Article

Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: A double-blind randomised controlled trial

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Reflexologists claim that massage to specific points of the feet increases blood supply to internal organs. This study measured changes in cardiovascular parameters in subjects receiving reflexology to areas of their feet thought to correspond to the heart (intervention) compared with other areas which are not (control). Method: 16 reflexology-naive healthy volunteers received an active and control reflexology treatment in an RCT, double-blind repeated measures study. Main Outcome Measures: ‘Beat-to-beat’ continuous measurement of selected cardiovascular parameters, State Anxiety Inventory. Results: Cardiac index decreased significantly in the intervention group during left foot treatment (LFT) (baseline mean 2.6; standard deviation (SD) 0.75; 95% CI +/- 0.38 vs. LFT mean 2.45; SD 0.68; CI 0.35), effect size (p= 0.035, omega squared effect (w2) = 0.002; w = 0.045). Conclusion: Reflexology massage applied to the upper part of the left foot may have a modest specific effect on the cardiac index of healthy volunteers.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... These performances may instigate relaxation which in turn could influence the functioning of physical and emotional health. Reflexology alone may also influence outcomes and although attempts have been made to isolate foot reflexes which have a physiological effect [28], it is challenging to separate the effects of the reflex points used in treatment from those effects created by the ambience of such an environment. Indeed Jones (2012) has demonstrated that there may be an association between the reflex points of the feet and potential links to discrete areas of the body. ...
... Reflexology alone may also influence outcomes and although attempts have been made to isolate foot reflexes which have a physiological effect [28], it is challenging to separate the effects of the reflex points used in treatment from those effects created by the ambience of such an environment. Indeed Jones (2012) has demonstrated that there may be an association between the reflex points of the feet and potential links to discrete areas of the body. What this amounts to in a complete reflexology treatment is less certain. ...
... These plaques on the sides of the artery act like buffers in a pinball game, pushing the blood from one side to the other impeding smooth flow. There is evidence that haemodynamic effects can be brought about through reflexology points in the feet [28]. It is feasible that both reflexology and osteopathy are activating mechanical forces to achieve similar outcomes in discrete areas of the body. ...
Article
Full-text available
Reflexology is a complementary therapy focusing mainly on the application of pressure on the feet, hands and ears. A small but growing evidence base suggests that positive outcomes can be gained in the management and improvement of symptoms across a range of conditions. Biological plausibility is a key concept in the determination of the usefulness of therapies. Research which tests for safety and efficacy alongside the underpinning mechanism of action are therefore important. This paper explores the potential mechanism of action for the outcomes associated with reflexology treatment as reflected in the current evidence. The influences of therapeutic touch, relaxation, placebo effects and the similarities with other therapeutic methods of structural manipulation are considered. The lack of clarity around the precise definition of reflexology and the challenges of researching the therapy as a treatment tailored to individual need are discussed. A deeper understanding of the mechanism of action for reflexology may help to further develop research into safety and efficacy. Such an understanding may lead to the integration of knowledge which may provide both symptomatic support and longer term preventative health benefits.
... Due to the methodological limitations [33] and the contradictory results of previous studies, some scholars highlighted the necessity for further studies in this area [25][26][27][28]. These limitations include, but are not limited to, small sample size and failure to eliminate the confounding effects of gender, prescribing physician, and therapist's presence. ...
... Moreover, reflexologists hold that reflexology stimulates endorphin release and thereby, brings feelings of wellbeing and relaxation [33]. Although some earlier studies also revealed the anxiolytic effects of foot reflexology, they differed from the present study respecting their target populations or reflexology interventions [25][26][27]29]. For instance, patients in a study had received general foot massage for relaxation before reflexology. ...
... [25]. Another study which was conducted on the candidates for coronary artery bypass graft surgery used reflexology not only on the solar plexus, heart, and pituitary reflex points, but also on the hypothalamus gland, lung, and adrenal gland points [27]. Moreover, a study implemented reflexology only on the solar grid point [29]. ...
... Reflexology is one of the top six forms of CAM used in the UK [3] and, according to a survey by McDonough et al. [4], it is the second most popular form of CAM used in Northern Ireland. In 2007 a national survey in the USA reported that 38% of adults and 12% of children were using some form of CAM [5] and in the same year a Norwegian survey indicated that 5.6% of the population had used reflexology in the preceding twelve months [6]. ...
... One of the earliest is the haemodynamic theory which suggests that reflexology stimulation enhances blood flow to the corresponding organ or body part [21]. The findings of an investigation using colour Doppler sonography [22] showed a significant effect on blood flow to the kidney during reflexology and an investigation by Jones et al. [3] displayed some evidence to support this theory. Recent research has also indicated that changes in the dermal layer structures and luminosity of the skin at specific reflex points on the feet may give rise to the changes felt by therapists during a treatment [23]. ...
... These were blood pressure in five studies, heart rate in three studies, cortisol in two studies, salivary amylase, lymphocyte production, heart rate variability 4 Evidence-Based Complementary and Alternative Medicine (HRV), R-R interval, pulse pressure, cardiac output, cardiac index (CI), and blood oxygen level dependant (BOLD) response, in one study each (Table 4). However, only four outcome measures showed significant changes between the reflexology and control group: salivary amylase [38], systolic and diastolic blood pressure [34], and CI [3]. Ruiz-Padial et al. [32] demonstrated significant changes in blood pressure as a factor of time, treatment number, and intervention. ...
Article
Full-text available
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.
... Reflexology is a popular complementary and alternative medicine, which is based upon the application of pressure to specific reflex points of the hands and feet, corresponding with specific areas of the body (12). It has been reported that the specific massage to these points, increases the blood supply to the corresponding organs (13). Although the exact mechanism of action underlying the reflexology is unknown, several theories exist. ...
... They found that stimulation of three reflexed areas on the left foot, relating to the eye, shoulder, and small intestine activated not only the somatosensory areas corresponding to the foot, but also activate the corresponding somatosensory areas to the eye, shoulder, and small intestine or neighboring body parts (15). A research in healthy volunteers showed that reflexology did not affect the heart rate, systolic and diastolic blood pressure, however analysis indicated that reflexology appeared to affect cardiac index to a significant level (13). ...
... Some experts believe that local finger pressure on reflex points of the feet can affect the function of target organs and promote relaxation and healing responses, therefore a range of symptoms can be treated by reflexology (13,19). McVicar et al. in a study on the effect of reflexolgy on anxiety, showed that reflexology intervention decreased the state anxiety but no evidence for its influence on the 'trait' anxiety was reported (19), that was an predictable result, since trait anxiety, unlike state type, is not a transitory state and needs a long time intervention. ...
Article
Full-text available
The anxiety reduction before coronary angiography has clinical advantages and is one of the objectives of nursing. Reflexology is a non-invasive method that has been used in several clinical situations. Applying reflexology might have effect on the reduction of anxiety before coronary angiography. The aim of this randomized clinical trial was to investigate the effect of reflexology on anxiety among patients undergoing coronary angiography. This trial was conducted in Shahid Beheshti Hospital, in Kashan, Iran. One hundred male patients who were undergoing coronary angiography were randomly enrolled into intervention and placebo groups. The intervention protocol was included 30 minutes of general foot massage and the stimulation of three reflex points including solar plexus, pituitary gland, and heart. The placebo group only received the general foot massage. Spielbergers state trait anxiety inventory was used to assess the anxiety experienced by patients. Data was analyzed using Man-Witney, Wilcoxon and Chi-square tests. The stepwise multiple regressions used to analyze the variables that are involved in anxiety reduction. The mean range of anxiety decreased from 53.24 to 45.24 in reflexology group which represented 8 score reduction (P = 0.0001). The reduction in anxiety was 5.9 score in placebo group which was also significant (P = 0.0001). The anxiety reduction was significantly higher in reflexology group (P = 0.014). The stepwise multiple regression analysis showed that doing reflexology can explain the 7.5% of anxiety reduction which made a significant model. Reflexology can decrease the anxiety level before coronary angiography. Therefore, reflexology before coronary angiography is recommended.
... Because it aims the body's balance, it is believed that the therapy acts by pressure on the corresponding reflex area, stimulating it when it is hypoactive and calming it when it is hyperactive (9)(10) . ...
... The blood circulation, one of the responsible for pigmentation and temperature of the body surface, depends on a number of factors so that the blood transportation is possible (20) . Heart, arteries, arterioles, venules and veins must be anatomically and physiologically preserved so that the perfusion of peripheral tissues occurs effectively (10) . In this way, the systemic circulation should be target of evaluation making possible to adjust the duration and the amount of therapy sessions implemented according to the cardiovascular condition (20) . ...
... In this study, however, there was no evaluation of the cardiac function at a systemic level. Since the person with diabetes is more prone to development of cardiovascular disorders (10) , it was found that the number of therapy sessions were insufficient to intervene in the systemic circulation, and thus be effective in the indicators of feet impairment related to color, pigmentation, blood circulation and tissue temperature of feet. ...
Article
Full-text available
Objective: to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus. Method: this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21) and Control group (n = 24), received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value <0.05). Results: participants who received the therapy showed better scores in some impairment indicators related to skin and hair (hair growth, elasticity/turgor, hydration, perspiration, texture and integrity of the skin/ skin peeling). Conclusion: the foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz.
... Previous research into the acute cardiovascular effects of reflexology demonstrated a small decrease in cardiac index in the intervention treatment, when reflexology was applied to the upper part of the left foot in healthy volunteers [6]. Despite a considerable degree of diversity in reflex point placement in published reflexology foot maps, in our previous survey of Association of Reflexologist (AoR) practitioners, the majority of UK practitioner respondents reported that they placed the heart reflex point within this area [5,6]. ...
... Previous research into the acute cardiovascular effects of reflexology demonstrated a small decrease in cardiac index in the intervention treatment, when reflexology was applied to the upper part of the left foot in healthy volunteers [6]. Despite a considerable degree of diversity in reflex point placement in published reflexology foot maps, in our previous survey of Association of Reflexologist (AoR) practitioners, the majority of UK practitioner respondents reported that they placed the heart reflex point within this area [5,6]. One possible mechanism to explain the decrease in cardiac index is that arterial compliance could have been affected (reduced). ...
... There are no data regarding the potential magnitude of any specific effects of reflexology on arterial compliance, therefore data were extracted from our earlier research studies for the power calculation based on changes in other parameters [6]. This pilot study data showed that cardiac output decreased in the intervention group with a mean difference of 0.26 L per min; (SD 0.32). ...
... [29] Jones et al. in two studies showed that reflexology had no effect on physiological parameters in healthy volunteers as well as in patients with heart failure. [30,31] Given the differences in the effectiveness and use of reflexology among healthcare staff, there was a need to study the effect of reflexology on patients admitted to the CCU. Therefore, the present study aimed to investigate the effect of hand reflexology on anxiety and physiological variables among patients with ACS hospitalized in the CCU. ...
... The STAI as a self-assessment questionnaire was consisted of short items and contained two separate scales consisting of a total of 40 items. The first part (1-20 items) was related to State Anxiety and the second part (questions [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] was about Trait Anxiety. The State Anxiety scale referred to an individual to describe how he/she felt at a given moment and in certain circumstances and describe her/his feelings about the situation. ...
