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Clinical Relief with Use of the FlexxiCore‡ Exerciser

by Hannah McDonald(more info)

listed in exercise and fitness, originally published in issue 141 - November 2007

This article relates to a type of passive exerciser that allows people of all ages and fitness levels to enjoy a stimulating workout without stress or strain. They originated in Japan more than 15 years ago, having emerged from the understanding of practitioners in techniques such as Nishishiki and Shiatsu about the value of swinging the legs to create a harmonic ‘pulsing’ through the hips and spine.

While some bodywork practitioners may tend to discount the value of using a machine as a substitute for hands-on techniques, experience has shown that the machine’s ability to swing the feet with a constant range and rhythm of movement allows the body and brain to instinctively tune in to the motion. These machines should not, therefore, be regarded as substitutes for therapy, but rather as aids to treatments, providing an extremely beneficial form of stress-free exercise in a convenient and enjoyable format.

More significantly perhaps, the fact that the exercise is taking place while the body is fully supported seems to allow the brain to recognize that it can ‘let go’ in a way rarely experienced with other forms of exercise. Generally speaking, even where body movement is elegant and graceful, there is an implicit need for the brain to continue computing an extraordinary number of complex and simultaneous command and response signals to the muscles, and some degree of tension is inevitable. The unique confluence of stimulation and potentially total relaxation that occurs during use of these exercise machines seems to allow the body’s healing and energy systems to enjoy a very deep process of rejuvenation. Typically this is experienced as a distinct release of tension in the back, neck and shoulders, a change in quality of respiration and circulation, and a noticeable boost of chi energy – all while the user lies down and simply focuses on letting go to the motion.

The original Japanese model was recognized as a remedial medical device by their Ministry of Health & Welfare in 1990, and was later brought to the West by a Taiwanese company, Hsin Ten Enterprises, which called it the ‘Sun Ancon Chi Machine’®. A more advanced version of these machines (the FlexxiCore® Passive Exerciser) was developed for Western physiques more recently, as there was a growing demand for more robust and sophisticated products – in particular for ones with variable and precisely controllable speeds.

The first version of the FlexxiCore Passive Exerciser was launched in Britain in late-2002, adopting a heavy-duty DC motor that gives a smoother ride and offers a broad range of speeds. The gentle starting speed and the ability to easily control speed during use, not only allows each user to find a speed that resonates with their own body, but has opened up use to a much larger audience – including many with conditions that would prevent them using the high fixed speeds of first-generation products. The electronic programming also allows users to select one of three pre-set programmes that alter the speed automatically over a 15-minute session.

In 2006 the results of some Practitioner Trials of the FlexxiCore based on personal use by 145 Healthcare Practitioners, were reported in Positive Health, Issue 125 (July 2006). In summary, 76% of the participants experienced improvement with pre-existing physical symptoms during regular use over 30 days, whilst 70% reported mental benefits, and 56% experienced improvement in emotional wellbeing.

The main conclusions of this first trial were that the FlexxiCore was found, inter alia, to be of benefit in boosting energy; relieving tension, aches and pains in the back, shoulders and neck; reducing stress held in the body; and improving mental clarity and overall wellbeing.

The trial also looked at the benefits of the variable speed and Auto programmes available with the FlexxiCore. The capacity for each individual to vary the speed was found to be important. These features are not available in the first generation of Chi machines – the original model and some other brands that came onto the market some years ago – which generally rely upon one fixed speed.

With these results pointing to great potential for use of the FlexxiCore in clinical settings, it was decided to follow up the first phase of trials to look at possible clinical applications with a view to developing a greater knowledge base and guidance for practitioners wishing to use the FlexxiCore with clients. A second phase of trials was, therefore, designed to investigate use of the FlexxiCore both as an addition to current treatments and also as a stand alone treatment that can be offered to clients needing to have a sustained course of treatments. What follows is a preliminary report on results so far in this second phase.

Practitioners were invited to join the trial for a period of two months, during which time they were asked to use the FlexxiCore with clients on a daily basis, and to find two clients whom they felt would benefit from a series of regular treatments. They were also encouraged to use the Exerciser themselves, and to record the benefits noticed.

Clinical use in the trials fell into three categories: a series of treatments for single clients held over a period of three to four weeks and recorded as case studies for regular use; a single session provided alongside another treatment such as massage, aromatherapy, osteopathy etc; a single session as a trial/demonstration without other treatment.

The results of the trials were recorded using questionnaires for the practitioners and case studies, and simple record forms for the single sessions. The questionnaires were designed with simple yes/no answers with space for additional feedback where necessary, and were provided for both the practitioner and the clients to fill in. The record forms for the single sessions were used to record the length, speed, other treatments and perceived benefits of both the practitioner and client.

