of a pair of heavy (57 kDa) and light (15 kDa) chains. It is a stored in azurophilic granules of polymorph nuclear neutrophils and monocyte macrophages and when released (typically with inflammation), catalyzes the conversion of chloride anion and hydrogen peroxide to hypochlorite, a metal ion-independent chlorinating oxidant that possesses potent microbicidal activity. Hence, it has a role in host defense against pathogens. MPO activity leads to oxidation of LDL-C. Oxidation of high-density lipoprotein cholesterol (HDL-C) reduce its capacity to transport cholesterol from tissues to the liver, and it consumes endothelial derived nitric oxide, which can lead to plaque formation and endothelial dysfunction.

MDA is generated by both lipid oxidation and as a by-product of prostaglandin and thromboxane synthesis. Its plasma concentration is increased in diabetes mellitus, and it is found in the atherosclerotic plaque, which is promoted by diabetes. The clinical relevance of the reaction between MDA and proteins is highlighted in atherosclerosis, in which the arterial intima becomes infiltrated with foam cells, resulting in thickened, non-resilient arteries with reduced blood flow. This is a major cause of CHD and strokes.

Diabetes mellitus and atherosclerosis are two main causes of cardiovascular morbidity and mortality. Epidemiological studies have shown that several factors contribute to the onset and progression of atherosclerosis. Factors such as age, gender and genetic predisposition are non-changeable parameters. Increased levels of serum cholesterol are the main risk factor for atherosclerosis, especially LDL-C fraction, and other risk factors for atherosclerosis: smoking, decreased glucose tolerance, obesity and sedentary lifestyle. diabetes

Prevalence of metabolic syndrome in developing countries is rising due to an increase in the incidence of obesity. Central obesity plays a key role in the pathogenesis of the metabolic syndrome: promotes inflammation, hypertension, dyslipidemia and it leads to the development of type 2 diabetes and atherosclerosis. Correcting and controlling these means less risk of increase or progression of atherosclerosis.



  1. To compare the serum levels of MPO, MDA, AIP, LDL-C, HDL-C, triglyceride (TG), TC body mass index (BMI) and waist hip ratio (WHR)
    1. In type 2 diabetics and age and sex matched healthy controls,
    2. In type 2 diabetics with duration of diabetes less than 10 years and ≥10 years.
    3. In type 2 diabetics with serum TC levels less than 200 mg/dl and ≥ 200 mg/dl.
  2. To correlate AIP with serum levels of MPO, MDA, LDL-C, HDL-C, TG, TC, BMI and WHR in type 2 diabetic individuals.

Amino acids are considered to contain “complete protein”

The human body requires protein for many reasons, so it is important to consume sufficient amounts of high protein foods. A good rule of thumb is to consume 0.75 grams of protein for every pound of body weight; e.g., 120 grams for a 160-pound person. This amount of daily protein intake can aid in the prevention and even reversal of osteoporosis. For athletes and active people who require additional tissue repair, protein intake should be increased. complete protein

These figures assume that you eat a mixed diet of proteins that match the amino acid ratios required by the body. There are twenty-two different amino acids that are important to the body. These combine together in thousands of intricate biochemical patterns to create a variety of complex protein structures. Nine of the amino acids are “essential” — the body cannot produce them so they must be supplied from whole food sources.

Foods that supply a specific ratio of the nine essential amino acids are considered to contain “complete protein.” Virtually all proteins from raw animal foods are complete. Foods that lack one or more of the essential amino acids, such as certain fruits, grains and vegetables, contain “incomplete protein.” Plant foods can be excellent sources of protein if eaten in combinations that supply the balance of essential amino acids. For example, in Latin cultures, the incomplete amino acid profile of beans combined with incomplete whole grain rice creates a balanced complete amino acid profile.

Essential Amino Acids










Nonessential Amino Acids




Aspartic acid


Glutamic acid








When we eat whole foods, a healthy digestive system breaks proteins down into its amino acids that enter the body’s “pool” of amino acids. Each cell assembles the proteins it needs using the amino acids as building blocks. If one or more of the “nonessential” amino acids is in short supply, the body can produce it from essential ones.

