Blood pressure

Digestive System

Rhinitis

Self-help foot reflexology (See Middle-aged women.)

Stress response (See middle-aged women.)

Respiratory System

Sleep

Age Groups

Children

Men

Pregnant Women

Women

Elderly

Reflexology work saved a Danish employer US$3,300 a month in fewer sick days for employees in addition to improving the work environment. "� Reflexology had been used to help the staff of the Scandinavian Airline's Cargo Department. They employ approximately 60 people and handle 2.4 million documents a year. Here is a statement made by the employees: " 'Our work is done through computers and people spending many hours in a chair doing their work, resulting in aching shoulders and back. Since we employed our reflexologist... we have experienced a substantial decrease of people being ill and away from work. The approximate amount is 20,000 Danish kroner a month (US$3,300). It has not only a physical effect, but also a psychological effect. There is a much better atmosphere in the department, because the employees feel there is something being done about their problems... Before we used to stay at home when ill, now we see the staff go to work anyway because they know they can get a treatment and feel better.'"

Eriksen, Leila, Reflexology: Research and Effect Evaluation in Denmark, Danish Reflexologists Association, Denmark, August 1995, pp. 15 - 16

"Over a 2 year period a reflexologist employed by the Telecom firm of Taastrup, Denmark treated 156 employees who experienced positive effects on back pains, the musculo-skeletal system, headache, migraine, stomache/intestinal sufferings. Sickness leave was reduced."

Eriksen, Leila, "A Close-up View on Company Reflexology," Danish Reflexologists Association Research Committee Report, Feb., 1995

"Three reflexologists employed by the municipality treated 143 patients over a 6 month period. 79% were either cured or helped with their primary health problem. 57% were helped with secondary problems. 30% became more satisfied with their jobs and 92% wanted to continue reflexology." (http://www.fdz-intranet.dk/english/research/results.htm)

Kristensen, Karin, Rasmussen, Inge, and Moller, Elsebeth, "Take Good Care of Your Fellow Employees, Reflexology as personnel care in the �rhus District Corporation," Danish Reflexologists Association Research Committee Report, Feb., 1995 (Originally published in Zonetherapeuten, (The FDZ Journal), No. 1, 1996)

"Staff of the municipality of Ishoj was treated by a reflexologist. During 6 month the municipality saved DKK 215,00 as absenteeism was reduced with 2,500 hours as compared to the provious year."

Eriksen, Leila, "Municipal Reflexology," Danish Reflexologists Association Research Committee Report, Feb., 1995

"In a three year period 235 employees were treated for a variety of health problems. 170 reported a good effect. 60 had some effect whereas 5 had no effect. Absenteeism was reduced from 11.4 to 8.5 days per person per year, implying savings of more than 1 million Danish kroner."

Madsen, Synn�ve and Andersen, Jette, "Postal Reflexology," Danish Reflexologists Association Research Committee Report, Feb., 1995

"A report on Company Reflexology as applied in the Danish municipality of Svendborg. Involves 52 female employees. 97.5% had positive effects on their primary ailments. 77.5% on secondary problems. Medicine intake was reduce with 27.5% and absenteeism with 65.9%"

Terp, Hanne, "Municipal Reflexology in Svendborg, A study of the effect of reflexology treatment in the eastern district of the municipal of Svenborg."

Thirty eight cases of acne were ages 18 to 29. All were treated with a daily reflexology session for 10 days as a course of treatment. All were successfully cured by foot reflexotherapy work: 5 after 3 courses, 26 after 4 courses, 4 after 5 courses and 3 after 6 courses.

Dong Dahai, Xiang Xiangdong, Shi Yanling, Kong Zhifeng, Dong Congjun, "Treatment of 38 Cases of Acne with Foot Reflexotherapy," 1998 China Reflexology Symposium Report, China Reflexology Association, Beijing, pp. 62-6

BACKGROUND: Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care. OBJECTIVE: To examine whether modifying environmental stimuli by the use of calming music and hand massage affects agitated behavior in persons with dementia.

METHOD: A four group, repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music, hand massage, or calming music and hand massage simultaneously, or no intervention (control) on the frequency and type of agitated behaviors in nursing home residents with dementia (N = 68). A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors.

RESULTS: Each of the experimental interventions reduced agitation more than no intervention. The benefit was sustained and increased up to one hour following the intervention (F = 6.47, p<.01). the increase in benefit over time was similar for each intervention group. when types of agitated behaviors were examined separately, none of the interventions significantly reduced physically aggressive behaviors (f = 1.93, p=.09), while physically nonaggressive behaviors decreased during each of the interventions (F = 3.78, p< 01). No additive benefit resulted from simultaneous exposure to calming music and hand massage. At one hour following any intervention, verbally agitated behavior decreased more than no intervention.

CONCLUSION: Calming music and hand massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding, offsetting disturbing stimuli, but no additive benefit was found by combining interventions simultaneously.

