Push-grasp is a literal translation of this term referring to medical manipulation of the body. It encompass a great many schools of thought and techniques for moving Qi and the parts of the body. It can be very light or strong, involve rotation of the extremities, slight twisting of muscle groups, grasping and releasing of muscle groups, brushing of the skin. The practitioner may use only fingers, the entire hand or other of his/her large joints to change the flow of Qi in the meridians. There are also techniques directed specifically at the internal organs and their functions. Tuina is used both as a primary therapy and as an adjunct to acupuncture, Chinese herbal medicine, and Qi-Gong therapy - internal and external types.