However, low consumption of any essential amino acid can limit the body’s effective use of the others. The body then cannot form protein, and isolated amino acids begin to accumulate in the bloodstream. Missing one of the essential amino acids is like trying to build a car on an assembly line without the engine. Supplies of tires, chassis, seats, brakes and windows keep arriving, but no cars can be completely built. Meanwhile, inventory of all these parts creates congestion in the manufacturing plant.

We need the nine essential amino acids in our diet as raw materials in just the right proportions and at the same time. It does little good taking in a few essential amino acids one day and getting the others later in the week.

Massage Therapy Shown To Be the Best Choice of Treatment for Lower Back Pain

Massage therapists often gush about the therapeutic properties of massage therapy, saying it can lower levels of anxiety and stress, improve wellness, and even reduce pain. And for the most part, they’re right.

Indeed, many academic studies have demonstrated the therapeutic properties of massage, but these studies are usually small in their number of participants, and often massage is indicated as a complementary treatment, for example, as a non-invasive pain reliever for cancer patients. A study in the July 5 issue of the Annals of Internal Medicine is therefore a breakthrough for massage therapists as it concludes that massage isn’t just a good complementary therapy, rather, it is the best choice for treating lower back pain.

The study, titled A Comparison of the Effects of 2 Types of Massage and Usual Care on Chronic Low Back Pain, is so newsworthy because it concludes that general massage therapy is more effective than standard medical treatment when dealing with back pain. This means that a weekly massage can do more to ease chronic back pain than painkillers, anti-inflammatory drugs (think Advil) and physical therapy.

According to The USA Today (1), the study monitored 410 women with chronic lower back pain. The women were randomly assigned to three groups, with one group receiving standard medical care as outlined above, one receiving an hour-long, weekly structural massage therapy session, and the final group receiving a standard, hour-long Swedish massage.

The results showed that women who received either form of massage were two times as likely to have spent less time in bed due to pain, used less pain medication, and generally were more active than the women who did not receive massage therapy. Stunningly, more than one-third of the women who received massage reported their back pain as much improved or completely gone, while only four percent of women who received standard medical care could say the same thing.

What does this mean for massage therapy and its practitioners? First and foremost, it is thorough proof that massage can do what therapists have been saying it can do all along: Provide effective pain management and improve people’s quality of life. Second, this claim can be made by all massage therapists – from the highest trained to the recently graduated – as almost all therapists are well versed in Swedish massage. Finally, this should motivate therapists to continue to promote massage as an effective, non-invasive therapy to people in areas where lower back pain is common, providing therapists with another reason to market, for example, chair massage therapy to office employees.

Secret Asian Sore Feet Remedies That Really Work!

Sore, aching feet plagues nearly everyone at one time or another. In this article I will introduce you to three “secret” Asian sore feet remedies that are highly effective in treating discomforting sore feet, and I will map out a strategy using these three remedies that is assured to leave you free of foot pain once and for all!


Originating in China more than 2,000 years ago, acupuncture is one of the oldest, most commonly used medical procedures in the world. This technique involves the use of small, slender needles that are gently inserted into specific areas along the body’s meridians, or energy channels, in order to correct energetic imbalances.

Studies have shown acupuncture to be effective in relieving certain types of foot pain. Many acupuncture practitioners utilize acupuncture techniques to treat pain associated with the ankles, heels, and balls of the feet.

Bear in mind, however, that while successful in many cases, whether acupuncture is ultimately effective in treating foot pain depends on the nature of the pain. Acupuncture therapy can also be pricey, sometimes requires multiple treatment sessions, and in many cases is not covered by insurance. For these reasons, I suggest using acupuncture as a last resort while exploring one of the following Asian foot pain relief techniques describes below.


Reflexology is the practice of stimulating specific “pressure points” of the feet which, according to the practice of Oriental medicine, are thought to correspond to the various organs of the body.

According to reflexology, when certain areas of the body are out of balance, this causes flare up, or pain, in the bottom of the feet. Additionally, because the bottoms of the feet are the collection area for the pressure points of the body’s organs, the bottoms of the feet are, themselves, highly sensitive, so even if you aren’t convinced about the validity of reflexology, anyone who has experienced a reflexology massage can attest to the fact that afterwards, your feet, if not your entire body, will feel renewed and refreshed and released of pain!

