Can foot reflexology be a complementary therapy for sleep disturbances? Evidence appraisal through a meta-analysis of randomized controlled trials

Acupoint massage: a comprehensive descriptive review of its forms, applications, and underlying mechanisms

Acupoint massage is a non-invasive traditional therapy that has demonstrated reliable clinical outcomes in pain management, mental health relief, sleep disorder regulation, gastrointestinal treatment, and as an adjunct therapy for cancer. Its convenience and cost-effectiveness further enhance its appeal. However, the existing English literature lacks a systematic review that encompasses the various forms of acupoint massage. The acupoint massage forms adaptability is particularly notable when considering the diverse conditions, it addresses, as well as its applicability across different age groups and gender differences. Providing a comprehensive understanding, it is crucial to outline common practices and explore specific applications in key areas. The comprehensive understanding can create opportunities for effective collaboration between preclinical and clinical studies. Defining and categorizing different forms of acupoint massage is essential, alongside investigating the neural circuits involved in touch sensation. Future efforts should enhance collaboration with modern biology, facilitating the transition from empirical to evidence-based practice. This review summarizes forms, applications, and mechanisms of mainstream acupoint massage and provides insights for future research and applications, promoting deeper integration into healthcare.

The Effect of Massage and Foot Reflexology on Sleep in Newborns

Objective: This study was conducted to examine the effects of massage and foot reflexology on the sleep of premature infants. Materials and Methods: The research was designed as a randomized controlled experimental study. The study population consisted of premature infants born at 30-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of a hospital in the Central Anatolia Region. The sample included 108 premature infants divided into three groups: Massage group (n = 36), Foot reflexology group (n = 36), and Control group (n = 36). Data were collected using a neonatal follow-up form and actigraphy. Massage and foot reflexology interventions were administered to the respective groups twice daily (Morning: 07:00-09:00 and Evening: 19:00-21:00) for 15 minutes each session over two consecutive days, making up a total of four sessions. The control group received routine nursing care without any additional intervention. Pre-test (once) and post-test (once) measurements of 24-h sleep durations were assessed using actigraphy for all groups. Results: Sleep duration in the massage group increased compared to pre-intervention (251 minutes) and the control group (272 minutes), while the sleep duration in the foot reflexology group similarly increased compared to pre-intervention (268 minutes) and the control group (266 minutes) (p < .001). Sleep efficiency also showed a significant increase post-intervention, rising to 73% in the massage group and 71.8% in the foot reflexology group compared to the control group (p < .001). Furthermore, the number of awakenings and wakefulness duration significantly decreased in the massage and foot reflexology groups compared to the control group (p < .05). Conclusion: The findings indicate that massage and foot reflexology are effective non-pharmacological methods for improving sleep duration and sleep efficiency while reducing wakefulness duration and the number of awakenings in premature infants.

Effect of foot reflexology massage on sleep, anxiety and quality of life in hemodialysis patients: A single-blind, randomized, placebo-controlled trial

OBJECTIVE

The aim of this study is to investigate the effects of reflexology foot massage on sleep, anxiety, and quality of life as compared to foot massage only in patients undergoing hemodialysis treatment.

METHODS

This study was conducted as a single blinded randomized placebo-controlled parallel-group trial. Data were collected using the "Demographic Characteristics Form", "Richards-Campbell Sleep Scale", "State-Trait Anxiety Inventory" and "Nottingham Health Profile". Individuals in the reflexology and placebo groups received massages for three weeks; three times a week, for 15 minutes on each foot. Participants in the reflexology and placebo groups were followed-up before the massage and after the ninth massage session.

RESULTS

In the statistical evaluation of the sleep quality scale mean scores, after the ninth massage session, it was determined that the average sleep score of the reflexology massage group was higher than that of the placebo group. Additionally, the state anxiety level was found to be lower in the reflexology group compared to the placebo group. As for the quality of life after the ninth massage session, it was determined that there was an improvement in the reflexology massage group compared to the placebo group.

CONCLUSIONS

This study has found that foot reflexology massage is effective in reducing anxiety levels, improving sleep, and enhancing the quality of life in patients undergoing hemodialysis treatment. The findings of this study may offer nurses greater awareness of the potential benefits of reflexology. In this way, more healthcare professionals can be encouraged to use reflexology in addition to other cares.

Comparative efficacy of non-pharmacological interventions on sleep quality in old adults: A systematic review and network meta-analysis

AIMS AND OBJECTIVES

To compare the effectiveness of non-pharmacological interventions in enhancing sleep quality in older people.

