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Does reflexology impact on cancer patients' quality of life?
Abstract
The objective of this study was to determine whether reflexology has an impact on the quality of life of patients in the palliative stage of cancer.
Twelve patients in the palliative stage of cancer with various tumour types were randomised into two groups. They were randomly assigned to receive either reflexology or placebo reflexology. All participants completed a linear analogue self-assessment scale relating to quality of life. All participants then received three sessions of either reflexology or placebo reflexology. The same person, a qualified reflexologist, provided the interventions for both groups. The participants were not aware of which intervention they were receiving. All participants then completed a second linear analogue self-assessment scale relating to quality of life.
All participants felt that their quality of life had improved, even those who had received the placebo treatment. The reflexology group, however, reported more benefit than the placebo group. There was a significant difference (p = 0.004) between the reflexology group and the placebo group.
This study showed that reflexology does have an impact on the quality of life of patients in the palliative stage of cancer.
... The premise is that reflex zones in the feet correspond to organs, glands, and systems of the body [31]. Foot reflexology used concomitantly with conventional treatment seems to decrease some side effects induced by chemotherapy; more specifically, this combination improves quality of life [32,33], significantly decreases pain intensity and anxiety in patients with metastatic cancer [34], and significantly improves the perceived pain and anxiety in postoperative patients with gastric cancer and hepatocellular cancer [35]. Moreover, a significant decrease in CINV has been observed in patients with breast cancer receiving chemotherapy and foot reflexology [36,37]. ...
... In contrast, foot reflexology did not have a significant effect on quality of life and anxiety, unlike findings reported in previous studies [32][33][34][35]. However, three of those previous studies [32,34,35] were conducted using pre-and postinterventions and suggested that the efficacy of foot reflexology had short-term effects. ...
... In contrast, foot reflexology did not have a significant effect on quality of life and anxiety, unlike findings reported in previous studies [32][33][34][35]. However, three of those previous studies [32,34,35] were conducted using pre-and postinterventions and suggested that the efficacy of foot reflexology had short-term effects. Furthermore, the Sharp et al study [33] demonstrated a significant effect on quality of life in patients with breast cancer. ...
BACKGROUND
Cancer is a chronic disease with an incident worldwide had been 24.5 million and 9.6 million deaths in 2017. Lung and colorectal cancer are the most common cancer for both sexes and according to national and international recommendations platinum-based chemotherapy is the reference adjuvant treatment. This chemotherapy can be moderately to highly emetogenic. Despite antiemetic therapy, chemotherapy-induced nausea and vomiting may persist. Moreover, cancer patient are increasingly interested in alternative and complementary medicines and express the desire that non-pharmacological treatments be used in hospitals. Among alternative and complementary medicines, foot reflexology decreases significantly the severity of chemotherapy-induced nausea and vomiting in breast cancer patients.
OBJECTIVE
The primary objective of the present study was to assess the benefits of foot reflexology as a complement to conventional treatments on severity of acute chemotherapy-induced nausea and vomiting in digestive or lung cancer patients. The secondary objectives assessed were the frequency and severity of delayed chemotherapy-induced nausea and vomiting, quality of life, anxiety, and self-esteem.
METHODS
The present study was conducted between April 2018 and April 2020 in French University Hospital. This is an open-label randomized controlled trial. Participants are randomized into two groups: 40 to interventional group (conventional care with foot reflexology) and 40 to control group (conventional care without foot reflexology). Foot reflexology sessions (30 minutes) are performed on an outpatient or inpatient. Eligible participants are patients with a lung or digestive cancer with indication for platinum-based chemotherapy.
RESULTS
The severity of acute nausea and vomiting was assessed with a visual analogue scale during the second cycle of chemotherapy. A significant increase of at least 2 points was observed for control group (20.6%, P = 0.01). Across all cycle, the foot reflexology group showed a trend towards less frequent delayed nausea (P=0.28), a significantly less frequent consumption of antiemetic drugs (P=0.04), and no significant difference for vomiting (P=0.99); there was a trend towards a perception of stronger severity for delayed nausea in the control group (P=0.39). According to quality of life and anxiety, there was no significant difference between the interventional group and the control group (P=0.32 and P=0.53 respectively).
CONCLUSIONS
In conclusion, the present study results indicated that foot reflexology decreased significantly the severity of acute nausea and consumption of antiemetic drugs in lung and digestive cancer patients. No side effects from foot reflexology have been noted. In order to better respond to a desire of patients for non-pharmacological treatments and CAMs to be used in hospitals to improve their care, the results of this study showed that foot reflexology seems to be a promising complement to conventional antiemetic drugs. To assess the performance of this intervention in routine practice, a larger study with several health care centers would be relevant with a cluster RCT.
CLINICALTRIAL
The present study registered with clinicaltrials.gov: NCT03508180 (28/06/2018)
INTERNATIONAL REGISTERED REPORT
RR2-10.2196/17232
... Eight trials evaluated aromatherapy, 14-21 eight trials evaluated massage [22][23][24][25][26][27][28][29] and six evaluated reflexology. [30][31][32][33][34][35] The aims of these trials were to evaluate outcomes, such as quality of life, for people with palliative care needs using complementary therapy. Of the 22 trials, 20 were conducted in high-income countries. ...
... Hodgson 30 Jahani et al. 31 Ross et al. 32 Stephenson et al. 33 Wyatt et al. 34 Wyatt et al. 35 Green indicates a match, yellow indicates uncertain and red indicates a mismatch. ...
... 32,34,35 None of the six trials gave participants choices over the intervention. Finally, two trials discussed promoting interaction between therapist and participants, while not giving any therapeutic advice 30,34 and two trials were conducted by participants' partners, which therefore gave no option for developing a relationship with someone outside of their immediate situation. 33 There were 30 items from the five scales that were not found as a benefit of complementary therapies as described by people with palliative needs. ...
Background
Interventions delivered in palliative care are complex and their evaluation through qualitative and quantitative research can lead to contrasting results. In a systematic review of trials, the effectiveness results of complementary therapies in palliative care were inconclusive; however, our qualitative synthesis showed participants perceived them to be beneficial.
Aim
Use a novel methodology to synthesise evidence from qualitative and quantitative systematic reviews on complementary therapy in palliative care to explore the following: (1) If interventions delivered in trials reflect how participants in qualitative studies report they are delivered in real-life settings and (2) whether quality of life measures used in trials capture perceived benefits that are reported in qualitative studies.
Methods
Two matrix tables were formulated. In one, key components in delivery of the complementary therapy from the qualitative synthesis which are as follows: (1) relationship with therapist, (2) comfortable environment, (3) choices (e.g. area of massage) and (4) frequent sessions, were plotted against intervention description, to explore matches and mismatches. In the other, items included in quality of life scales were compared with perceived benefits of complementary therapy.
Results
None of the trials included all four key delivery components. The five quality of life scales used in the trials failed to capture the range of perceived benefits from the complementary therapies and many included inappropriate or redundant items.
Conclusions
By integrating qualitative and quantitative review data, we determined the reasons trials may be inconclusive. This methodological exemplar provides a framework for understanding complexity in outcomes across trials and a direction for future research.
... 26 In the six reflexology studies, the sessions ranged from a one-off 30-min session 32 to a session a week for 6 weeks. 31 The reflexology was conducted in hospital, 30,32,35 at a participants' homes 33,34 and a day-care centre. 31 The reflexology was conducted by trained reflexologists 30,31,33 and participants' caregivers or partners. ...
... 31 The reflexology was conducted in hospital, 30,32,35 at a participants' homes 33,34 and a day-care centre. 31 The reflexology was conducted by trained reflexologists 30,31,33 and participants' caregivers or partners. 32,34 One study did not report on this. ...
... For example, 10 had an unclear risk of bias due to a lack of reporting. 17,21,24,28,[30][31][32][36][37][38] Only, five studies adequately described methods to conceal group allocation, namely by using, for example, sealed packs and opaque envelopes. 21,22,27,33,34 Four studies had a high risk of bias as the assessors were not blind. ...
Background
Aromatherapy, massage and reflexology are widely used in palliative care. Despite this, there are questions about their suitability for inclusion in clinical guidelines. The need to understand their benefits is a public priority, especially in light of funding pressures.
Aim
To synthesise current evidence on the effectiveness of aromatherapy, massage and reflexology in people with palliative care needs.
Design
A systematic review of randomised controlled trials (PROSPERO CRD42017081409) was undertaken following international standards including Cochrane guidelines. The quality of trials and their pooled evidence were appraised. Primary outcomes on effect were anxiety, pain and quality-of-life.
Data sources
Eight citation databases and three trial registries were searched to June 2018.