Remington R. ,"Calming music and hand massage with agitated elderly," Nursing Res. 2002 Sep-Oct;51(5):317-23, University of Massachusetts, Lowell 01854, USA. rem@rem.ultranet.com PMID: 12352780

Introduction: Purpose: A randomized clinical trial with a crossover design was used to test the impact of foot reflexology on mimic foot reflexology in 28 hospitalized AIDS patients about their perception of pain and fatigue in Nonthaburee, Thailand. Sample: The sample was 67.9% (n=19) male with an age range from 22-47 years and a mean of 30.64 years. The mean score on the Piper Fatigue Scale before intervention was high (M=95.98; SD=26.73) and the mean Pain Descriptor Intensity Scale was low (M=8.64; SD=-6.05).

Methods: Research nurses were trained in the procedures of true foot reflexology and mimic foot reflexology. Each procedure required 30 minutes (15 minutes per leg). Patients had either true or mimic reflexology once a day for four days, each receiving a total of two session of each procedure in random order. The outcome variables included self-report of fatigue and pain and vital signs pre and post treatment.

Results: There were significant differences between the true foot and mimic reflexology on the fatigue and pain descriptive intensity scale, but not on a 1-item numeric pain intensity scale. The only vital sign difference was lower systolic blood pressure but the difference was not clinically meaningful. Conclusion True foot reflexology may offer a low cost, effective nursing intervention to reduce the symptom of fatigue and pain for hospitalized AIDS patients. The numeric pain intensity item was reduced in both groups, but not significantly, and this may be due to an inadequate power in the study to detect a potential difference. Foot reflexology is a way to enhance the nurse patient interrelationship. It offers a strategy to fulfill the goals for human touch and holistic nursing care. It can be performed at any location, is non-invasive, and does not interfere with patients' privacy. Foot reflexology can also be taught to family members and become part of family self-care for people living with HIV/AIDS

Ounprasertpong LA., Internatinal Conference AIDS. 2004 Jul 11-16; 15: abstract no. ThPeD7743. Ramathibodi Hospital,Mahidol University, Bangkok, Thailand (http://gateway.nlm.nih.gov?MeetingAbstracts/102281513.html)

Alzheimer's patients saw a reduction in body stiffness and arthritis as well as alleviation of the illness's symptoms of restlessness and wandering following reflexology work.

"Old age converts to the New Age," Daily Mail (England), September 14, 1995

Ninety-five cases of amenorrhea were divided into two groups, a foot reflex therapy treatment group of 50 and a control group of 45 with participants using traditional Chinese medicine tablets. The effective rate of the foot reflex therapy group was 96% compared to the control group rate of 33%.

Xiu-hua, Xu, "Analysis of 50 Cases of Amenorrhea Treated by Foot Reflex Therapy," (19)96 Beijing International Reflexology Conference (Report), China Preventive Medical Association and the Chinese Society of Reflexology, Beijing, 1996, p. 36

A forty-six year-old woman with megaloblastic anemia was treated with foot reflexology. At the start of foot reflexology treatment her WBC/mm measured 4200 and hemoplobin 5.5. After three months of foot reflexology treatment she could walk. WBC/mm measured 8200 and hemoglobin measured 11.0.

Yong-gui, Yang, "A Case Report on Treatment of Megaloblastic Anemia with Paraplegia by Foot Reflexology," 1994 China Reflexology Symposium Report, China Reflexology Association, Beijing, p. 48 (Worker's Hospital of Zhuhai Chentang Enterprise, Tianjin, China)

Foot reflexology applied during an active onset of angina and observed with EKG showed disappearance of symptoms and a change to T-waves in V1.3 elevated from depressed T-waves and T-waves in V5 inverted upright from an inversion of T-waves. Following a 10-day course of daily 50 minute foot reflexology sessions, nocturnal attacks of premature beats were relieved though premature beats still occurred occasionally.

Bing-zhao, Zhang, "Effect of Foot Massage on a Patient with Angina Observing with EKG; A Case Report," 1994 China Reflexology Symposium Report, China Reflexology Association, Beijing, p. 53 (Outpatient Dept., Senile Convalescent Hospital, Shenyang, China)

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.

McVicar AJ, Greenwood CR, Fewell D'Arcy V, Chandrasekharan S, Alldridge LC, "Evaluation, of anxiety cortisol and melatonin secretion following reflexology treatment: A pilot study in healthy individuals," Complementary Therapeutic Clinical Practice 2007 Aug;13(3):137-45 Institute of Health and Social Care, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ, UK. PMID: 17631256

See Hyperlipimia, Shou-qing, Gui; Yuna-zhong, Li; Xian-qing, Xiao; Chen Shengping and Gu Xuejauna (The People's Hospital, Xianning District, Hubei Province), Zhu Shanhan, Liao Enguang (The People's Hospital of Hubei Province) and Luo Desheng (Xianning College of Medicine, Hubei Province), "Impact of the Massotherapy Applied to Foot Reflexes on Blood Fat of Human Body," 1998 China Reflexology Symposium Report, China Reflexology Association, Beijing, pp. 34-37

Forty-two cases of acromioclavicular (shoulder) arthritis received thirty minute sessions of foot reflexology once a day for 15 days. At the finish, 8 were "cured," 20 were "distinctly effective" and 14 cases were "improved."

