RAISED BED SURVEY
Therapeutic approach by Andrew Fletcher
(Raised the head of the bed by six inches/ 15 cm)
Interviews conducted face to face 20th-22nd June 1997
9 with people who have MS, 4 with people who have: -
Severe spinal injury =2, psoriatic arthritis =1,
Ex-terminal alcoholic =1.
(in some instances the experiences of the partners were noted)
plus 1 telephone interview with a person who has MS
1 discounted face to face interview where bed was not used over 7 months
Interviewers Mr John Simkins & Mrs Jean Simkins
(Andrew Fletcher attended some interviews as observer)
Method & Approach
Evaluation in every case and on each aspect considered is based on the answers given by the interviewees and therefore each report amounts to a subjective review. IN a few cases there is some more objective evidence, e.g. reports of optical examinations and access to records of physical recovery of the spinal injuries, psoriatic arthritis and alcoholism. Medical reports haven not been sought but two opticians reports were supplied.
The values given to answers obtained from specific questions are based on perceived degrees of change on using the raised bed, from the 'norms' described for the preceding months or years. Pertinent to this approach is the comment by one responder to a 1997 MSRC survey:- "When my MS started my condition was considered abnormal, now MS is well established my condition is considered normal!"
Thus changes from what had been considered 'normal' were verbally examined for extent, depth, permanence and influence on lifestyle.
 The Multiple Sclerosis Resource Centre Limited- Company No. 284203-Registered Charity No. 1033731. Registered Office- 4a Chapel Hill, Stansted, Essex CM24 8AG. Fax No. 01279 647179 
 
Basis of assessment 
This report is submitted in the knowledge that no scientific validity can be claimed nor indeed was there ever any intention to do so. The objective was to identify why and how people believe they have benefited, or not, and to quantify and where possible evaluate the quality of their information about use of the raised bed.
We have done that with 14 people, most of who have MS. What we found at worst is generally encouraging and, in the case of certain signs and symptoms, suggests that substantial benefits may be obtained.
We believe there is good reason to conduct further investigation into the therapeutic value of sleeping on a bed raised by six inches / 15cm at the head. What is at work here is not specific to multiple sclerosis but the disease offers an excellent test-bed for investigation of affect on wide range of symptoms. The basis of physical and sensory sign and symptom improvement via this therapy is rooted in encouraging a body process that is normal and essential to human life and is an integral function in every human body.
It is our view that further work could best be done by a series of relatively short term studies on group of people who would be subject to detailed analyses of medical and health condition before and after the study period, and be monitored regularly throughout.
We believe that nothing in this report is overstated. A study protocol would benefit from taking on board much of what was learned and is reported from this survey. The additional use of other parameters including biological data related to blood and fluid circulation in the human body and a whole-body approach to analysing the results, would be likely to provide a viable objective view of this approach.
 MS ONLY INTERVIEWEES
Breakdown- age, time from diagnosis, time using bed
Ages 
30-39 years = 2: 40-49 =2: 50-59 =5: 60-75 =1
TIME FROM DIAGNOSIS
Range- 3 months to 26 years: Average = 11 years
TIME USING RAISED BED
3-6 months =3: 7-12 months=2: 13-18 months=5 
 EVALUATIONS
Key to scores and values shown below are as used throughout.
Value 
(1) Change noticed at minimum level; may be spasmodic; may not continue; may not be obvious to others. 
Table 1, Second highest number of changes at this level
(2) Definite change; mostly continuous; obvious to others; sufficient to relieve a sign/symptom to a moderate level.
Table 1, Highest numbers of changes were described at this level.
(3) Definite change with good sign/symptom relief; commented on by others; benefit is functional ability, virtually continuous; any fall back is short term and benefit recurs at a similar level 
Table 1, Fourth highest number of changes.
(4) High level of change; very good benefit in functional ability; very obvious to others; only occasional short-term regressions in level of benefit.
Table 1, third highest number of changes.
(5) Exceptional change particularly with tremor and Oedema; very obvious to others
Table 1, Only two people at this level
Table 1 All;
Overall, the analysis shows various levels of improvement over 18 different signs/symptoms. All figures show that for every sign/symptom at least three people (30%) have indicated a benefit at one of the five values.
Value 2 shows the largest number of indications of benefit (which may include the same people in more than one sign/symptom).
There are three signs and symptoms with the highest number of people (7) claiming benefits, (at various values). They are Mobility: Balance: Bladder: Hair condition.
The second highest number (6) includes Co-ordination: Optical: Oedema/Veins: Sleep: Wakeup: Finger/toe nails: Temperature.
The third highest number (5) includes Tremor: Spasm: Healing/Skin Quality: Sensory Perception; Energy level: Pain.
The least number (3) includes mood swings: Endurance
 
