the elbows, knees, legs, and fists). However, in some cases, curricula were modified so that within these disciplines, martial proficiency was de-emphasized in favor of physical betterment. In one notable study, an Israeli researcher (who was a former Judo champion of Israel) taught a modified form of judo to children that had significant visual and mental impairments (blindness, retardation), and in some cases, physical impairment (such as cerebral palsy). The resulting increase in physical and cognitive abilities of all the children was of greater quantity than other previous forms of physical exercise, in addition to being longer lasting (Gleser, 1992). In Kalarippayattu, Marmachikilsa (Marmam=Vital points) is another expertise achieved by masters who heal the Marma damages –impacts, internal injuries, dislocation, fracture, or paralysis type cases in fight or fall. Course of uzhichil or particular massage with special herbal oil, like ayurvedic model treatment is a routine affair for all Kalari trainees to enhance the flexibility of joints and toning of muscles. Chavitiuzhichil or foot massage is given at the stage of ankathari. Areas for consideration Current trends in research on martial arts' therapeutic benefit points towards generally positive outcomes, especially for physical benefits (one exception to this being possible sustained injuries from competitive applications). But for assessing psychosocial benefits, the evidence is more ambiguous. As with any psychological study, defining concepts such as "happiness", "aggressive attitudes" and "self-confidence" can be a challenging task compared to defining physically related concepts such as "improved cardiovascular health." A frequent measure used in martial arts research to determine therapeutic outcome is the Profile of Mood States (POMS), created by McNair, Lorr, and Droppleman (1971). This is a 65-item survey that measures 6 distinct mood areas, such as "tension-anxiety" and "anger-hostility." A commonly used methodology in martial arts studies that employed the POMS was to administer it before a set period of martial instruction and after that same period (ranging from a single lesson to several over days/weeks/months). A successful demonstration of therapeutic benefit would be if study participants showed positive, statistically significant changes in their scores from the first administration to the second. Beyond these issues of construct validity, even if every study of therapeutic martial arts netted a positive outcome (which has not been the case), determining which facets of the instruction were responsible for the change would be vital for widespread application. Potential factors in martial arts could be: cultivating martial ability