Particularly for those who are active on their feet and experience chronic foot pain, an occasional professional reflexology massage, if available nearby, is highly recommended!

The only real drawback to a reflexology massage is the ongoing cost. At a cost of about $25 per massage or more, most sore feet sufferers likely cannot afford to get a reflexology massage more than once a month or so.

Japanese Foot Massage Tools

The Japanese, who enjoy the world’s highest life expectancy, are not coincidentally highly aware of and attentive to the importance of daily foot care.

Although acupuncture and reflexology originated in China, the Japanese were early adopters of these practices, and probably more than any other culture, diligently apply these principles specifically to foot care.

One likely reason for the Japanese attention to foot care is entirely practical: the Japanese are notorious walkers! Required to walk during the medieval period due to a prohibition on horseback travel, today, the Japanese continue to walk much more than most cultures due to the impractical nature of cars in Japan’s large cities, where most of its population is concentrated.

As a result, the Japanese have invented a plethora of creative foot massage tools to combat sore foot pain. While Japan is well known for its highly advanced technical innovation, I believe that the most effective Japanese foot massage tool is also the country’s oldest and most primitive.

Japanese Bamboo Foot Massager

The Japanese bamboo foot massager is just that, a piece of bamboo, naturally shaped to stimulate the arches of the feet, that is simply placed on the floor and stepped on for a soothing, gentle yet effective massage that provides instant foot pain relief.

This bamboo foot massager is said to have been invented when a wandering samurai chopped a piece of bamboo in half with his sword and stepped on the arched surface to soothe his aching feet.

From this lone samurai, the popularity of this foot massage tool exploded. Although little known outside of Japan, today in Japan you can find one of these in just about every Japanese household.

This Japanese foot massager is my favorite Asian remedy for sore feet because it is inexpensive, lightweight, easily portable, highly durable, easy to use, and most importantly, because it provides a great foot massage that provides daily relief from sore, aching feet just by using for a couple minutes per day.

Putting it All Together

Therefore, in utilizing my “secret” Asian sore feet remedies, I would suggest the strategy that I myself employ to keep your feet pain free: use a Japanese foot massage tool for daily maintenance; get a professional reflexology massage every month or two or as needed for a more intense and concentrated foot therapy session; and finally, consider acupuncture treatment as a last resort if you continue to experience chronic foot pain.

Follow the above strategy and I’m confident that you’ll soon be free at last of unpleasant sore foot pain!

Massage Techniques for Beginners

Everyone wants more attention from their partner. As the saying goes, you have to give a little to get a little. A massage is a great way for partners to connect. It improves blood and lymphatic circulation, loosens tight muscles and releases endorphins and serotonin, helping your partner to feel happy and relaxed.

Not everyone knows how to give a good massage. There are a few tricks to know to make it a little bit better. If you want your partner to really enjoy the experience you should put some thought into setting the mood. It sounds cheesy but turn off the phone, shut the curtains, put on some quiet music and dim the lights. You want to create a comfortable setting where you won’t have to worry about being interrupted.

Find a good massage oil to reduce friction on the skin. Do not just pull something out of the bathroom cupboard. Moisturizers and hand creams absorb too quickly so you need to keep reapplying which can be disruptive. Vaseline is too thick and sticky. There is a huge range of cheap nice smelling massage oils available.

Be careful not to get massage oil on your partners clothing. Either have them remove their clothing or be sure to wipe up excess oils. The most important thing is your partner should be comfortable. Get women to tie up their hair so it won’t get oily.

There are a number of techniques but the key is moderate pressure. A massage it to relax the muscles not the skin. In order to avoid irritating the skin or tickling apply these methods below:

Soft and fluid strokes should be used to start. It helps to relax your partner. Use the palm of your hand and gently apply pressure to the muscles across the shoulders, upper and lower back. It is good on the tissue and feels pleasant.

