Article

The Effect of Reflexology on the Autonomic Nervous System in Healthy Adults: A Feasibility Study

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Abstract

Reflexology has been shown to reduce anxiety and stress in various populations. The mechanism by which this occurs may be in modulating autonomic nervous system (ANS) function; however; there is limited evidence available in the area. The aim of the study was to investigate the feasibility of using an experimental model to determine the physiological effect of reflexology on stress. A feasibility study to assess an experimental study design to compare the effect of reflexology and control interventions on heart rate (HR) and blood pressure (BP) following mental stress tests. The Health and Rehabilitation Science Research Institute at the University ofUlster, Northern Ireland, United Kingdom. Twenty-six healthy volunteers. Mental stress was induced before and after intervention. Participants in the reflexology group received 20 minutes of reflexology, and the control group received 20 minutes of relaxation with a therapist holding each participant's feet. The outcome measures, HR and BP, were measured throughout mental stress testing intervention, and a second period of mental stress testing following intervention. The study design was considered feasible. There were significant reductions in systolic blood pressure (SBP) (22%; P = .03) and in diastolic blood pressure (DBP) (26%; P = .01) during mental stress following reflexology compared to the stress period prior to intervention. In contrast, there was a 10% reduction in SBP (P = .03) but a 5% increase in DBP (P = .67) during the period of mental stress following the control intervention compared to results obtained during mental stress prior to this intervention. However, there were no significant differences between reflexology and control groups. This study has demonstrated the feasibility of conducting an experimental study on the effect ofreflexology in stress using BP as the primary outcome measure. Results from such a study would address the lack of high-quality evidence for the physiological effects of reflexology.

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... Foot reflexology is a complimentary therapy frequently used in various countries of Europe and America [1][2][3][4] . It has been shown to be effective in improving the quality of life of cancer patients, decreasing anxiety and stress 5 , reducing anxiety associated with menopause symptoms 6 , helping to cope with the pain of fibromyalgia 7,8 , improving the quality of sleep in women after giving birth 9 and in many other health problems 1,4,10 . It has also been recognized as a therapy that brings other benefits such as an increase in vital energy, body consciousness, relaxation and general well-being 4 . ...
... It has also been recognized as a therapy that brings other benefits such as an increase in vital energy, body consciousness, relaxation and general well-being 4 . Evidence shows physiological effects such as a better synchronization between heart rate and breathing, as well as vagal activity 5,7 , changes in EEG records 11,12 and cortical activity 13 . ...
... Different theories explain these changes 14 . Most studies attribute the changes to a modulation of the nervous system 5 . Despite all this, there is little solid scientific evidence to explain the mechanisms of reflexology and the health benefits it can provide 1,2,6,15 . ...
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.
... These parameters are sensitive to stressors and fluctuate according to the physical or psychological changes experienced by an individual, via vagal modulation which controls calming and restful changes and regular functioning or sympathetic modulation, responsible for controlling arousal and the "fight or flight" response. ANS modulation has also been supported by Hughes et al. [25] and Sliz et al. [26]. A commonly held belief, often cited by reflexologists and suggested by Poole et al. [27] and Tiran [28], states that reflexology may work by stimulating the release of endorphins and in this way may help to reduce pain and increase feelings of wellbeing and relaxation. ...
... The physiological parameter most commonly investigated within reflexology studies was BP, with 13 studies including this as an outcome measure. BP responded in a positive manner to reflexology in half of the studies: Mollart [10], Mc Vicar et al. [40], Mackereth et al. [37], Hughes et al. [25], Lu et al. [33], and Moeini et al. [34]. The work by Moeini et al. [34] was the only trial to show a significant difference between the treatment and control groups. ...
... A meta-analysis was performed on seven papers investigating BP and HR [3,25,30,34,37,38,40]. The study by Wilkinson et al. [41] was not included as only one participant completed 6 Evidence-Based Complementary and Alternative Medicine all parts of the study, Mollart [10] presented no data and was therefore, excluded, and Gunnarsdottir and Jonsdottir [39] and Ruiz-Padial et al. [32] were also excluded as no results means or standard deviations were available to the research team. ...
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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.
... e explication for the mechanism of action in foot reflexology is based on the theory that helps to equilibrate the energy in the whole physical structure [3,4]. Currently, the most promising theory suggests that the benefits of foot reflexology may be caused by modulating our autonomic nervous system [5]. ...
... Two reviewers independently assessed the risk of bias in each study. ere were seven domains of assessment for the risk of bias including the following: (1) random sequence generation, (2) allocation concealment, (3) blinding of participants and personnel, (4) blinding of outcome assessment, (5) incomplete outcome data, (6) selective reporting, and (7) other biases using the Cochrane Systematic Review Manual riskof-bias assessment tool [16]. ese rates were then labeled as "low risk," "high risk," or "unclear risk" of bias. ...
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Objectives: The aim of this study was to conduct a systematic review, meta-analysis, and metaregression to determine the current best available evidence of the efficacy and safety of foot reflexology for adult depression, anxiety, and sleep quality. Methods: Electronic databases (PubMed, ClinicalKey, ScienceDirect, EMBASE, PsycINFO, and the Cochrane Library) were searched till August, 10, 2020, and the validity of the eligible studies was critically appraised. Randomized controlled trials comparing foot reflexology groups with control groups for adult depression, anxiety, and sleep quality were included. Twenty-six eligible studies were included to assess the effect of foot reflexology intervention on the reducing symptoms of depression and anxiety and improving quality of sleep, respectively, as the primary outcome. Results: Twenty-six randomized controlled trials involving 2,366 participants met the inclusion criteria. The meta-analyses showed that foot reflexology intervention significantly improved adult depression (Hedges' g = -0.921; 95% CI: -1.246 to -0.595; P < 0.001), anxiety (Hedges' g = -1.237; 95% CI -1.682 to -0.791; P < 0.001), and sleep quality (Hedges' g = -1.665; 95% CI -2.361 to -0.970; P < 0.001). Metaregression reveals that an increase in total foot reflexology time (P = 0.002) and duration (P = 0.01) can significantly improve sleep quality. Conclusions: Foot reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance. However, high quality and rigorous design RCTs in specific population, along with an increase in participants, and a long-term follow-up are recommended in the future.
... and homeostasis (18). ...
... 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). ...
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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.
... This effect of reflexology on anxiety and sleep seems to be mediated by activation of the parasympathetic and inhibition of the sympathetic nervous systems by stimulation of reflex points on the foot [11]. Similarly, Hughes et al. (2011) reported that reflexology reduces stress parameters such as heart rate, systolic and blood pressure [12]. ...