Zhi-xian, Ma and Jin-li, Zhang, "Foot Reflexology in the Treatment of Acromioclavicular Arthritis, (19)96 Beijing International Reflexology Conference (Report), China Preventive Medical Association and the Chinese Society of Reflexology, Beijing, 1996, p. 55

"Ten weeks of either active or simulated (placebo) reflexology were compared in an otherwise blind, controlled trial of 40 patients with asthma. Results: Objective lung function tests did not change. Subjective scores and bronchial sensitivity to histamine improved on both regimens but no differences were found in the groups receiving active or placebo reflexology. However, a trend in favour of reflexology became significant when a supplementary analysis of symptom diaries was carried out. At the same time a significant pattern compatible with subconscious un-blinding was found. Discussion: We found no evidence that reflexology has a specific effect on asthma beyond a placebo influence."

Brygge T, Heinig JH, Collins P, Ronborg SM, Gehrchen PM, Hilden J, Heegaard S, Poulsen LK "Zone Therapy and Asthma," Ugeskr Laeger, 2002, Apr. 29; 164(18):2405-10- Danish language (PMID: 12024846)

"Thirty patients with proved bronchial asthma receiving treatment with inhaled steroid in dosages of less than 1,000 micrograms daily were subdivided at random into two groups of 15 patients. One group received foot zone therapy and the other merely uniform clinical care but without "placebo foot zone therapy". The "active" group received a total of ten foot zone therapy sessions of one hour at intervals of one week. The asthmatic symptoms, consumption of medicine and the objective pulmonary function parameters were followed-up during the subsequent six months. Decrease in consumption of beta-2-agonists and increase in peak-flow levels were observed in the group which had received foot zone therapy, but the same changes were observed in the control group. The authors do not find that this investigation demonstrates that foot zone therapy is of effect on the disease bronchial asthma. They conclude, however, that the favourable effect in both of the groups are due to increased care and control which occurred in both patient groups."

Petersen LN, Faurschou P, Olsen OT, Svendsen UG. Ugeskr Laeger. 1992 Jul 20;154(30):2065-8. Ugeskr Laeger. 1993 Feb 1;155(5):329-31. Lungemedicinsk/allergologisk afdeling Y, Kobenhavns Amts Sygehus i Gentofte. PMID: 1509577

Following the daily application of foot reflexology for 40 to 50 minutes over a period of two to twelve weeks, all 45 patients with infantile bronchial asthma (ages 1 to 7) experienced a disappearance of symptoms.

Hui-xian, Duanmu, "A Clinical Analysis of Foot Reflexomassage for Treatment of 45 Cases with Infantile Asthma, 1994 China Reflexology Symposium Report, China Reflexology Association, Beijing, October 1994, pp. 41 - 43 (Health Center for Women and Children, Haimen, Jiangsu Province, China)

"Proactive health-care services emphasize health promotion and the prevention of disabling conditions, Currently in Thai society, the number of elderly with deteriorating health has increased. Therefore, self-care health promotion activities have become essential in order for the elderly to maintain their well-being. The purpose of this study was to investigate the effects of foot massage with biofeedback. Foot massage, a Thai primary self-care custom, has been found to enhance blood circulation, relaxation, and one's own healing power. In addition, touch has been found to stimulate secretion of endorphins and reduce pain and anxiety. It appears therefore that foot massage, or reflexology, promotes a healthy lifestyle for all age groups.

"An experimental study, utilizing a pilot project in elderly health care, was employed to investigate the effects of biofeedback using foot massage A pretest/post-test quasi-experimental design was used. The sample consisted of four mean and 16 women (age group 61-69). Four trained researchers massaged the feet of the subjects and measured vital-sign changes. Biofeedback was also investigated before and after the foot massages. Results showed that the average biofeedback and temperature were lower before than after the foot massage (P<0.01). the average pulse rate, respiratory rate and blood pressure, however, were found to be higher before rather than after the foot massage (p<0.01). it was concluded that the foot massage provided good circulation, relaxation and comfort. all subjects expressed positive feelings when they received the foot massage (i. e. "it is very nice that foot massage can relieve my joint pain, i an happy and comfortable.") these findings appear to indicate that foot massage is beneficial both for physical and mental conditions. foot massage, however, is just one key to achieving a full range of primary health-care services. it needs to no only be performed by nurses. families also, can provide foot massage for the elderly, anywhere and anytime."

Jirayingmongkol P, Chantein S, Phengchomjan N, Bhanggananda N, "The effect of foot massage (reflexology) with biofeedback: a pilot study to enhance health promotion," Nursing Health Science, 2002 Aug;4(Suppl):A4 (PMID: 12153420)

Of 593 women who gave birth at Gentofte County Hospital (Great Britain) in 1988, 103 chose reflexology as an alternative to both pain killing drugs and to labor stimulating and inducing drugs. Of sixty-eight women who chose reflexology with no analgesic drugs, sixty one (89.71%) stated that reflexology had helped reduce pain., six (8.82%) felt no effect, and, one had increased pain in spite of reflexology treatment. Four of the sixty-one women who were helped by reflexology also required pain medication. Of forty-nine women who chose reflexology to stimulate labor, twenty-four gave birth without additional drug treatment. Fourteen women who were candidates for surgical delivery, received reflexology treatment between 30 and 60 minutes of birth. Eleven (78.57%) were then able to discharge the placenta. The other three had it surgically removed. All participants, except one, found the reflexology treatments extremely pleasant.

