Effects of Foot Reflexology on Fatigue, Sleep and Pain: A Systematic Review and Meta-analysis

Department of Nursing, Christian College of Nursing, Gwangju, Korea.
Journal of Korean Academy of Nursing (Impact Factor: 0.38). 12/2011; 41(6):821-33. DOI: 10.4040/jkan.2011.41.6.821
Source: PubMed


The purpose of this study was to evaluate the effectiveness of foot reflexology on fatigue, sleep and pain.
A systematic review and meta-analysis were conducted. Electronic database and manual searches were conducted on all published studies reporting the effects of foot reflexology on fatigue, sleep, and pain. Forty four studies were eligible including 15 studies associated with fatigue, 18 with sleep, and 11 with pain. The effects of foot reflexology were analyzed using Comprehensive Meta-Analysis Version 2.0. The homogeneity and the fail-safe N were calculated. Moreover, a funnel plot was used to assess publication bias.
The effects on fatigue, sleep, and pain were not homogeneous and ranged from 0.63 to 5.29, 0.01 to 3.22, and 0.43 to 2.67, respectively. The weighted averages for fatigue, sleep, and pain were 1.43, 1.19, and 1.35, respectively. No publication bias was detected as evaluated by fail-safe N. Foot reflexology had a larger effect on fatigue and sleep and a smaller effect on pain.
This meta-analysis indicates that foot reflexology is a useful nursing intervention to relieve fatigue and to promote sleep. Further studies are needed to evaluate the effects of foot reflexology on outcome variables other than fatigue, sleep and pain.

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    • "However, few studies have attempted to correlate these results with any quantitative physiological or biochemical outcomes. To date six literature reviews of reflexology have been carried out [13] [14] [15] [16] [17] [18] and three further reviews on reflexology for cancer care [19], pain and fatigue [2], and pain management [11] are also available. None of these have focused specifically on the quantitative aspect of the results available, although the overwhelming opinion from the authors is that there is not enough high quality RCTs to produce significant scientific data for recommending reflexology as an evidencebased treatment option. "
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    ABSTRACT: Background: Reflexology is one of the top forms of Complementary and Alternative Medicine in the UK and is used for healthcare by a diverse range of people. However, it is offered by few healthcare providers as little scientific evidence is available explaining how it works or any health benefits it may confer. The aim of this review was to assess the current evidence available from reflexology randomised controlled trials (RCTs) that have investigated changes in physiological or biochemical outcomes. Methods: Guidelines from the Cochrane Handbook of Systematic Reviews of Interventions were followed: the following databases were searched from inception-December 2013: AMED, CAM Quest, CINAHL Plus, Cochrane Central Register of Controlled Trials, Embase, Medline Ovid, Proquest and Pubmed. Risk of bias was assessed independently by two members of the review team and overall strength of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation guidelines. Results: Seventeen eligible RCT’s met all inclusion criteria. A total of 34 objective outcome measures were analysed. Although twelve studies showed significant changes within the reflexology group, only three studies investigating blood pressure, cardiac index and salivary amylase resulted in significant between group changes in favour of reflexology. The overall quality of the studies was low. Keywords: Biochemistry, physiology, reflexology, systematic review.
    Evidence-based Complementary and Alternative Medicine 05/2014; DOI:10.1155/2014/502123 · 1.88 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the effectiveness of spiritual intervention studies by examining biological, psychological, and spiritual outcomes. From electronic databases 2522 studies were retrieved, of which 21 studies met the inclusion criteria. These studies had 1411 participants. Two authors independently extracted data from the selected studies and assessed the methodological quality. The data were analyzed using the RevMan 5.1 program of the Cochrane library. Overall effect size of spiritual intervention on spiritual and psychological (depression and anxiety) outcomes were moderate (d=-0.65 to d=-0.76, p<.001). The effects on biological outcomes (pain and functional status) ranged from -0.51 to -0.39, respectively. No publication bias was detected as evaluated by a funnel plot. Spiritual intervention had a moderate effect on psychological and spiritual outcomes and a smaller effect on biological outcomes. The results of this study suggest that spiritual intervention can relieve depression and anxiety. Further randomized controlled trials studies are needed to evaluate the effects of spiritual intervention on biological outcomes.
    Journal of Korean Academy of Nursing 12/2012; 42(6):833-42. DOI:10.4040/jkan.2012.42.6.833 · 0.38 Impact Factor
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    ABSTRACT: Objectives: Self-administered foot reflexology is unrestricted by time and space, economical, and practical because it is easy to learn and apply. This study estimated the effectiveness of self-foot reflexology for symptom management in healthy persons through a systematic review and meta-analysis. Methods: The participants were healthy persons not diagnosed with a specific disease. The intervention was foot reflexology administered by participants, not by practitioners or healthcare providers. The comparative studies either between groups or within group comparison were included. Our search utilized core databases (MEDLINE, EMBASE, Cochrane, and CINAHL). We also searched Chinese (CNKI), Japanese (J-STAGE), and Korean databases (KoreaMed, KMbase, KISS, NDSL, KISTI, and OASIS). The search was used MeSH terminology and key words (foot reflexology, foot massage, and self). Results: Analysis of three non-randomized trials and three before-and-after studies showed that self-administered foot reflexology resulted in significant improvement in subjective outcomes such as perceived stress, fatigue, and depression. However, there was no significant improvement in objective outcomes such as cortisol levels, blood pressure, and pulse rate. We did not find any randomized controlled trial. Conclusions: This study presents the effectiveness of self-administered foot reflexology for healthy persons' psychological and physiological symptoms. While objective outcomes showed limited results, significant improvements were found in subjective outcomes. However, owing to the small number of studies and methodological flaws, there was insufficient evidence supporting the use of self-performed foot reflexology. Well-designed randomized controlled trials are needed to assess the effect of self-administered foot reflexology in healthy people.
    Complementary Therapies in Medicine 12/2014; 23(1). DOI:10.1016/j.ctim.2014.11.005 · 1.55 Impact Factor
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