... This effect of reflexology on anxiety and sleep seems to be mediated by activation of the parasympathetic and inhibition of the sympathetic nervous systems by stimulation of reflex points on the foot [11]. Similarly, Hughes et al. (2011) reported that reflexology reduces stress parameters such as heart rate, systolic and blood pressure [12]. ...
... As well, those suffering from secondary hypertension related to the kidneys will also benefit from this point. Harmonizing the Kidney meridian helps to support kidney function [18]. ...
... The ANS controls the body frameworks that are under unconscious control as heart rate, breathing, and blood pressure. These parameters are very delicate to the stressors and fluctuate according to the psychological or physical alterations that experienced by an individual, though the vagal modulation that controls restful and calming alterations and sympathetic modulation or conventional functioning, that are responsible for regulating the arousal and the "fight or flight" reaction [18]. Furthermore, through impact of the foot reflexology on the baroreceptor reflex, which regulates the blood pressure. ...
... Refleksolojinin anksiyete, stres, KHD ve kan basıncı üzerinde olumlu etkileri olduğu gösterilmiştir ve bunların tümü OSS işlevi tarafından modüle edilmektedir. 54 Refleks noktalarına masaj uygulaması, ciltteki basınç reseptörlerinin uyarılmasıyla indüklenen bir PSS tepkisini içerir. Masaj terapisinin nöroendokrin faktörler üzerindeki etkileri, vagal nöronlar tarafından innerve edilen dermal ve subdermal basınç reseptörlerinin uyarılmasıyla ortaya çıkabilir. ...
... On the same line, the present finding agreed with another study that investigated the effect of reflexology on mental stress-induced tests in healthy individuals. The study found that there were significant reductions in systolic and diastolic blood pressures following reflexology (Hughes et al., 2011). Similarly, Lu et al. (2011), investigated the effect of foot reflexology on the autonomic nervous modulation in patients with CAD. ...
... Reflexology is an adjunctive non-drug therapy that can improve mental and emotional health and improve life quality [56]. The benefits of foot reflexology may be associated with changes in the autonomic nervous system [57]. Reflexology has a strong physical and psychological impact, which may be associated with relaxation and energy balance in the body [58]. ...
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Sexual problems of hemodialysis patients are one of the most significant factors affecting their quality of life and families. On the other hand, an essential part of the quality of life is the quality of sexual life and sexual dysfunction that will affect people's perception of the quality of sexual life. Reflexology massage is one of the complementary and alternative therapies combined with conventional medical treatments to reduce disease and treat its complications. This study aimed to determine the effect of foot reflexology on hemo-dialysis patients' quality of sexual life. This was a parallel randomized sham-controlled trial which conducted in hemodialysis center of Imam Reza (AS) Hospital in Sirjan, Iran. Forty-seven patients under hemodialysis were divided into two groups of foot reflexology (n = 24) and sham (n = 23) using block randomization method. The intervention group received foot reflexology treatment during dialysis for 4 weeks, 3 times a week, 30 min each time (15 min per foot). In the sham group, non-specific foot massage was conducted without squeezing the standard points of reflexology with the same conditions and duration as the intervention group. Quality of sexual life was assessed using female sexual quality of life questionnaire (SQOL-F) and male sexual quality of life questionnaire (SQOL-M) before the intervention, immediately, and one month after the intervention. The results showed that the quality of sexual life of participants in the reflexology group immediately after the intervention (69.74) was significantly higher than before (47.73) and one month after the intervention (52.27). There was no significant difference in the average quality of sexual life of participants in the sham group at different times (before intervention 46.67, immediately after intervention 45.66, and 1 month after intervention 48.18). Immediately after the reflexology intervention, the quality of sexual life was significantly higher than in the sham group (p < 0.001). This study highlights the potential benefit from reflexology in improving the quality of sexual life in patients undergoing hemodialysis. Trial registration IRCT20200712048085N1. Registered 15 July 2020, https:// en. irct. ir/ trial/ 49604
... The benefits of reflexology include its capability to stimulate nerve function, increase energy, boost circulation, and induce a deep state of relaxation (37)(38)(39)(40)(41)(42)(43)(44). Furthermore, it helps stimulate the central nervous system and avoid migraines (45)(46)(47)(48)(49)(50). ...
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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.
... A third cause, explain that applying pressure on hands or feet activate large diameter fibers to close the pain gate, thereby inhibit the transmission of pain. Finally, the depression would consequently reduce (Hughes, et al., 2011). Furthermore, Fard et al, (2013) in their study of "Effect of foot reflexology on physical and psychological symptoms of premenstrual syndrome ", mentioned that the average reduction of general severity of PMS symptoms was 23.39% in foot reflexology group while it was -9.68% in the control group (p<0.0001). ...
... However, laxatives are expensive and have some side-effects (15). As a CAM, reflexology has been used to improve constipation symptoms (4). Previous systematic reviews on the subject have merely used abdominal massage or hand reflexology (16, 17). ...
Article
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Context: Constipation is a prevalent symptom of gastrointestinal disorders, which has an annoying impact on health and quality of life. On the other hand, reflexology is a popular type of complementary and alternative medicine in medical practices. Objectives: The present study aimed to assess the effect of foot reflexology on constipation symptoms. Methods: Nine databases were systematically searched to detect relevant Randomized Clinical Trials. The current used the Cochrane Risk of Bias tool to evaluate the methodological quality of the included articles. The primary outcome was the improvement of constipation symptoms. The Standardized Mean Difference (SMD) was measured, and random effects were reported instead of the fixed effects due to the high heterogeneity. Results: Out of the 693 articles retrieved from the databases and eight additional records identified through other sources, 496 titles, 48 abstracts, and 16 full-texts were reviewed, and 11 articles were included in this study, out of which nine articles entered the meta-analysis. The findings of the meta-analysis indicated that foot reflexology had a significant effect on the constipation score (SMD:-0.82; 95% CI:-1.47 to-0.17; P value = 0.0001; I 2 = 93%) Conclusions: Foot reflexology can effectively improve constipation symptoms; however, clinical trials with better designs are recommended .
... Studies showed that reflexology leads to reduced stress and increased local blood perfusion [30]. In addition, reflexology reduces systolic and diastolic blood pressure [31]. However, the mechanism of reflexology's effect is not fully understood. ...
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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.