Changes	1	%	2	%	3	%	4	%	5	%	All	%	
													
Mobility/Balance	4	40			1	10	2	20			7	70	
Tremor	1	10	2	20	1	10			1	10	5	50	
Spasm	1	10	2	20	1	10	1	10			5	50	
Co-ordination	2	20	2	20	1	10	1	10			6	60	
Skin Qual/Healing	1	10			1	10	3	30			5	50	
Optical	2	20	2	20	2	20					6	60	
Oedema & Veins					4	40	1	10	1	10	6	60	
Bladder	2	20	3	30	1	10	1	10			7	70	
Sensory	2	20	2	20			1	10			5	50	
Mood Swings	2	20	1	10							3	30	
Strength/Endurance	2	20					1	10			3	30	
Energy Level	3 	30			1 	10	1 	10			5 	50	
Sleep Patterns 	2 	20	2 	20	1 	10	1 	10			6 	60	
Wake Up	1	10	3	30	1	10	1	10			6	60	
Condition Nails			5	50			1	10			6	60	
Condition Hair			4	40	1	10	2	20			7	70	
Temperature	1	10	3	30	1	10	1	10			6	60	
Pain			3	30			2	20			5	50	
							
Totals	26	34	17	20	2	99	
 
Table 1
The list of signs and symptoms includes only those with 3 people or more reporting improvements whatever the strength of those improvements. Improvements in signs and symptoms reported by less than 3 people over all values are listed in table 1a.
Table 1 illustrates the range of values for each of the 18 signs/symptoms, reported by the 10 people with MS we interviewed. Each person was permitted only one beneficial change, (horizontal axis) against any one sign/symptom. 
The interviewers allocated the value.
Table 1a Improvements in signs/symptoms reported by less than three people.
General weakness = 1 person: Bowel = 2: weight change = 2: Memory = 2: Concentration=2: Fatigue = 2: Speech = 1: 
Asthma = 1: Other respiratory = 2: Circulation = 1:
We find this an interesting list, as there was very little benefit reported in the respiratory function and related conditions. It seemed natural to assume that these would respond very well to this particular type of therapy. However it appeared that only three people had these conditions at a reportable level.
Fatigue also offers food for thought, as it can be one of the root causes of problems with memory, concentration and speech. Considered as a composite area of benefit then the total becomes a hefty 7, and maybe the relationship of these and the therapy could be grounds for a study that we did not have time to do.
 Notes related to table 2
There were 38 reports of no change over the full range of 18 signs/symptoms. 
People reporting no change may have reported on more than one sign/symptom.
The highest number of no change reports
16 including spasm; oedema/veins; sensory; mood swings; strength/endurance; energy level; condition of nails; temperature
9 including mobility/balance; tremor; bladder;
8 including numbness; optical.
5 including co-ordination; skin quality/healing; sleep patterns; wake up; pain.
Perceptions of no change were a disappointment to people trying this therapy method, a response to be expected with any failed therapy. It is our belief that
table 2 indicates a high degree of integrity on the part of the interviewees.
Continued deterioration
We were surprised to receive only 4 reports of MS deterioration. It was not possible in the time available to establish much in the way of detail but as shown in table 2 the signs/symptoms involved were :- numbness: mood swings: Strength/endurance.
TABLE 2	NO CHANGE AND DETERIORATION	
Changes	No Change	%	 	Continued Deterioration	
Mobility/Balance	3	30	 	1	
Numbness	4	40	 	 	
Tremor	3	30	 	 	
Spasm	2	20	 	 	
Co-ordination	1	10	 	 	
Skin Quality/Healing	1	10	 	 	
Optical	4	40	 	 	
Oedema & Veins	2	20	 	 	
Bladder	3	30	 	 	
Sensory	2	20	 	 	
Mood swings	2	20	 	1	
Strength/Endurance	2	20	 	2	
Energy Level	2	20	 	 	
Sleep Pattern	1	10	 	 	
Wake up	1	10	 	 	
Condition Nails	2	20	 	 	
Temperature	2	20	 	 	
Pain	1	10	 	 	
 INTERVIEWS WITH 4 PEOPLE NOT HAVING MS

Although these interviewees do not have multiple sclerosis we considered it relevant to talk with them in view of the way the therapy is thought to influence the overall functioning of the body. It seemed reasonable to investigate changes they experienced using the raised bed, particularly those producing similar reports to those of the people with MS.
We saw two men who have severe spinal injuries, a lady who has psoriatic arthritis, a male alcoholic of fifteen years addiction, whose medical specialist had given a prognosis of death within 3 months.
Improvements were reported in twenty different signs/symptoms, each with a value of between 1 and 5. Not every person reported on the same signs/symptoms and some reported no change. Overall, the best responding sign/symptom with this small group was Strength/Endurance with all 4 reporting beneficial change. (See table 3).
The second most common benefits included
Optical; Bladder; Sensory; Energy level; Sleep pattern; Wake up; Condition of nails; Temperature.
The least responses were seen in,
Mobility/Balance, Spasm, Co-ordination, Skin Quality/Healing, Oedema, Bowel, Weight change, Fatigue, Respiratory conditions, Pain. 
No benefits were reported for
Tremor, Weakness, Mood swings, Memory, Concentration, Speech, and Circulation.
The highest number of changes were recorded at value 2 (21) closely followed by value 3 (19) and there were 5 changes at value 4 (see chart for details).
There were 3 reports of no-change, including Condition of hair, condition of Nails and Optical
There were no reports of deterioration.
 