"Easier Births Using Reflexology." by Gabriella Bering Liisberg, "Tidsskrift for Jordemodre," No. 3, 1989.

Thirty-seven of 64 pregnant women, who were offered free reflexology, completed the set course of ten treatments. The effects of reflexology on labor outcomes were perceived as outstanding. Some had labor times of only 2 hours, some 3 hours. The 20 - 25 year olds had an average time of First stage labor of 5 or 6 hours. The 26 - 30 year olds seemed to have the longest labors. In total, the average first stage was 5 hours, second stage 16 minutes, and third stage 7 minutes. This is compared to textbook figures of 16 to 24 hours' first stage, and, 1 to 2 hour's second stage.

"The Effects of Reflexology on Labour Outcome," Dr. Gowri Motha and Dr. Jane McGrath, Forest Gate, London, England, Nursing Times, Oct. 11, 1989

The objective of this study was to investigate the association of antenatal reflexology with different outcomes in the intranatal period. A convenience sample of 150 low risk primigravid women (reflexology group n = 50, control group receiving no reflexology treatment n = 100) was included. The key variables of interest were onset of labour, duration of labour, analgesia used and mode of delivery. The findings showed there was no significant difference in the onset of labour or duration of labour between the two groups. The group who had four or more reflexology treatments had a reduced length of labour but this was not statistically significant. There was a significant difference in the use of Entonox between the two groups with the reflexology group having a lower uptake. Fewer women in the reflexology group had a normal labour with a higher percentage of women having a forceps delivery.

McNeill JA, Alderdice FA, McMurray F. A retrospective cohort study exploring the relationship between antenatal reflexology and intranatal outcomes. Complementary Therapeutic Clinical Practice 2006; 12: 119�25.

The authors treated 108 cases of normal primapara with foot reflexology (as treatment group) to alleviate pain during delivery. A control group of 105 normal primapara treated with intravenous drip of 500 ml. of 10% glucose plus 3.0 Vitamin C injection was set to compare the therapeutic effect. Result" The effective rate of the treatment group was 94.4% and the average birth process of the treatment group was 2.48 + 1.48 hours, which was shorter than that of the control group (3.32 + 1.19 hours). The results indicated the feasibility of foot-reflexology being used as an analgesia during delivery.

Zhang Changlong, "The application of foot reflexology in relieving labor pains," China Reflexology,Centre du Documentation du Groupes d'Etudes et de Recherches en Acupuncture," Registre des essais comaratifs randomises en acupuncture publies en 2000-2001, March 1 2001 (acudoc@wanado. fr) (http://www.meridiens.org/ECR/ecr2000.pdf)

One quarter of the midwifery staff at the hospital are trained in reflexology, a 40-hour certificate course on reflexology and uses in midwifery practice endorsed by the national midwifery board. The staff trained with Susanne Enzer, author of Maternity Reflexology (1997) and Reflexology; A Tool for Midwives (2000).

("Midwifery around the World, Midwives of the Central Coast of New South Wales, Australia, Midwifery Today E-News, Vol. 3, Issue 7, February, 14, 2001)

"90% of 68 women had a positive effect of reflexology as a pain killer during delivery. 11 out of 14 with retention of the placenta avoided operation."Sorrig, Kirsten, "Easier Births Using Reflexology, "Danish Reflexologists Association, Research Committee Report, Feb., 1995 (Originally published in the Danish daily newspaper "Berlingske Tidende," July 15, 1988)

The tradition of stone stepping first came to the attention of Oregon Research Institute (ORI) researchers when researcher Fuzhong Li, a native of China, visited Shangha and saw people walking along cobblestone paths in bare or stocking feet. When he was told they did it for health reasons, he saw the potential for studying its impact on the aging.

A randomized, controlled study of 48 individuals was conducted at non-profit ORI in Eugene, Oregon. It tested the results of cobblestone-mat walking three times a week with 45 minute sessions over 8 weeks. Made of a synthetic material, the mats are 6 feet long and 1.5 feet wide.

The study "indicated that older adults experienced significant improvements in mental and physical well-being, including reductions in blood pressure and pain levels. � Elderly participants in the study experienced considerable improvements in their ability to perform 'activities of daily living,' increased psychosocial well-being, and significantly reduced daytime sleepiness and pain. Participants also reported greatly improved perceptions of control over falls and had reductions in resting diastolic blood pressure."

Perhaps most importantly for those who work with the elderly, the cobblestone-mat walking meets a need "to develop simple, convenient, and readily accessible exercise programs that will reduce health problems and improve the quality of life of the aging population." Exit interviews indicated that participants "enjoyed the activity (90%), � "would continue the activity if it were available (75%)� and "(90%) would recommend the activity to friends or relatives."