... The sensory nervous system is in the organization with the upper enters in brain such as hypothalamus, cortex, and amygdala. These centers include nuclei that affect the central nervous system, such as blood pressure, heart rate, and baroreceptor reflex [22]. In another study, the status of the heart was monitored by connecting the electrocardiogram to the patients during reflexology practice. ...
... The ANS regulates body systems that are under unconscious control such as breathing, heart rate, and blood pressure. These vital signs are sensitive to stressors and fluctuate according to the physical or psychological changes experienced by an individual, via vagal modulation which controls calming and restful changes and regular functioning or sympathetic modulation, responsible for controlling arousal and the "fight or flight" response [21]. This result came in agreement with the results of Paul et al., 2003 [22] who reported a significant reduction in RR in healthy subjects after doing relaxation technique. ...
... It was emphasized that the reflexology induced changes in the body by stimulating the autonomic nervous system. 24 This assertion is supported by a study which shows that the effect of reflexology on the circulatory system relies on the change in the heart rate and baroreceptor reflex which are controlled by the autonomic system of the body. 25 The influence of reflexology on the autonomic nervous system supports the 'nerve theory'. ...
Article
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Background: There is no evidence regarding the effects of reflexology on constipation and motor functions in children with cerebral palsy. This study was planned to investigate the effects of reflexology combined with neurodevelopmental therapy on constipation and motor functions in children with cerebral palsy. Methods: Forty children between the ages of 3 and 15 years with cerebral palsy within levels 3/4/5 according to the Gross Motor Function Classification System (GMFCS) were included in the study. The participants were divided into two groups. While children in Group 1 received neurodevelopmental therapy, children in Group 2 also received reflexology. The therapy continued for two sessions per week for 8 weeks. Each session of neurodevelopmental therapy lasted for 45-60 min and reflexology took around 20 min. Motor performance of the children was evaluated with the Gross Motor Function Measure (GMFM) while constipation was assessed with the Modified Constipation Assessment Scale (MCAS). Results: Both groups showed significant improvements in the GMFM scores after therapy (<0.001). In the group where neurodevelopmental therapy was applied together with reflexology, there was a decrease in MCAS scores (<0.001). Conclusion: NGT improved motor performance in both groups and adding reflexology to therapy had a positive effect on constipation. We suggest applying reflexology to children with cerebral palsy who experience constipation problems.
... By applying pressure to these points the reflexologist aims to promote homeostasis and, as a result, restore and maintain physiological and psychological health and wellbeing [2]. The exact mechanism of action for reflexology has not yet been established; currently modulation of the autonomic nervous system (ANS) [3][4][5] and the release of endorphins following reflexology [6] are the most popular hypotheses. However, due to the lack of an established model for the theoretical and physiological underpinnings of reflexology, many health care professionals (HCP) continue to question its credibility. ...
... Another study designed to evaluate the effect of reflexology on mental stress induced tests in healthy individuals. The results showed that there were significant reductions in systolic and diastolic blood pressure following reflexology (24). Lu et al. investigated the effect of foot reflexing on the autonomic nervous modulation in patients with coronary artery disease. ...
Article
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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.
... Compared to reflexology, LLET seemed to be more effective in improving shoulder ROM and pain severity in diabetic patients with frozen shoulder. Reflexology has been reported as a non-invasive complementary therapy for several medical conditions [37,38]. The beneficial effects of reflexology observed in the current study may be explained according to Pitman and Mackenzie [39] who stated that reflexology therapy may amend the organ dysfunction and provide homeostasis in the organ function. ...
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Objective: Adhesive capsulitis is common in Type 2 diabetic patients. The painful nature of adhesive capsulitis and the lack of effective therapy for improving motion and diminishing pain demonstrate the demand for a new effective therapeutic intervention. The current study aimed to determine the efficacies of low-level laser therapy (LLLT) and reflexology for improving range of motion (ROM) in diabetic patients with adhesive capsulitis. Methods: Totally, 40 volunteer patients of both sexes with proven Type 2 diabetes and adhesive capsulitis were included in the current study. The patients were divided into two groups each comprising 20 patients as follows; Group I (LLLT): Patients received LLLT for 15 minutes and Group II (Reflexology): Patients received reflexology in the form of thumb walk for 15 minutes. Therapy was applied 3 times/week for 8 weeks with concurrent 15 minutes exercise. Results: Patients received LLLT showed a significant increase in ROM of abduction, internal rotation, flexion, and external rotation at the end of 4 and 8 weeks. Reflexology induced a significant improvement in shoulder ROM at 8 weeks posttreatment, however, its effect on internal rotation ROM was nonsignificant at the end of 4 weeks period. Conclusion: LLLT and reflexology significantly improved ROM and reduced pain severity in diabetic patients with adhesive capsulitis; LLLT seemed to be more effective. Thus, both therapies may be recommended in the treatment of frozen shoulder, pending further investigations to trace out their exact efficacies.
... Reflexology therapy has emerged as a form of noninvasive and nonpharmacological complementary therapy for several medical conditions [9,10]. Reflexology is the science of studying the human health through certain specific reflex/reflexology areas (RAs) quantized on feet, hands, and ears. ...
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Background. The restricted usage of existing pharmacological methods which do not seem to provide the treatment of diabetic neuropathy may lead to exploring the efficacy of a complementary therapy. In this context, this paper was devoted to evaluate the efficacy of foot reflexology. This health science works on the hypothesis that the dysfunctional states of body parts could be identified by observing certain skin features and be rectified by stimulating certain specific areas mapped on feet. Method. Subjects (N = 58) with diagnosed diabetic neuropathy were randomly distributed into reflexology and control groups in which both group patients were treated with ongoing pharmacological drugs. Reflexology group patients were additionally treated holistically with the hypothesis that this therapy would bring homeostasis among body organ functions. This was a caregiver-based study with a follow-up period of 6 months. The outcome measures were pain reduction, glycemic control, nerve conductivity, and thermal and vibration sensitivities. The skin features leading to the detection of the abnormal functional states of body parts were also recorded and analyzed. Results. Reflexology group showed more improvements in all outcome measures than those of control subjects with statistical significance. Conclusion. This study exhibited the efficient utility of reflexology therapy integrated with conventional medicines in managing diabetic neuropathy.
