CLINICAL RESEARCH

Foot Reflexology: An Intervention for Pain and Nausea Among Inpatients With Cancer

Kristen D Anderson 1Marty Downey 2

Affiliations expand

Free PMC article

Abstract

Background: Pain and nausea affect a significant number of patients with cancer. Applying foot reflexology to this population has had some positive effects, but more studies are needed to confirm its efficacy.

Objectives: The purpose of this study was to conduct a randomized controlled trial to evaluate the effects of foot reflexology on pain and nausea among inpatients with cancer as compared to traditional nursing care alone.

Methods: A pilot study was conducted with adult patients with cancer hospitalized on a 24-bed inpatient oncology unit. Using convenience sampling, 40 patients provided consent and were randomized into either the intervention or control group. Each group had a treatment session of 20-25 minutes in which pre- and postsession surveys were completed, with reflexology performed in the intervention group only.

Findings: Results show that foot reflexology significantly decreases pain for inpatients with cancer as compared to traditional nursing care alone. Although the effects on nausea are not statistically significant, they may be clinically relevant; the mean changes in pre- and postsession nausea ratings indicate at least some decreased nausea among patients in the intervention group.

Keywords: integrative therapies; nausea; pain; reflexology; side effects; symptom management.

 

 

 

 

Foot reflexology in feet impairment of people with type 2 diabetes mellitus: randomized trial

[Article in English, Portuguese, Spanish]

Natália Chantal Magalhães da Silva 1Érika de Cássia Lopes Chaves 2Emilia Campos de Carvalho 1Leonardo César Carvalho 2Denise Hollanda Iunes 2

Affiliations expand

Free PMC article

Abstract

Objective: to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus.

Method: this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21) and Control group (n = 24), received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value <0.05).

Results: participants who received the therapy showed better scores in some impairment indicators related to skin and hair (hair growth, elasticity/turgor, hydration, perspiration, texture and integrity of the skin/ skin peeling).

Conclusion: the foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz.

Figures

 

Figure 1. Flowchart Consort. Alfenas, MG, Brazil,…

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References

    1. Chand G, Mishra A, Kumar S, Agarwal A. Diabetic foot. CQN. 2012;1(2):144–150.

    1. Bowering K, Embil JM. Foot care. Can J Diabetes. 2013;37:45–49. - PubMed

    1. Moura LIF, Dias AMA, Carvalho E, Sousa HC. Recent advances on the development of wound dressings for diabetic foot ulcer treatment a review. [Revisão]. Acta. Biomater. 2013;30(1):1–21.

    1. Ministério da Saúde (BR) Caderno de Atenção Básica: Diabetes Mellitus. Brasília (DF): Conselho Nacional de Saúde; Ministério da Saúde; 2006. 52

    1. Nuñes HMF, Ciosak SI. Terapias alternativocomplementares o saber e o fazer das enfermeiras do distrito administrativo 71 - Santo Amaro - São Paulo. Rev Esc Enferm USP. 2003;37(3):11–18. - PubMed

    1. Ozdemir G, Ovayolu N, Ovayolu O. The effect of reflexology applied on haemodialysis patients with fatigue, pain and cramps. Int J Nurs Pract. 2013;19(1):265–273. - PubMed

    1. Ernst E, Posadzki L. Reflexology an update of a systematic review of randomized clinical trials. Maturitas. 2011;68(2):116–120. - PubMed

    1. Li CY, Chen SC, Li CY, Gau ML, Huang CM. Randomised controlled trial of the effectiveness of using foot reflexology to improve quality os sleep amongst Taiwanese postpatim women. Midwifery. 2011;27(1):181–186. - PubMed

    1. Wright S, Courtney U, Donnelly C, Kenny T, Lavin C. Clients' perceptions of the benefits of reflexology on their quality of life. Complement Ther Nurs Midwifery. 2002;8(1):69–76. - PubMed

    1. Jones J, Thomson P, Lauder W, Howie K, Leslie S. Reflexology has an acute immediate haemodynamic effect in healthy volunteers A double-blind randomised controlled trial. Complement Ther Clinl Pract. 2012;30(1):1–8. - PubMed

    1. American Diabetes Association Standards of Medical Care in Diabetes - 2013. Diabetes Care. 2013;36:11–66. - PMC PubMed

    1. Vaz D, Santos L, Machado M, Caneiro AV. Métodos de Aleatorização em Ensaios Clínicos. Rev Portuguesa Cardiol. 2004;23(5):742–755.