Results
Twenty-two trials, involving 1956 participants were identified. Compared with a control, four evaluated aromatherapy, eight massage and six reflexology. A further four evaluated massage compared with aromatherapy. Trials were at an unclear risk of bias. Many had small samples. Heterogeneity prevented meta-analysis. In comparison with usual care, another therapy or an active control, evidence on the effectiveness of massage and aromatherapy in reducing anxiety, pain and improving quality-of-life was inconclusive. There was some evidence (low quality) that compared to an active control, reflexology reduced pain.
Conclusions
This review identified a relatively large number of trials, but with poor and heterogeneous evidence. New clinical recommendations cannot be made based on current evidence. To help provide more definitive trial findings, it may be useful first to understand more about the best way to measure the effectiveness of these therapies in palliative care.
... Concernant l'anxiété, même si celle-ci est probable pour les patient(e)s du groupe réflexologie plantaire à l'inclusion (score moyen>8) à la fin de l'étude aucun patient(e) ne présente d'état anxieux (score moyen <8). Si l'on examine plus précisément les bénéfices de la réflexologie plantaire au niveau de ces deux critères, elle n'a pas eu d'effet significatif, contrairement à ce qui a été rapporté dans des études précédentes (149,150,217,218). Mais trois de ces études précédentes (149,150,217) ...
... Si l'on examine plus précisément les bénéfices de la réflexologie plantaire au niveau de ces deux critères, elle n'a pas eu d'effet significatif, contrairement à ce qui a été rapporté dans des études précédentes (149,150,217,218). Mais trois de ces études précédentes (149,150,217) ...
« En Février 2016, le troisième rapport sur la « Survie des personnes atteintes de cancer en France métropolitaine 1989-2013 » révèle une amélioration de la survie à 5 ans pour la plupart des cancers. Cette augmentation réside à la fois dans des diagnostics de plus en plus précoces et des thérapeutiques de plus en plus performantes. Ces avancées ont modifié le paradigme du cancer, soit guéri par la chirurgie soit mortel, qui est devenu dépassé car le cancer est devenue une maladie chronique qui nécessite un accompagnement pluriprofessionnel et pluridisciplinaire. Parallèlement, les patients atteints d’un cancer ont de plus en plus recours aux médecines alternatives et complémentaires MAC pour traiter leur cancer, pour prévenir voire diminuer les effets secondaires de la maladie et des traitements et arriver en soutien à leur bien-être physique et psychologique. À partir de 2004 le premier Plan Cancer a établi l’accès aux soins de support définis comme « l’ensemble des soins et soutiens nécessaires aux personnes malades atteintes de maladies graves potentiellement mortelles, tout au long de la maladie, conjointement aux traitements spécifiques, lorsqu’il y en a ». Toutefois, pour la majorité des MAC peu voire aucune preuve scientifique n’est disponible à ce jour, sans oublier le fait qu’elles puissent être plus néfastes que bénéfiques aux patients. Au Centre de Coordination en Cancérologie de l’Hôpital Lyon Sud (Hospices Civils de Lyon), pour répondre aux attentes des patients, des séances de réflexologie plantaire leur sont désormais proposées conjointement à leurs traitements conventionnels. Ce travail de thèse avait trois objectifs : i) faire un état de l’art des preuves scientifiques apportées par des essais cliniques randomisés (ECR) des MAC dans le cadre du cancer, ii) s’assurer que la réflexologie plantaire n’interfère pas avec les pratiques professionnelles, iii) évaluer les bénéfices de la réflexologie plantaire auprès de patients sous chimiothérapie en particulier les nausées/vomissements chimio-induits. Tout d’abord, la revue de la littérature montre que l’évaluation des MAC à l’aide d’ECR au niveau mondial est rare et est essentiellement menés par les États-Unis et la Chine. Ces études concernent principalement l’acupuncture, le yoga et les herbes chinoises avec des bénéfices significatifs au niveau de la qualité de vie globale, fatigue, douleur et anxiété. Enfin, l’évaluation de leur innocuité fait souvent défaut dans ces études. Ensuite, l’enquête réalisée auprès des professionnels de santé de l’hôpital suggère que la réflexologie plantaire délivrée lors des soins conventionnels n’interfère pas avec leur pratique et que ces derniers perçoivent de réels bénéfices pour leurs patients. Enfin les résultats de notre étude prospective contrôlée randomisée montrent une diminution significative des nausées aiguës. Nous observons également une tendance à une diminution des nausées retardées, conjointement à une diminution significative de la consommation des médicaments antiémétiques entre chaque cure de chimiothérapie. Aucun événement indésirable n’a été constaté dans cet ECR. En conclusion, les résultats de ce travail de thèse ont montré que la réflexologie plantaire, accueillie très favorablement par les professionnels de santé, semble être un complément prometteur aux médicaments antiémétiques. Cette thèse ouvre des perspectives de recherches des MAC avec des enjeux de santé publics majeurs : fournir aux professionnels de santé des données scientifiques rigoureuses, évaluer l’innocuité des MAC et améliorer la communication entre les professionnels de santé et les patients à propos des MAC.
... In a study conducted by Ö zdelikara and Tan [33] on patients with breast cancer, the general quality of life increased in the patients who underwent reflexology [33]. Studies conducted on different types of cancer patients have shown that reflexology positively affects the quality of life [6,23,49]. The present study suggested that life quality may have increased due to reduced anxiety, depression, and other physical symptoms following reflexology. ...
... Dikmen and Terzioglu [28] found in their randomized controlled study with gynecological cancer patients that reflexology was effective in reduction of pain and fatigue. Several studies have shown that reflexology is used to manage pain experienced by cancer patients [6,21,33,34,41,49,[51][52][53][54][55][56]. Reflexology has also been found to be effective in reducing fatigue in patients with different types of cancer [20,24,33,54,56,58,59]. ...
Objectives
This study aimed to examine the effects of reflexology based on Watson’s theory of human caring on anxiety, depression, and quality of life in gynecological cancer patients.
Material and Methods
The study was a prospective, single-blind, randomized controlled trial with a pretest-posttest and a control group. The clinical trial was conducted at a university hospital in the Aegean region between October 2016 and June 2018. It was completed with 62 women, of whom 31 were in the intervention group and 31 were in the control group. Data were collected by using a personal information form, the Beck Anxiety Inventory, the Beck Depression Inventory, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-version 3.0.
Results
Anxiety and depression levels were lower in the intervention group than in the control group. Besides, the quality of life was higher in the intervention group than in the control group. Reflexology significantly reduced symptoms due to chemotherapy, such as fatigue, pain, insomnia, and loss of appetite. Although there was a decrease in symptoms, such as nausea, vomiting, diarrhea and constipation immediately after reflexology, an increase in symptoms was observed in the intervention group two weeks later.
Conclusion
These results showed that reflexology based on Watson’s theory of human caring is effective in reduction of anxiety and depression and improves the quality of life in gynecological cancer patients during chemotherapy. It can be suggested that offering reflexology at certain intervals during chemotherapy will increase the duration of its effect.
... Although there are no studies on standing workers and reflexology, reflexology has been studied on medical patients who experience chronic pain for specific health challenges, with promising results (Oleson & Flocco, 1993;Poole et al., 2007;Tsay Occupational Health Science et al., 2008;Hodgson, 2000). For example, postoperative patients with gastric cancer who received reflexology reported less pain and anxiety after follow-up than patients who received usual pain management (Tsay et al., 2008). ...
... For example, postoperative patients with gastric cancer who received reflexology reported less pain and anxiety after follow-up than patients who received usual pain management (Tsay et al., 2008). Hodgson (2000) found cancer patients who received reflexology reported significantly lower pain levels than patients who received "placebo reflexology," or a gentle foot massage that did not stimulate reflex points on the feet. While these studies are limited by small sample sizes, they employed a similar methodology to the one used in the current study: participants were randomly assigned to a 40-min reflexology or "placebo reflexology" group involving gentle foot massage and were blind to the intervention. ...
Many jobs require workers to stand for prolonged periods of time while performing their job duties. Prolonged standing at work has been linked to negative health outcomes, particularly musculoskeletal symptoms (MSS) and fatigue. Reflexology is a complementary and alternative medicine technique that may be well-suited to reduce musculoskeletal symptoms, fatigue, stress, and anxiety in workers who stand for prolonged amounts of time because it involves stimulating reflex points on the feet purported to correspond to different bodily parts, increases relaxation, and reduces stress. Additionally, general relaxation techniques applied to the feet and lower leg, combined with passive relaxation time, may also provide some relief. In the current longitudinal, mixed-method intervention study, participants are randomized to either a reflexology condition or a passive relaxation condition, and their self-reported levels of MSS, fatigue, stress, and anxiety are assessed for two weeks at pre-test, two weeks during the intervention stage, and two-weeks post-intervention along with qualitative responses about their experiences. Multilevel analyses reveal participants in both groups reported significant reductions in scores across all measures from pre-test through intervention, but the decreases did not vary significantly by condition for any outcomes except anxiety. In addition, results from qualitative thematic analysis substantiate findings regarding the prevalence of negative health outcomes in standing workers and provide support for the use of reflexology or relaxation in helping to alleviate those outcomes.