Thesis
« En Février 2016, le troisième rapport sur la « Survie des personnes atteintes de cancer en France métropolitaine 1989-2013 » révèle une amélioration de la survie à 5 ans pour la plupart des cancers. Cette augmentation réside à la fois dans des diagnostics de plus en plus précoces et des thérapeutiques de plus en plus performantes. Ces avancées ont modifié le paradigme du cancer, soit guéri par la chirurgie soit mortel, qui est devenu dépassé car le cancer est devenue une maladie chronique qui nécessite un accompagnement pluriprofessionnel et pluridisciplinaire. Parallèlement, les patients atteints d’un cancer ont de plus en plus recours aux médecines alternatives et complémentaires MAC pour traiter leur cancer, pour prévenir voire diminuer les effets secondaires de la maladie et des traitements et arriver en soutien à leur bien-être physique et psychologique. À partir de 2004 le premier Plan Cancer a établi l’accès aux soins de support définis comme « l’ensemble des soins et soutiens nécessaires aux personnes malades atteintes de maladies graves potentiellement mortelles, tout au long de la maladie, conjointement aux traitements spécifiques, lorsqu’il y en a ». Toutefois, pour la majorité des MAC peu voire aucune preuve scientifique n’est disponible à ce jour, sans oublier le fait qu’elles puissent être plus néfastes que bénéfiques aux patients. Au Centre de Coordination en Cancérologie de l’Hôpital Lyon Sud (Hospices Civils de Lyon), pour répondre aux attentes des patients, des séances de réflexologie plantaire leur sont désormais proposées conjointement à leurs traitements conventionnels. Ce travail de thèse avait trois objectifs : i) faire un état de l’art des preuves scientifiques apportées par des essais cliniques randomisés (ECR) des MAC dans le cadre du cancer, ii) s’assurer que la réflexologie plantaire n’interfère pas avec les pratiques professionnelles, iii) évaluer les bénéfices de la réflexologie plantaire auprès de patients sous chimiothérapie en particulier les nausées/vomissements chimio-induits. Tout d’abord, la revue de la littérature montre que l’évaluation des MAC à l’aide d’ECR au niveau mondial est rare et est essentiellement menés par les États-Unis et la Chine. Ces études concernent principalement l’acupuncture, le yoga et les herbes chinoises avec des bénéfices significatifs au niveau de la qualité de vie globale, fatigue, douleur et anxiété. Enfin, l’évaluation de leur innocuité fait souvent défaut dans ces études. Ensuite, l’enquête réalisée auprès des professionnels de santé de l’hôpital suggère que la réflexologie plantaire délivrée lors des soins conventionnels n’interfère pas avec leur pratique et que ces derniers perçoivent de réels bénéfices pour leurs patients. Enfin les résultats de notre étude prospective contrôlée randomisée montrent une diminution significative des nausées aiguës. Nous observons également une tendance à une diminution des nausées retardées, conjointement à une diminution significative de la consommation des médicaments antiémétiques entre chaque cure de chimiothérapie. Aucun événement indésirable n’a été constaté dans cet ECR. En conclusion, les résultats de ce travail de thèse ont montré que la réflexologie plantaire, accueillie très favorablement par les professionnels de santé, semble être un complément prometteur aux médicaments antiémétiques. Cette thèse ouvre des perspectives de recherches des MAC avec des enjeux de santé publics majeurs : fournir aux professionnels de santé des données scientifiques rigoureuses, évaluer l’innocuité des MAC et améliorer la communication entre les professionnels de santé et les patients à propos des MAC.
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Introduction: We evaluated the effects of foot reflexology on bodily vital signs. Methods: Randomized controlled trials (RCTs) evaluating the effects of foot reflexology on vital signs were collected for a meta-analysis. Statistical analysis was conducted using RevMan5.4 software and pooled estimates of the effects were reported as mean differences (MDs) with 95% confidence intervals (CIs). Results: Thirteen studies, including 819 patients, met our inclusion criteria. Our results showed that systolic blood pressure (SBP) (MD = -4.62, 95% CI: -5.58 to -3.66; P < 0.00001), diastolic blood pressure (DBP) (MD = -3.32, 95% CI: -4.48 to -2.17; P < 0.00001), heart rate (HR) (MD = -4.76, 95% CI: -6.49 to -3.04; P < 0.00001), respiratory rate (RR) (MD = -0.77, 95% CI: -1.50 to -0.48; P < 0.00001), and pulse oxygen saturation (SpO2) (MD = 0.95, 95% CI: 0.39 to 1.52; P = 0.0009) showed statistical significance in the foot reflexology group. Conclusions: Short-term followup results showed that foot reflexology exerted positive effects on vital signs, reduced BP, HR, and RR and increased SpO2.
Article
Objective: Weakness in the sensory-deep receptors of the sole is one of the essential factors in lower limb movement disorders and balance in blindness. Therefore, this study aimed to compare the effect and durability of foot massage techniques on the balance of the blindness Methods: The present study was a one-way blind with a pretest-posttest design. The statistical sample consisted of 30 blind boys aged 20-30 years randomly divided into three groups of 10 people. The protocol of massage methods was performed on the samples for 21 days. Biodex balance system was used to evaluate the balance. The normality of the data was analyzed using the Shapiro-Wilk test. The analysis of variance with repeated measures was used to analyze the differences within the group. The ANOVA test was used to examine the differences between the groups at the significance level of 0.05. Results: The results of the intra-group test showed that all three methods of foot massage improved static and dynamic balance in the blind (P0.05) only on the general surface index. There is a significant difference in the dynamics of hand massage compared to the other two massages (P
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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
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Introduction Neonatal jaundice is considered as the most common reason for newborns’ admission and methods for the prevention of this condition are therefore important. This randomized sham-controlled trial aimed to evaluate whether foot reflexology could affect levels of cutaneous bilirubin and reduce neonatal jaundice. Methods In this single-blind trial, sixty eligible neonates were randomly assigned to one of three groups. Neonates in the foot reflexology group received genuine foot reflexology, while neonates in the sham reflexology group received sham reflexology, administered in four 30-min sessions on the first day of life. The neonates in the control group only received routine neonatal care services. Cutaneous bilirubin level, dermal icterus, and need for phototherapy were assessed at baseline, the first, third and fifth day post-baseline measurements. Data were analyzed by chi-square, analysis of variance, and post hoc tests. Results Despite the increase of cutaneous bilirubin levels after birth in three groups, it was significantly lower in the foot reflexology group than other two groups on the first and third days but not on the fifth day (P < 0.001, P = 0.003, and P = 0.07, respectively). Dermal icterus did not differ between the three groups at any of the measurement time points (P > 0.05). A significant reduction was observed in the need for phototherapy in the foot reflexology group compared with the sham reflexology and control groups (P = 0.04). Conclusions Foot reflexology seems to be a potentially beneficial complement for preventing or reducing jaundice without any serious side effects. Nevertheless, larger well powered randomized controlled trials (RCTs) are needed to confirm these findings.