... [40] Such differences in results can be attributed to different techniques and reflexology spots on hands. Disagreements of specialists in the field of reflexology are confirmed by Jones et al. [30,31] Adib-Hajbaghery et al. believed that any kind of massage can have many effects on physiological parameters. [41] Some experts referred to such changes as adverse effects and believed that at the early stages of hand reflexology, the phenomenon of 'healing crisis' or 'cleansing process' may occur, which is accompanied by some changes in physiological symptoms such as HR. ...
Article
Full-text available
Background and objective: Admission to the cardiac care unit may cause physiological and psychological problems in patients. This study aimed to investigate the effect of hand reflexology on anxiety and physiological variables among female patients with acute coronary syndrome hospitalized in the cardiac care unit. Methods: This randomized placebo controlled clinical trial was conducted on 90 female patients hospitalized in the cardiac care unit in an urban area of Iran. The patients were chosen using a convenient sampling method and then were randomly assigned into intervention (n = 45) and placebo (n = 45) groups. While the intervention group received hand reflexology for 20 minutes, the placebo group received a simple touch of hand without the stimulation of reflexology points. Demographic data was collected at the beginning of the study using face-to-face interviews with the patients. The anxiety level was assessed using the Spielberger's State-Trait Anxiety Inventory (STAI) immediately after the intervention and 30 min after the intervention. Also, physiological variables including respiratory rate, heart rate, blood pressure and oxygen saturation were measured before, immediately after the intervention and 30 minutes after the intervention. Descriptive and inferential statistics were used for data analysis. Results: There was no statistically significant differences between the intervention and placebo groups before the intervention (p > .05). The anxiety level in the intervention group was significantly lower than that of the placebo group immediately after the intervention and 30 minutes after the intervention (p < .05, η = 0.090). However, no statistically significant differences in physiological variables between the groups were observed (p > .05). Conclusions: Hand reflexology influenced the level of anxiety. Therefore, nurses can use hand reflexology as a method for reducing patients' anxiety along with other nursing interventions.
... Complementary and alternative medicine procedures find place in the lives of cancer patients ever-increasingly, in a controlled or uncontrolled manner. 1 According to data obtained from surveys conducted in Europe; approximately 36% of cancer patients try complementary alternative medicinal procedures. 2 Reflexology, among the manipulative and body-based practices, is one of the 6 most commonly used complementary medicine procedures in the United States. 3 Reflexology is a complementary medicine procedure based on the principle of providing relaxation and healing by systematically applying pressure to specific reflex points mostly located in the feet but also in the hands, depending on some other practices. In this procedure, it is believed that some energy channels pass through certain points in the feet, and that when pressure is applied to these points, the blocked channels are unblocked in such a way as to restore the balance in the corresponding organs, glands or systems. ...
... So indeed, apart from a few reports and warnings, the literature does not contain important reports about undesirable effects caused by reflexology. 3,9 Some studies reported certain side effects such as weakness and changes in renal and intestinal functions. 5 In a study conducted with the participation of 130 patients, who had previously undergone an abdominal surgery, reflexology was applied to the patients for a period of 10 days from the day before surgery, and then its effect on the general condition and pain were evaluated. ...
Article
Full-text available
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.
... Nevertheless, there is a growing body of evidence to suggest that stimulation of certain reflexes can activate the corresponding regions of the brain [4,7,8]. Reflexology may be a valuable tool as studies have reported positive effects on quality of life, stress levels and pain levels [9][10][11][12][13][14]. A recent study has also reported that reflexology reduced low back and pelvic pain (LBPP) and associated disability during pregnancy [15]. ...
... According to Laplantine, (1999) in Bordes 3 , through these manifestations, the body is attempting to balance its functions 3,27 using its capacity of self-regulation 27,28 spontaneously re-establishing therapeutic restoration. Some of these physiological or emotional manifestations could be related to the nervous system 7,25,[33][34][35] . However, little is known about the physical behaviors associated with reflexology or what they express 23 . ...
Article
Recent studies on reflexology describe the appearance of different application-associated effects, attributed to a self-regulatory mechanism related to treatment efficacy. On the other hand, sleep is a physiological process of vital importance for health. Its main value lies in restoring the natural balance between neuronal centers. Among its associated behavioral characteristics are spontaneous movements and eye movements. The aim of this study is to investigate the effects that occur during application of reflexology and that are not described in the literature. This is a descriptive observational study with a quantitative methodology. Abivariate anlysis has been conductec through chi-square test or Anova as apropiate. A total of 111 clients of a therapy center in Tarragona have participated in the study. They were assigned into four groups (musculoskeletal, stress, anxiety, mantenance). Reflexology was administered and observered the manifestations that occured during the session. The findings have identified four categories of effects, of which there was no previous reference. These effects can be related to any of the stages of sleep. This study shows that reflexology promotes its application for different effects, such as eye movements and spontaneous movements. These data reveal the need to investigate these effects and their impact on health as well as their possible relationship with sleep.
... terapinin teorik prensiplerine dayanan bir şifa ve sağaltım uygulaması olarak tanımlanan refleksoloji uygulamasında (Ayçeman 2009), her bir seansın 10 dakikadan 45 dakikaya varan sürede gerçekleştirilmesi önerilmektedir (Tabur 2008). Terapistler tarafından optimal terapötik sonuçlar elde etmek için genellikle 6-8 seans olması tavsiye edilmektedir (Jones ve ark. 2012). Refleksolojiyle ilgili yapılan çalışmalarda da uygulama süresinin genelde 30 dakika tutulduğu (Stephenson ve ark. 2000, Tovey 2002,Bishop ve ark. 2003, Hodgson ve Anderson 2008, Ghaffari ve Ghaznein 2010, Li ve ark.2011, Özdemir 2011) ve haftada tek seans olmak üzere 6-8 haftalık süre ile uygulandığı görülmektedir (Williamson ve ark. 2 ...
... This could be attributed to the haemodynamic theory which suggests that reflexology stimulation enhances blood flow to the corresponding organ or body part [42]. The findings of an investigation using color doppler sonography [43] showed a significant effect on blood flow to the kidney during reflexology and an investigation by Jones et al., displayed some evidence to support this theory [44]. Reflexology can stimulate microcirculation, increase oxygen and nutrients supply to tissues, and thus activate reparation of damaged tissues or limit damage caused by hypoxia and inflammatory toxins, therefore, may help in treating RA. ...
Article
Full-text available
The purposes of this study are to determine and compare efficacy of laser acupuncture versus reflexology in elderly with rheumatoid arthritis. Thirty elderly patients with rheumatoid arthritis aged between 60 and 70 years were classified into two groups, 15 patients each. Group A received laser acupuncture therapy (904 nm, beam area of 1cm², power 100 mW, power density 100 mW/cm², energy dosage 4 J, energy density 4 J/cm², irradiation time 40 s, and frequency 100,000 Hz). The acupuncture points that were exposed to laser radiation are LR3, ST25, ST36, SI3, SI4, LI4, LI11, SP6, SP9, GB25, GB34, and HT7. While group B received reflexology therapy, both offered 12 sessions over 4 weeks. The changes in RAQoL, HAQ, IL-6, MDA, ATP, and ROM at wrist and ankle joints were measured at the beginning and end of treatment. There was significant decrease in RAQoL, HAQ, IL-6, and MDA pre/posttreatment for both groups (p < 0.05); significant increase in ATP pre/posttreatment for both groups (p < 0.05); significant increase in ankle dorsi-flexion, plantar-flexion, wrist flexion, extension, and ulnar deviation ROM pre/posttreatment in group A (p < 0.05); and significant increase in ankle dorsi-flexion and ankle plantar-flexion ROM pre/posttreatment in group B (p < 0.05). Comparison between both groups showed a statistical significant decrease in MDA and a statistical significant increase in ATP in group A than group B. Percent of changes in MDA was 41.82%↓ in group A versus 21.68%↓ in group B; changes in ATP was 226.97%↑ in group A versus 67.02%↑ in group B. Moreover, there was a statistical significant increase in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation in group A than group B. Laser therapy is associated with significant improvement in MDA and ATP greater than reflexology. In addition, it is associated with significant improvement in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation greater than reflexology in elderly patients with rheumatoid arthritis.
... Stimulating particular reflexes in these areas affects related organs and systems. [17] Most studies showed that reflexology caused deep relaxation, body and mind balance, reduced stress symptoms and created good feelings in patients. [18] The theory of reflexology is based on the principle that energy flows through vertical zones throughout body from organs toward the head. ...
Article
Full-text available
Background and objective: Admission to the cardiac care unit may cause physiological and psychological problems in patients. This study aimed to investigate the effect of hand reflexology on anxiety and physiological variables among female patients with acute coronary syndrome hospitalized in the cardiac care unit.Methods: This randomized placebo controlled clinical trial was conducted on 90 female patients hospitalized in the cardiac care unit in an urban area of Iran. The patients were chosen using a convenient sampling method and then were randomly assigned into intervention (n = 45) and placebo (n = 45) groups. While the intervention group received hand reflexology for 20 minutes, the placebo group received a simple touch of hand without the stimulation of reflexology points. Demographic data was collected at the beginning of the study using face-to-face interviews with the patients. The anxiety level was assessed using the Spielberger’s State-Trait Anxiety Inventory (STAI) immediately after the intervention and 30 min after the intervention. Also, physiological variables including respiratory rate, heart rate, blood pressure and oxygen saturation were measured before, immediately after the intervention and 30 minutes after the intervention. Descriptive and inferential statistics were used for data analysis.Results: There was no statistically significant difference between the intervention and placebo groups before the intervention (p > .05). The anxiety level in the intervention group was significantly lower than that of the placebo group immediately after the intervention and 30 minutes after the intervention (p < .05, η = 0.090). However, no statistically significant differences in physiological variables between the groups were observed (p > .05).Conclusions: Hand reflexology influenced the level of anxiety. Therefore, nurses can use hand reflexology as a method for reducing patients’ anxiety along with other nursing interventions.
... Every piece of evidence must be evaluated without fraud to make a scientific claim valid. However, a clinical trial, supporting foot massage and reflexology, only recruited 16 subjects, indicating it was impossible to apply randomization for the clinical trial [4]. This was a fraudulent evidence. ...
... A randomized controlled trial reported that reflexology significantly decreased patients' fatigue after eight reflexology sessions (Unal and Balci Akpinar, 2016). However, another randomized controlled trial study, with healthy volunteers, demonstrated that reflexology did not affect cardiovascular parameters (Jones et al., 2012). ...
Article
Full-text available
Background: Fatigue and abnormalities in cardiovascular parameters are recognized as major problems for patients with acute coronary syndrome. Non-pharmacological nursing interventions are useful for controlling this fatigue and reducing patients' suffering during hospitalization. Aim: The present study compared the effects of aromatherapy massage and reflexology on fatigue and cardiovascular parameters in older female patients with acute coronary syndrome. Design: This study was a randomized clinical trial. Methods: The study was conducted with 135 older female patients with acute coronary syndrome who were hospitalized in a cardiac care unit in 2014. They were invited to participate in the study and then were randomly divided into three groups: 'aromatherapy massage', 'reflexology' and 'control'. The fatigue severity and cardiovascular parameters were assessed using the Rhoten fatigue scale and a checklist. Measurements in the groups were performed before and immediately after the intervention. Data analysis was performed using descriptive and analytical statistics via the SPSS software. Results: Aromatherapy massage significantly decreased fatigue, systolic blood pressure, mean arterial pressure and O2 saturation more than the reflexology intervention. However, reflexology reduced patients' heart rates more than an aromatherapy massage (P < 0·05). Moreover, no significant changes were observed in patients' diastolic blood pressures when compared to the control group (P = 0·37). Conclusions: Implementation of both aromatherapy massage and reflexology has positive effects on the fatigue and cardiovascular parameters of patients with acute coronary syndrome. However, aromatherapy massage can be more beneficial to use as a supportive approach in coronary diseases. Relevance to clinical practice: The need for reducing fatigue in acute coronary syndrome (ACS) patients in a cardiac care unit is evident. The implementation of aromatherapy massage and reflexology had positive effects on patients' fatigue as related to both physical and mental health.