... Parmi un grand nombre de pratique, la réflexologie, développée en Occident à partir de la fin du XVIII e , aurait démontré son efficacité dans différentes populations. Elle serait particulièrement efficiente dans le traitement de la douleur et de l'anxiété [1][2][3], aurait également un effet positif sur l'état de santé et sur la qualité de vie des personnes atteintes de cancer et de maladie chronique [4,5]. ...
... À notre connaissance, aucune étude ne porte sur la réflexologie réalisée au niveau de la main ; aucune étude ne s'intéresse à la réflexologie en tant que médiation à la relation clinique, et peu d'études s'intéressent spécifiquement aux effets de la réflexologie auprès des personnes âgées institutionnalisées [2,10]. Enfin, la littérature objective rarement l'amélioration de la qualité de vie et les résultats sont controversés [5,11,12]. La dimension de la qualité de vie est pourtant majeure dans l'accompagnement de ces populations vulnérables. Les auteures encouragent à évaluer l'impact de l'utilisation de la réflexologie palmaire en tant que médiation à l'entretien clinique sur la qualité de vie et sur le bien-être subjectif auprès d'une population vulnérable, et aussi à investiguer les effets de cette approche sur les processus en jeu dans l'alliance thérapeutique. ...
Résumé
Cet article a pour objectif d’illustrer l’intérêt potentiel de la réflexologie durant des entretiens cliniques avec une population vulnérable. La réflexologie réalisée au niveau des mains est particulièrement adaptée aux spécificités de cette population, quel que soit le contexte. Les trois cas cliniques présentés concernent des personnes âgées institutionnalisées. Ils décrivent l’impact de la réflexologie palmaire dans l’établissement d’une communication efficiente avec la thérapeute et dans l’amélioration de l’état affectif des bénéficiaires. Chaque personne prise en soin a vu ses symptômes neuropsychiatriques fortement diminués. Aussi, la question de l’amélioration du bien-être subjectif, de la qualité de vie se pose et mériterait d’être explorée.
... This is based on the principle that there are reflexes running along the body, which terminate in the feet and the hands, and that the body's organs and systems are represented on the skin's surface. (Hodgson 2000;Norman & Cowan 1989). First documents describing the use of reflexology are dated to 2300 BC in Egypt (Lockett 1992). ...
There is ample evidence that children and adolescents in large numbers are actively using integrative (complementary and alternative) therapies. Various studies now indicate that over 50% of pediatricians surveyed would refer a patient for integrative therapy, and they would welcome more natural therapies for children provided they were safe and effective. However, there has been little training for pediatricians in this area. Integrative Pediatrics addresses these issues and provides guidelines for pediatricians, parents, and general audiences in a balanced, evidence-based manner. In this volume in the Weil Integrative Medicine Library series, the authors describe a rational and evidence-based approach to the integrative therapy of childhood disorders and well-child care, integrating the principles of alternative and complementary therapies into the principles and practice of conventional pediatrics. The authors examine what works and what doesn’t and offer practical guidelines for physicians to incorporate integrative medicine into their practice and how to advise patients and their parents on reasonable and effective therapies. The text also covers areas of controversy and identifies areas of uncertainty where future research is needed. Chapters also cite the best available evidence for both safety and efficacy of all therapies discussed. The series editor is Andrew Weil, MD, Professor and Director of the Program of Integrative Medicine at the University of Arizon. Dr. Weil’s program was the first academic program in the US and he is the major name in integrative medicine in the US, and well-known around the world. His program’s stated goal is “to combine the best ideas and practices of conventional and alternative medicine into cost effective treatments without embracing alternative practices uncritically.”
... Factors such as lack of response to appropriate treatment of conventional medicine, coordination of complementary medicine treatments with the patient's own nature, low cost and simple treatment are among the reasons for patients' tendency to complementary medicine methods [22] . Reflexology is a non-invasive, convenient and easy method of treating cancer patients, so that some patients consider this method as an alternative to drugs [23] , which improves the quality of life and reduces stress in such patients [24] . ...
... Several studies conducted by the National Cancer Institute and the National Institutes of Health show that reflexology may lessen pain and psychological symptoms, such as nervousness and depression, and improve relaxation and sleep (13)(14)(15)(16)(17). Studies also report that reflexology may have profits in the palliative care of people with cancer (18)(19)(20)(21)(22)(23)(24). Reflexologists claim that reflexology is also able to treat a wide range of medical conditions such as asthma, diabetes, and cancer. ...
Aim: this study was conducted to review the related articles and draw a final conclusion regarding the application of reflexology for delivery (labor and cesarean section) pain management in woman all over the world.
Methodology: In this systematic review, relevant articles were searched in Google Scholar, PubMed, Cochrane Library, Science Direct, and Scopus databases from the year 2000 to 2018. All the human clinical trials that examined the effects of reflexology methods on delivery pain (labor or Cesarean section) were included and others excluded from the study.
Results: All the 18 included original articles (with 1391 patients) reported that reflexology significantly reduces the pain of delivery, confirming its decreasing effect on labor, Cesarean section, and post-delivery pain. Results of all articles showed that, if true reflexology is performed on the right location of the body and at the appropriate time, the pain of delivery can be significantly decreased
Conclusion: Reflexology is an appropriate pain relief and prophylaxis for any kind of pain, especially delivery and post-delivery pain. It is a safe remedy with no adverse effects reported so far.
... After screening the titles and abstracts 3968 studies were excluded and 44 studies and 27 systematic review articles in complementary medicine scope were fully evaluated. Finally, 10 articles were included that 8 articles (9, 14-20)published from 1998 to 2018-were entered into the metaanalysis and other articles were reported narratively because of the defect in data (21,22). The analyzed articles consisted of five randomized clinical trials, one quasiexperimental research, and two pre-post design studies. ...
... After screening the titles and abstracts 3968 studies were excluded and 44 studies and 27 systematic review articles in complementary medicine scope were fully evaluated. Finally, 10 articles were included that 8 articles (9, 14-20)published from 1998 to 2018-were entered into the metaanalysis and other articles were reported narratively because of the defect in data (21,22). The analyzed articles consisted of five randomized clinical trials, one quasiexperimental research, and two pre-post design studies. ...
Context: Pain is a common symptom associated with cancer and its treatment. The conventional treatment does not often relieve cancer pain optimally. The complementary therapies are increasingly used as adjunct therapy alongside pharmacological and conventional treatments in patients. Objectives: The aim of this systematic review was to investigate the existing evidence for reflexology effect on cancer pain through a meta-analysis. Data Sources: In this systematic review, electronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and PubMed were searched to find relevant studies until December 2018. Study Selection: We included before-after studies and trials of interventions that focused on pain management using reflexology modality as an intervention in patients with cancer regardless of cancer type. The effect of reflexology for patients with cancer pain was investigated as the main outcome. Data Extraction: The extracted information included name of authors, year of publication, study location, type of study, sample size, and outcome indicator. Consensus was reached by discussion in case of disagreement during each stage of selection, qualitative assessment, and extraction of data. We assessed heterogeneity using the I2 statistics. The publication bias was explored using the Egger’s and the funnel plot. We meta-analyzed the data and reported the standardized mean difference (SMD) with 95% confidence intervals (CI) using the random-effects model. Meta-analysis was done using the Revman software. Results: Eight studies with 948 participants were analyzed using a random- effects model meta-analysis. Included studies consisted of five randomized clinical trials, one quasi-experimental, and two pre-post design. We observed a positive effect for reflexology in patients with cancer pain compared with usual care (SMD- 0.55 [95% CI-0.82 to 0.21] P < 0.001). Conclusions: This systematic review provides sufficient evidence for the effectiveness of reflexology as an effective treatment in cancer pain. But we recommend conducting studies with larger sample size, well-designed trials with sufficient duration and longer follow-up periods with clear details about reflex practitioners, duration of intervention, instrument for pain assessment, and outcome. Meanwhile, patients should be adequately monitored and adverse effects should be reported. All of the aforementioned issues might affect the impact of reflexology adjuvant treatment.