Fuzhong Li, Peter Harmer, Nicole L. Wilson, K. John Fisher, "Healthy Benefits of Cobblestone-Mat Walking: Preliminary Findings," Journal of Aging and Physical Activity, 11(4), October 2003, p. 1

Three different methods were used to work with pneumonia and bronchitis in children. Foot reflexology was utilized in 103 cases, antibiotics in 40 cases and antibiotics with Chinese herbs in 68 cases. Foot reflexology was found to be more effective than either of the others.

Hui-ming, Wu, "Perspectives of foot reflex based on foot massage for treatment of pneumonia and bronchitis in childhood," (19)96 Beijing International Reflexology Conference (Report), the China Preventive Medical Association and the Chinese Society of Reflexology, Beijing, p. 42

Cancer: Guided imagery, reflexology, reminiscence therapy

The purpose of this observational pre-/post test design was to compare outcomes of patients undergoing chemotherapy for cancer who received standard care with those who received standard care plus an eight-week program of complementary therapies, including: 91) guided imagery (healing images set to music), and/or (2) reflexology (10-minute massage of each hand or foot)., and/or (3) reminiscence therapy (family storytelling discussions between the patient and the family caregiver). To be eligible, participants had to be 21 years of age or older, and be willing to engage in the complementary therapy program during chemotherapy. Family caregivers participated in the intervention with their family member (patient). An educational session for the complementary therapies was provided to the family caregiver and patient at the initial chemotherapy appointment, with 4 reinforcement sessions over an 8-week period. The Wyatt Quality of Life Model guided this study. The intervention group was compared on the following variables: depression, anxiety, spirituality, and patients' reports of quality of life. Findings indicate that: (1) patients who used one or more complementary therapy experienced lowered levels of depression (<.024) and anxiety (p<.006) over time; and (2) patients who used one or more complementary therapies experienced increased levels of spirituality (p<.019), emotional quality of life (p<.000) and total quality of life (p<.000). findings from this study will be used as a model for designing future randomizes clinical trials that utilize complementary therapies with cancer patients who are undergoing treatment. an: mn030250

Gwen K. Wyatt, Sharon Kozachik, Charles W. Given, Barbara Given, "Outcomes of Complementary Therapy Use by Cancer Patients and Family Members," Midwest Nursing Research Society Conference, 2003

Results of study: Reflexology modifies the distressing symptoms of pain and nausea in patients hospitalized with cancer. "87 patients participated in the study and each received a 10-minute reflexology foot massage (5 minutes per foot). The results revealed that the treatments produced a significant and immediate effect on the patients' perceptions of pain, nausea and relaxation when measured with a visual analog scale. The use of reflexology foot massage as a complementary method is recommended as a relatively simpler nursing intervention for patients experiencing nausea or pain related to the cancer experience. The results were so positive that the researchers recommend that further research using larger numbers of patients in controlled clinical trials into its effectiveness of reflexology in alleviating pain, nausea and anxiety in the management of these symptoms by the family at home is warranted."

Grealish, L. Lomasney, A., Whiteman, B., "Foot Massage: A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer," Cancer Nurse 2000, June;23(3):237-43 (On-line review: "Reflexology Used for Cancer Patients," Internet Health Library, October 11, 2000)

Results of study: 100% of the reflexology group benefited from an improvement in quality of life: appearance, appetite, breathing, communication (doctors), communication (family), communication (nurses), concentration, constipation, diarrhea, fear of future, isolation, micturition, mobility, mood, nausea, pain, sleep and tiredness. Within the reflexology group, the participants reported an improvement in all components of the quality of life scale compared to 67. 5 in the placebo group. Nevertheless, this study would suggest that the provision of reflexology for palliative patients within the general setting could be beneficial. Not only did the patients in this study enjoy the intervention, they were also 'relaxed,' 'comforted' and achieved relief from some of their symptoms.

Hodgson, H. "Does reflexology impact on cancer patients' quality of life?," Apr. 2000, Nursing Standard, 14, 31, pp. 33-38

Awareness has increased among health-care professionals, patients and the general public of the importance of an holistic approach to cancer care. Psychosocial interventions, including complementary therapies, may help to improve the quality of life (QoL) of people with cancer by helping to reduce the distress associated with the diagnosis and treatment of cancer and by facilitating improved psychological adjustment to the experience of cancer. The following article presents anecdotal findings at ARC Cancer Support Centre Dublin, Ireland, of clients' perceptions of the benefits of reflexology interventions on their QoL. Reflexology interventions were perceived to impact positively upon clients' levels of impairment and functional status, including physical and psychological function, with implications for general health perceptions. The paper discusses how these findings might form the basis of further, more rigorous evaluation of the benefits of reflexology for people with cancer at ARC Cancer Support Centre.