... The history of reflexology dates back to 2000 B.C.E. in ancient China. Reflexologists believe that each internal organ has a reflection point on the palms, in the ears, and under the feet [22,23]. Recently, the tendency to apply reflexology as a treatment for pain relief has been increasing [24]. ...
... Therapists recommend 6-8 sessions to obtain theopathic outcomes. Studies in the literature report that the practice generally lasts 30-40 min in one or two sessions a week and is usually administered in 6-8 sessions (Jones et al., 2012;Özveren, 2011). In this study, the participants were administered 30-40 min of reflexology in total, 15 min on each foot, twice a week, and throughout six sessions. ...
Article
Full-text available
This study aims to identify the effect of reflexology based on Watson’s Caring Model on lombalgia and quality of life in older adults. This study was conducted as a randomized-controlled study. The target population included 194 older patients who received outpatient physical therapy and rehabilitation service in a city located in the eastern part of Turkey between February 2020 and October 2020. The sample of the study was 68 patients who agreed to participate in the study and met the research criteria. Data were collected through the Socio-Demographic Form, the Visual Analogue Scale, the Geriatric Pain Measure, and the World Health Organization Quality of Life Instrument-Older Adults Module. The pre-test and post-test mean scores of the experimental group indicated a statistically significant decrease in the pain levels and a statistically significant increase in the quality-of-life mean scores (p < 0.01). A negative and statistically significant relationship was detected between the quality-of-life total mean score and the Geriatric Pain Measure mean score and the Visual Analogue Scale mean score (p < 0.01). No significant differences were detected between the experimental and control groups’ Visual Analogue Scale, Quality of Life and Geriatric Pain Measure post-test mean scores. Reflexology based on Watson’s Caring Model was found to have positive effects on lombalgia and quality of life in older adults.
... Foot reflexology massage affects the function of target organs, increasing relaxation and recovery response. As a result, it can improve a wide range of symptoms [28]. In reflexology, massage stimulates the secretion of enkephalins and endorphins, which can relieve anxiety and pain and create a sense of well-being and health. ...
Article
Full-text available
Introduction Anxiety is a common feeling in cesarean section and lack of attention to it is associated with negative consequences for health of mother and child. Reflexology is a way to reduce anxiety. So far, the effect of reflexology on pre-cesarean anxiety has not been evaluated. Therefore, we aimed to evaluate the effect of pre-cesarean foot reflexology massage on the anxiety of women during their first pregnancy. Materials and Methods This study is a three-group clinical trial that was conducted in 2019. The study sample consisted of 90 pregnant women hospitalized for cesarean section in Zahedan who were randomly divided into three groups of 30 women. The subjects completed the state section of Spielberger anxiety questionnaire. The control group did not receive any intervention. For two groups, 1 h before surgery, a group received reflexive massage, and the another group simple massage. Duration of massage for each group was 30 min. After 30 min, the subjects completed the state section of Spielberger questionnaire again. Statistical analysis was performed by SPSS software program, version 21.0. ANOVA and ANCOVA tests were used to compare between groups and paired t -test was used for intra-group comparisons . Results The results showed that the level of anxiety was significantly reduced in the reflexology massage group (from 55 ± 8 to 40 ± 7) as well as simple massage group (from 51 ± 10 to 47 ± 7) (p<0.001). In the control group, anxiety was increased (from 49 ± 9 to 56 ± 9) (p<0.001). Comparison between the three groups by ANCOVA indicated that reflexology massage and simple massage significantly decreased anxiety scores (p>0.001 and p>0.001,respectively). Reflexive massage significantly reduced anxiety scores (p>0.001) as compared to simple massage. Conclusion The results of this study revealed the positive effect of reflexology massage on pre-cesarean anxiety. Because reflexology massage is an inexpensive, simple, and easy approach, the use of this non-pharmaceutical method is recommended to reduce pre-cesarean anxiety.
... Nonetheless, the exact mechanism of the reflexology action needs further confirmation. Various theories have been proposed in this regard, including the "hemodynamic theory", which was supported by Doppler blood flow studies (28,29), and the "nerve impulse theory" which suggests that the stimulation of specific points on the feet enhances nervous connections to the corresponding body parts and is therefore effective on the autonomic nervous system (18,30,31). ...
Article
Full-text available
Objectives : Reflexology is a popular type of complementary medicine in medical practices, especially in midwifery fields. Materials and Methods: This randomized controlled trial aimed to determine the effect of foot reflexology on idiopathic constipation symptoms, as well as anxiety and fetal activity during pregnancy. This study was conducted on seventy-four nulliparous women with constipation, referring to private and public health care centers in Tabriz-Iran, between 2017 and 2018. The participants were then randomly assigned to foot reflexology or control groups. The intervention group underwent 12 minutes of weekly foot reflexology treatment for 6 weeks. Constipation symptoms were measured at baseline and 6 times (weekly) after the intervention by the Constipation Assessment Scale (CAS). In addition, the State-Trait Anxiety Inventory (STAI) questionnaire was used to measure the participant’s anxiety at baseline and 6 weeks after the completion of the study. Finally, fetal movements were measured at baseline and 6 times (weekly) after the intervention using a kick chart. Results : Based on the results, 97% of women reported improvement in their CAS measures at the end of six weeks following reflexology. The mean scores of STAI at the end of the intervention were 38.5 and 42.2 (State anxiety), as well as 39.1 and 40.2 (Trait anxiety) in the reflexology and control groups, respectively. Statistically significant differences in fetal movements between the two groups were only observed in the fourth ( P =0.001) and fifth weeks ( P =0.007) after intervention sessions. The results further indicated that about 67% of mothers were satisfied with reflexology intervention for improvement in their constipation symptoms. Eventually, no harmful side events were reported among women. Conclusions : Short-term foot reflexology in this context may have potential healing benefits in improving constipation and anxiety symptoms during pregnancy. However, further investigation for antenatal reflexology is necessary.
... 12 Pijat refleksi adalah salah satu dari enam bentuk CAM terbaik yang digunakan di Inggris. 13 Terapi ini bukan untuk mengobati pengobatan konvensional (kedokteran), melainkan sebagai pelengkap untuk mengontrol tekanan darah. 8 Berdasarkan beberapa latar belakang di atas, peneliti tertarik melakukan penelitian untuk mengetahui efek pijat refleksi pada telapak kaki terhadap tekanan darah pada pasien hipertensi. ...
Article
Full-text available
Latar belakang: Hipertensi sering disebut sebagai pembunuh yang tidak diketahui, karena penderita tidak tahu bahwa dirinya menderita hipertensi. Banyak macam terapi komplementer yang dapat diterapkan untuk mengobati hipertensi, salah satunya pijat refleksi. Metode: Penelitian ini bertujuan untuk mengetahui pengaruh pijat refleksi terhadap tekanan darah pada pasien hipertensi di Klinik ATFG-8 Palembang. Desain yang digunakan pada penelitian ini adalah pra-eksperimen dengan menggunakan rancangan one group pre-test post-test. Sampel pada penelitian ini adalah keseluruhan pasien hipertensi yang tidak mengkonsumsi obat penurun tekanan darah dan berkunjung untuk melakukan terapi pijat refleksi pada bulan 17 April s.d 17 Mei 2018. Penentuan sampel dengan metode purposive sampling sebanyak 18 subjek penelitian. Hasil: Hasil yang diperoleh adalah rata-rata usia sampel 54,22 tahun (± 7,216), tekanan darah sistolik sebelum 148,44 mmHg (± 4,527) dan setelah pijat refleksi 143,78 mmHg (± 8,633). Hasil paired sample T test menunjukkan efek pijat refleksi pada tekanan darah sistolik (p = 0,026) dan diastolik (p = 0,001) Kesimpulan: Terjadi penurunan tekanan darah secara statistik, namun secara substansi tidak bermakna. Peneliti berikutnya diharapkan untuk melakukan penelitian lebih lanjut dengan menambahkan sampel dan menggunakan kelompok kontrol.
... (2011) Xiang (2012) Zhai (2013) Zhang (2014) Zhang (2015) Zhao (2013) Zhao & Chen (2006) Zhang (2008) Zhong (2016) Zhou (2016) Zong (2010) Study name Model Statistics for each study Odds ratio using functional magnetic resonance imaging (fMRI) and evaluated findings using the blood oxygen level demand response which is related to changes in blood flow to the brain during activation and results showed positive responses due to foot reflexology (Sliz et al., 2012). Additionally, research using fMRI demonstrated that foot reflexological stimulation induced a somatosensory process corresponding to the stimulated reflex areas (Nakamaru et al., 2008) and showed an immediate hemodynamic effect corresponding to the stimulated reflex areas by cardiac index or colour Doppler sonography (Jones et al., 2012;Sudmeier et al., 1999). Also, skin contact is considered a secondary mechanism because of relaxation and the release of oxytocin. ...
Article
Full-text available
Aims To systematically summarize and quantify the effects of foot reflexology on improvements in sleep disturbances. Design Systematic review and meta‐analysis. Data sources Datasets including PubMed, Web of Science, Scopus, EMBASE, Cochrane Library, Google Scholar, CINAHL and two Chinese electronic databases (i.e., AiritiLibrary and China National Knowledge Infrastructure) were used to search from their inception to 31 January 2019. Review methods Studies which were randomized controlled trials that reported changes in sleep disturbances after the intervention among adults over 18 years old and written in the English or Chinese language were included. Two reviewers’ independently assessed the eligibility, extracted data, and conducted a quality assessment. Based on the extracted data, two separate meta‐analyses were performed. Results Forty‐two articles with a total sample of 3,928 participants were included in the systematic review and were eligible for the meta‐analysis. The most commonly employed outcome measurement tool was the Pittsburgh Sleep Quality Index, followed by the therapeutic effect between the intervention and control groups (as evaluated by participants with sleep problems compared with those without sleep problems in each group after the intervention). Results revealed that foot reflexology resulted in a greater reduction in the sleep quality score compared with the controls (Hedges’ g = −1.37; 95% confidence interval (CI) = −1.81~‐0.94). As for the therapeutic effect, participants in the intervention group were less likely to have sleep problems than those in the control group (pooled odds ratio = 0.25; 95% CI = 0.19 ~ 0.31). Conclusion The findings suggested that foot reflexology produced significant improvements in sleep disturbances. Impact Foot reflexology is a non‐invasive and convenient intervention and regularly receiving foot reflexology can be considered complementary therapy to improve the sleep quality of adults with sleep disturbances. Furthermore, healthcare providers can actively press the solar plexus and heart zones to alleviate sleep disturbances when performing foot reflexology.
... Changes in the sensitivity of barometric receptors in different situations can increase or decrease blood pressure. Also, these baroreceptors have an inhibitory effect on the brain under the influence of reflexology, thereby decreasing muscle tension and stimulating sleep and the inhibition of the sensory nerves of the spinal cord that decreases pain and anxiety (119)(120)(121)(122)(123). ...