... A systematic review indicated that foot reflexology seems to be effective for patients with cancer but this field requires further rigorous research with a randomized controlled trial [5]. More specifically, foot reflexology improved the quality of life of patients in the palliative stage of cancer [6], significantly decreased pain intensity and anxiety in patients with metastatic cancer [7], and significantly decreased the perceived pain and anxiety of postoperative patients with gastric cancer and hepatocellular cancer [8]. Moreover, a significant decrease in chemotherapy-induced nausea and vomiting (CINV) was observed in patients with breast cancer who received reflexology treatments [9,10]. ...
Background:
Side effects of chemotherapy are feared by patients, specifically chemotherapy-induced nausea and vomiting. To relieve them, it is recommended to prescribe antiemetic drugs. However, some patients report that they are not sufficiently effective. Moreover, patients with chronic disease, including cancer, are increasingly interested in alternative and complementary medicines and express the desire that non-pharmacological treatments be used in hospitals. Foot reflexology is a holistic approach that is reported to decrease significant reduction in the severity of chemotherapy-induced nausea and vomiting in breast cancer patients. Some chemotherapy for lung and digestive cancer patients is moderately or highly emitting.
Objective:
The primary objective of the present study is to assess the benefits of foot reflexology as a complement to conventional treatments on severity and frequency of chemotherapy-induced nausea and vomiting in digestive or lung cancer patients. The secondary objectives assessed are quality of life, anxiety, and self-esteem.
Methods:
This study is an open label randomized controlled trial conducted over 22 months (18 months intervention and 4 months follow-up). Eligible participants are patients with a lung or digestive cancer with indication for platinum-based chemotherapy. Participants are randomized into two groups: conventional care with foot reflexology and conventional care without foot reflexology. Foot reflexology sessions (30 minutes) are performed on an outpatient or inpatient. It was estimated that 40 participants per group will be required. The benefits of foot reflexology will be assessed by comparing the relative change in the severity of nausea and vomiting, as assessed by a visual analogic scale, and the frequency of this between the two groups. The secondary objectives will be assessed with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 items, Hospital and Anxiety Depression Scale and Body Image Questionnaire.
Results:
The present study was approved by the regional ethics committee (Île de France X CPP) on 3 April 2018 (n°ID RCB 2018-A00571-54). The enrollment started in Jun 2018 and as of November 2019, we enrolled 70 patients. The results are expected for the first quarter of 2020.
Conclusions:
The lack of knowledge regarding the efficacy and safety of foot reflexology limits oncologists to recommend this use. The present study will provide evidence on the benefits of foot reflexology. If efficacy is confirmed, foot reflexology may be a promising complement to conventional antiemetic drugs.
Clinicaltrial:
The present study registered with clinicaltrials.gov: NCT03508180 (28/06/2018) https://www.clinicaltrials.gov/ct2/show/NCT03508180?term=NCT03508180&draw=2&rank=1.
... Energetic reflex therapy results of many years of monitoring, with young and old men and women, taking drugs or not, can be randomized against foot massage or non-energetic reflexology results [9], as placebos, and general practitioner, acupuncturist, physiotherapist, rheumatologist, endocrinologist, neurologist or osteopath, results, as controls. Improvements were significant for: -exhaustion, insomnia, night awakenings, anxiety, hypersensitivity, depression, stress, agitation, confusion, dizziness, ictus, memory loss, headaches, migraine, -cognitive or motor dysfunction, traumas; -anorexia, loss of appetite, excess weight, obesity, -sugar or tobacco addiction, perverted taste sensation; -diarrhea, constipation, intestinal obstruction, abdominal discomfort, flatulence, colitis, -stomach discomfort, irritation, ebb or ulcer, dysphagia or dyspepsia, nausea, vomiting; -too low or too high blood pressure, palpitation, -low blood flow, venous or lymphatic drain disorders, edemas, haemorrhoids, veins varicose, syndrome of Raynaud; -hormonal disorder, pineal, pituitary or hypothalamus disorders, libido disorders; -bone, muscle, nerve or vessel pains, cramps, sciatic pain, facial neuralgia; -allergy, inflammation, skin disorders, eczema, acne, lupus; -osteoporosis, osteoarthritis, rheumatisms, fibromyalgia, hernia; -rhinitis, bronchitis, emphysema, asthma, -apnea, mucositis; -nephrite, cystitis, incontinence, -pancreatitis, diabetes; -kidney cysts, thyroid nodules. ...
The core of the Taoism philosophy of the optimal balance between Yin-Yang is the same as the meden agan Antique Greek philosophy. Both agreed that sustainability is obtained neither through a greater efficiency (yang excess) nor through a greater resilience (yin excess) but with an in-between optimal balance, a window of viability. From their experience of interactions between Man and Nature, particularly in agriculture and health, the Chinese ancestors pointed to the ethics of the harmony and the order. Confucius said: “harmony is over all”. To maintain the harmony between Man and Nature is the systemic way for sustainability and Societies have to respect the laws of Nature. Taoism principles made their proofs in ecology, which is the economy of Nature: too little diversity (yang excess) leads towards breakage, too much (yin excess) leads to stagnation, and in economy: complementary currencies of diverse types enable economy to flow back towards greater sustainability.
re-discovered. Foot reflex therapy can be used for diagnosis and as a tool for chronic pain, vascular flow and lung or breast cancer treatments. In a study, with a significant number of patients, 100% improvement was found [8]. How to summarize what the researchers know? How to use energetics reflex therapy tools? How to prove their efficiency?
Opinion
Unless proved otherwise, every living system is rhythmic. Biological rhythms are essential components of homeostasis, and periodicity is inherited. Major pathologies result from rhythm disruption. Drugs show rhythmic variations in pharmacokinetics and pharmacodynamics. Drugs abuse makes money but has triggered antibiotic resistances and environmental pollution. Other ways for quality-of-life restoration are needed. Since, 5000 years, with antique Egyptian medicine and traditional Chinese medicine, foot reflex therapy was experimented and taught, with success. With time the energetic principles were forgotten, and it was misapplied and rejected by modern occidental chemical medicine. But with the failure of more and more aggressive treatments it was
Energetic reflex therapy results of many years of monitoring, with young and old men and women, taking drugs or not, can be randomized against foot massage or non-energetic reflexology results, as placebos, and general practitioner, acupuncturist, physiotherapist, rheumatologist, endocrinologist, neurologist or osteopath, results, as controls. Improvements were significant for: -exhaustion, insomnia, night awakenings, anxiety, hypersensitivity, depression, stress, agitation, confusion, dizziness, ictus, memory loss, headaches, migraine, -cognitive or motor dysfunction, traumas; -anorexia, loss of appetite, excess weight, obesity, -sugar or tobacco addiction, perverted taste sensation; -diarrhea, constipation, intestinal obstruction, abdominal discomfort, flatulence, colitis, -stomach discomfort, irritation, ebb or ulcer, dysphagia or dyspepsia, nausea, vomiting; -too low or too high blood pressure, palpitation, -low blood flow, venous or lymphatic drain disorders, edemas, haemorrhoids, veins varicose, syndrome of Raynaud; -hormonal disorder, pineal, pituitary or hypothalamus disorders, libido disorders; -bone, muscle, nerve or vessel pains, cramps, sciatic pain, facial neuralgia; -allergy, inflammation, skin disorders, eczema, acne, lupus; -osteoporosis, osteoarthritis, rheumatisms, fibromyalgia, hernia; -rhinitis, bronchitis, emphysema, asthma, -apnea, mucositis; -nephrite, cystitis, incontinence, -pancreatitis, diabetes; -kidney cysts, thyroid nodules.
... One study randomized 12 patients receiving palliative care to receive reflexology or placebo. 25 Interventions were carried out on Days 1, 3, and 5; assessments using the VAS were recorded at baseline and after the intervention. Multiple symptoms were assessed including appetite, breathing, communication, constipation, pain, and tiredness. ...
Context:
The aim of palliative care is to improve quality of life for patients with serious illnesses by treating their symptoms and adverse effects. Hospice care also aims for this for patients with a life expectancy of six months or less. When conventional therapies do not provide adequate symptom management or produce their own adverse effects, patients, families and caregivers may prefer complementary or alternative approaches in their care.
Objectives:
To evaluate the available evidence on the use of complementary or alternative medicine (CAM) in hospice and palliative care and to summarize their potential benefits.
Methods:
A defined search strategy was used in reviewing literature from major databases. Searches were conducted using base terms and the symptom in question. Symptoms included anxiety, pain, dyspnea, cough, fatigue, insomnia, nausea, and vomiting. Studies were selected for further evaluation based on relevancy and study type. References of systematic reviews were also assessed. After evaluation using quality assessment tools, findings were summarized and the review was structured based on PRISMA guidelines.
