1. The HR is performed by the patients themselves by placing the contralateral hand directly on the affected area according to Ou MC decrescendo phenomenon (Figure 1).

2. For lesions on or adjoining the midline of the body, the HR is applied first to one side of the lesion and then the other.

3. The effects of Ou MC decrescendo phenomenon are related to the duration, frequency of administration and the distance between the hand and the lesion.

4. If HR is not efficacious, measures such as getting the hand nearer to the lesion, applying other hand gesture and increasing the duration or frequency of administration may be helpfula.

5. Patient positioning may be useful when performing the HR. For example, when treating lumbosacral pain, the patient may wish to lie down (supine) with the contralateral hand beneath the affected lumbosacral and adjoining areas.

6. Severe emotional disturbance possibly may affect HR’s effectivenessb.