Complementary Therapeutic Nursing Midwifery. 2002 May;8(2):69-76. Clients' perceptions of the benefits of reflexology on their quality of life. Wright S, Courtney U, Donnelly C, Kenny T, Lavin C.ARC Cancer Support Centre, Dublin, Ireland. PMID: 12188160

Results of study: Foot reflexology alleviated anxiety and pain for twenty-three patients with breast and lung cancer. Researchers noted a significant decrease in anxiety for patients diagnosed with breast or lung cancer and a significant decrease in pain for patients with breast cancer. "This has important implications for nursing practice as both professionals and lay people can be taught reflexology. Reflexology is a simple technique for human touch which can be performed anywhere, requires no special equipment, is non-invasive and does not interfere with patients' privacy."

Stephenson, N. L., Weinrich, S. P. and Tavakoli, A. S., "The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer," Oncology Nursing Forum. 2000, Jan.-Feb.;27(1):67-72

PURPOSE/OBJECTIVES: To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. DESIGN: The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. SETTING: Four hospitals in the southeastern United States. SAMPLE: 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino.

METHODS: The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners.

MAIN RESEARCH VARIABLES: Pain and anxiety.

FINDINGS: Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety.

CONCLUSIONS: A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention.

IMPLICATIONS FOR NURSING: Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.

Stephenson NL, Swanson M, Dalton J, Keefe FJ, Engelke M. Oncology Nursing Forum. 2007 Jan;34(1):127-32. School of Nursing, East Carolina University, Greenville, NC, USA. stephensonn@mail.ecu.edu PMID: 17562639

"Thirty-six oncology inpatients participated in this third pilot study investigating the effects of foot reflexology in which equianalgesic dosing was calculated. Foot reflexology was found to have a positive immediate effect for patients with metastatic cancer who report pain, although there was no statistically significant effect at 3 hours after intervention or at 24 hours after intervention. Further study is suggested for foot reflexology delivered by family in the homes for management of cancer pain."

Stephenson N, Dalton JA, Carlson J, "The effect of foot reflexology on pain in patients with metastatic cancer," Appl Nursing Res. 2003 Nov;16(4):284-6 PMID: 14608562

"The purpose of study was to determine the effects of hand massage on nausea, vomiting and anxiety in acute lymphocytic leukemia children with high dose chemotherapy. The subjects of this study consist of 15 in experimental group and 15 in control group. All subjects were diagnosed as acute lymphocytic leukemia and admitted for high dose chemotherapy at the C University Medical Center in Seoul, Korea. The hand massage was performed for 10 minutes twice a day through three days in the experimental group, not in the control group. To evaluate the effects of hand massage, the Index of Nausea, Vomiting by Rhodes et al and State-Trait Anxiety Inventory for children by Spielberger were measured before and after the experiment in both groups. Also, the level of anxiety as measured by blood pressure, pulse rate were measured before and after hand massage therapy.

"Result of the study were as follows;1. The score of nausea, vomiting decreased in the experimental group, not in the control group. There was a significant difference of nausea, vomiting between the two groups. 2. The score of state anxiety decreased in the experimental group and increased in the control group. After hand massage, the state anxiety of the experimental group was significantly more positive than the control group at the 2nd measurement 3. There was no significant difference of pulse rate between the two groups. 4. systolic blood pressure decreased in the experimental group and some increased in the control group. There was a significant difference of systolic blood pressure between the two groups. 5. The level of diastolic blood pressure in the two groups was significantly decreased over time.

"In conclusion, hand massage could be effective in decreasing nausea, vomiting, state anxiety, pulse rate and blood pressure of acute leukemia children receiving high dose chemotherapy."

Ji-Eun Han, Master, RN, Young-Im Moon, PhD, and Ho-Ran Park, PhD. College of Nursing, Catholic University of Korea, Seoul, none, South Korea, "Effect of Hand Massage on Nausea, Vomiting and Anxiety of Childhood Acute Lymphocytic Leukemia with High Dose Chemotherapy," Presented at Back to Evidence-Based Nursing: Strategies for Improving Practice, Sigma Theta Tau International, July 21, 2004

Purpose: The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy.

Method: The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program.

Results: There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times. "Conclusion: Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy.

Yang JH., "The effects of foot reflexology on nausea, vomiting and fatigue of breast cancer patients undergoing chemotherapy" (Korean), Taehan Kanho Hakhoe Chi. 2005 Feb;35(1):177-85

Cancer (Vital Signs, Fatigue and Mood in Cancer Patients receiving Chemotherapy)�

PURPOSE: This study was done to investigate the effect of foot reflexology on vital signs, general fatigue, mood and foot fatigue in cancer patients receiving chemotherapy. METHOD: Data were collected from a convenience sample of 11 patients who were admitted at S and E University Hospital. Changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate(PR), general fatigue, mood status, and foot fatigue between pre and post foot reflexology were analyzed using Wilcoxon signed rank test and Friedman test at 0.05 level of significance. RESULTS: There were significant differences in the SBP(p=.009), DBP(p=.014), PR(p=.015), general fatigue (p=.015), mood status(p=.007), and foot fatigue(p=.007) between pre and post foot reflexology. CONCLUSION: Foot reflexology can improve vital signs, general/foot fatigue, and mood status, therefore we recommend to use foot reflexology as an effective nursing intervention in cancer patients receiving chemotherapy.