Article
Full-text available
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.
Article
Introduction Cardiovascular disease is one of the leading causes of morbidity and mortality in both developed and developing countries. The present research was designed to determine the effects of reflexology on physiological parameters and mechanical weaning (MV) weaning time. Methods In this non-randomized controlled clinical trial, 85 patients who underwent open heart surgery were allocated into either an experimental group (n = 42) or aut control group (n = 43) using convenience sampling. The participants were informed about the study and a written and oral informed consent was obtained from each patient. Along with the study, a twenty-thirty-minute foot reflexology and routine care treatments were applied to the patients in the experimental group and control group, respectively in the post-operative period. In this context, physiological parameters and mechanical ventilation weaning time of the patients were examined at certain intervals. Results According to the values obtained before reflexology for experimental and control group, the pulse rate (p = 0.013) and diastolic blood pressure (p = 0.021) of the patients in the experimental group at 5 min before reflexology were significantly higher. Moreover, oxygen saturation values of the patients in the experimental group at 5 min after extubation were lower (p = 0.012). However, reflexology did not exhibit any significant changes in other physiological parameters but the mechanical ventilation weaning time after reflexology was shorter in the experimental group (p = 0.023). Conclusion Reflexology did not have a significant effect on physiological parameters in patients receiving mechanical ventilation support. Shortening the weaning time from mechanical ventilation suggests that it might be applied effectively in patients receiving mechanical ventilation support in intensive care unit.
Article
Full-text available
Purpose: Wet cupping (hijamah) therapy relieves the pain and relaxes the body. The research team aimed to examine the efficacy of wet cupping therapy on the sleep quality parameters in a healthy population. Methods: Participants were seventy-five healthy subjects (50 women, 25 men, median age = 29.61 years, SD = 8.92). Wet cupping was applied by a cupping practitioner. The assessment of the sleep quality parameters by Pittsburg Sleep Quality Index Inventory was applied one hour before and one month after wet cupping therapy. Results: All sleep quality parameters were positively affected after wet cupping therapy in healthy subjects. Conclusions: Wet cupping therapy should be considered as a complementary therapy method for people with sleep problems.
Article
Full-text available
Aims This study used pretest-posttest randomized group comparison to investigate the acute effects of foot reflexology massage (FRM) intervention on the pulse harmonic and parasympathetic modulation after repeated sprint ability test (RSA) and Yo Yo intermittent recovery test level 1 (YOYO). Background The arterial pulse wave characteristics (APW) is a physiological indicator of peripheral arterial compliance. Reflexology massage is a non-invasive intervention to improve arterial compliance. However, the acute effect of FRM on APW after intense exercise has not been examined. Objective The purpose of this study was to investigate the acute effect of FRM after short-term bouts of anaerobic-based and aerobic-based intermittent exercises. Methods Twenty-six collegiate male football/futsal players voluntarily participated in this study. All participants were randomly assigned to FRM group ( n = 14) or control group ( n = 12). The participants performed RSA and YOYO exercise protocols at least 3 days apart within a week. The electrocardiography (ECG), and APW of right hand (RH), left hand (LH), and left foot (LF) were recorded for 10 min in supine position before and after interventional/control period. A standard of 30 min FRM was given immediately after exercises, whereas those of control group were requested to rest comfortably on a massage table for 30 min. Non-parametric statistical analyses (The Mann-Whitney rank and Wilcoxon signed rank test) were used to compare the measured variables. Results The results showed different characteristics of sympathetic nervous system index after RSA and YOYO protocols in the FRM and control groups [FRM: RSA ( p = 0.01); Control: YOYO ( p < 0.01)]. The results also identified similar exercise-induced modulation of 1 st and 2 nd pulse harmonics in LF location with or without FRM treatment. Conclusion The FRM intervention demonstrated minor impact on the recovery of APW and parasympathetic modulation after RSA and YOYO exercises. Clinical Trail Registration Number : NCT03821805
Article
Reflexology is one of the most popular forms of complementary therapy in the UK and cardiac patients are seeking reflexology treatment. This study measured the immediate haemodynamic effects of reflexology treatment applied to specific areas of the feet (which are thought to correspond to the heart) in patients with coronary artery disease, and compared this with treatment applied to other areas that are not. This study found no acute (immediate) specific changes in any of the haemodynamic parameters measured. While long-term treatment effects are uncertain, the results indicate that reflexology is safe for use by patients with coronary artery disease.
Article
Full-text available
Background and aims: Non-pharmacological approaches such as foot reflexology massage for reducing complications and costs in different patients have been the focus of researchers. This study aimed to investigate the effect of foot reflexology on anxiety and agitation in patients undergoing mechanical ventilation after open heart surgery. Methods: This study was a double blind three-group randomized controlled trial. This research was conducted in two hospitals affiliated to Baqiyatallah University of Medical Sciences in Tehran from February 2014 to April 2015. 96 patients were recruited and randomly allocated to the experimental group received 20 minutes foot reflexology (n=34), placebo group simple surface touching (n=30), and the control group (n=32). Foot reflexology massage for 20 minutes was provided to patients in the experimental group on the reflection points in the heart and lungs. The rate of anxiety and agitation based on Faces of Anxiety Scale (FAS) and the Richmond Agitation Scale (RSAS) were recorded in 6 stages. Results: Data from 92 patients (31 in the intervention group and 30 in placebo group and 31 in the control group) were collected. Data from 92 patients, intervention, placebo and control groups (31, 30, and 30, respectively) were collected. Friedman test indicated that there were statistically significant differences between the mean of anxiety and agitation level in groups at different stages of time (P<0.001). The Kruskal-Wallis test indicated that there were not statistically significant differences between the level of anxiety and agitation among the three groups at different stages of time (P>0.05). Conclusion: Foot reflexology massage in reflection points of the heart and lung in patients after surgery did not reduce anxiety and agitation in patients. Keywords: Foot reflexology, Anxiety, Agitation, Mechanical ventilation, Open heart surgery,
Article
Full-text available
Purpose: The relationship between the number of cytosine-adenine base pair repetition [(CA)n] in the promoter zone of ADAMTS9 gene, which may affect the collagen structure, and the developmental hip dysplasia was investigated. Methods: Using DNA isolating from 26 patients diagnosed with developmental hip dysplasia (DDH) and 29 patients without DDH, the (CA)n in the promoter zone of ADAMTS9 was calculated. The distributions of groups were measured by Shapiro-Wilk test, and the average results of the groups in the state of their normal distributions were compared using parametric Student t test. Results: While the (CA)n values varied between 15 and 30, the group average was found to be 17.9. While the (CA)n values of the patient group varied between 11 and 20, its average was computed to be 17.3. The averages of groups were not statistically different (p = 0.960). Conclusion: According to the results of our study, ADAMTS9 gene promoter (CA)n in the individuals with developmental hip dysplasia was not found to be different from that of healthy individuals. Nevertheless, when strong impact of ADAMTS9 gene on the ligament tissue is considered, it is necessary to evaluate ADAMTS9 gene role with different aspects.
Article
Turgut Ozal University Scientific Research Committee (TOBAT) was established in Turgut Ozal University Faculty of Medicine in 2009 to encourage young medical students and scientists to carry out novel scientific research in addition to their medical education in order to 1) establish a platform of informing the latest advancements in science, 2) present this work to colleagues and 3) meet and interact with their peers within the international medical and scientific community. Our committee annually organizes Turkey's most highly-qualified medical student congress with the highest number of presenters and attendants, the International Medical Student Congress (IMSC). Over 1,500 medical students and experts attend our congress to present, learn and discuss new research in medicine. Medical students from all over Turkey present the results from their scientific work of the previous year. Because of the international nature of this congress, experts, scientists and attendants from other countries enrich the content and atmosphere of the congress. We also invite successful students who have trained in their own countries and who are interested in science and medicine. Students from abroad present their splendid work and also strengthen the global student network. The congress is covered by the media, both print and television, and has a positive impact on public opinion. The conference organization, design and coordination and the configuration of the scientific program are completed by Turgut Ozal University's medical students with the assistance of their supervisors; which is a success in itself. Research and scientific work performed by students compose the main portion of the congress. The latest congress included 161 oral and 74 posters presentations. The topics covered by these presentations often show the promise of playing an important role in the future of medical research. Over the past years, topics have included the following: "CRISPR/Cas9 system": its utilities and its possible applications, especially for tuberculosis infection; the use of synthetic biology to re-program heart coronary arteries for "the rapid treatment of myocardial infarction"; tissue engineering and its novel approaches; and, a state-of-art method for "the colon cancer therapy by using synthetic gut flora". This year, for the first time, we have included a very important opportunity for the congress attendees: 20 studies of the participating scientific presentations have been selected to be published in this supplementary of the Journal of Clinical and Investigative Medicine, a journal cited in SCI and PubMed database. We believe that this opportunity has encouraged the young scientists to improve their research skills, to carry out better and more novel studies and to collaborate for effectively with each other. The selection was difficult because of the high quality of the scientific research. In this supplementary, you will find several well-documented studies on different topics including the genetic roots of Alzheimer's disease related to the clusterin gene, novel approaches for cancer stem cell, a novel reporter protein to be used in lab as an alternative to GFP, the effects of traditional moving dry cupping therapy on sleep quality and shoulder-neck pain and the inhibition of gram negative E.coli by LALF-secreting engineered gram positive B. subtilis. By seeing the quality and breadth of these topics, the contributions and potential impact of our congress to the scientific community can be better understood. We wish to express our sincere appreciation to the editors of the Journal of Clinical and Investigative Medicine for their editing and their support in publishing this supplementary material. We would like also to take this opportunity to thank the Rector of Turgut Ozal University, the Dean of Faculty of Medicine, our instructors, mentors, seniors, advisors and technical staff for their kind advice and assistance in organizing this huge undertaking. Kind regards, Mustafa Semih Elitok on behalf of Turgut Ozal University Scientific Research Committee (TOBAT).
Article
Full-text available
Purpose: Alzheimer's disease (AD), the most common form of dementia, is characterized by abnormal protein storage in the brain and primarily causes a progressive loss of memory and all other cognitive functions. According to the World Health Organization (WHO) report, AD is steadily increasing among people 65 years of age and over. Genome wide association studies have shown that various gene polymorphisms are highly associated with the occurrence of AD. Among them, clusterin (CLU) gene polymorphism was identified as one of the highest genetic risks in late-onset AD. Our aim was to investigate the relation of CLU rs11136000 and AD and its potential use as a biomarker for AD susceptibility in the Turkish population. Methods: 50 samples obtained from AD patients and 55 samples obtained from a control group were used for the presented study. Genomic DNA was isolated from peripheral blood by SDS/proteinase K treatment followed by phenol-chloroform extraction and ethanol precipitation. Presence of the CLU rs11136000 polymorphism was investigated by PCR-RFLP and selected samples were confirmed by DNA sequencing. Chi-square test was used for statistical analysis. Results: In the Turkish population, the CLU rs11136000 polymorphism did not show a significant association with AD as compared with the control group (p>0.05). Polymorphic CLU-C allele of AD patients showed an increased association with diabetes (p=0.015) as compared with CLU-T allele of AD patients, whereas in the control group the CLU-C allele did not show a significant association with diabetes (p=0.332). Conclusion: Individuals with diabetes and polymorphic CLUC allele may have a higher susceptibility to develop AD later in life.