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Background The current literature shows that one of the alternative therapies used to control constipation is reflexology. This study was conducted to assess the effect of reflexology on the constipation status of elderly people. Methods This study was randomized clinical trial conducted from at the private nursing home in the Ankara Province. At the nursing home, 60 eligible elderly people were randomly assigned into experimental (n = 30) and control (n = 30) groups. The experimental group received foot reflexology massage for 1 month three times per week for 30 min. Reflexology was initiated from the patient’s right foot. The foot was relaxed primarily by applying effleurage followed by shaking, rotation, and stretching methods. The practice ended by applying solar plexus pressure on both feet. For elderly people in the control group foot surface massage without pressure was applied to simulate the interventions similar to the experimental group. The scale scores before and after reflexology were noted for the experimental group, and those for the control group, which did not receive any reflexology massage, were also determined Results After the implementation of reflexology, the rate of emptying bowels on alternate days increased in the experimental group as opposed to that in the control group (P < 0.001). In this study, reflexology was found to improve the quality of life of the elderly and decrease the severity of constipation. Conclusion Foot reflexology massage was found to be effective in relieving the constipation of elderly people. Therefore, reflexology is recommended as part of nursing care to reduce the constipation status of elderly people.
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Purpose: This study aimed to evaluate the effect of reflexology on fatigue, pain, and sleep quality in lymphoma patients. Method: This study was a randomized clinical trial with pre-post design. Seventy-two lymphoma patients admitted in hematology wards affiliated to Shiraz University of Medical Sciences, Shiraz, Iran in 2018 were randomly assigned to intervention and control groups. Patients in the intervention group underwent foot reflexology for five consecutive days. The control group received usual care. The data were collected by the Multidimensional Fatigue Inventory, a numerical pain scale, and Pittsburgh Sleep Quality index. Data analysis was done by the SPSS software, version 21 using ANCOVA, paired t-test, and Wilcoxon test. Results: At baseline, both intervention and control groups were the same in terms of fatigue, pain, and sleep quality (p > 0.05). However, a significant difference was found between the two groups regarding fatigue, pain, and sleep quality after the intervention (all p < 0.05). Conclusion: The results showed that reflexology could reduce fatigue and pain and improve the quality of sleep in patients with lymphoma. Considering the effectiveness of reflexology in lymphoma patients, healthcare workers including nurses are recommended to use this complementary therapy to reduce fatigue and pain and improve sleep quality in lymphoma patients.
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Introduction: Reflexology is the systematic practice of applying some pressure to particular points on the feet and hands to impact on health of related parts of the body. Objective: To explore the practitioners' perspectives of reflexology in Malaysia. Methods: Data was collected using face-to-face semi-structured interviews with practitioners in Malaysia. The interviews were conducted in the Malay language and recorded. Interview conversations were translated and transcribed verbatim. Responses relating to different themes were identified in each of the interviews and a coding frame was developed. For each theme, the relevant data enabled a description of the range of views and experiences. Data collection and analysis were conducted concurrently and recruitment was stopped when saturation had been reached. All respondents gave written consent for their participation. Results: The findings show that reflexology treatment nowadays has been accepted as one of the ways to maintain general health. Practitioners believe that reflexology is able to detect some problems in to the body, which can make patients aware of a health condition and seek further treatment. However, if reflexology is not performed correctly, it may cause negative effects such as pain and bruises. Some practitioners voiced concern that illegal activities are taking place in unethical reflexology centers. Conclusions: Empowering the practitioner as a professional would help gain the public's trust and confidence in their treatment. Strict enforcement of regulation related to illegal conduct in reflexology centers will improve people's perception of the practice.
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Background: This report is based on the results of a randomized parallel controlled trial conducted to determine the efficacy of reflexology therapy in managing intractable epilepsy. Methods: Subjects who failed epilepsy surgery or were not candidates for epilepsy surgery or were non-responders of antiepileptic drugs (AEDs) took part in this study. The trial was completed by 77 subjects randomly assigned to 2 arms: control (AEDs) and reflexology (AEDs + reflexology therapy). The hypothesis was that hand reflexology therapy could produce results similar to those of vagus nerve stimulation, and foot reflexology therapy could maintain homeostasis in the functional status of individual body parts. Reflexology therapy was applied by family members. The follow-up period was 1.5 years. Quality of life in epilepsy patients was assessed with the QOLIE-31 instrument. Results: In the reflexology group, the median baseline seizure frequency decreased from 9.5 (range 2-120) to 2 (range 0-110) with statistical significance (p < 0.001). In the control arm, the decrease was less than 25% with a baseline value of 16 (range 2-150). The pretherapy QOLIE-31 scores in the control group and the reflexology group were 41.05 ± 7 and 43.6 ± 8, respectively. Posttherapy data were 49.07 ± 6 and 65.4 ± 9, respectively (p < 0.002). The reflexology method allowed detection of knee pain in 85% of the reflexology group patients (p < 0.001), and 85.3% of patients derived 81% relief from it (p < 0.001). 4 reflexology group patients reported nausea/vomiting (n = 1), change in voice (n = 2), and hoarseness (n = 1). Conclusion: Reflexology therapy together with AEDs may help reducing seizure frequency and improving quality of life in individuals with epilepsy.
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Many issues related to the selection, reliability, and validity of mental stress testing in cardiovascular research are discussed. Five categories of mental stress testing are distinguished: problem-solving tasks, information-processing tasks, psychomotor tasks, affective conditions, and aversive or painful conditions. A series of practical and theoretical criteria are outlined for the selection of appropriate tests, and the measurement of a range of dependent variables is emphasized. The temporal stability of cardiovascular responses to mental stress tests is examined through an analysis of test-retest correlations (weighted for sample size) in 28 comparisons with intervals between sessions varying from 1 day to more than 1 year. Heart rate reactions to tasks show an average-weighted Z of 0.732 +/- 0.031 (r = 0.62), with Z = 0.575 +/- 0.034 (r = 0.52) for systolic blood pressure and Z = 0.313 +/- 0.035 (r = 0.30) for diastolic blood pressure. It is argued that the validity of mental stress tests can be judged in relation to several different aspects, specifically, methodological, ecological, diagnostic, prognostic, and therapeutic validities. The nature of these standards is described, and pertinent literature is presented.