Results:
Out of 4682 studies, 17 were identified for further evaluation. Therapies included acupressure, acupuncture, aromatherapy massage, breathing, hypnotherapy, massage, meditation, music therapy, reflexology, and reiki. Many studies demonstrated a short-term benefit in symptom improvement from baseline with CAM, although a significant benefit was not found between groups.
Conclusion:
CAM may provide a limited short-term benefit in patients with symptom burden. Additional studies are needed to clarify the potential value of CAM in the hospice or palliative setting.
... 20 Among these, in a study conducted with the participation of these 20 patients, it was reported that reflexology significantly increased the quality of life of palliative cancer patients. 21 However, when considering the number of patients enrolled in the study, it is difficult to say that the results are convincing. 20 A meta-analysis published in 2015 reviewed the effect of reflexology on symptoms such as stress, anxiety, and fatigue as well as on parameters such as blood cortisol levels, blood pressure, and pulse, when self-applied by people after being trained; and consequently, the conclusion was that there were no adequate evidence to recommend its use. ...
Reflexology is a complementary alternative medicine procedure carried out by applying pressure to specific points located mostly in the feet (sometimes in the hands), with intent to provide relief from certain symptoms. In reflexology thought to have a history of approximately 5000 years, it is believed that specific points in the feet are linked to certain organs and systems in the body, through energy channels, and that applying pressure to these points provides relief in the relevant organ and system, as well. However, no evidence has yet to be found that proves the alleged connections and mechanisms of reflexology. Indeed, studies carried out up to date were focused on the symptomatic effects of reflexology, rather than such links and mechanisms. In some studies, certain positive results have been obtained especially in terms of pain and anxiety. However, these studies were methodologically incomplete, as well, due to challenges such as the difficulty in creating blinding and placebo effect. As a result, currently we have no reliable evidence about the use of reflexology in any clinical situation. Nevertheless, when it is considered to be a safe procedure in terms of unwanted effects, it can be provided to patients as a supportive care service.
... These findings were strongly supported by other studies. (10,11) Thus the findings of the study suggested that there is a need to plan and implement this therapy during the chemotherapy treatment. ...
... Depression becomes worse Nurses as important part of the health care team and as care provider, need to increase the use of alternative therapies to improve the physical and psychological performance and feeling of well-being of cancer patients receiving cancer treatment. 4 Mokhtari Nouri J et al stated that there are variety of commonly used relaxation techniques such as progressive muscle relaxation, imagery, relaxation, Benson relaxation, deep relaxation, selected relaxation and meditation. 5 Several studies have assessed the effects of yoga on depression, anxiety and stress in breast cancer patients undergoing chemotherapy. ...
Background: Breast cancer has ranked number one cancer among Indian females. Women undergoing chemotherapy experience many side effects including alteration in their body image. The present study assessed effectiveness of yoga on anxiety, depression and stress level of breast cancer patients undergoing chemotherapy.Methods: Quantitative Research approach and Randomized Clinical Controlled Trial with Time series design was adopted in the present study. The consecutive sampling technique was done to recruit 100 breast cancer patients fulfilling the eligibility criteria. Recruited patients were randomized to control (N=52) and experiment (N=48) groups by concealed randomization. Written informed consent was taken from each participant. Baseline data was collected during cycle one by using Anxiety depression and stress scale. The patients in the experimental group were taught Diaphragmatic breathing, systematic relaxation and alternate nostril breathing and Joints and Gland neck and shoulder exercises, and were instructed to practice them twice daily at home. They were supervised in practicing these when they received second, third, fourth, fifth and sixth cycles of chemotherapy. Participants in control group received routine care. Data was again collected after 21 days during second, third, fourth, fifth and sixth cycles of chemotherapy.Results: Analysis revealed that at the baseline breast cancer patients in control and experimental group were homogenous in terms of their Sociodemographic and anxiety depression and stress scores. After the yoga intervention the experimental group showed statistically significant difference in anxiety scores from control group during second, third and sixth cycles (p 0.01, p 0.02, p 0.02), in depression score during the second, third, fourth, fifth and sixth cycles (p 0.02, p 0.02, p 0.02, p 0.001, p 0.000), and in stress scores during third cycle (p 0.01) of chemotherapy.Conclusions: On the basis of findings of the study it was concluded that yoga was effective in reducing the anxiety, depression and stress of breast cancer patients undergoing chemotherapy. Therefore, it is recommended as complementary therapy for patients receiving treatment for cancer.
... In their research on the effects of reflexology on the quality of life of breast cancer patients, Shadan et al. reported that reflexology improved the quality of life of breast cancer patients and that the effect of reflexology on the quality of life was statistically significant [18]. In his research with cancer patients, Hogson also found that reflexology had significant positive effects on the quality of life [19]. Other studies also demonstrated that reflexology significantly improved the quality of life of breast cancer patients who receive radiotherapy, hypertensive patients, MS patients and patients with rheumatoid arthritis [20e27]. ...
Background:
This study aims to identify the effect of reflexology on the quality of life in patients with breast cancer.
Methods:
The population of the study conducted comprised of 60 patients; 30 forming the control and 30 the experimental groups (30 experimental, 30 control). Patient identification forms and EORTC QLQC30 Quality of Life Scale were used to collect the data.
Statistical analysis used:
The data obtained as a result of the study were assessed via computer using 'Statistical Package for Social Science 21.0' software.
Results:
The results of the experiment demonstrated that the within-group symptom total score average of the patients in the experiment/treatment group decreased after the reflexology treatment; while the general health and functional total score averages in the treatment group increased; and the difference between pretest and posttest measurements was statistically significant (p = 0.000). Once symptom, functional, and general health total score averages from the posttest measurement are compared across treatment and control groups, symptom total score average of the patients in the treatment group turned out to be significantly lower than that of the patients in the control group (p = 0.001). In terms of functional and general health score averages, patients in the treatment group scored significantly higher than those in the control group (p = 0.000).
Conclusion:
Reflexology was found to reduce the symptoms experienced by breast cancer patients, while at the same time increasing the functional and general health status.
... This result may be attributed to the effect of reflexology on decreasing leg cramps intensity, frequency and duration may increase patient's ability to perform physical activities, as some patients from the current study participants reported that reflexology massage relieve leg cramps as soon as muscle pain after cramp so, ability to walk, stand and climb stairs increased. This finding is in harmony with Quattrin et al. 2000) studies which revealed that reflexology massage improve physical activities (46,47,48,49,50) . ...
... Reflexology has been offered to patients with cancer in an attempt to improve the adverse physical and psychological symptoms associated with the illness or its treatments (Hodgson, 2000;Quattrin et al., 2006;Ross et al., 2002;Stephenson et al., 2000;Wright et al., 2002,). Studies evaluating the effect of reflexology in a variety of health conditions have shown that it is a promising treatment in promoting well-being with little risk of side-effects (Richardson as cited in Hodgson & Anderson, 2008) and does not interfere with patients' privacy (Stephenson et al., 2000). ...
Objective: This study aims to develop a foot massage program to support care activity in reducing nausea and vomiting for cancer patients undergoing chemotherapy. Two phases, a literature review and the development of a foot massage program were conducted. The literature review was to analyze state of the art massage techniques by reviewing problems, related theories and supporting evidence. Method: Eight published studies in the English language were reviewed. A massage can be performed for different durations, from 10 minutes up to 60 minutes for three to six weeks and can be applied on various body areas. We found that the soft stroke/effleurage seems to be the best method and is most suitable for patients with cancer. It is also evident that foot massaging can be applied as a modality to reduce nausea and vomiting for cancer patients undergoing chemotherapy. Result: We developed a foot massage program specifically for patients with cancer. The foot massage program comprised of three sessions, including 1) education session, 2) preparation session, and 3) foot massage session. In the education session, patients obtain brief information about the definition of a foot massage, the benefits and contraindication of foot massaging. During the preparation phase, foot soaking and warming up are performed. Subsequently, the foot massage is applied and should last for 30 minutes. Further research is recommended to test the effectiveness of the proposed foot massage program for nausea and vomiting in cancer patients across countries including Indonesia. Key Words: Foot massage program, chemotherapy, nausea and vomiting
... W ostatnich latach pojawiło się kilka badań analizujących skuteczność terapeutyczną masażu i refleksoterapii [35][36][37]. Ich wyniki nie określają jednoznacznie wyższości którejkolwiek z porównywanych metod. ...
This article reviews the rules, meaning and aims of physiotherapy intervention in palliative care. Authors present rehabilitation procedures, which are applying in palliative patients. There were analyzed the treatments involving kinesitherapy, massage, reflexotherapy, physical therapy, acupununcture and treatment of lymphoedema. In addition, article describes clinical trials studying therapeutic effectiveness rehabilitation treatment.