    1. Silva NCM, Chaves ECL, Carvalho EC, Iunes DH. Avaliação dos pés de com de diabetes mellitus uma proposta de escala. Acta Paul Enferm. 2013;26(6):53541–53541.

    1. Moreira RO, Castro AP, Papelbaum M, Appolinario JC, Ellinger VCM, Coutinho WF. Tradução para o português e avaliação da confiabilidade de uma escala para diagnóstico da polineuropatia distal diabética. Arq Bras Endocrinol Metabol. 2005;49(6):944–950. - PubMed

    1. R Development Core Team . R: A language and enviroment for statistical computing [internet] Vienna (AUT): R foundation for statistical computing; 2012. http://www.rproject.org/

    1. Fogaça MC, Carvalho WB, Verreschi ITN. Estimulação tátil-cinestésica uma integração entre pele e sistema endócrino? Rev Bras Saúde Materno Infantil. 2006;6(3):277–283.

    1. Papanas N, Ziegler D. New diagnostic tests for diabetic distal symmetric polyneuropathy. J Diabetes Complications. 2011;25(1):44–51. - PubMed

    1. Oleson T, Flocco W. Randomized controlled study of premenstrual symptoms treated with ear, hand and foot reflexology. Obstet Gynecol. 1993;82(6):906–911. - PubMed

    1. Arbizu RLT, Reventós KE, Fernendez MTL, Pardeño SAD. Efecto pos-tratamiento de la reflexoterapia podal en la tensión arterial y la frecuencia cardiaca estudio piloto. Fisioterapia. 2006;28(3):125–132.

    1. Sanchez MMC, Lorenzo M, Peñarrocha M, Ojeda JA, Labraca NS, Ortega FZ. Diminuición de la presión arterial en pacientes con arteriopatía periférica mediante el masaje reflejo del tejido conjuntivo. Fisioterapia. 2009;31(2):50–54.

    1. Valiani M, Babaei E, Heshmat R, Zare Z. Comparing the effects of reflexology methods and Ibuprofen administration on students of Isfahan University of Medical Sciences. Iran J Nurs Midwifery Res. 2010;15(1):371–378. - PMC PubMed

    1. Valiani M, Shiran E, Kianpour M, Hasanpour M. Reviewing the effect of reflexology on the pain and certain features and outcomes of the labor on the primiparous women. Iran J Nurs Midwifery Res. 2010;15(1):302–310. - PMC PubMed

    1. Lidgren L, Lehtipalo S, Winso O, Karlsson M, Wiklund U, Brulin C. Touch massage a pilot study of a complex intervention. Nurs Crit Care. 2013;18(13):1–8. - PubMed

 

"Reflexology for Symptom Relief in Patients With Cancer"

Wilkinson, Susie PhD; Lockhart, Karen; Gambles, Maureen; Storey, Lesley PhD

Author Information

Cancer Nursing: September 2008 - Volume 31 - Issue 5 - p 354-360

Abstract

Complementary therapies are increasingly being used in hospices and hospitals alongside orthodox treatments in an attempt to improve patients' emotional, spiritual, psychological, and physical well-being. An average of 31% of UK patients with cancer use some form of complementary therapy. Many UK cancer centers, out-patient units, and hospices are providing complimentary services. There is strong anecdotal evidence that complementary therapies assist in the palliation of physical and psychological symptoms. This systematic review examines the research evidence base for the effectiveness of reflexology in cancer care. The study reports the results of a systematic review following the Cochrane principles of systematic reviewing. No meta-analysis was possible. Studies were retrieved from a comprehensive search of electronic databases from their start dates. An initial search was carried out in 2003 and updated in 2005 to 2006. Eligible studies were randomized controlled trials, controlled before and after studies, and interrupted time-series studies. Participants were adults with a diagnosis of cancer, receiving care in any healthcare setting. Interventions were limited to reflexology carried out by a qualified therapist as distinguished from another healthcare professional carrying out a reflexology intervention. Outcome measures were patient-reported levels of physical and psychological indices of symptom distress and quality of life (measured using validated assessment tools).