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In this study, we compared the biomechanical and physiological responses of healthy men and women during bilateral load carriage while they walked on a treadmill at their self-selected velocity. Eleven men mean (SD) maximal oxygen uptake, [V˙O2max = 56.0 (7.1) ml · kg−1 · min−1] and 11 women [V˙O2max = 44.6 (7.6) ml · kg−1 · min−1] carried 15-kg and 20-kg loads in random order using a custom-designed load-carriage device. The load supported by each hand was measured by placing strain gauges in each handle of the device. The load supported by the body was calculated as the difference between the load carried and that supported by each hand. Physiological measurements were recorded using standard procedures, and cardiac output was measured by carbon dioxide rebreathing while standing, walking, and during load carriage. Three-way analysis of variance (gender by load by test phase) indicated no significant (P > 0.05) three-way interaction, implying that the overall trend in these responses was similar in men and women. A-priori Scheffe multiple comparisons revealed the following significant (P < 0.05) gender differences during load carriage: (1) women supported a lower proportion of the load with the hands and transferred a greater amount to the body by resting the load against the chest, (2) the oxygen uptake increased by a greater amount in the women compared with men and exceeded the ventilatory threshold during the 20-kg walk in women, and (3) the cardiovascular stress, as indicated by the percentage of maximal heart rate and rate pressure product (product of heart rate and systolic blood pressure), was significantly higher in women compared with men during both of the load-carriage walks. These observations suggest that when carrying absolute loads of 15 kg and 20 kg, women are more susceptible to fatigue and are at a greater risk of cardiovascular complications than men.
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This experimental, repeated-measures, crossover design study with nursing home residents examined the efficacy of reflexology in individuals with mild-to-moderate stage dementia. Specifically, the study tested whether a weekly reflexology intervention contributed to the resident outcomes of reduced physiologic distress, reduced pain, and improved affect. The study was conducted at a large nursing home in suburban Philadelphia. The sample included 21 nursing home residents with mild-to-moderate stage dementia randomly assigned to two groups. The first group received 4 weeks of weekly reflexology treatments followed by 4 weeks of a control condition of friendly visits. The second group received 4 weeks of friendly visits followed by 4 weeks of weekly reflexology. The primary efficacy endpoint was reduction of physiologic distress as measured by salivary alpha-amylase. The secondary outcomes were observed pain (Checklist of Nonverbal Pain Indicators) and observed affect (Apparent Affect Rating Scale). The findings demonstrate that when receiving the reflexology treatment condition, as compared to the control condition, the residents demonstrated significant reduction in observed pain and salivary alpha-amylase. No adverse events were recorded during the study period. This study provides preliminary support for the efficacy of reflexology as a treatment of stress in nursing home residents with mild-to-moderate stage dementia.
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The electrocardiogram is a representative signal containing information about the condition of the heart. The shape and size of the P-QRS-T wave, the time intervals between its various peaks, etc., may contain useful information about the nature of disease afflicting the heart. However, the human observer cannot directly monitor these subtle details. Besides, since bio-signals are highly subjective, the symptoms may appear at random in the time scale. Therefore, the heart rate variability signal parameters, extracted and analyzed using computers, are highly useful in diagnostics. Analysis of heart rate variation (HRV) has become a popular non-invasive tool for assessing the activities of the autonomic nervous system. HRV analysis is based on the concept that fast fluctuations may specifically reflect changes of sympathetic and vagal activity. It shows that the structure generating the signal is not simply linear, but also involves nonlinear contributions. This work is an attempt made to do a quantitative study on the effect of reflexology on the HRV during reflexologic stimulation. The nonlinear parameters are evaluated for this study and the results obtained for 20 subjects are tabulated.
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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.
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Simple interval estimate methods for proportions exhibit poor coverage and can produce evidently inappropriate intervals. Criteria appropriate to the evaluation of various proposed methods include: closeness of the achieved coverage probability to its nominal value; whether intervals are located too close to or too distant from the middle of the scale; expected interval width; avoidance of aberrations such as limits outside [0,1] or zero width intervals; and ease of use, whether by tables, software or formulae. Seven methods for the single proportion are evaluated on 96,000 parameter space points. Intervals based on tail areas and the simpler score methods are recommended for use. In each case, methods are available that aim to align either the minimum or the mean coverage with the nominal 1 - α.
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( This reprinted article originally appeared in the Journal of Experimental Psychology, 1935, Vol 18, 643–662. The following abstract of the original article appeared in PA, Vol 10:1863.) In this study pairs of conflicting stimuli, both being inherent aspects of the same symbols, were presented simultaneously (a name of one color printed in the ink of another color—a word stimulus and a color stimulus). The difference in time for reading the words printed in colors and the same words printed in black is the measure of the interference of color stimuli on reading words. The difference in the time for naming the colors in which the words are printed and the same colors printed in squares is the measure of the interference of conflicting word stimuli on naming colors. The interference of conflicting color stimuli on the time for reading 100 words (each word naming a color unlike the ink-color of its print) caused an increase of 2.3 sec or 5.6% over the normal time for reading the same words printed in black. This increase is not reliable, but the interference of conflicting word stimuli on the time for naming 100 colors (each color being the print of a word which names another color) caused an increase of 47.0 sec or 74.3% of the normal time for naming colors printed in squares.… (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Multiple sclerosis (MS) results in pain and other symptoms which may be modified by conventional treatment, however, MS is still not curable. Several studies have reported positive effects of reflexology in the treatment of pain, however, no randomised controlled clinical trials for the treatment of pain have been conducted within this population. The objective of this study was to investigate the effectiveness of reflexology on pain in and MS population. We randomly allocated 73 participants to receive either precision or sham reflexology weekly for 10 weeks. Outcome measures were taken pre-and post-treatment with follow-up at 6 and 12 weeks by a researcher blinded to group allocation. The primary outcome measure recorded pain using a Visual Analogue Scale (VAS). A significant (p < 0.0001) and clinically important decrease in pain intensity was observed in both groups compared with baseline. Median VAS scores were reduced by 50% following treatment, and maintained for up to 12 weeks. Significant decreases were also observed for fatigue, depression, disability, spasm and quality of life. In conclusion, precision reflexology was not superior to sham, however, both treatments offer clinically significant improvements for MS symptoms via a possible placebo effect or stimulation of reflex points in the feet using non-specific massage.
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Work stress is a major occupational problem in the UK. Few studies have examined the role of complementary therapies in reducing stress in the workplace. To help determine the usefulness of reflexology in managing stress a preliminary study was conducted in an occupational setting. To explore the use of reflexology in managing stress in the workplace. In a single-subjects experimental design, four employees from a single organisation received reflexology treatments. A range of outcome measures, including the GHQ-12 and the MYMOP2, were used to monitor psychological health and well-being, symptoms and quality of life. Measures were taken at baseline, intervention and follow-up. The data suggested some trends towards improvement in perceived health and well-being following reflexology intervention. Improvements varied by participant and across the different measures. This study was limited by the size of the sample and the nature of the design, which cannot demonstrate cause and effect. The trends towards improvement associated with reflexology suggested that further research may be warranted.