... Other therapeutic effects, such as strengthening the immune system, improving sleep quality, and wound healing have also been claimed (Xavier, 2007). Reflexology has also been offered to cancer patients to improve the adverse physical and psychological symptoms associated with the illness or its treatments (Hodgson, 2000;Stephenson et al, 2000;Ross et al., 2002;Wright et al., 2002;Quattrin et al., 2006). In addition, the human touch accompanied by reflexology offers care and attention for patients, and this psychological comforting has been reported as one of its primary benefits (Gambles et al, 2002). ...
Patients with rheumatoid arthritis (RA) face considerable physical, social and emotional disabilities. In this chronic disease, for which a cure is not yet available, improving patients' health, quality of life and reduce pain is of the utmost concern. The purpose of this work was to measure the effect reflexology has on pain and quality of life (QOL) in a patient with rheumatoid arthritis. Using an 8-week course of reflexology treatments were given to a patient who has RA. A quasi experimental research design was used with 2- month follow-up. The study was conducted in the outpatient clinic of the RA Departments at Zagazig University Hospitals. On 39 female adult patients diagnosed as having RA without deformity of bones or destruction of joints. The exclusion criterion was the presence of any other chronic illness that may affect patient's QOL as diabetes, ischemic heart disease, chronic obstructive pulmonary disease, and stroke. Perceived pain and QOL were assessed using three validated outcome measures: Bio-socio-demographic and disease (RA) characteristics, the Rheumatoid Arthritis Quality of Life (RAQOL) questionnaire, the Pain Assessment Questionnaire (Numerical Rating Scale) and Health assessment questionnaire (HAQ). The study results revealed that, improvements in patients' QOL, pain and health status at the post-intervention phase and at the follow-up phase. Satisfaction QOL scores had moderate statistically significant negative correlations with the duration of illness throughout the study phases, while the scores of the importance of QOL had weak to moderate statistically significant negative correlations with age and duration of illness. On the other hand, the poor health status scores had moderate statistically significant positive correlations with age and duration of illness throughout the study phases, while pain had no correlation with either of them. The study concludes that hands and feet reflexology applied to rheumatoid arthritis patients is effective in reducing their pain, improving their QOL and their total health status, and these positive impacts are not affected by patient's age and duration of illness. Therefore, reflexology must be considered as a complementary treatment modality in rheumatoid arthritis. It should be introduced to nursing and medical students, and in postgraduate staff development programs. Further research is recommended for the long-term effects of this treatment modality in terms of pain and disablement. Research may also extend to assess the effectiveness of as a useful modality in geriatric care and for patients with other chronic conditions.
... Other therapeutic effects, such as strengthening the immune system, improving sleep quality, and wound healing have also been claimed (Xavier, 2007). Reflexology has also been offered to cancer patients to improve the adverse physical and psychological symptoms associated with the illness or its treatments (Hodgson, 2000;Stephenson et al, 2000;Ross et al., 2002;Wright et al., 2002;Quattrin et al., 2006). In addition, the human touch accompanied by reflexology offers care and attention for patients, and this psychological comforting has been reported as one of its primary benefits (Gambles et al, 2002). ...
... Quasi-experimental, pre-/post-, cross-over trial VAS -anxiety (Cline et al. 1992 also reported a statistically signiicant decrease in anxiety after relexology treatments (Hodgson & Andersen 2008;Quattrin, Zanini, Buchini, Turello, Annunziata, Vidotti, Colombatti & Brusaferro 2006;Stephenson, Swanson, Dalton, Keefe & Engelke 2007). An experimental study conducted by Hodgson (2000) on patients in the palliative stage of cancer who received relexology treatments reported statistically signiicant improvements in pain management, decrease in constipation, better sleep, decreased anorexia and nausea. ...
An integrative literature review of identified scientific evidence, published from January 2000 to December 2008, of the utilisation of reflexology as complementary and alternative medicine (CAM) modalities to promote well-being and quality of life in adults with chronic diseases was done to facilitate nurses to give informed health education during comprehensive nursing care to patients with chronic diseases. Selected accessible databases were searched purposefully for research articles (N = 1171). Pre-set inclusion criteria were applied during the study selection process. The methodological study quality was reviewed and appraised with appropriate tools from the Critical Appraisal Skills Programme (CASP) and the American Dietetic Association's (ADA) Evidence analysis manual (n = 21). Evidence extraction, analysis and synthesis of studies (n = 18) were done through the evidence class rating and level of strength as prescribed in the manuals of ADA and CASP. Findings indicate statistically significant reduction in the frequency of seizures in patients with intractable epilepsy, an improvement of sensory and urinary symptoms associated with multiple sclerosis and clinically significant reduction of anxiety and pain in patients with cancer and fibromyalgia syndrome. These findings can be utilised by nurses to inform patients with these chronic diseases about alternative ways of treatment.
... positive effect on quality of life, stress, anxiety, and pain [9][10][11][12]. However, few studies have attempted to correlate these results with any quantitative physiological or biochemical outcomes. ...
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.
Breast radiotherapy has been an integral part of the breast cancer treatment and is done after breast surgery. All patients who undergo conservative breast surgery need to receive post-operative radiotherapy, with or without regional lymph node irradiation depending on the stage of the breast cancer. In case of patients who have had mastectomy, breast radiotherapy is given in large tumours, positive regional lymph nodes or positive resection margins. The decision to treat with more extensive regional fields has been increasing given recent updated NICE guidelines. The dose fractionation currently ranges from 26Gy in 5 fractions for breast-only treatment, with or without a breast boost, to 40Gy in 15 fractions in the breast, chest wall and regional nodes with or without a breast boost. Partial breast irradiation is limited to only specific patients who meet certain early-stage of cancer criteria. As the majority of the breast cancer patients receive whole breast or whole chest wall radiotherapy, late radiation-induced skin toxicity is affecting most patients, despite the more advanced radiation techniques obtaining a better dose homogeneity within the irradiated area (Franco et al., Radiat Oncol 7:12, 2012).
Background
As cancer and its therapy comes with a wide range of negative effects, people look for options to mitigate these effects. Reflexology is among the options of complementary medicine.
Method
In March 2022 a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning the use, effectiveness and potential harm of reflexology on cancer patients.
Results
From all 821 search results, 29 publications concerning 26 studies with 2465 patients were included in this systematic review. The patients treated with reflexology were mainly diagnosed with breast, lung, gastrointestinal and hematological cancer. Outcomes were mainly pain, quality of life, anxiety, depression, fatigue. The studies had moderate to low quality and reported heterogeneous results: Some studies reported significant improvements in above mentioned outcomes while other studies did not find any changes concerning these endpoints.
Conclusion
Due to the very heterogeneous results and methodical limitations of the included studies, a clear statement regarding the effectiveness of reflexology on cancer patients is not possible. The current evidence indicates that reflexology is superior to passive control groups for pain, quality of life and fatigue, however, more studies with comparable active control groups are needed.
Background
and purpose: The current body of research examining the effectiveness of reflexology in patients with cancer have predominantly focused on managing physical symptoms and treatment side effects. This review aimed to synthesise evidence from randomised controlled trials (RCTs) examining the effectiveness of reflexology on mental health outcomes in people with cancer.
Methods
RCTs published in English and measuring stress, anxiety, depression or quality of life (QoL) were included. Eligible RCTs were identified through search of MEDLINE, Embase, Emcare, PsycINFO, Scopus, the Cochrane Library, OTseeker, PEDro (18 June 2021) and Google and Google Scholar (21 June 2021). The Critical Appraisal Skills Programme Randomised Controlled Trials Checklist was used to assess risk of bias. Meta-analysis and narrative synthesis were undertaken. The certainty of evidence was assessed by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.
Results
Fifteen RCTs (1356 adult participants) were included. Evidence for stress and anxiety (primary outcomes), as well as depression and QoL (secondary outcomes), were mixed and conflicting. The certainty of the evidence was low to very low.
Conclusion
An unequivocal recommendation supporting reflexology cannot be made. Greater utilisation of well-established reporting guidelines, together with increased investment in well-designed, high-quality clinical research are required.