Won JS, Jeong IS, Kim JS, Kim KS, "Effect of Foot Reflexology on Vital Signs, Fatigue and Mood in Cancer Patients Receiving Chemotherapy," J Korean Acad Fundam Nurs. 2002 Apr;9(1):16-26. Korean; Department of Nursing, Seoul Health College, Korea; Department of Nursing, College of Medicine, Pusan National University, Korea; Head Nurs of GS Dept, Dondaemoon Hospital of Ewha Woman's University, Korea; College of Nursing, Seoul National University, Korea. kimks@snu.ac.kr

In Switzerland, many new nurses are taught this approach. When applied skillfully, a reflexology massage is pleasantly relaxing and able to diminish painful sensations in the body. Given the number of uncontrollable variables involved in the decrease of pain and the establishment of a feeling of relaxation, our small study has no scientific value. It was only intended to motivate nurses to look for ways to integrate aspects of alternative care in the management of terminal patients. ... Our purpose for using reflexology with these patients was to decrease their pain but we soon realized the beneficial effect of reflexology on the morale of patients and families. Something was being done for them. Patients expressed feelings of being less abandoned and the families expressed satisfaction at seeing that something painless existed that could aid their relative. In three situations we taught a relative how to use reflexology and the benefit seemed to have been as important for the relative as for the patient. ... Patients' comments about reflexology seem to show that it could be one way for them to feel this support and to have a helping presence near them in their last days.

(Dobbs, Barbara Zeller, "Alternative health approaches," Nursing Mirror (England), Vol. 160, No. 9, Feb. 27, 1985)(Can Nurse 82: 39-41 (1986) PMID: 3634658, MUID: 86189470)

AIM: To examine the effectiveness of reflexology foot massage in hospitalized cancer patients undergoing second or third chemotherapy cycles.

BACKGROUND: Since the late-1970s, studies have been conducted to assess the efficacy of behavioral and relaxation approaches in controlling nausea/vomiting, anxiety and other side-effects associated with chemotherapy.

METHODS: The study consisted of 30 patients being admitted to the oncology unit at a Scientific Research Hospital in Italy. Only 15 of the 30 participants received therapeutic massage. The subjects' self-reports of anxiety (measured by the Spielberger State-Trait Anxiety Inventory) were recorded before, after and 24 hours after the intervention.

RESULTS: There was an average decrease of 7.9 points on the state-anxiety scale in the treatment group and of 0.8 points in the control group (P < 0.0001).

CONCLUSIONS: Reflexology foot massage can be considered a support treatment used in combination with traditional medical treatments and executed by an expert, qualified person to help cancer patients receiving chemotherapy feel better and also cope better with their disease.

Quattrin, R, Zanini A, Buchini S, Turello D, Annunziata D, Vidotti, C, Colobatti A, Brusagerro S, "Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes" Journal of Nursing Management 2006 Mar;14(2):96-105 Chair of Hygiene, DPMSC School of Medicine, University of Udine, Udine, Italy. r.quattrin@med.uniud.it PMID: 16487421

BACKGROUND: Fatigue is one of the most distressful symptoms experienced by patients with advanced cancer. Aromatherapy, footsoak, and reflexology are popular health care modality treatments in Japan, however, the effectiveness of each treatment for cancer-related fatigue has not been fully established.

DESIGN AND SUBJECTS: To investigate the effectiveness of combined modality treatment consisting of aromatherapy, footsoak, and reflexology against fatigue, an open study was performed in 20 terminally ill patients with cancer. After a patch test was performed, patients received aromatherapy that was accompanied with footsoak in warm water containing lavender essential oil for 3 minutes, followed by reflexology treatment with jojoba oil containing lavender for 10 min. Fatigue was evaluated using the Cancer Fatigue Scale (CFS) before, 1 hour after, and 4 hours after treatment.

RESULTS: Total CFS scores improved significantly after this treatment (from 25.6 +/- 11.0 to 18.1 +/- 10.0, p < 0.001). among three cfs subscales, physical and cognitive subscale scores were reduced significantly (11.3 +/- 6.1 to 6.7 +/- 6.1, p < 0.001; 4.5 +/- 3.2 to 2.4 +/- 2.4, p < 0.001). no adverse effects were experienced. because all patients desired to continue this treatment, they received treatment eight times on average.

CONCLUSIONS: Combined modality treatment consisting of aromatherapy, footsoak, and reflexology appears to be effective for alleviating fatigue in terminally ill cancer patients. To confirm safety and effectiveness of this combined modality treatment, further investigation including randomized treatment assignment is warranted.

Kohara H, Miyauchi T, Suehiro Y, Ueoka H, Takeyama H, Morita T., "Combined modality treatment of aromatherapy, footsoak, and reflexology relieves fatigue in patients with cancer," Journal Palliative Medicine, 2004 Dec;7(6):791-6. (Department of Internal Medicine, Palliative Care Unit, National Sanyo Hospital, Yamaguchi, Japan. hkohara@bk4.so-net.ne.jp) PMID: 15684846

BACKGROUND: Complementary and alternative medicine (CAM) is used by one in ten of the UK population yearly and 47% during their lifetime. One-third of cancer patients seek some form of CAM treatment during their illness. AIM: To evaluate the use of and attitudes to CAM among patients and all healthcare staff in the Southampton Cancer Care Directorate (UK).