 

Background

Complementary therapies are increasingly being used in hospices and hospitals alongside orthodox treatments in an attempt to improve the patients' emotional, spiritual, psychological, and physical well-being.1 In healthcare, reflexology is probably one of the most frequently used complementary therapies.2 Reflexology is defined as the systematic application of pressure to specific reflex points on the feet (or hands) with the intention of promoting homeostasis. Working from the premise that reflex areas in the foot (or hand) are linked to principal organs and glands via energy zones, it is presumed that the application of pressure to these areas releases congestion and promotes the flow of energy.2 By enabling optimum circulation, helping to eliminate toxins, and aiding the major systems of the body (immune, nervous, and glandular), it is purported that the therapy helps to promote and restore balance.3

An average of 31% of UK patients with cancer use some form of complementary therapy.4 Many UK cancer centers, out-patient units, and hospices are providing complimentary services.1 According to the Macmillan Cancer Support, the most common complementary therapies offered are massage, aromatherapy massage, reflexology, relaxation therapy/imagery, hypnotherapy, and acupuncture/acupressure.

There is a strong anecdotal evidence that complementary therapies assist in the palliation of physical and psychological symptoms. This systematic review examines the research evidence base for the effectiveness of reflexology in cancer care.

 

Objectives

The objective of this study was to assess the evidence of reflexology in improving physical and psychological well-being in patients with cancer. Specifically, it aimed to determine the following:

  • whether reflexology reduced physical symptoms such as pain, nausea, fatigue, and constipation,

  • whether reflexology reduced psychological symptoms such as anxiety, and

  • whether reflexology improved quality of life and produced any unwanted adverse effects.

 

Methods

The search (summarized in Box 1) was undertaken according to Cochrane principles of systematic reviewing.

 

Box 1

 

Data Sources

The databases which were searched (listed in Box 1) were used to obtain relevant studies for this review. No language restrictions were applied. MeSH keyword terms were modified as necessary for each database searched. The search was not restricted by the application of methodological filters in case this eliminated a number of the "best available" studies, should there not have been any trials which fully met the inclusion criteria.

 

Inclusion Criteria

The review sought the following:

  • randomized controlled trials (RCTs), controlled before and after studies, and interrupted time-series studies;

  • adult participants with a diagnosis of cancer receiving care in any healthcare setting;

  • reflexology carried out by a qualified therapist; and

  • patient-reported levels of physical and psychological indices of symptom distress and quality of life (measured using validated assessment tools).

 

Data Extraction

One reviewer screened the titles and abstracts and eliminated those which are clearly not relevant to reflexology. Two reviewers then independently screened the remaining titles and abstracts to derive a list of studies potentially eligible for inclusion in the review. When necessary, full copies of studies were retrieved. The full texts of all potentially eligible studies were obtained for independent review by 2 to 4 reviewers. Disagreements regarding inclusion or exclusion were resolved by discussion between the reviewers. Studies that met the inclusion criteria are described in Table 1; studies that were excluded and the reason for their exclusion at this stage are listed in Table 2.

 

 

"Reflexology and Bronchial Asthma"

Author links open overlay panelT.BRYGGEaf1J.H.HEINIGaP.COLLINSaS.RONBORGaP.M.GEHRCHENbJ.HILDENcS.HEEGAARDdL.K.POULSENa

https://doi.org/10.1053/rmed.2000.0975Get rights and content

Abstract

Many asthma patients seek alternative or adjunctive therapies. One such modality is reflexology, whereby finger pressure is applied to certain parts of the body. The aim of the study was to examine the popular claim that reflexology treatment benefits bronchial asthma. Ten weeks of active or simulated (placebo) reflexology given by an experienced reflexologist, were compared in an otherwise blind, controlled trial of 20+20 outpatients with asthma.