BACKGROUND

Sleep problems in older adults have become increasingly prominent. Sleep problems not only affect the health and quality of life of older people, but also the range of chronic diseases caused by sleep problems also impose a huge burden on social services and health care. Non-pharmacological interventions are an effective alternative to pharmacological therapies, but it is unclear which non-pharmacological therapies are most effective in enhancing sleep quality in older adults.

DESIGN

A systematic review and network meta-analysis based on PRISMA-NMA.

METHODS

A total of seven databases were searched from the establishment of the database to March 2023. After literature screening and data extraction, the Cochrane Bias assessment tool 2.0 version of randomised controlled trials (RCTs) was used to evaluate literature quality. A network meta-analysis was performed to evaluate the relative efficacy of the non-pharmacological interventions on sleep quality.

RESULTS

A total of 71 RCTs involving nine non-pharmacological interventions were included. The results of the network meta-analysis showed that the joint intervention may be the most effective non-pharmacological intervention to enhance sleep quality in older adults.

CONCLUSION

This study confirms that non-pharmacological interventions can improve sleep quality in older adults. The use of non-pharmacological interventions can be promoted by healthcare professionals in the future to improve the quality of sleep and thus the physical and mental health of older people.

RELEVANCE TO CLINICAL PRACTICE

This evidence suggests that joint interventions may be most effective. Therefore, in the future, a combination of non-pharmacological interventions could be used to maximise their effectiveness in improving sleep quality in older people and promoting healthy aging.

NO PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution is not applicable to this study.

Comparing the Efficacy of Acupressure and Foot Reflexology on Sleep Quality in Patients With Leukemia: A Comparative Clinical Trial

BACKGROUND

Among leukemia patients, sleep disruptions are prevalent and can profoundly affect their overall quality of life. Acupressure and foot reflexology, modalities rooted in traditional Chinese medicine, have garnered attention for their potential to address sleep disturbances and mitigate associated symptoms.

METHODS

This research utilized a randomized controlled trial with a pretest-posttest design involving 102 leukemia patients admitted to Imam Khomeini Hospital in Urmia. Participants were randomly allocated to 3 groups: acupressure (n = 34), reflexology (n = 34), or control (n = 34). Prior to the intervention, patients completed a demographic survey and the Pittsburgh Sleep Quality Index (PSQI) for baseline assessments. Acupressure involved stimulation of the SP6 point twice daily for 10 minutes over 4 weeks, while reflexology entailed daily 10-minute sessions with sweet almond oil on the soles for the same duration. The control group received standard care without additional interventions. Following the 4-week intervention period, post-intervention evaluations were conducted using identical measurement tools.

RESULTS

The findings underscored the efficacy of both acupressure and foot reflexology in significantly improving sleep quality within the intervention groups (P < .001). Initially, there were no notable differences in sleep quality among the 3 groups (P > .05). Subsequently, pairwise comparisons adjusted with Bonferroni corrections revealed significant disparities in sleep quality between the acupressure and reflexology groups compared to the control group (P < .001). However, post-intervention analysis indicated no statistically significant variance in enhancing sleep quality between the acupressure and foot reflexology groups (P < .05).

CONCLUSION

This study demonstrates that acupressure and foot reflexology interventions can enhance sleep quality in individuals with leukemia. These findings support the effectiveness of these complementary modalities, offering targeted relief and relaxation. While these non-invasive therapies show promise in improving well-being, further research is needed to confirm and expand upon these results due to study limitations.

The effects of reflexology on symptoms in pregnancy: A systematic review of randomized controlled trials

Objective

This review assessed the effects of reflexology on symptoms in pregnancy.

Methods and analysis

PubMed, Embase, Springer, Web of Science, the Cochrane Library, and reference lists of previous systematic reviews were searched for the eligible randomized controlled trials (RCT) from the inception date of each predefined database up to May 31st, 2023. Data were extracted, and methodological quality was evaluated by the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2). The efficacy of treatment was assessed using pooled effect sizes (Hedges' g) and 95% confidence intervals (CI). Meta-analysis was performed using the RevMan 5.4 manager, and publication bias was evaluated by Begg's test.

Results

The included a total of 13 RCTs in this review, of eleven was high risk of bias and two were low, reported the effects of reflexology on low back and/or pelvic pain (LBPP), labor pain, duration of labor, anxiety, fatigue, sleep quality, constipation symptoms, and ankle and foot edema in pregnancy. The effect sizes (Hedges' g) for reflexology in labor pain, duration of labor, anxiety, fatigue, and sleep quality showed statistical significance, which the meta-analysis also confirmed except for fatigue and sleep quality due to insufficient studies.