The practitioner questionnaires looked at frequency and timing of personal use, personal benefits, ease and frequency of clinical use and recommendations. The client questionnaires were similar, with additional questions for the case study clients on ease of attendance at the clinic for the regular sessions. Each questionnaire included a list of symptoms to record before and after condition. These symptoms were determined from the results of the first round of trials in 2005 and reflected the most common improvements found by the 145 participants of that trial.

A total of 45 practitioners completed the trials with 28 (62%) of those having returned their reports at the time of writing. From these 28 reports there are 26 practitioner questionnaires, 41 client questionnaires, 51 case studies and 152 records of single session demonstrations.

Practitioner Questionnaires

The majority (81%) of practitioners used the FlexxiCore themselves at least once a day, with the others using it mainly on alternate days.

All the practitioners who returned their personal questionnaires recorded some benefits from regular use. The most common benefits noted were for such symptoms as increase in energy (65%), relaxation (65%), improvements in back, neck and shoulders (62%), improved mobility (58%), less stressed (58%), improved sense of wellbeing (73%) and feeling calmer (65%).

The majority of the use with clients was before a current treatment, and 77% of the practitioners found the FlexxiCore Passive Exerciser easy to use in a clinic situation – with 88% finding the variable speed to be useful in a treatment context. Of the practitioners who responded on the questionnaire, 69% found the FlexxiCore a useful clinical tool, and 85% stated that they would recommend the FlexxiCore to clients for use at home.

Of the 28 practitioners who have returned reports to date, 79% have purchased the FlexxiCore for their own use and/or for continued use in clinic.

Client Questionnaires

Forty-two clients filled in the questionnaire either after a course of treatment or after a single session. The majority, 81%, of these stated that they felt that the treatment was beneficial either in relation to a single symptom or to their general health. Ninety percent found the FlexxiCore simple to use, and would be happy to use it on their own in a clinic situation, while 88% found it easy and convenient to travel to the clinic for a treatment session.

The range of physical benefits was similar to those experienced by practitioners, with the top ten benefits being almost identical. Relaxation and reduced stress were the most common benefits being recorded in 60% and 52% of cases, respectively. Forty percent found that the treatment on the FlexxiCore was beneficial for their back, neck and shoulders, with 21% recording an improvement in mobility. Also 48% felt calmer after a session – with 43% feeling that their overall sense of wellbeing had been improved.

Overall, the majority of clients (81%) who used the FlexxiCore in a clinic situation found that it was a useful and beneficial addition to the services offered to clients – with 64% saying that they would consider it as a regular treatment and 83% happy to recommend it to friends and family.

These findings were also reflected in the records of those clients who had a single session on the FlexxiCore alongside their usual treatment. Of these 103 sessions, the majority (76%) were given prior to a normal treatment. The type of treatment varied quite a lot, but the three most common treatments that were combined with the FlexxiCore were Reflexology (30%), Massage (25%) and Aromatherapy (21%). Other kinds of treatments used alongside the FlexxiCore in the trials reported to-date included Osteopathy, Reiki and Physiotherapy. Seventy-five percent of the clients who had a single session on the FlexxiCore felt that it enhanced the benefits of their other treatment, while 15% felt that it was of no benefit alongside their usual session. The other 16% were unsure but felt that it was an interesting experience that they would consider repeating.

Case Studies

At the time of writing this article, a total of 51 case studies have been returned. Practitioners were asked to choose clients who they felt would benefit from regular sessions on the FlexxiCore in a clinic situation.

Many of the clients chosen by practitioners had symptoms and conditions for which they have been receiving treatment over a period of time. The type of clients who have taken part ranges from those with symptoms such as back ache and migraines to those with conditions such as Multiple Sclerosis and

Most clients had a history of more than one symptom, and the records returned show that the most common symptoms seen in clients who took part in the case study were joint/muscle pain in 63% and back problems in 59%. Other common symptoms seen in case study histories were low energy (22%); sleep disorders (29%); headaches/migraine (24%); and depression (27%).

The average number of sessions for a case study was ten over a period of three to four weeks, with the majority of clients (76%) finding that the treatment was beneficial for their stated primary symptoms. The case study form also allowed for recording improvements in historical symptoms like those recorded on the practitioner and client questionnaires.

A small number of clients (16%) experienced an initial adverse reaction to the treatment. However, most of these clients persevered and found that these adverse symptoms disappeared. Indeed most also felt benefits in other areas by the end of their course of treatments. Only two clients out of 51 found they could not continue with treatment as a result of adverse reactions.

The four case studies outlined below exemplify some typical results that follow patterns seen in many of the cases. Most practitioners were able to report that each case study had experienced multiple benefits, including some that were stated to be unexpected.

At the end of their course of treatments, 80% of those taking part in the case study part of the trial said that they would like to continue using the FlexxiCore either in the clinic or at home – and would also recommend its use to friends and family.

Case Study A

Client presented with a history of back problems (three collapsed discs), joint and muscle pain, sleep disorders, arthritis, and depression. She had suffered a car accident 18 months earlier which had aggravated the back condition and increased pain levels. The primary reasons for wanting to try the FlexxiCore were back pain, which was currently being managed by regular intake of pain killers, sleeplessness (from pain), and depression.