Heart strokes: Using slightly increased pressure, place your hands flat on either side of your partner’s spine. Slide your hands upwards, maintaining pressure. At the shoulder blades move your hand to the side and slide them down the rib cage, making a rough heart shape.

Circle strokes: This stroke is very relaxing and usually a favorite with women. Place your hand flat on your partner’s back, apply pressure with one hand moving clockwise and the other hand moving anti-clockwise. Movements should be firm but slow. This stroke often leaves recipients feeling sleepy.

Kneading strokes: This is a little more complicated and there is room to end up simply pinching your partner, which is unpleasant. The idea is to squeeze the muscles in a gentle and rhythmic way. If done properly it can be very relaxing and is generally the preferred stroke for men. Do not use this stroke for too long as it may lead to discomfort.

The most important part of a massage is allowing your partner to enjoy it. When you finish give them time to relax and enjoy what you have just done. Do not just expect them to jump up return the favor immediately or you ruin the whole gesture.

A Common Cause of Low Back and Sciatic Pain – The Piriformis

As a licensed massage therapist, I specialize in chronic pain and injury management using deep tissue massage therapy. Most of my clients come in with a common complaint: pain in the low back, hips (primarily on one side), and/or shooting pain or numbness down the back of the leg.

More than two million Americans suffer either from back pain or a form of sciatica that is often misdiagnosed and improperly treated. Many suffer from pain for months or years without a proper diagnosis. I work with these symptoms so frequently that I have noticed some common characteristics with this all-too-common pain complaint.

The most common characteristic I find are aggravated trigger points (TrPs) in the piriformis muscle. Piriformis trigger points are often confused for a herniated disc, sciatica, or other back issues, and many sufferers undergo unnecessary and costly tests, injections, and surgeries.

What is the piriformis?

The piriformis muscle is a small external rotator of the hip whose function primarily is to turn the knee and foot outward. It lies deep within the gluteal muscles, originates from the sacral spine, and attaches to the greater trochanter of the femur – the big bony “bump” on the outside top of the thigh. The sciatic nerve passes beneath through an opening called the sciatic notch.


In non-weight bearing activities, foot unloaded and hip extended, the piriformis rotates the thigh outward. When the hip is flexed at 90 degrees it aids in hip abduction.

In weight bearing activities, foot loaded, the pirifomis is often needed to control rapid medial rotation of the thigh – for example, as the foot strikes the ground during walking or running, the knee turns inward.

Piriformis Trigger Points (TrPs)


The myofascial pain component includes pain in the low back, groin, buttock, and hip. A TrP may cause the muscle to compress and irritate the sciatic nerve, causing the pain to travel along the course of the nerve. The pain may radiate down the back of the leg and into the hamstrings, the calf muscles, and possibly the foot. The pain may initially be confused with a hamstring strain. Weakness, stiffness and a general restriction of movement are also quite common. Tingling, numbness, or shooting pains down the leg can also be experienced. Symptoms tend to be aggravated by prolonged sitting or by intense activity.


Piriformis TrPs are predominantly caused by a shortening or tightening of the piriformis muscle. Piriformis TrPs are commonly associated with sports that require a lot of running, change of direction, or weight-bearing activity. Piriformis TrPs can result from acute overload (as when catching oneself from a fall), from repetitive overload (as with the rapid internal rotation of the weight bearing experienced by walkers and runners with poor biomechanics), or from sustained overload (as when holding the leg bent and turned outward for prolonged periods while driving a car or working at a desk). Sciatic pain from piriformis TrPs is also a common complaint during pregnancy.

The piriformis muscle is responsible for the symptoms of pain by projecting pain from activation of the TrPs and by nerve entrapment upon the sciatic nerve. Once TrPs are activated, the piriformis muscle begins to put pressure on the sciatic nerve. The sciatic nerve runs under (and sometimes through) the piriformis muscle on its way out of the pelvis. The piriformis muscle can squeeze and irritate the sciatic nerve in this area, leading to the symptoms of sciatica.