Les Interventions Non-Médicamenteuses (INM), et autres procédures qui peuvent leur être associées (Médecine Traditionnelle, Médecines Complémentaires et Alternatives), sont aujourd’hui d’une prépondérance à ne pas sous-estimer dans l’optique d’une santé intégrative. Une évaluation scientifique robuste est nécessaire afin de trier les pratiques néfastes ou inefficaces, de celles attestant de réels bénéfices. Dans ce domaine, les essais randomisés contrôlés (ERC) font loi, à un titre discutable du fait de leurs limites intrinsèques. Par le biais d’une revue systématique de littérature centrée sur les pratiques de manipulation corporelles comme soins de support proposés en oncologie, nous confirmons la difficulté qu’ont les ERCs de tirer des conclusions fermes et bien appuyées. Nous présentons alors une méthode interventionnelle différente et peu enseignée, les protocoles expérimentaux à cas unique, et proposons leur illustration à travers quatre études. Celles-ci portent sur l’évaluation de différentes interventions dans des contextes de maladies chroniques ou de problèmes de santé variables : 1) Jeu vidéo thérapeutique dans le cadre de la réadaptation physique de la maladie de Parkinson, 2) Intervention musicale en Soins Palliatifs, 3) Hypnose face aux restrictions hydriques de patients sous hémodialyse et 4) Séances de shiatsu face à la dysménorrhée primaire. Ces études rendent compte de résultats intéressants, et permettent de discuter des forces et faiblesses de cette méthode. Nous plaidons alors en sa faveur du fait de ses principes expérimentaux légitimes ainsi que son adéquation avec la pratique fondée sur la preuve. Nous profitons enfin de la faible qualité des études que nous avons menées pour dresser une liste de recommandations et d’écueils à considérer afin de les employer de façon optimale.
Background
Cancer is a chronic disease with an incidence of 24.5 million and 9.6 million deaths worldwide in 2017. Lung and colorectal cancer are the most common cancers for both sexes and, according to national and international recommendations, platinum-based chemotherapy is the reference adjuvant treatment. This chemotherapy can be moderately to highly emetogenic. Despite antiemetic therapy, chemotherapy-induced nausea and vomiting (CINV) may persist. Moreover, cancer patients are increasingly interested in alternative and complementary medicines and have expressed the desire that nonpharmacological treatments be used in hospitals. Among alternative and complementary medicines, foot reflexology significantly decreases the severity of CINV in patients with breast cancer.
Objective
The primary aim of this study was to assess the benefits of foot reflexology as a complement therapy to conventional treatments regarding the severity of acute CINV in patients with digestive or lung cancer. The secondary objectives assessed were the frequency and severity of delayed CINV, quality of life, anxiety, and self-esteem.
Methods
This study was conducted between April 2018 and April 2020 in the Hospices Civils de Lyon, France. This was an open-label randomized controlled trial. Participants were randomized into two groups: the intervention group (ie, conventional care with foot reflexology; n=40) and the control group (ie, conventional care without foot reflexology; n=40). Foot reflexology sessions (30 minutes each) were performed on outpatients or inpatients. Eligible participants were patients with lung or digestive cancer with an indication for platinum-based chemotherapy.
Results
The severity of acute nausea and vomiting was assessed with a visual analog scale during the second cycle of chemotherapy. A significant increase of at least 2 points was observed for the control group (7/34, 21%; P=.001). Across all cycles, the foot reflexology group showed a trend toward less frequent delayed nausea (P=.28), a significantly less frequent consumption of antiemetic drugs (P=.04), and no significant difference for vomiting (P=.99); there was a trend toward a perception of stronger severity for delayed nausea in the control group (P=.39). Regarding quality of life and anxiety, there was no significant difference between the intervention group and the control group (P=.32 and P=.53, respectively).
Conclusions
This study’s results indicate that foot reflexology provides significantly better management of acute nausea severity and decreased consumption of antiemetic drugs in patients with lung or digestive cancer. In order to fulfill patients’ desires to use nonpharmacological treatments and complementary and alternative medicines in hospitals, foot reflexology could be provided as a complementary intervention to conventional antiemetic drugs. Foot reflexology did not result in adverse effects. To assess the benefits of foot reflexology in routine practice, a larger study with several health care centers would be needed with a cluster randomized controlled trial.
Trial Registration
ClinicalTrials.gov NCT03508180; https://clinicaltrials.gov/ct2/show/NCT03508180
International Registered Report Identifier (IRRID)
RR2-10.2196/17232
Background
Complementary and Alternative Medicines (CAM) are widely used by cancer patients, despite limited evidence of efficacy. Manipulative and body-based practices are some of the most commonly used CAM. This systematic review evaluates their benefits in oncology.
Method
A systematic literature review was carried out with no restriction of language, time, cancer location or type. PubMed, CENTRAL, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection and SOCindex were queried. Inclusion criteria were adult cancer patients and randomized controlled trials (RCT) assessing manipulative and body-based complementary practices on psychological and symptom outcomes. Effect size was calculated when applicable.
Results
Of 1624 articles retrieved, 41 articles were included: massage (24), reflexology (11), acupressure (6). Overall, 25 studies showed positive and significant effects on symptom outcomes (versus 9 that did not), especially pain and fatigue. Mixed outcomes were found for quality of life (8 papers finding a significant effect vs. 10 which did not) and mood (14 papers vs. 13). In most studies, there was a high risk of bias with a mean Jadad score of 2, making interpretation of results difficult.
Conclusion
These results seem to indicate that manipulative CAM may be effective on symptom management in cancer. However, more robust methodologies are needed. The methodological requirements of randomized controlled trials are challenging, and more informative results may be provided by more pragmatic study design.
zet Amaç: Hipertansiyon tedavisinde, ilaç tedavisine ek olarak veya tek başına nonfarmakolojik önlemlerin de önemli bir yeri vardır. Bu önlemler birçok defa ilaç tedavisi gerekliliğini ortadan kaldırabilmekte veya kullanılan ilaç dozunu azaltmaya yardımcı olabilmektedir. Hastalıkların tedavisinde kullanılan nonfarmokolojik yöntemlerden birisi refleksolojidir. Bu araştırma hipertansiyonlu hastalara uygulanan ayak refleksolojinin kan basıncı, kolesterol düzeyleri ve yaşam kalitesine etkisini belirlemek amacıyla kendinden kontrollü klinik çalışma olarak yapıldı. Yöntem: Kendinden kontrollü klinik çalışmanın örneklemini 219 esansiyel hipertansiyon tanısı olan hasta oluşturmuş, hastalar önce müdahale öncesi dönemde izlenmiş sonra müdahale uygulanmıştır. Araştırmada veriler; anket formu, kan basıncı ve kolesterol düzeyleri kayıt formu, kısa form-36 (SF-36) yaşam kalitesi ölçeği kullanılarak toplanmıştır. Elde edilen verilerin değerlendirilmesinde, gruplar arası farklılığı test etmek için Friedman ve Wilcoxon İşaretli Sıra testleri kullanılmıştır. Friedman testi karşılaştırmalarında p<0,01, Wilcoxon İşaretli Sıra testi karşılaştırmalarında p<0.05 anlamlı olarak kabul edilmiştir. Bulgular: Müdahale sonrası sistolik kan basıncının, birinci seansta 145.63 mmHg iken altıncı seans sonrası 137,57 mmHg'ye, diastolik kan basıncının birinci seansta 89.17 mmHg iken altıncı seans sonrası 78.92 mmHg'ye düştüğü, müdahale öncesine göre müdahale sonrası LDL, total kolesterol, trigliserid ortancalarının düştüğü, HDL değeri ortancasının yükseldiği ve müdahale sonrası tüm yaşam kalitesi alanları puan ortancalarının yükseldiği tespit edilmiştir. Gruplar arasındaki bu fark yaşam kalitesinin sosyal fonksiyon alanı dışındaki tüm alanlarında istatistiksel olarak anlamlı bulunmuştur (p<0.05).
Purpose:
To determine the effects of a home-based reflexology intervention delivered by a friend/family caregiver compared to attention control on health-related quality of life of women with advanced breast cancer undergoing chemotherapy, targeted and/or hormonal therapy.
Methods:
Patient-caregiver dyads (N=256) were randomized to 4 weekly reflexology sessions or attention control. Caregivers in the intervention group were trained in a 30-minute protocol. During the 4 weeks, both groups had telephone symptom assessments, and intervention group had fidelity assessments. The intervention effects were assessed using linear mixed effects models at weeks 5 and 11 for symptom severity and interference with daily activities, functioning, social support, quality of patient-caregiver relationship, and satisfaction with life.
Results:
Significant reductions in average symptom severity (p=.02) and interference (p<.01) over 11 weeks were found in the reflexology group compared to control, with no group differences in functioning, social support, quality of relationship or satisfaction with life at weeks 5 and 11. Stronger quality of relationship was associated with lower symptom interference in the entire sample (p=.02), but controlling for it did not diminish the effect of intervention on symptoms. Significant reductions in symptom severity in the reflexology group compared to attention control were seen during weeks 2-5, but were reduced at week 11.