Article
Full-text available
Purpose: Autism is a neurodevelopmental disorder characterized by deficits in social interaction.. It is referred to as cerebral lateralization abnormality. The purpose of this study was to investigate if the different unilateral or lateralized therapeutic applications associated with left cerebral lateralization decreased autistic symptoms. Methods: Autistic symptoms were assessed in six autistic children following stimulation and/or evoking techniques specifically for the left cerebral hemisphere. Results: The use of left cerebral hemisphere stimulation and/ or evoking techniques decreased the autistic symptoms in four of the children with autism. Conclusions: These approaches show promise as a technique to restore dominance delay in the left hemisphere in children with autism and can be useful as a complementary treatment to the other modern methods.
Article
Full-text available
Background Hyperbilirubinemia is one of the most common problems in infancy in the world. The aim of this study was to compare the effect of foot therapy and body massage on physiological indicators and bilirubin levels in infants under phototherapy. Methods This study was a randomized clinical trial that conducted on 51 infants with jaundice at Imam Hussein Pediatrics’ Medical Center, Goldis Hospital in Isfahan (Iran). The samples randomly assigned to first intervention (reflexology), second intervention (body massage) and control groups using the block randomization. In the reflexology group, the relevant area on each foot was massaged for 15 minutes in a relaxed position. In the massage body group, the limbs were massaged with circular motion. The massage was performed once a day for 15 minutes and the control group did not receive any intervention. Physiological indicators were monitored using vital sign monitoring tools, and blood bilirubin levels were measured photo metrically (intravenous blood samples from the wrist). Finally, the data were analyzed using descriptive and inferential statistics and SPSS software version 18. Results The results showed that before the intervention there was no significant difference in the mean of physiological indicators and bilirubin level between the three groups (p > 0.05), but after the intervention the average percentage of arterial oxygen saturation and bilirubin levels were significantly improved in the intervention groups compared to the control group (p < 0.05), while the mean of heart rate and respiration rate between the three groups were not significant (p > 0.05). Conclusion The results showed that reflexology and massage therapy can be effective in improving the condition of physiological indicators and blood bilirubin levels.
Article
Full-text available
Purpose: Reflexology activate all body systems physically, mentally and emotionally by relieving pain and relaxing the body, in a manner similar to acupuncture and cupping therapies. The aim of this study was to examine the effect of reflexological therapy on heart rate variability (HRV) parameters in a healthy population. Methods: Participants were twenty-six healthy subjects (8 women, 18 men, median age=32.77 years, SD=8.04). All reflexology procedures were applied by a reflexology practitioner. The reflexology practitioner used thumbs and fingers to apply appropriate pressure to reflexology points, especially the heart point in both feet. The recording ECG was applied 1 hour before and 1 hour after reflexological therapy. Subjects rested for 10 minutes without recording ECG in order to stabilize autonomic parameters. The digital signals were then transferred to a laptop and analyzed using LabChart® software (MLS310/7 HRV Module). Results: Almost all HRV parameters increased and heart (pulse) rate and LF/HF ratio decreased after reflexological therapy compared with before reflexological therapy in healthy persons. Conclusions: These results indicate for the first time in humans that reflexology might induce a state of balance between sympathetic and parasympathetic systems and might be helpful to prevent possible cardiac arrhythmias. Therefore, reflexology may be accepted as a complementary therapy method for many cardiac problems, especially tachycardia and other cardiac arrhythmias.
Article
Full-text available
Purpose: The effectiveness of active dry cupping of the upper shoulder and neck to alleviate pain caused by office workers will be investigated. Methods: This randomized, parallel-group trial compared the effectiveness and safety of dry moving cupping therapy for office workers whose neck pain had persisted at least 5 weeks. Those randomized to cupping received up to 10 dry moving cupping therapy sessions over a 5 week period. The study was completed with 40 healthy women subjects who worked at one univeristy in Turkey, with 20 as control and 20 as the study group. Results: Participants mean score of pain on neck was 5.55 (SD:0.57) for pre-test and 2.7 (SD:0.27) for post-test. The decrease of score of pain between pre- and post-test was statistically significant (t=10.14, p=0.002). In the control group there was no significant change in pain score in the statistical significant (t=0.326, p=0.748). Conclusions: Cupping therapy is a non-invasive and harmless therapeutic application and it can be confidently used to reduce the upper shoulder and neck pain in office. It should be considered for all musculoskeletal pain conditions as a complementto medical treatment.
Article
Full-text available
Introduction: Acute myocardial infarction (AMI) is of particular importance within the range of cardiovascular diseases. AMI is accompanied by changes in physiological indicators that can put patients at risk. The aim of this study was to determine the effect of foot reflexology massage on physiological indicators in patients with AMI. Materials and Methods: This study was a randomized clinical trial, sampling methods was purposeful and group assignment was done randomly in coronary care unit at Shahid Rajaei hospital, Karaj. Ninety patients with AMI were assigned in three experimental, placebo and control groups. Foot reflexology intervention was done on three consecutive days, each time 20 minutes. Physiological indicators including vital sign, blood oxygen saturation and cardiac rhythm were recorded before, immediately after and 20 minutes later for each group. Results: In three periods, the percentage of blood oxygen saturation in experimental group was increasing (P <0.001), but there was no significant difference between the placebo and control groups. Incremental changes in blood oxygen saturation immediately and 20 minutes after intervention were significantly different from the pre-intervention in three groups. In all cases, the increase in the intervention group was higher (P <0.001). But these changes were not significant in 20 minutes after the procedure in compare to the immediately after intervention in three groups. Changes in vital sign and cardiac rhythm were not significantly different between the three groups in different times. Conclusion: These findings indicate that foot reflexology massage increased blood oxygen saturation. Therefore, it is recommended to use this simple and cost effective method to improve oxygenation in patients with AMI.
Article
Full-text available
Purpose: The aim of this study was to determine vitamin D levels in children and adolescents aged between 2 months and 16 years, and to investigate risk factors leading to deficient or insufficient vitamin D levels. Patients and Methods: One thousand and ten patients from the pediatric clinic of Turgut Ozal University Hospital in Turkey between January 2010 and May 2014 were enrolled in the study. Patients were divided into three groups: 25(OH) vitamin D deficiency, insufficiency and sufficiency according to their 25(OH) vitamin D levels (≤15 ng/mL, 15-20 ng/mL and ≥20 ng/mL, respectively). 25(OH) Vitamin D levels were measured by HPLC. Results: Approximately a quarter of the children (24.3%) had 25(OH) vitamin D deficiency and 16.5% had 25(OH) vitamin D insufficiency; leaving only (59.2%) of the subjects with sufficient 25(OH) vitamin D levels. Risk factors for 25(OH) vitamin D deficiency were identified by logistic regression analysis using variables of age, gender and season. Logistic regression analysis revealed that winter, spring and autumn seasons and female gender are independent risk factors for 25(OH) vitamin D deficiency/insufficiency (odds ratios: 5.85, 3.93, 1.62 and 1.44, respectively). 25(OH) vitamin D levels decreased as subjects age giving increased odds ratios for subjects aged 13-48 months old (OR: 3.69), 49-108 months old (OR: 4.48) and 109-192 months old (OR: 6.70) compared with 2-12 months old. Conclusion: 25(OH) vitamin D deficiency is a common health problem in childhood. Implementing of 25(OH) vitamin D supplementation should be considered after infancy.
Article
Full-text available
Purpose: Higher LF/HF ratio and lower heart rate variability have been reported among shift compared with non-shift workers. We aimed to investigate the possible harmful effects of sleep deprivation on cardiac rhythm, specifically heart rate variability (HRV), in work shift physicians. Patients and Methods: Eighty seven healthy male physicians participated in this study. The present study was done in Ankara, Turkey, from January to September 2014. Work shift (sleep deprivation) group (n=45) remained awake for 26 h. Non-work shift group slept in their homes. ECG (HRV) was applied at 9 am for both shift and non-shift groups. Results: Almost all HRV parameters, except LF/HF, decreased in the work shift group compared with the non-shift group. Conclusions: Sleep deprivation due to work shift may cause sympathovagal imbalances by affecting the biological rhythm.
Article
Full-text available
Purpose: Fibromyalgia is a chronic pain disorder and its etiology is not well understood. Methods: The relationships among handedness score, Beck depression points and serum S100B levels in fibromyalgia patients were determined and compared between fibromyalgia patients and healthy controls. Results: The rate of left handedness was 10.81%. There were no statistically significant correlations among handedness score, Beck depression point and serum S100B level. Serum S100B levels and depression points were increased in patients with fibromyalgia compared with controls. The high S100B levels in patients with fibromyalgia may have diagnostic and prognostic value in monitoring of fibromyalgia syndromes. Conclusion: These results show that fibromyalgia syndrome is not a cerebral lateralization abnormality.
Article
Background and purpose: Migraine affects approximately 2% of the population of the UK with around 190,000 people experiencing a migraine daily. This study investigated the effectiveness of reflexology on migraine symptoms provided under pragmatic, personally funded conditions. Materials and methods Data was gathered on a case series of 20 reflexology clients with medically diagnosed migraine. All participants self-referred to a member of the Association of Reflexologists (AoR). The Measure Yourself Medical Outcome Profile (MYMOP) was completed at each appointment. All participants received six reflexology sessions. Results In terms of an improvement in the overall MYMOP profile, 75% (n=15) of clients had an improvement of two or more points. The minimal clinically important difference for the MYMOP change score is 1.0; this was achieved by 90% (n=18) of participants. The mean difference in scores for each of the MYMOP aspects was calculated and the greatest improvement was found with symptom 1, their chosen primary symptom, which changed an average of 3.40 points (95% CI: 2.35, 4.45.) Conclusion The results indicate the potential for reflexology to relieve the symptoms of migraine.
Article
Objectives: This study aimed at finding out the effects of reflexology on pain, anxiety levels after abdominal hysterectomy. Desing & methods: The study was performed on women hospitalized in the intensive care unit and gynecology services of Ege University Hospital in İzmir after abdominal hysterectomy between September 2013 and September 2014. This study was designed and conducted as a randomized controlled trial. The study sample consisted of 63 female patients: 32 in the experimental group and 31 in the control group. The postoperative daily monitoring sheet, Spielberger State Anxiety Inventory (SAI), was employed to collect research data and "visual analog scale" to evaluate pain levels. Results: The female patients' average age was found to be 47.23 ± 4.71. The three-day monitoring showed a significant difference between the experimental and control groups in terms of average pain levels and anxiety scores after reflexology (p < 0.05). Conclusion: Foot reflexology may serve as an effective nursing intervention to increase the well-being and decrease the pain of female patients after abdominal hysterectomy, and nurses should be aware of the benefits of reflexology.
Article
This study measured the effects of reflexology in 12 reflexology-naive patients with chronic heart failure in a placebo-controlled, double blind randomised controlled study design. Outcomes included 'beat-to-beat' non-invasive continuous measurement of cardiovascular parameters and measurement of state of anxiety and pain/discomfort. There were no changes in any of the haemodynamic parameters measured (all p > 0.05). Perceived state of anxiety was significantly reduced post treatment in the control group only (p = 0.03). Reflexology applied to the feet of patients with chronic heart failure appears to have no immediate haemodynamic effects. While any long term treatment effect is uncertain, it would appear that reflexology is safe for use in this patient group.