Objective lung function tests (peak flow morning and evening, and weekly spirometry at the clinic) did not change. Subjective scores (describing symptoms,β2 -inhalations, and quality of life) and also bronchial sensitivity to histamine improved on both regimens, but no differences were found between groups receiving active or placebo reflexology. However, a trend in favor of reflexology became significant when a supplementary analysis of symptom diaries was carried out. It was accompanied by a significant pattern compatible with subconscious un-blinding, in that patients tended to guess which treatment they had been receiving.

No evidence was found that reflexology has a specific effect on asthma beyond placebo influence.

"Clients' perceptions of the benefits of reflexology on their quality of life"

Author links open overlay panelS.WrightPh.D., BA (Hons), RGN, RM.(Research Fellow)af1U.CourtneyM.Med.Sc., RGN(Director)bC.DonnellyBN., ITEC. Dip. Reflexology & Aromatherapy. Cert.Ed.T.KennyITEC. Dip. Reflexology, Aromatherapy & Massage. Cert.Ed.C.LavinITEC. Dip. Reflexology, Aromatherapy Massage & Nutrition

https://doi.org/10.1054/ctnm.2001.0593Get rights and content

Abstract

Awareness has increased among health-care professionals, patients and the general public of the importance of a holistic approach to cancer care. Psychosocial interventions, including complementary therapies, may help to improve the quality of life (QoL) of people with cancer by helping to reduce the distress associated with the diagnosis and treatment of cancer and by facilitating improved psychological adjustment to the experience of cancer. The following article presents anecdotal findings at ARC Cancer Support Centre Dublin, Ireland, of clients' perceptions of the benefits of reflexology interventions on their QoL. Reflexology interventions were perceived to impact positively upon clients' levels of impairment and functional status, including physical and psychological function, with implications for general health perceptions. The paper discusses how these findings might form the basis of further, more rigorous evaluation of the benefits of reflexology for people with cancer at ARC Cancer Support Centre.

 

“Reflexology: An intervention for Advanced Breast Cancer”

 

Completed 2010, NCI grant #R01 CA104883-01A1, $3,127,692,

 

clinicaltrials.gov identifier #, NTC01577420

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576031/

 

Basic results:

  • Reflexology is safe.

  • Reflexology is a specialized therapy; it is not foot massage.

  • Significant improvement in dyspnea (shortness of breath) and ability to function in everyday activities such as walking up a flight of stairs or carry a bag of groceries.

 

 

"Home-Based Symptom Management via Reflexology for Breast Cancer patients” 

 

Completed April, 2018, NCI grant #R01 CA157459-01, approx. $3,000,000.

 

clinicaltrials.gov identifier #, NTC01582971

 

Basic Results-

The total symptom scores showed significant improvement after reflexology. This total symptom improvement was led by the strength of improvements in fatigue and pain. The list of symptoms below were the ones showing improvement in the total symptom score.

  • Pain

  • Nausea/vomiting

  • Disturbed sleep

  • Distress or being upset

  • Shortness of breath

  • Difficulty remembering things

  • Lack of appetite

  • fatigue

  • Dry mouth or sore mouth

  • feeling sad

  • Numbness and tingling

  • Diarrhea/constipation

 

 

“Using SMART Design to Improve Symptom Management Strategies Among Cancer Patients”

 

NCI grant # R01 CA193706

 

2015-2020. Cancer Clinics in Michigan, Chicago, and Arizona worked with this study. Results available soon-

 

All three studies were multi-site, longitudinal, randomized clinical trials and funded by the National Institutes of Health.

 

Principal Investigators-
Gwen Wyatt, PhD, RN, FAAN
Alla Sikorskii, PhD
(Michigan State University, College of Nursing)

Lead Reflexologist 2008-2016, Chicago cancer clinics & 2016-2020, Michigan, Chicago & Arizona cancer clinics: Sarah Preusker.

Nationally Approved Curriculum