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In animal studies, acupuncture has been shown to be sympathoinhibitory, but it is unknown if acupuncture is sympathoinhibitory in humans. Nineteen healthy volunteers underwent mental stress testing pre- and postacupuncture. Muscle sympathetic nerve activity (MSNA), blood pressure, and heart rate during mental stress were compared pre- and postacupuncture. Control acupuncture consisted of acupuncture at nonacupoints and “no-needle” acupuncture. Acupuncture had no effect on resting MSNA, blood pressure, or heart rate. After real acupuncture, the increase in mean arterial pressure (pre- vs. postacupuncture 4.5 vs. 1.7 mmHg, P < 0.001), but not MSNA or heart rate, was blunted during mental stress. Similarly, following nonacupoint acupuncture, the increase in mean arterial pressure was blunted during mental stress (5.4 vs. 2.9 mmHg, P < 0.0003). No-needle acupuncture had no effect on these variables. In conclusion, acupuncture at traditional acupoints, nonacupoints, and no-needle acupuncture does not modulate baseline MSNA or MSNA responses to mental stress in normal humans. Acupuncture significantly attenuates the increase in blood pressure during mental stress. Needling nonacupoints, but not “no-needle” acupuncture, have a similar effect on blood pressure.
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Activation of the sympathetic nervous system may increase hematocrit (Hct), whole blood viscosity (WBV), and possibly cardiovascular risk. The aim was to study gender specific differences of mental stress on sympathetic reactivity and blood rheology. Responses in blood pressure, heart rate (HR), Hct, WBV (Bohlin rotational viscosimeter), and plasma catecholamines to a mental arithmetic stress test (MST) were measured in male (n = 10, 23 +/- 3 years, BMI 23 +/- 2 kg/m2) and female (n = 10, 21 +/- 4 years, BMI 24 +/- 2 kg/m2) students. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR increased during MST in men and women, and declined to baseline levels after 15 min of recovery. In men, plasma adrenaline increased by 217% during MST (p < 0.01, ANOVA). and plasma noradrenaline increased by 68% (p < 0.05). Hct and WBV at low shear rates (0.5 and 1.1 l/s) increased as well (p < 0.001, p < 0.05, and p < 0.05, respectively). In women, the increase in plasma adrenaline averaged 118% during MST (p < 0.05) while plasma noradrenaline (-3%, p = 0.38), Hct, and WBV at all shear rates remained unchanged. Men and women differed in A adrenaline (p < 0.05), A noradrenaline (p = 0.01), delta Hct (p < 0.05), and delta WBV (p < 0.05). A Hct tended to correlate with delta SBP (r= 0.60, p = 0.07), A DBP (r = 0.57. p = 0.09). and delta HR (r = 0.50, p = 0.14), and correlated significantly with A noradrenaline (r = 0.66, p < 0.05) in men only. Multiple regression analysis showed that gender independently explained 22% of the change in Hct during mental stress. Data suggest gender specific differences in sympathetic and hemorrheological responses to mental stress in healthy young subjects. In men, sympathetic responses were related to hemorrheological responses, but not in women. It may be speculated whether such differences in stress responses may contribute to lower cardiovascular risk in premenopausal women than in men.
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From among the few human experimental models that can be used to predict the clinical activity of new anxiolytic drugs, the video-recorded Stroop Color-Word Test (VRSCWT), which uses subjective scales to evaluate anxious states, is notable for its simplicity. However, considering that the choice of treatment for anxiety disorders is heavily dependent on the level of somatic symptomatology, a quantitative evaluation of the physiological alterations elicited by the anxiogenic situation of the VRSCWT would also be of great interest. In the present study, 36 healthy male and female volunteers were submitted to either the VRSCWT or to a nonanxiogenic test. The results showed that, as well as a sensation of anxiety, the VRSCWT elicited increases in heart rate and gastrocnemius tension. Subsequently, a further 48 healthy men and women were randomly assigned to three treatments: placebo, 5 and 10 mg of diazepam, and were submitted to the VRSCWT. The results showed that in men, diazepam blocked the feeling of anxiety elicited by the test, although it did not prevent the physiological alterations, while in women, there was no response to the anxiolytic action of the drug. Taken as a whole, these results suggest that the VRSCWT is an efficient method of inducing anxiety experimentally. It is able to elicit observable psychological and physiological alterations and can detect the blocking, by an anxiolytic, of the feelings of anxiety in healthy men. Furthermore, the results suggest that the neural pathways for the control of the psychological and physiological manifestations of anxiety may be separate. This study also draws attention to the fact that gender is an important variable in the evaluation of anxiolytic drugs.
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The emotional Stroop task has been the most widely used task to examine attentional bias to emotionally salient stimuli. In one format of this task, words are presented to participants in a mixed randomized or quasi-randomized sequence. Using a mixed smoking Stroop task, we have previously demonstrated that smokers are slower to respond to words which follow smoking-related words than words which follow neutral words. Here we show that this carry-over effect is present in heroin addicts-but not control subjects-in a heroin Stroop task, and in normal subjects in a stress Stroop task. Thus, the effect generalizes to other populations. In addition, an examination of the studies that have collected data from both mixed and blocked formats provides converging evidence for the presence of carry-over effects. We discuss the implications of the carry-over effect for research using the emotional Stroop task.
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The impact of stress on respiratory airflow in asthmatics is unclear. Part of the uncertainty may spring from the different physiological effects of different stressors. Given their potential to elicit increases in parasympathetic vagal activity, stressful situations that present few opportunities for coping (passive coping stressors) may be particularly problematic for people with asthma. Thirty-one adult asthmatics participated in a protocol including a widely used passive coping stressor (the cold pressor test), an active coping stressor (mental arithmetic), an interview about an upsetting asthma-related incident (viewed as a potential passive coping stressor given the exposure to unpleasant memories), and progressive muscle relaxation. Repeated measurements of airflow (via peak expiratory flow), vagal tone (via heart rate variability), and other variables were obtained. The cold pressor test, asthma interview and progressive muscle relaxation produced significant decreases in airflow compared to the baseline period. The cold pressor test and progressive muscle relaxation produced significant, complementary increases in vagal tone. These results suggest that passive coping stressors and other stimuli (e.g., certain forms of relaxation) that elicit increased vagal tone may be associated with poorer asthma control, a view consistent with a significant negative correlation between the participant's mean vagal tone response to the tasks and score on a measure of asthma self-efficacy.