Conclusion

Reflexology is probably effective and safe for labor pain, duration of labor, and anxiety in pregnancy, while the evidences for reflexology in LBPP, fatigue, sleep quality, constipation symptoms, and ankle and foot edema during pregnancy were insufficient. Based on the low to high quality of included studies, strong supportive evidence is not yet available. Rigorous-design and large-scale clinical trials should be conducted to provide higher-quality, reliable evidence.

[Foot reflexology for caregivers in palliative care]

Foot reflexology is the use of massage and acupressure techniques on the feet, which represent each organ of the human body. The reflexologist knows precisely the anatomy of the body and the reflex points on the feet in order to relieve and treat the person's problems. A team from the University Hospital of Clermont-Ferrand shares a very positive experience, unfortunately interrupted by the Covid-19 health crisis.

Comparing the influence of foot reflexology and fasting mimicking diet on quality of life and sleep quality in obesity hypoventilation syndrome

OBJECTIVES

Obesity hypoventilation syndrome is one of the most serious outcomes of obesity-related respiratory difficulties, resulting in higher healthcare costs as well as increased cardio-respiratory morbidity and mortality.

METHODS

Sixty-two males who had a high risk of obstructive sleep apnea according to the STOP-BANG Sleep Apnea Questionnaire were enrolled in the study. Their age is 50-60 years old, and they have a BMI of 35-40 kg/m², daytime hypercapnia, and sleep breathing problems. The patients were divided into two equal groups at random reflexology fasting-mimicking diet groups. Weight, height, waist, and neck circumference were assessed at the beginning of the study and after two months of the intervention. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), which is used to evaluate sleep quality. The Maugeri Obstructive Sleep Apnea Syndrome (MOSAS) questionnaire was used to assess a patient's quality of life.

RESULTS

There was a significant change in the MOSAS and PSQI questionnaires for both groups post-intervention, as the p-value was less than 0.05. The percentage change in the MOSAS questionnaire score and PSQI questionnaire was higher in the mimic diet group than in the reflexology group. Also, the mimic diet group's weight and neck circumference were considerably reduced after the intervention, with no change in the reflexology group.

CONCLUSIONS

Reflexology and a fasting-mimicking diet were found to have a substantial impact on enhancing the quality of life and sleep in people with obesity hypoventilation syndrome.

The Effects of Foot Reflexology on Vital Signs: A Meta-Analysis of Randomized Controlled Trials

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.

The effects of foot reflexology on pain and physiological indicators in children with leukemia under chemotherapy: a clinical trial study

BACKGROUND

Foot reflexology is a popular complementary medicine method; however, previous studies have shown conflicting results. This study aimed to investigate the impact of foot reflexology on pain and physiological responses caused by intrathecal injection of chemotherapy drugs in children with leukemia.

MATERIALS AND METHODS

This clinical trial included 80 children with leukemia. The participants received 20 min foot reflexology (10 min each foot). The primary measured outcomes included pain and physiological indicators (blood pressure and heart rate).

RESULTS

The results showed that foot reflexology had a significant effect on reducing pain (p = 0.002) and improving physiological indicators [blood pressure (p = 0.002) and heart rate (p = 0.003)].

CONCLUSION

Based on the results of the present study, which shows the positive effect of foot reflexology on the improvement of pain and physiological indicators, foot reflexology can be used as a complementary treatment along with conventional therapies.

Aromatherapy Massage vs. Foot Reflexology on the Severity of Restless Legs Syndrome in Female Patients Undergoing Hemodialysis

This study aimed to compare the effects of reflexology and aromatherapy massage on the severity of restless legs syndrome (RLS) in 105 female patients undergoing hemodialysis. A randomized placebo-controlled clinical trial was conducted in a hemodialysis center with 48 beds in a high turnover hospital in an urban area of Iran. Intervention groups received reflexology (n = 35) and aromatherapy massage using lavender essential oil (n = 35) for 24 sessions, and the placebo group (n = 35) received simple foot massage. The restless legs syndrome rating scale was used to assess RLS severity in the groups before the intervention and after 4 and 8 weeks of the interventions. Results obtained by the mixed model analysis 3 * 3 (3 groups * 3 times) revealed the significant effect of time, group, and the time-group interrelationship (p = 0.001). Aromatherapy massage reduced the RLS severity, but reflexology did not appear to cause any significant reduction in it. Therefore, we suggest that aromatherapy massage be incorporated into routine care for relieving the ailment and suffering of patients undergoing hemodialysis.