TIME USING RAISED BED
Non MS Interviewees
Range = 8 months to 15 months

  TABLE 3 NON MS 4--People
Changes	1	%	2	%	3	%	4	%	5	%	All	%	
													
Mobility/Balance			1	25							1	25	
Numbness							1	25			1	25	
Spasm			1	25	1	25					3	50	
Co-ordination			1	25							1	25	
Skin Quality/Healing					2	50					2	50	
Optical			1	25	2	50					3	75	
Oedema & Veins							2	50			2	50	
Bladder	1	25	1	25	1	25					3	75	
Sensory			2	50	1	25					3	75	
Strength/Endurance			3	75	1	25					4	100	
Energy Level			2	50			1	25			3	75	
Sleep Patterns 					2	50	1	25			3	75	
Wake Up			1	25	2	50					3	75	
Condition Nails			2	50	1	25					3	75	
Condition Hair			1	25	1	25					2	50	
Temperature			1	25	2	50					3	75	
Respiratory					1	25					1	25	
Pain					2	50					2	50	
Combined Results IN 14 People MS & NON MS
We finally combined the results for both the MS only group of ten and the Non-MS group of 4 to give an overall analysis of the full 14 interviewees. (See table 4).
This provides, in our view, some confirmation of the conclusion, based on the MS only results, that there could be an autonomic function at work, which may well be capable of influencing certain signs/symptoms.
TABLE 4 MS & Non MS Improvements 14 People	
Changes	1	%	2	%	3	%	4	%	5	%	All	%	
													
Mobility/Balance	4	28	1	7	1	7	2	14			8	56	
Tremor	1	7	2	14	1	7			1	7			
Spasm	1	7	3	21	2	14	1	7			5	35	
Co-ordination	2	14	3	21	1	7	1	7			7	49	
Skin Quality/Healing	1 	7	2 	14	1 	7	3 	21			7 	49	
Optical	2	14	3	21	4	28					9	63	
Oedema & Veins					4	28	3	21	1	7	8	56	
Bladder	3	21	4	28	2	14	1	7			10	71	
Sensory	2	14	4	28	1	7	1	7			8	56	
Strength/Endurance	2	14	3	21	1	7	1	7			7	49	
Energy Level	3	21	2	14	1	7	2	14			8	56	
Sleep Patterns 	2	14	2	14	3	21	2	14			9	64	
Wake Up	1	7	4	28	3	21	1	7			9	64	
Condition Nails			7	50	1	7	1	7			9	64	
Condition Hair			5	35	2	14	2	14			9	64	
Temperature	1	7	4	28	3	21	1	7			9	64	
Pain			3	21	2	14	2	14			7	49	
Table 4 lists 17 signs/symptoms which, with the exception of 'Mood swings', correlate with the 18 listed in Table1. This table combines the results of the two groups (14 people) and relates only to signs and symptoms recorded for five people or more. (36%), as the cut off point.
CONCLUSION 
In each of the Tables we have presented results in terms of numerical strengths per sign/symptom, the related percentages of the appropriate total of interviewees and also how each of the values benefits (1-5) points to the corporate perception of benefits that the groups report they have obtained.
Overall we received well explained subjective reports in most instances, firmly suggesting that people believe there are benefits, many of them substantial, to be gained from using the raised bed as proposed by Andrew K Fletcher.
The obvious determination of the interviewees to be as accurate as they could with their comments was very helpful, if occasionally adding to the time needed to complete the interview. Unfailingly, we were received with great courtesy and interest in what we were there to do.
We carefully looked for evidence of exaggeration without finding any beyond the normal tendency to sound positive and present a good face. Even so, there were one or two who were clearly fearful of believing in what they considered genuine.
There is a lot of interesting information to be obtained from our survey, which we believe should be used to look more intensely at this therapeutic approach. Not, it is emphasised, simply from an MS standpoint alone, but taking into account of the autonomic function that forms the basis of Andrew Fletcher's proposal.
Should there be a proposal for further study, there must be an adequate protocol that includes provision for educational and training input to patients involved, explanation of the practice of using the bed and the general principle on which the concept is founded; frequent and effective monitoring of each user between starting and follow-up medical examinations.
It is no secret that it is difficult for people in any project to keep to the protocol if they are left to their own devices, without regular encouragement to stay with it.

Signed   John Simkins