Massage Just for the Wealthy – Invest in Yourself

Many people look at massage as a luxury, something to treat yourself with once a year for your birthday or anniversary, or even something that only the ‘wealthy’ do. I’ve had many people ask, or even state and assume that my clients must only be wealthy clients. Their expectation is that only the ‘rich’ can afford massage. If that’s the case, then why are their so many spas and massage therapists? There can’t be that many ‘rich’ people keeping these places in business can there? Ya, I don’t think so.

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Massage is for most everyone including kids and animals (and yes I’ve massaged kids, dogs, cats and a horse). It doesn’t matter what your checking account balance is, it’s a whole variety of people that get massages. For my business I have the range of clients that yes others would consider wealthy. I also have middle-income as well as the other end of the spectrum of clients that live solely on disability and social security income. Would they be considered wealthy? Not in a financial sense, no. In a healthy, well-being sense? Absolutely! And that goes for all my clients, the amount of money they have doesn’t factor into the massage I do. I consider every client I have wealthy in who they are and the type of person they are. There is a quote I heard a while ago that I think relates to this topic: First Wealth is Health ~ Ralph Waldo Emerson.

Massage is something people do for themselves, it is an investment into their own health, something that you do for you to help keep your body and mind in check. What one person may consider expensive another doesn’t. I may consider paying $60 or more for pants expensive while someone else freely spends their money on $100 pants. Part of it really comes down to what you want to spend your money on. Do you want to spend money on you? Do you think you’re worth the cost of massage? Do you think your health is worth it? Well you should think you’re worth it, because you are! What I really think it comes down to is that we are taught not to ever be selfish and we consider massage a selfish act. Again, it’s not and your first wealth is your health and it’s an investment into you! So go ahead, make that investment! Aren’t you worth it?

Could Your Computer Be Hurting You?

In today’s world we are hooked on computers, myself included. Most people spend their whole work day on the computer and then come home and play on it more for personal fun and social networking sites like one of my favorites, Facebook. The downfall of all this time on the computer is that we do not take the time to be aware of our posture using the computer, nor do we take a moment to step away and give our body and minds a much needed break, even if it is just for 5 minutes. With this, most of us find ourselves in a bit of pain from the all day use of the keyboard and the mouse. This pain could be in your upper shoulders, your forearms, wrists and for some in the fingers (ever feel that numbing sensation). Sometimes these muscle issues start showing up right away. Sometimes they may not be for years.

I’m sure if you take a good look at your computer set-up and your posture, you’ll quickly realize that things are not ergonomically correct. Yet there are some ways to help yourself have better posture and be more ergonomically correct. These simple measures can help deter you from compromising your body.

Receive regular massages

Acquire ergonomically correct products to support your wrists, arms, lower back and even for your legs.

Take breaks away from the computer. Even a quick 1 to 2 minute walk down the hall will refresh your body, get the blood flowing and even refresh your mind.

Bring the mouse and keyboard closer to your body so that your not reaching for either.

Take a few moments to stretch. Here are a few suggestions:
Doorway Stretch: Place your forearm against the frame of a doorway with elbow up. Step forward with the same leg that matches the forearm and lunge. Hold and gently come back. Switch sides.

Deltoid Stretch: Pull the right arm across the front of the body using the left arm. Make sure you stretched arm has the thumb facing down. Hold and then switch arms.

Tricep and Lat Stretch: Point your right elbow toward the ceiling, then lean the upper torso to the left. You may grab the elbow with the left hand for a further stretch. Hold and switch arms.

Wrist Stretch: Hold arm straight out with hand upside down. Gently pull down on the fingers to stretch. Switch hands.

I’m sure one of your first thoughts is how could I fit this into my day? Or I can’t do these, what if the boss sees me and thinks I’m being unproductive? Please realize that these simple things don’t take up much time and will help you be more productive. If your body is not in pain you will not be spending the time complaining about it, you will get more done and you’ll feel better. In the end it is your body and you only have one chance to take care of it.

Becoming An Effective Massage Therapist

Our body needs to be pampered right after a long and tiring day at work. You have to free your mind from several stress stimuli and be comforted by a therapeutic massage that promotes utmost rest and relaxation period. Pressures, tension and anxiety can be present anywhere. Therefore, you have to counter it with a touch of comfort in order to bring balance.