After 14 sessions the client reported that she was experiencing a reduction in pain to the point of being able to manage without pain killers the majority of the time. She also reported improvements in sleep, energy levels, joint mobility, decreased tension and general wellbeing.

Case Study B

Client presented with a history of lower back pain, joint/muscle pain, sleep disorders, anxiety, difficulty in relaxing, and regular headaches/migraines. The primary reasons for wanting to take part in the trial were to ease muscle and joint pain, to help with sleep and anxiety, and a wish to experience more general relaxation.

After 12 sessions the client reported that her headaches had completely disappeared shortly after starting the trial, and that her pain levels had reduced by around 75%. The client also saw improvement in stress levels, posture and general wellbeing. In particular, the client reported feeling more aligned in their body.

Case Study C

Client presented with a history of Type 2 Diabetes which he had been managing to the best of his ability. He also presented a recent history of pains across the chest, back and shoulders which had been investigated by a consultant – who had prescribed pain killers and physiotherapy having found no associated pathology.

After ten sessions the client reported that the pain had dissipated completely within two to three weeks, and he felt better muscular/skeletal alignment. He also reported an improvement in general wellbeing, and that as an additional benefit his blood sugar readings were now lower than the previous average.

Case Study D

Client presented with a history of back problems following an operation to remove a benign tumour on her cervical spine in 1995. Since the operation, the client suffered from a high level of muscular pain and had become reliant on morphine-based pain killers. There was also a history of exhaustion, asthma, and constipation (related to the pain killers). Before beginning the trial the client checked with her spinal consultant who confirmed that she could go ahead.

The main reason for undertaking the trial was to try to reduce pain, and improve general mobility and relaxation. Other reasons given were to help energy levels, and loosen muscles, particularly in shoulders and legs.

After just ten sessions the client reported an improvement in all areas, reduced pain, increased mobility in all areas, improved energy levels, decreased tension, better breathing, and improved general wellbeing. The client reported a general feeling of hope for the future even if the tumour were to re-grow slowly, and felt more able to cope with future treatments.


Although the trials are still on-going with some very interesting questionnaires, and case studies still coming in, the results achieved so far have confirmed many of the results and conclusions drawn from the first set of trials in 2005, but with the added dimension of how valuable this form of exercise can be for people suffering from a broad spectrum of chronic disease.

In 2005 the results showed that regular use can benefit each individual in ways that are appropriate to the individual body’s needs. As well as general improvements in energy, tension, back pain and sleep that were seen by a large proportion of participants, those taking part generally reported some benefits on an individual level, such as improvement in skin health, breathing quality, circulation, etc.

Improvements were also seen on a mental and emotional level by a large percentage of participants. The general areas of improvement reported were improved mental clarity and focus, along with the ability to cope better with everyday stress. Again, improvements at this level were very individual, based it would seem on the body’s own priorities.

One of the additional findings from the current trials concerns the benefits that can be found from using the FlexxiCore as an adjunct to a normal treatment regime. Practitioners and clients alike found that a short session on the FlexxiCore could enhance the benefits felt from other treatments, and that clients also felt an increased sense of wellbeing beyond their usual response to these treatments.

It also appears from the results of these trials that regular sessions on the FlexxiCore Passive Exerciser are beneficial even if they are spaced out over a period of a few weeks, making it a viable addition to a clinical situation. The sessions in the 2005 trials were mostly taken on a daily basis, and it had been supposed-up until this point that daily treatments were important for achieving significant changes in health status. The 2006 trials show that sustained benefits can be experienced by many clients with ten to 14 sessions spaced over a period of 30 days.

The main conclusion that can be drawn from these results is that the FlexxiCore Passive Exerciser can be beneficial for many clients in a clinical situation, as well as, through regular use in a home situation, enabling practitioners to offer an additional treatment and feel confident that it will enhance their practice and the results experienced by their clients.


†.   “Sun Ancon Chi Machine” is the registered Trade Mark for the original machine invented in Japan.
‡.   “FlexxiCore” is the Registered Trade Mark for the machine on which this article is based; the original version of this article in 2007 used the term “Chi Exerciser” but it was in fact the FlexxiCore that was used in the trials which are the subject of this article.


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About Hannah McDonald

Hannah McDonald has been working with Diet and Nutrition for over 11 years. She trained as a Nutritionist at the Institute for Optimum Nutrition and has a successful practice in Gloucestershire. She specializes in a multi-discipline approach, working closely with many other therapists, including Osteopaths, Chiropractors, Acupuncturists and Homeopaths, developing specialist protocols for chronic and acute illnesses. Hannah regularly gives talks on many aspects of Nutrition and Health, and has written articles for a variety of publications. She can be contacted via Tel: 0845 130 3248;


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