Article
Ill-health changes the anatomy and physiology of affected organs, some of which can be observed visually, elicited through physical examination or confirmed through biomedical analysis. Understanding how anatomical changes contribute to physiological signs and symptoms will help practitioners identify the pathology, appreciate its origin and development and justify prescribed interventions in a way which can be upheld by critical external scrutiny. Reflexology contributes to an holistic approach to care and has recently improved its credibility as a discipline which supports orthodox care. Several research publications have identified possible theories and principles for the mechanism of action of reflexology, but more research to explain its contribution in identifying ill-health and diseases, as well as appropriate treatment modalities, is needed. This paper explores the physiological basis of reflexology, some of the theories for the mechanism of action and its potential as a diagnostic tool.
Article
We studied plasma adrenaline (A) in relation to physical fitness, metabolic cardiovascular risk factors and cardiovascular responses. Men (age 21-24 years) with high and normal (both n=19) screening blood pressure (BP) were studied cross-sectionally. We measured peak oxygen uptake (VO2peak) (treadmill exercise), and plasma catecholamines, heart rate (HR), finger systolic (SBP) and diastolic (DBP) BP, and insulin-adjusted glucose disposal rate (GDR/I) during a hyperinsulinaemic glucose clamp (rest) and mental arithmetic stress test (MST). By multiple regression, A at rest (Arest) (beta=0.37, p<0.05) and during MST (Amst) (beta=0.40, p<0.01) were associated with high screening BP. In the respective models, Arest was negatively related to body mass index (BMI) (beta=-0.56, p<0.001) and Amst positively to VO2peak (beta=0.54, p<0.001). BP and HR responses correlated positively with VO2peak, but were determined by Amst in multiple regression models. Independently of BMI and VO2peak, serum high-density lipoprotein cholesterol was positively related to A levels, whereas GDR/I was independently related only to VO2peak. Increased adrenaline secretion may be related to high BP, but may at the same time be associated with a beneficial metabolic profile.
Article
To investigate the reliability and validity of the Physiological Cost Index (PCI) scores, as a measure of energy expenditure, when healthy subjects walk on 2 different tracks (20-m and 12-m figure eight tracks). Intra- and interrater reliability and construct validity. Physiotherapy division of a university in London, UK. Forty healthy subjects (15 men, 25 women; mean age +/- standard deviation, 34.5+/-12.6 y). Not applicable. Heart rate (in beats/min) and speed (in m/min) were used to calculate the PCI (in beats/m). Rate of oxygen consumption (VO2, in mL x kg(-1) x min(-1)) and oxygen cost (EO2, in mL x kg(-1) x m(-1)) were used as criterion estimates of energy cost EO2. Pearson correlation coefficients between the PCI, components of the PCI, EO2, and VO2 were used to quantify validity. Intrarater reliability was assessed in all participants and interrater reliability was assessed on a subset of 13 subjects using intraclass correlation coefficients and Bland-Altman plots. Intrarater (r=.73, r=.79) and interrater (r=.62, r=.66) reliability were acceptable between PCI scores from 20-m and 12-m tracks, respectively. Correlations between VO2 and EO2 with PCI were weak. PCI scores from the 20-m track were significantly lower than those on the 12-m track (P=.002). Subjects walked significantly faster on the 20-m track (P<.001). Results suggest a large difference in PCI scores would be necessary to indicate a "true" alteration in performance (52% for 20-m track, 43.4% for the 12-m track). The PCI is reliable but not valid as a measure of the energy cost of walking in healthy subjects, on either track. The 20-m track is recommended for clinical use because it enables subjects to walk at a faster pace.
Article
This study was aimed to identify the effects of a self-foot reflexology massage on depression, stress responses and functions of the immune system of middle-aged women. This study was a one group pretest-posttest experimental design and the data was collected from August 1st, 2004 to May 31st, 2005. The subjects consisted of 46 middle-aged women (40 - 64 years) who were recruited from the Community Health Center in Busan city. Subjects were not treated for 4 weeks, subsequently they were trained in self foot reflexology massage for 2 weeks, and then they did their own daily for 6 weeks (2 days at the research center, 5 days at home). The outcome variables were measured 4 times, at baseline, pre training, after training, and after the intervention. The collected data was analyzed using repeated measure ANOVA by the SPSS/WIN program. There was a statistically significant difference in depression, perceived stress, systolic blood pressure, natural-killer cells and Ig G. However, there was not a statistically significant difference in diastolic blood pressure, pulse or serum cortisol. These results suggest that a self-foot reflexology massage could be utilized as an effective nursing intervention to reduce depression and stress responses, and to strengthen immune systems in middle-aged women.
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
To investigate current management of low back pain (LBP) by reflexologists. A postal survey of reflexologists (n=500) sampled from the International Institute of Reflexology. The questionnaire used investigated a range of areas including: professional details, reflexology training and practice, views and experiences of reflexology, reflexology and LBP, and views on other complementary therapies. Response rate was 49.6% (n=248). The majority of respondents were female (95%), and were primarily employed within another profession such as nursing or teaching. Respondents perceived reflexology to have a positive effect on relieving LBP (94.3%) and to provide more benefit than simply relaxation. Practitioners also commented on other treatment effects, e.g. improving sleep patterns, decreasing anxiety and stress. It was reported that other healthcare practitioners, including general practitioners, referred patients to reflexologists for treatment. Respondents considered reflexology to be an effective therapy for LBP. Further work is warranted to investigate the potential role of such treatment in the management of this prevalent and intractable condition.
Article
Success of blinding is a fundamental issue in many clinical trials. The validity of a trial may be questioned if this important assumption is violated. Although thousands of ostensibly double-blind trials are conducted annually and investigators acknowledge the importance of blinding, attempts to measure the effectiveness of blinding are rarely discussed. Several published papers proposed ways to evaluate the success of blinding, but none of the methods are commonly used or regarded as standard. This paper investigates a new approach to assess the success of blinding in clinical trials. The blinding index proposed is scaled to an interval of -1 to 1, 1 being complete lack of blinding, 0 being consistent with perfect blinding and -1 indicating opposite guessing which may be related to unblinding. It has the ability to detect a relatively low degree of blinding, response bias and different behaviors in two arms. The proposed method is applied to a clinical trial of cholesterol-lowering medication in a group of elderly people.