Being a therapist has a lot of things to consider. She must have the desire and willingness to do the job with a whole heart since kneading could greatly affect a client’s mood and general health condition. Body massage could be that simple but its health benefits are tremendous. Every pressure point has a definite equivalent to the body. Therefore, rubdown must be performed with care and delicacy. Once you’ve decided to become a therapist, an extensive training must be acquired. As mentioned earlier, each pressure point has an equivalent effect to the human body. That’s why it is very important to learn the dos and don’ts of this therapy. By undergoing necessary trainings, you will definitely improve your skills in rendering therapeutic care, eventually.

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There are different courses being offered in order to become a credible therapist. You can even choose a modality as to which area you want to specialize. The modality you’re going to use in rendering a therapeutic care would always depend on the physical condition and health needs of the patient. There are some techniques intended for relaxation while others are used for aiding body impurities and impairments. Keep in mind that the main goal of your job is to rejuvenate the body and be able to attain freedom from pain and stresses. For this reason alone, a therapist must really take necessary measures with enough knowledge in order to satisfy the needs of the client.

In using special techniques to delicate patients such as pregnant mothers, infants and stroke patients, adequate knowledge and skill is also a requirement. You cannot just give anything to the mentioned clients above. Remember that circulation and nerve endings are greatly affected in every pressure that is being introduced to the body. You have to make certain that acupuncture or other stroke movement is not contraindicated to your client so that complications will be avoided.

Health clubs and spa clinics require highly qualified personnel so that the treatment they would render to the clients are surely comforting. Be aware that a therapist who does not obtain enough skill could actually add to the stress that the patient feels. Therefore, as personnel who provide therapeutic care, be very sure to give comfort and alleviate the patient’s suffering and not to aggravate his condition. Ensure patient’s safety too and always aim for a good feedback.

Do not confuse yourself to physical therapists and massage therapists because they have different job descriptions. Physical therapists are more focused on previously injured or disabled patients. It requires thorough knowledge and a college degree in order to complete the course. You must also obtain the license to practice.

How Was Technology Incorporated To Massage Chairs?

In recent time, several electronic massage chairs had been introduced to the market in order to give optimum rest and comfort that would ease all your body pains and daily stresses in life. A lot of massage techniques had been incorporated to this type of equipment leading to its utmost popularity and efficiency. As technology continues to advance from time to time, new inventions had been made too. One of the latest and useful innovations done by experts is robotic and reclining chair massagers.

When you visit some shopping malls, hardware and even department stores, you would easily notice the different types of massage equipment with a lot of goodies to pamper every user. These recliners can offer so many health benefits to human beings. Its outside appearance might look so simple and ordinary but its features are actually amazing. This chair can give a complete body massage in a short period of time by just turning the settings on. Most of them are controlled by a wireless or hardwired remote so you won’t find it difficult to control in terms of duration, speed, strength and strokes. Its functions and operations are being displayed clearly in LCD.

There are manufacturers who preset the programs which make it automatic. There are also certain features in this hi-tech device that could be accessed only with the use of a remote control. Just by pressing a single button, you will definitely be able to experience an instant full body massage. There is no need for you to look for a good and quality spa and health clubs. This device has specific functions too. You can opt for a manual massage technique or a roller with kneading, acupuncture and compression and so on.

Upon looking to the product reviews, you will notice that the manufacturer was able to develop unique roller designs. Rollers re commonly used to give a back massage to the user. It usually targets the shoulder muscles, upper and lower back and the legs including the calf. Each type of roller has different mechanism of action. It will now vary according to the manufacturer’s design and purpose. In every mechanism, there is a particular movement. Rolling, tapping and kneading are the most common movements associated with these rollers. Therefore, upon purchase, you have to make sure that its function will surely meet your needs.

Another interesting high-end feature of chair recliners is the presence of body position sensors. It is not common to all massage equipment but some chairs have this kind of property. It enables the chair to determine where you are while lying or sitting in a recliner. Once you will about to move, the sensor will able to detect it and the program will change automatically. This is actually great but the cost can be expensive. Having a massage chair at home is really wonderful especially if you have the latest model. You can easily avail a therapy any time of the day as long as you have vacant schedules.