Discussion:
Efficacy findings of caregiver-delivered reflexology with respect to symptom reduction open a new evidence-based avenue for home-based symptom management.
This randomized controlled clinical study aimed to determine the effect of 2 foot massage methods on symptom control in people with colorectal cancer who received chemoradiotherapy. Data were collected between June 16, 2015, and February 10, 2016, in the Department of Radiation Oncology of an oncology training and research hospital. The sample comprised 60 participants. Data were collected using an introductory information form, common terminology criteria for adverse events and European Organization for Research and Treatment of Cancer Quality of Life Questionnaires C30 and CR29. Participants were randomly allocated to 3 groups: classical foot massage, reflexology, and standard care control. The classical massage group received foot massage using classical massage techniques, and the reflexology group received foot reflexology focusing on symptom-oriented reflexes twice a week during a 5-week chemoradiotherapy treatment schedule. The control group received neither classical massage nor reflexology. All patients were provided with the same clinic routine care. The classical massage was effective in reducing pain level and distension incidence while foot reflexology was effective in reducing pain and fatigue level, lowering incidence of distension and urinary frequency and improving life quality.
Mind-body medicine focuses on the ways in which emotional, mental, social, spiritual, experiential, and behavioral factors can directly affect health. Mind-Body therapies are the least “alternative” of the integrative therapies. Many cognitive and expressive therapies, such as hypnosis, guided imagery, biofeedback, art, and music have been used since the 1980s to manage procedural pain and anxiety in children with cancer undergoing procedures and are now considered standard approaches in pediatric care. Randomized controlled trials provide evidence for the use of massage and Healing Touch to reduce cancer related anxiety, negative mood states, sleep disturbances, and fatigue, and emerging evidence supports movement therapies for physical conditioning in survivors. Children respond to interventions that foster creative expression and movement. Mind-body therapies are both healing and fun and offer perceived benefit with little risk. This chapter summarizes the evidence for the effectiveness of select mind-body therapies categorized as cognitive, expressive, physical/kinesthetic, sensory, and biofield/energy interventions and proposes applications for use in pediatric oncology. Actual case scenarios provide examples for integrating mind-body therapies into clinical pediatric oncology care.
Prendre soin des patients est une tâche difficile. Le stress, souvent présent au sein d’équipes soignantes pour des raisons de charge de travail, de confrontation quotidienne à la souffrance voire à la mort, peut mettre en danger la santé des professionnels de santé. Le CHU de Limoges, dans le cadre de son projet d’établissement, souhaite renforcer la qualité de vie au travail, de son personnel. Des études qualitatives mettent en évidence l’efficacité de la réflexologie plantaire sur la qualité de vie des patients. La réflexologie plantaire permet au corps de retrouver équilibre et harmonie. La réflexologie plantaire peut être une ressource au prendre soin et ainsi améliorer la qualité de vie au travail des professionnels de santé. La finalité de ce travail propose, en améliorant la qualité de vie des professionnels de santé, d’avoir une répercussion sur la qualité de soins proposée aux patients.
The nature and complexities of complementary therapies and their underpinning philosophical approaches present a challenge to the research community. Some complementary therapies have the potential to provide supportive (such as quality of life) benefits and symptom relief in patients with cancer. Evidence for their effectiveness from randomised controlled trials is limited due to the lack of trials of high methodological quality. Nonetheless, in an increasingly evidence-based treatment culture, healthcare professionals and people with cancer will need to have access to the best-available evidence on the effectiveness of complementary therapies. This chapter presents a summary of the current research findings, considers the methodological challenges and safety issues, and provides resources for further details. Complementary therapies, such as acupuncture, homeopathy, massage, aromatherapy, and yoga, have the potential to provide some relief for the symptoms of cancer and the side effects of treatments. These symptoms range from breathlessness to hot flushes, dry mouth problems due to chemotherapy, nausea and vomiting induced by chemotherapy, and pain. Plant-based treatments for cancer are also discussed.
This evidence-based text brings together the theory and practice of palliative care. It examines at all aspects of palliative care i.e. psycho social, spiritual and physical in a highly practical way. The evidence base for cancer care has been developed within the Hospice Movement over the past 50 years and, in the main, it transfers across to patients dying of diseases other than cancer. The book addresses the palliative needs of any patient with any disease in any care setting, which gives it a generic approach. This is in line with current government directives. Contributions to care and treatment are considered in a multidisciplinary and complementary way.
There is evidence that the use of complementary health approaches (CHAs), especially for pediatric cancer survivors, is increasing. Research examining the usefulness and efficacy of various practices is still developing, but is showing increased acceptance in the lay population as well as in the medical community. However, while these practices can be thought of as benign, they have the potential for being misused, may interact with conventional medication, and require an understanding of the mechanisms underlying these practices. Furthermore, patients often do not fully appreciate the potential impact of these methods on their medical care, and in many instances, withhold information from their primary care and specialty physicians either because they do not feel that the methods are important enough or forget to disclose, or feel that their provider may discount its use. This chapter reviews the key literature on studies that pertain to CHAs that have been utilized in the cancer survivor population, with discussion regarding use with children when available. Many of the available research studies are lacking in strong methodology; therefore, have limited generalizability. We will discuss the background of the methods, review the available clinical trials, offer summary of efficacy, review risks and benefits, and provide the practitioner with resources. It is our goal to provide the practitioner with a better understanding of the various approaches so that they may be active in their patients’ decision-making process of including these promising techniques that may provide some additional benefit to improve overall quality of life and psychological well-being.
Context:
Complementary therapies are frequently used by breast cancer patients for symptom management; however, documentation of the components of intervention fidelity for studies is not widely available.
Objective:
This report examines the components of intervention fidelity, as put forth by the Treatment Fidelity Workgroup of the Behavior Change Consortium at the National Institutes for Health (NIH-BCC Workgroup), within an ongoing acupressure study of breast cancer survivors with persistent cancer-related fatigue (PCRF).
Design:
For the acupressure study, the research team designed a randomized, controlled trial (RCT) with 3 parallel groups: (1) stimulating acupressure (intervention group); (2) relaxing acupressure (intervention group); and (3) standard care (control group).
Setting:
At baseline and at wk 3 and wk 6 of the study, women in the acupressure study attended sessions for training and data collection at clinics in the counties of Michigan where they lived. The self-administration of acupressure occurred in participants' homes.
Participants:
Targeted enrollment for the acupressure study is 300 breast cancer survivors who had experienced moderate-to-severe PCRF lasting longer than 1 y beyond treatment. The women are being recruited from 5 counties in Michigan, using the Michigan Tumor Registry to identify potential participants. The subsample report includes 183 participants who have completed all 10 wk of the acupressure study. Most participants in the acupressure study are Caucasian, are married, and have some college education.
Intervention:
The acupressure study's educators teach participants in the intervention groups to self-administer either relaxing or stimulating acupressure for a 30-min period on a daily basis for 6 wk. All 3 groups receive the usual care for breast cancer survivors.
Outcome measures:
For the acupressure study, the participants log the frequency of the self-administered acupressure sessions and their fatigue levels. Symptom assessments are made for all groups by telephone in the acupressure study at wk 2 through wk 5 to assess fatigue. A competency checklist is used at each session of training and retraining of both acupressure educators and participants. For this report, the 5 recommended fidelity components for interventions are (1) dose, (2) training, (3) intervention delivery, (4) intervention receipt, and (5) enactment of the intervention.
Results:
The ongoing RCT incorporated all 5 components of fidelity and can serve as a model for future work in this area.
Conclusions:
Research protocols that address intervention fidelity can provide results that support internal and external validity. Clinicians should consider recommending complementary interventions that have incorporated fidelity components into their efficacy testing.
Purpose: This study was to examine the effects of foot reflexology on ADL and fatigue in stroke patients. Method: The subjects were 31 stroke patients hospitalized in the Oriental Medicine Hospital of D University from June to November, 2002. Foot reflexology was applied to the experimental group twice a week for 6 weeks, 40 minutes each. For the data analysis, -test was conducted to verify the homogeneity of general characteristics and clinical characteristics, and t-test was done to verify the homogeneity of ADL and fatigue. To examine the relative efficacy of the intervention, ANOVA and ANCOVA were conducted. Results: After foot reflexology, the subjects in the experimental group showed significant improvement in ADL. They also had less physical, psychological, and neurosensory fatigue, which are three areas of fatigue. Conclusion: The results suggest that foot reflexology is an effective intervention that helps the body work efficiently, eases stress and strain, and enhances the homeostasis of the body through stimulating the reflex zone of internal organs in the body. Therefore, it is necessary to develop foot reflexology as an unique nursing intervention.
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