Article
Full-text available
Influence of Reflex Zone Therapy of the Feet on Intestinal Blood Flow Measured by Color Doppler Sonography Objective: An influence on organ-associated blood flow is considered as a possible mechanism of action of reflex zone massage of the feet (FRZM) therapy. In the present study we investigated whether changes in intestinal blood flow can be achieved by FRZM. Material and Methods: 32 healthy adults (19 women and 13 men) were randomly assigned to the treatment or the placebo group. Subjects of the treatment group received foot massage on the zones assigned to the intestines and those of the placebo group received massage on zones unrelated to the intestines. Before, during and after FRZM, the blood flow velocity, the peak systolic and the end diastolic velocities in the superior mesenteric artery as well as the resistive index as a parameter of vascular resistance were calculated. Results: During FRZM, in the subjects of the treatment group there was a significant reduction in the resistive index (p = 0.021), suggesting an increase in the blood flow in the superior mesenteric artery and the subordinate vascular system. In contrast, there were no significant changes in the resistive index in the subjects of the placebo group. Conclusion: The reduction in the resistive index observed in the treatment group supports the assumption that FRZM improves blood flow in the organs considered to be associated with the specific foot zones, at least during the therapy process.
Article
Full-text available
Objectives: The original aim was to assess the nature and extent of the placebo effect and to consider how it may be harnessed within the NHS to improve the quality of care. The first step was to develop an approach to the review that would address specific questions about the placebo effect. Methods: A broad definition of placebos was adopted, and a placebo component was assumed to be associated with all aspects of health care. A model of the placebo effect was derived from the background literature. This review focused on the expectancy mechanism. Expectancies were defined as treatment- related outcome expectations (beliefs that treatments will have positive or negative effects on health status) and patient-related self-efficacy expectations (beliefs that one can carry out the actions necessary for successful management of a disease or coping with the treatment). On this theoretical basis, this review tested the hypothesis that changes in health status attributed to placebos are achieved by manipulations of these outcome and self-efficacy expectations. The review was confined to health care delivery in the clinical sector. A case was made for the exclusion of studies concerned with psychotherapy, complementary therapies and laboratory-based experiments. A structured review of a subset of the literature on the placebo effect was conducted. Initial searches of electronic data bases identified 47,600 references which were narrowed down to 689. These were screened and this reduced the total to 489 abstracts, of which 93 were primary research papers. Data were extracted from the primary research papers and tabulated. All studies were rated for methodological quality as either acceptable or poor. A working definition of expectancy was developed together with criteria for identifying papers in which expectancy was the key feature; these reduced the number of primary research papers to 85. Expectancy was classified as process expectancy, positive outcome expectancy, negative outcome expectancy, interaction self-efficacy and management self-efficacy. Classification was based on information reported in the methods sections on the content of the intervention. Papers were classified into three clinical areas, in terms of the type of expectancy they addressed. A narrative review of the studies in each category was conducted. The analysis made explicit the placebo element of the three clinical areas by identifying which of the expectancies were either implicitly or explicitly changed in the course of the intervention or treatments. Results: Preparation for medical procedures. The expectancies created were process expectancy and management self-efficacy and, to a lesser extent, positive outcome expectancy. The main health outcomes were reduced use of analgesics and a more comfortable subjective experience for the patient through less anxiety. Management self-efficacy created by skills training prior to the medical procedure, either alone or in combination with process expectancy, was more effective than process expectancy created alone. Management of illness. The expectancies created were primarily management self-efficacy or interaction self-efficacy and both resulted in benefits for the patient. Benefits included an improvement in the patient's symptoms (e.g. improved mood, less anxiety, reduced pain, and less bothered by asthma) and an improvement in the patient's disease status (e.g. lowered blood pressure, immunological changes, and better metabolic control). A few studies also reported a reduction in the use of health services. Medical treatment. This area involved the creation of positive (and occasionally negative) outcome expectancies. The majority of studies provided evidence of the power of positive outcome expectancy to enhance the effects of medical treatment. Most of the improvements were patient self-reports of reduced anxiety, pain and distress. There was also some evidence for the effects of negative outcome expectancy where the frequency of the patient's self-report of symptoms increased. Expectancies and the placebo effect. Given the evidence for the subjective and objective benefits of creating expectancy, the studies reviewed provide support for the hypothesis that expectancies are a mechanism by which placebos have their effects. However, because of the heterogeneity of outcomes assessed and the uneven distribution of the expectancies across the three clinical areas, it was not possible to use meta-analysis to combine effect sizes across studies. A more quantitative analysis of the results was not, therefore, possible. Few studies addressed economic issues in any of the three clinical areas. The review of the methodological quality indicated that the main weakness of studies concerned with placebo effects were small sample sizes and a lack of detail on design, randomisation and statistics. Conclusion and recommendations. The existing evidence justifies the use of strategies to enhance expectancies, specifically to: enhance patients' accurate expectations about medical procedures and how to cope with them and their effects, enhance patients' skills for self-management of their illness and their ability to communicate about their health problems with health- care providers, enhance patients' beliefs in the benefits of effective medical treatments. Enhancement of these expectancies would be achieved by training healthcare professionals to communicate positive outcome expectations effectively and training them in interaction styles that promote patient involvement in consultations. Equally, training of patients is also recommended to increase their ability to manage their disease and its treatment, and to participate more fully in consultations. Such training is often viewed as patient education; however, it involves training in specific skills that the patient can apply in combination with medical interventions and may therefore be more usefully viewed as an integral part of health care. Through provision and implementation of such training, beneficial so-called 'placebo' effects can be increased. A number of areas for further research are identified to help increase our understanding of the expectancy mechanism in the placebo effect.
Article
Full-text available
Using colour Doppler sonography blood flow changes of the right kidney during foot reflexology were determined in a placebo-controlled, double-blind, randomised study. 32 healthy young adults (17 women, 15 men) were randomly assigned to the verum or placebo group. The verum group received foot reflexology at zones corresponding to the right kidney, the placebo group was treated on other foot zones. Before, during and after foot reflexology the blood flow of three vessels of the right kidney was measured using colour Doppler sonography. Systolic peak velocity and end diastolic peak velocity were measured in cm/s, and the resistive index, a parameter of the vascular resistance, was calculated. The resistive index in the verum group showed a highly significant decrease (p </= 0.001) during and an increase (p = 0.001) after foot reflexology. There was no difference between men and women and no difference between smokers and non-smokers. Verum and placebo group significantly differed concerning alterations of the resistive index both between the measuring points before versus during foot reflexology (p = 0.002) and those during versus after foot reflexology (p = 0.031). The significant decrease of the resistive index during foot reflexology in the verum group indicates a decrease of flow resistance in renal vessels and an increase of renal blood flow. These findings support the hypothesis that organ-associated foot reflexology is effective in changing renal blood flow during therapy.
Article
Full-text available
An influence on organ-associated blood flow is considered as a possible mechanism of action of reflex zone massage of the feet (FRZM) therapy. In the present study we investigated whether changes in intestinal blood flow can be achieved by FRZM. 32 healthy adults (19 women and 13 men) were randomly assigned to the treatment or the placebo group. Subjects of the treatment group received foot massage on the zones assigned to the intestines and those of the placebo group received massage on zones unrelated to the intestines. Before, during and after FRZM, the blood flow velocity, the peak systolic and the end diastolic velocities in the superior mesenteric artery as well as the resistive index as a parameter of vascular resistance were calculated. During FRZM, in the subjects of the treatment group there was a significant reduction in the resistive index (p = 0.021), suggesting an increase in the blood flow in the superior mesenteric artery and the subordinate vascular system. In contrast, there were no significant changes in the resistive index in the subjects of the placebo group. The reduction in the resistive index observed in the treatment group supports the assumption that FRZM improves blood flow in the organs considered to be associated with the specific foot zones, at least during the therapy process.
Article
Full-text available
To evaluate the effect of reflexology on symptoms of multiple sclerosis (MS) in a randomized, sham-controlled clinical trial. Seventy-one MS patients were randomized to either study or control group, to receive an 11-week treatment. Reflexology treatment included manual pressure on specific points in the feet and massage of the calf area. The control group received nonspecific massage of the calf area. The intensity of paresthesias, urinary symptoms, muscle strength and spasticity was assessed in a masked fashion at the beginning of the study, after 1.5 months of treatment, end of study and at three months of follow-up. Fifty-three patients completed this study. Significant improvement in the differences in mean scores of paresthesias (P = 0.01), urinary symptoms (P = 0.03) and spasticity (P = 0.03) was detected in the reflexology group. Improvement with borderline significance was observed in the differences in mean scores of muscle strength between the reflexology group and the controls (P = 0.06). The improvement in the intensity of paresthesias remained significant at three months of follow-up (P = 0.04). Specific reflexology treatment was of benefit in alleviating motor; sensory and urinary symptoms in MS patients.
Article
A model of the electron is proposed in which it is composed of a known and detectable particle. This model clearly defines what is mass, what is energy and why E = mc 2 . It shows that the special relativity corrections of mass, length and time with velocity are automatically a function of the structure of an electron as it moves. It also proposes the origin of electric charge and uses that origin to derive the equation for the Bohr magnetron. It shows that the electron's spin of ½ħ is simply angular momentum, further explaining why the electron has only two states of spin. This model gives an expression for the radius of an electron, at the same time pointing out why it has been detected as a point particle, yet still has angular momentum of ½ħ. It explains why the mass of an electron increases with velocity while its spin and charge remain the same and its magnetic moment decreases, as well as why its charge spirals when it travels through space. This model gives a physical reason for the existence of the de Broglie wavelength and derives the expression for it. As well as matching the known properties of an electron it also makes predictions of previously unknown properties, pointing out that they may have been detected but not recognized as such.
Article
The objective of this pilot study is to identify if reflexology and foot massage (FM) affect the physiology of the body by measuring baroreceptor reflex sensitivity (BRS) using phase IV of the Valsalva manoeuvre, blood pressure (BP) and sinus arrhythmia (SA). The reflexology (n = 10) and FM groups (n = 10) showed significantly greater reductions in BRS compared to the control group (n = 4). Analysis of the mean differences between groups showed a greater difference in BRS between reflexology or FM and the control group than between reflexology and FM. This study found no significant difference in resting BP after intervention. The frequency of SA after reflexology and FM increased by 43.9% and 34.1% respectively. Further thoughts from the results of this study suggest a ‘neuro theory’ whereby reflexology and FM alter the BRS by stimulating the sensory nervous system in the feet.
Article
The use and practice of complementary and alternative medicine (CAM) may have potential safety issues. These may relate to practitioner competence, product quality, interactions with medication and non-compliance with conventional medicine. Safety is central to all healthcare practitioners and is an area where CAM groups should work together to achieve consensus.With many CAM professions in the UK moving towards regulation, the Research Council for Complementary Medicine (RCCM) recognised the need for consensus between professions on the best way forward for collecting and using safety data. A 3hour consensus workshop of UK CAM professional body representatives was convened. Results highlighted the importance of, and challenges inherent in, collecting CAM safety data. The definition of safety was discussed, in particular variation in adverse effects between therapies and recognition of both practitioner and product safety issues. A range of methods of collecting safety data were suggested, with triangulation of many approaches felt to be most useful. The main problem in recording adverse event data within practice was identified as the barrier of distrust. However, three examples of safety data collection projects were cited, which were all well received by practitioners, suggesting that developing such a scheme across CAM professions is a valuable endeavour. It is important to demonstrate the benefits or ‘rewards’ of collecting such data to practitioners, rather than ‘punish’ non-collection.We suggest that new schemes are piloted with a small, local groups of practitioners, and supported by their professional organisations. Feedback from the professional bodies represented at the workshop was very positive and suggests that in the UK they are keen to move forward with the safety agenda. We would welcome comments from other countries on the safe practice of CAM.
Article
Objectives: Reflexology has become one of the most frequently used treatment modalities within complementary medicine. This level of popularity makes it desirable for healthcare professionals to understand the essential facts about it. The aim of this article is therefore to review the existing literature on reflexology and compile the facts. Particular emphasis is put on clinical trials. Methods: Two independent, computerised literature searches were performed. All articles with factual information were included. Various other sources of information were used as well. Particular emphasis was on data relating to prevalence, effectiveness, safety and costs. For reviewing the effectiveness of reflexology, only controlled clinical trials were considered for a systematic review. Results: The prevalence of reflexology is variable. Only few controlled clinical trials on the subject have been published. Collectively they do not support the motion that reflexology is associated with specific therapeutic effects. The data on safety and costs are similarly insufficient. Conclusion: Reflexology is popular, yet little factual information exists about it. On the basis of the existing data, it seems possible, even probable, that its perceived benefit is brought about by non-specific effects.
Article
Reflexology is a popular form of complementary and alternative medicine (CAM). The aim of this update is to critically evaluate the evidence for or against the effectiveness of reflexology in patients with any type of medical condition. Six electronic databases were searched to identify all relevant randomised clinical trials (RCTs). Their methodological quality was assessed independently by the two reviewers using the Jadad score. Overall, 23 studies met all inclusion criteria. They related to a wide range of medical conditions. The methodological quality of the RCTs was often poor. Nine high quality RCTs generated negative findings; and five generated positive findings. Eight RCTs suggested that reflexology is effective for the following conditions: diabetes, premenstrual syndrome, cancer patients, multiple sclerosis, symptomatic idiopathic detrusor over-activity and dementia yet important caveats remain. It is concluded that the best clinical evidence does not demonstrate convincingly reflexology to be an effective treatment for any medical condition.
Article
Continuous non-invasive arterial pressure measured with CNAP (CNAP) has been shown to be superior to intermittent oscillometric measurements during procedural sedation and spinal anaesthesia. We assessed the performance of CNAP during general anaesthesia by analysis of agreement with invasive measurements of arterial pressure (AP). Eighty-eight patients undergoing elective abdominal surgery, cardio-, or neurosurgery were included in the study. Systolic, diastolic, and mean AP measured by an intra-arterial catheter in the radial artery (IAP) were compared with those obtained by CNAP from the same arm. Data were analysed to determine the precision (i.e. measurement error) and accuracy (i.e. systematic error) of beat-to-beat CNAP values with respect to IAP. Also, we compared the frequency of fast changes in AP (FCAP) and hypotension (IOH) by both methods. CNAP precision of 4.5, 3.1, and 3.2 mm Hg (systolic, diastolic, and mean AP, respectively) was not significantly different from IAP precision, and CNAP accuracy was +6.7, -5.6, and -1.6 mm Hg. The frequency of AP pairs having a difference within the calculated limits of agreement was 81%, 64%, and 76% for systolic, diastolic, and mean AP, respectively. The calculated limits of agreement were +/-17.6, +/-11.4, and +/-12.0 mm, Hg, respectively. CNAP and IAP detected simultaneously to 82.1% FCAP and to 84.6% IOH. CNAP provides real-time estimates of arterial pressure comparable with those generated by an invasive intra-arterial catheter system during general anaesthesia.
Article
Integrative therapies such as massage have gained support as interventions that improve the overall patient experience during hospitalization. Cardiac surgery patients undergo long procedures and commonly have postoperative back and shoulder pain, anxiety, and tension. Given the promising effects of massage therapy for alleviation of pain, tension, and anxiety, we studied the efficacy and feasibility of massage therapy delivered in the postoperative cardiovascular surgery setting. Patients were randomized to receive a massage or to have quiet relaxation time (control). In total, 113 patients completed the study (massage, n=62; control, n=51). Patients receiving massage therapy had significantly decreased pain, anxiety, and tension. Patients were highly satisfied with the intervention, and no major barriers to implementing massage therapy were identified. Massage therapy may be an important component of the healing experience for patients after cardiovascular surgery.
Article
Sex differences in systolic and diastolic blood pressure levels and trends with age have been consistently observed in both industrialized and unindustrialized populations. However, the impact of sex on pulse pressure, an index of vascular aging, in unindustrialized populations has not been addressed. The objective of this report was to characterize sex differences in aging trends of pulse pressure within unindustrialized populations. Using PubMed and Medline, we identified 60 articles with blood pressure data from unacculturated or partially acculturated populations. Data on 27 populations from 22 articles were included for analysis, on the basis of adequate description of study design and blood pressure measurement. Blood pressure means of adult age groups were modeled by linear and polynomial regression. The pulse pressure levels of women were lower than those of men in early adulthood and higher in older ages. Women had a steeper, steady increase in pulse pressure with age than men (P<0.001), whereas men had a stronger curvilinear upswing in pulse pressure with age (P=0.006). Partially acculturated populations had higher pulse pressures than unacculturated populations. Sex had a stronger effect on pulse pressure than acculturation. Pulse pressure trajectories of unindustrialized populations were slightly attenuated compared with those seen in National Health and Nutritional Examination Surveys III and IV of the US population. A sex effect on pulse pressure trends with age prevails across unacculturated and acculturated populations. Accordingly, the biological principles of arterial aging, as expressed in pulse pressure, are the same in all humans, regardless of demography.
Article
To evaluate the evidence for and against the effectiveness of reflexology for treating any medical condition. Six electronic databases were searched from their inception to February 2009 to identify all relevant randomised controlled trials (RCTs). No language restrictions were applied. RCTs of reflexology delivered by trained reflexologists to patients with specific medical conditions. Condition studied, study design and controls, primary outcome measures, follow-up, and main results were extracted. 18 RCTs met all the inclusion criteria. The studies examined a range of conditions: anovulation, asthma, back pain, dementia, diabetes, cancer, foot oedema in pregnancy, headache, irritable bowel syndrome, menopause, multiple sclerosis, the postoperative state and premenstrual syndrome. There were > 1 studies for asthma, the postoperative state, cancer palliation and multiple sclerosis. Five RCTs yielded positive results. Methodological quality was evaluated using the Jadad scale. The methodological quality was often poor, and sample sizes were generally low. Most higher-quality trials did not generate positive findings. The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.
Article
Arterial stiffness and compliance are major predictors of adverse cardiovascular events and are influenced by female sex hormones, including estrogen and progesterone. The aim of this longitudinal study was to evaluate the effect of the menstrual cycle, normal pregnancy, and preeclampsia on central and systemic arterial stiffness. Ten healthy nulliparous women with regular menses were studied in the early and midfollicular, periovulatory, and luteal phases of a single menstrual cycle. Twenty-two primigravida pregnant women were studied throughout pregnancy at 16, 24, 32, and 37 weeks gestation and at 7 weeks postpartum. Fifteen primigravida women with preeclampsia were studied at diagnosis and 7 weeks postpartum. Augmentation index and carotid-radial and carotid-femoral pulse wave velocities were measured using applanation tonometry. Augmentation index fell during the luteal phase of the menstrual cycle (luteal phase versus periovulatory phase; P<0.05). In normal pregnancy, pulse wave velocity and augmentation index increased from 24 weeks over the third trimester (P<or=0.01 for both). All of the measures were increased in women with preeclampsia (P<or=0.01), with augmentation index and carotid-femoral pulse wave velocity remaining elevated 7 weeks postpartum (P<or=0.02). We conclude that systemic arterial stiffness undergoes major changes during the menstrual cycle and pregnancy and that preeclampsia is associated with greater and more prolonged increases in arterial stiffness. These effects may contribute to adverse cardiovascular outcomes of pregnancy and preeclampsia.
Article
We examined the somatotopical relationship between cortical activity and sensory stimulation of reflex areas in reflexology using functional magnetic resonance imaging. Three reflex areas on the left foot, relating to the eye, shoulder, and small intestine were stimulated during the experiment. A statistical analysis showed that reflexological stimulation of the foot reflex areas corresponding to the eye, shoulder, and small intestine activated not only the somatosensory areas corresponding to the foot, but also the somatosensory areas corresponding to the eye, shoulder, and small intestine or neighboring body parts. Thus, the findings showed that reflexological stimulation induced a somatosensory process corresponding to the stimulated reflex area and that a neuroimaging approach can be used to examine the basis of reflexology effects.
Public interest in complementary therapies continues to grow and many nurses and midwives are incorporating complementary therapies such as reflexology, aromatherapy and massage into their clinical practice. However, there are concerns regarding the use of such therapies when their effectiveness has not been clearly demonstrated. This article is a review of the literature relating to the effectiveness of reflexology. Anecdotal evidence is described and concerns relating to the literature's reliance on personal beliefs and experiences are presented. The need for research evidence to demonstrate effectiveness is highlighted. A critical review of published research studies is presented which focuses in particular on methodological issues such as the use of the randomized controlled trial to determine the effectiveness of complementary therapies such as reflexology.
Critical care can be considered to be a stressful environment at both physiological and psychological levels for patients. In this article, a research study in which a five-minute foot massage was offered to 25 patients (68 sessions in total) as a stress-reduction intervention is described. A quasi-experimental repeated measures design was used to collect data before, during and after the intervention. Physiological data (heart rate, mean arterial blood pressure, respirations and peripheral oxygen saturation) were obtained from the patient bedside monitoring system. Repeated measures analysis of variance indicated there was no significant effect from the intervention on peripheral oxygen saturation. However, a significant decrease in heart rate, blood pressure and respirations was observed during the foot massage intervention. Results indicated foot massage had the potential effect of increasing relaxation as evidenced by physiological changes during the brief intervention administered to critically ill patients in intensive care.
Article
The goals of this study were to examine agreement and estimate differences in sensitivity between pain assessment scales. Multiple simultaneous pain assessments by patients in acute pain after oral surgery were used to compare a four-category verbal rating scale (VRS-4) and an 11-point numeric rating scale (NRS-11) with a 100-mm visual analog scale (VAS). The sensitivity of the scales (i.e., their ability [power] to detect differences between treatments) was compared in a simulation model by sampling from true pairs of observations using varying treatment differences of predetermined size. There was considerable variability in VAS scores within each VRS-4 or NRS-11 category both between patients and for repeated measures from the same patient. Simulation experiments showed that the VAS was systematically more powerful than the VRS-4 in all simulations performed. The sensitivity of the VAS and NRS-11 was approximately equal. In this acute pain model, the VRS-4 was less sensitive than the VAS. The simulation results demonstrated similar sensitivity of the NRS-11 and VAS when comparing acute postoperative pain intensity. The choice between the VAS and NRS-11 can thus be based on subjective preferences.
Article
Reflexology is an increasingly popular complementary therapy in which parts of the body are deemed to be represented on the soles of the feet. The aim of this study was to investigate whether this representation can be used as a valid method of diagnosis. Three experienced reflexologists took part in this study. Eighteen adults with one or more of six specified conditions were identified from primary care records. Two reflexologists, who were blinded to the patients' conditions and monitored, then examined each patient's feet and rated the probability that each of the six conditions was present. There is little evidence that the distribution of ratings vary with the status of the condition. Receiver operating curves suggest that this diagnostic method is very poor at distinguishing between the presence and absence of conditions. Inter-rater reliability (kappa) scores were very low, providing no evidence of agreement between the examiners. Despite certain limitations to the data provided by this study, the results do not suggest that reflexology techniques are a valid method of diagnosis.
Article
Because of the widely presumed association between heart disease and psychological wellbeing, the use of so-called 'complementary' therapies as adjuncts to conventional treatment modalities have been the subject of considerable debate. The present study arose from an attempt to identify a safe and effective therapeutic intervention to promote wellbe ing, which could be practicably delivered by nurses to patients in the postoperative recovery period following coronary artery bypass graft (CABG) surgery. Aim. To investigate the impact of foot massage and guided relaxation on the wellbeing of patients who had undergone CABG surgery. Twenty-five subjects were randomly assigned to either a control or one of two intervention groups. Psychological and physical variables were measured immediately before and after the intervention. A discharge questionnaire was also administered. No significant differences between physiological parameters were found. There was a significant effect of the intervention on the calm scores (ANOVA, P=0.014). Dunnett's multiple comparison showed that this was attributable to increased calm among the massage group. Although not significant the guided relaxation group also reported substantially higher levels of calm than control. There was a clear (nonsignificant) trend across all psychological variables for both foot massage and, to a lesser extent, guided relaxation to improve psychological wellbeing. Both interventions were well received by the subjects. These interventions appear to be effective, noninvasive techniques for promoting psychological wellbeing in this patient group. Further investigation is indicated.
Article
This pilot study sought to identify an appropriate methodology to investigate the impact of reflexology in healthcare settings. The study involved healthy volunteers to prevent unnecessary intervention to individuals who may already be experiencing health related trauma. Thirty participants underwent either reflexology or no treatment (control), in a cross-over experimental design. Self-reported anxiety (Spielberger STAI), cardiovascular parameters (BP and pulse rate) and salivary cortisol and melatonin concentrations were assessed before and after reflexology. Control data were obtained at the same time points in identical settings. Reflexology had a powerful anxiety-reduction effect ('state'; P<0.001) but no significant effect on underlying anxiety ('trait'). Cardiovascular parameters decreased (P<0.001). Baseline salivary cortisol and melatonin were not significantly correlated with STAI scores and did not change significantly following reflexology. Reflexology reduced 'state' anxiety and cardiovascular activity within healthy individuals, consistent with stress-reduction. Considering the connection between stress/anxiety and well being, the effects of reflexology may have beneficial outcomes for patients. These findings will be transferred to a study involving breast cancer patients where effects may be more pronounced particularly since cancer patients display disregulation of cortisol and melatonin secretion.
Article
The study aimed to compare the effects of facial massage with that of foot massage on sleep induction and vital signs of healthy adults and to test a methodology that could be used by a lone researcher in such a study. A randomised within-group crossover pilot study of six healthy female volunteers was conducted. The interventions were a 20min foot and a 20min facial massage using peach-kernel base oil Prunus persica. A drop in systolic blood pressure of 8.5mmHg was recorded immediately after facial massage compared to that of 1mmHg recorded after foot massage. Both treatments were equally effective in reducing subjective levels of alertness during the interventions, with face massage marginally better at producing subjective sleepiness. A lone researcher using these methods would be able objectively to measure vital signs before and after interventions, but not during; and would be able subjectively to measure sleep induction in non-sleep-laboratory contexts.
Article
This paper is a report of a systematic review to evaluate the efficacy of reflexology in any condition. Anecdotal evidence has shown potential benefits of reflexology in a variety of health conditions. However, the efficacy of reflexology has yet to be determined. Cochrane library, PubMed, MEDLINE, EBM review, ProQuest Medical Bundle and SCOPUS databases were searched using the following medical subject headings or key words: reflexology, foot reflexotherapy, reflexological treatment, foot massage and zone therapy. Chinese articles were searched through the Chinese electronic periodical services and Wangfane database. The publication date was limited from 1996 to 2007. Studies were selected if they were written in English or Chinese, used a controlled clinical trial design, used reflexology as a stand-alone modality, and reported such outcomes as symptoms relief, quality of life and patients' perceptions of reflexology. Study quality was reviewed based on the evidence rating system of the United States Preventive Services Task Force, and studies with the evidence rating of II-2 fair or above were included in this review. Among the five studies suitable for review, there was only one report of a statistically significant treatment effect. Among the 12 outcome variables examined, the treatment effect size for urinary symptoms was large, whereas the effect size for other conditions was negligible. There is no evidence for any specific effect of reflexology in any conditions, with the exception of urinary symptoms associated with multiple sclerosis. Routine provision of reflexology is therefore not recommended.
Reflexes present in the hands and feet. Stories the feet can tell thru reflexology; stories the feet have told thru reflexology
  • E Ingham
Ingham E. Reflexes present in the hands and feet. Stories the feet can tell thru reflexology; stories the feet have told thru reflexology. 11th ed. St Petersburg, Florida: Ingham Publishing; 1984. pp. 10e11.
Assessing complementary practice: building consensus on appropriate research methods. The King's Fund
  • C Black
Black C. Assessing complementary practice: building consensus on appropriate research methods. The King's Fund 2009.
Ref Type: Online Source, http://www.reflexology-uk.net/site/ training-courses/iir-diploma-course
  • Iir About
IIR. About the IIR. Ref Type: Online Source, http://www.reflexology-uk.net/site/ training-courses/iir-diploma-course; 2012.
Review of literature on the effectiveness of reflexology. Complementary Therapies in Nursing and Midwifery
  • D Botting
Botting D. Review of literature on the effectiveness of reflexology. Complementary Therapies in Nursing and Midwifery 1997 Oct;3(5):123e30.
Clinical reflexology: a guide for health professionals
  • Pa Mackereth
  • D Tiran
Mackereth PA, Tiran D. Clinical reflexology: a guide for health professionals. Edinburgh: Churchill Livingstone Elsevier; 2002.
what is it all about? Reflexology, a better way to health. Bath: Gateway Books
  • N Hall
  • Reflexology
Hall N. Reflexology, what is it all about? Reflexology, a better way to health. Bath: Gateway Books; 1993. pp. 6e26.
Complementary and alternative medicine (CAM) professional practice and safety: a consensus building workshop House of Lords SC. The individual disciplines examined. House of lords select committee on science and technology: complementary and alternative therapies
  • Robinson N A Lorenc
  • Lewith
Robinson N, Lorenc A, Lewith G. Complementary and alternative medicine (CAM) professional practice and safety: a consensus building workshop. European Journal of Integrative Medicine 2011;10:1e6. 21. House of Lords SC. The individual disciplines examined. House of lords select committee on science and technology: complementary and alternative therapies 2000. p. 21.
The role of complementary and alternative medicine in the NHS: an investigation into the potential contribution of mainstream complementary therapies to healthcare in the UK. Fresh Minds
  • C Smallwood
Smallwood C. The role of complementary and alternative medicine in the NHS: an investigation into the potential contribution of mainstream complementary therapies to healthcare in the UK. Fresh Minds; 2010.
Hands on feet contact & prices Ref Type: Online Source
  • Rossana Hof
Rossana HoF. Hands on feet contact & prices. Ref Type: Online Source, http:// www.handsonfeet.com/contact.html; 2010.
Reflexology foot chart Ref Type: Online Source
BRA. Reflexology foot chart. Ref Type: Online Source, http://www.britreflex.co. uk/product_reflexology_foot_chart.html; 2011.
Lisfranc fracture dislocation Reflex zone therapy of the feet: a textbook for therapists
  • M Medline
Medline M. Lisfranc fracture dislocation. Reflex zone therapy of the feet: a textbook for therapists, vol. 2. Wellingborough, Northamptonshire: Thorsons Publishing Group; 2012. pp. 20e25.
Anesthesia for thoracic aortic surgery. Cardiac anesthesia: principles and clinical practice
  • F Estafanous
  • P Barash
  • J Reves
Estafanous F, Barash P, Reves J. Anesthesia for thoracic aortic surgery. Cardiac anesthesia: principles and clinical practice. 2nd ed. New York: Lippincott Williams & Wilkins; 2001. p. 815.
Specialisation in individual circulations An introduction to cardiovas-cular physiology. Edinburgh
  • Jr Levick
Levick JR. Specialisation in individual circulations. An introduction to cardiovas-cular physiology. Edinburgh. 5th ed. 2010. pp. 279e307. J. Jones et al. / Complementary Therapies in Clinical Practice 18 (2012) 204e211
Ref Type: Online Source
  • Vifab
  • Karcfamiutmotiah
  • Reflexology
ViFAB. KaRCfAMIutMotIaH. Reflexology. Ref Type: Online Source, http://www. vifab.dk/uk/alternativeþmedicine/alternativeþtherapies/reflexology?; 2005.
A comparison of the verbal rating scale and the visual analogue scale for pain assessment
  • Rc Cork
  • I Issac
  • A Elsharydah
  • S Saleeni
  • F Zavisca
Cork RC, Issac I, Elsharydah A, Saleeni S, Zavisca F, Alexander L. A comparison of the verbal rating scale and the visual analogue scale for pain assessment. Internet Journal of Anesthesiology 2004;8(1).
Effect of massage therapy on pain, anxiety, and tension after cardiac surgery: a randomized study
  • Bauer Ba
  • Sm
  • Wentworth Lj
  • D Engen
  • Messner
  • Pk
  • Wood
  • Cm
Bauer BA, Cutshall SM, Wentworth LJ, Engen D, Messner PK, Wood CM, et al. Effect of massage therapy on pain, anxiety, and tension after cardiac surgery: a randomized study. Complementary Therapies in Clinical Practice 2009;16(2): 70e5.
State-trait anxiety inventory for adults manual, instrument and scoring guide
  • Cd Spielberger
  • Rl Gorsuch
  • R Lushene
  • Pr Vagg
  • Ga Jacobs
Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. State-trait anxiety inventory for adults manual, instrument and scoring guide. 2nd ed. Mind Garden Incorporated; 1983.
Reflexology personalised training courses with Ann Gillanders Ref Type: Online Source
  • Ann Gillanders
Ann Gillanders RI. Reflexology personalised training courses with Ann Gillanders. Ref Type: Online Source, http://www.footreflexology.com/Pages/training.html; 2012.
Treatment procedure Reflex zone therapy of the feet: a textbook for therapists
  • H Marquardt
Marquardt H. Treatment procedure. Reflex zone therapy of the feet: a textbook for therapists. Wellingborough, Northampton: Thornsons Publishers Ltd; 1983. pp. 37e65.
Original inham method foot wall chart. Ref Type: Online Source, http://store. reflexology-uk.net/products?tag¼charts%20%26%20promo
  • Iir
IIR. Original inham method foot wall chart. Ref Type: Online Source, http://store. reflexology-uk.net/products?tag¼charts%20%26%20promo; 2011.
BSoR foot reflexology wall chart Ref Type: Online Source
  • Bsor
BSoR. BSoR foot reflexology wall chart. Ref Type: Online Source, http://www. footreflexology.com/Pages/shop_charts_more.html%20C02; 2011.
The reflex areas of the feet and hands. Reflexology for women. London: Thorsons
  • N Hall
Hall N. The reflex areas of the feet and hands. Reflexology for women. London: Thorsons; 1994. pp. 27e91.
The individual disciplines examined. House of lords select committee on science and technology: complementary and alternative therapies
  • House
  • Sc Lords
House of Lords SC. The individual disciplines examined. House of lords select committee on science and technology: complementary and alternative therapies 2000. p. 21.