SETTING: The Royal South Hants Hospital, Countess Mountbatten and Oakhaven Hospices.

METHOD: A questionnaire-based survey performed between January 2001 and March 2001.

RESULTS: Two hundred and seventy questionnaires were distributed to patients and 162 responses received. The distribution of cancers within this population was generally typical of those in the community. Thirty-two percent (n = 52) were receiving some form of CAM, half of those receiving CAM were in hospice care. Forty-nine percent of those not receiving CAM would like to, and 76% of all patients would be prepared to pay for this treatment. The five most popular treatments were massage, nutrition, aromatherapy, relaxation and reflexology. While most patients expected CAM to palliate their symptoms (n = 149, 92%), some had unrealistic expectations that CAM would cure their cancer (n = 13, 8%). Four hundred and forty-eight staff questionnaires were distributed and 196 responses were received: 148 (75.5%) from nurses. Twenty-one percent of staff responding had CAM training and two-thirds would like to receive training. The most popular therapies used by staff were the same as those identified by the patients. Ninety-nine percent of staff and 98.5% of patients wished to see CAM treatments introduced into service provision within the Cancer Care Directorate.

CONCLUSIONS: The use of CAM for cancer care in Southampton is widespread and consistent with its use nationally. There is a clearly expressed need for CAM treatments by patients and a willingness to pay. Two-thirds of the cancer care staff responding wished to receive training in and provide these therapies. There are some misconceptions among patients about the role of CAM in cancer care which need to be discussed and resolved. We believe that all cancer care units should have clear policies on the use of CAM for cancer patients.

Lewith GT, Broomfield J, Prescott P. �Complementary cancer care in Southampton: a survey of staff and patients," Complementary Therapeutic Medicine 2002 Jun;10(2):100-6. (University of Southampton, GL3@soton.ac.uk) PMID: 12481958

PURPOSE/OBJECTIVES: To evaluate patient characteristics to predict selection and maintenance of a complementary therapy and the feasibility of a randomized clinical trial (RCT) of complementary therapies. DESIGN: Quasi-experimental, exploratory study, unblinded and nonrandomized.

SETTING: A comprehensive cancer center in Michigan.

SAMPLE: 96 patients undergoing chemotherapy, predominantly Caucasian women.

METHODS: Consenting patients with caregivers could choose a reflexology, guided imagery, guided imagery plus reflexology, or interview-only group. Patients without caregivers were restricted to guided imagery or interview-only groups. Data on demographics, depression, anxiety, and functional status were collected using established instruments.

MAIN RESEARCH VARIABLES: Quality of life (QOL) and patient characteristics in relation to complementary therapy choice.

FINDINGS: Patients who chose a complementary therapy rather than an interview only tended to be older and in worse health and had higher percentages of lung cancer, late-stage cancers, higher anxiety, depressive symptoms, and physical limitations at baseline. Patients lost from the guided imagery and guided imagery plus reflexology groups had greater symptom severity, depressive symptoms and anxiety, and worse physical and emotional well-being than those lost from the reflexology group.

CONCLUSIONS: Patient characteristics influence choice of complementary therapies, highlighting the need for RCTs to evaluate the true effect of complementary therapies on the QOL of patients with cancer. Further research on complementary therapies can help healthcare providers identify patients who are likely to benefit most by addressing nursing-sensitive outcomes.

IMPLICATIONS FOR NURSING: An RCT of reflexology as a single therapy for females with breast cancer is most feasible compared to other complementary therapies.

Wyatt G., Sikorskii A, Siddiqi A, Given CW, "Feasibility of a reflexology and guided imagery during chemotherapy: results of a quasi-experiemental study, Oncology Nursing Forum, 2007 May; 34(3):635-42 The College of Nursing, Michigan State University, East Lansing, MI, USA. gwyatt@msu.edu PMID: 17573322

B. S. M. Frankel of the Department of Physiology, University of Leeds, England has conducted a pilot study "to identify if reflexology and foot massage affect the physiology of the body by measuring baroreceptor reflex sensitivity, blood pressure, and sinus arrhythmia." Ten recipients of reflexology work and ten recipients of foot massage work were compared to a control group of four individuals in a single blind study.

Frankel found that "The reflexology and foot massage groups showed significantly greater reductions in baroreceptor reflex sensitivity compared to the control group. This study found no significant difference in blood pressure after intervention. The frequency of sinus arrhythmia after reflexology and foot massage increased by 43.9% and 34.1% respectively."

The study examines the link between pressure to the feet and baroreceptors of the heart. The baroreceptor reflex "maintains blood pressure and homeostasis by changes in the autonomic outflow." It effects behavior such as "sleep, mental arithmetic and exercise" and "physiological processes and reflexes such as aging and the defense reflex." It also interacts with certain diseases such as heart failure. The implication of the study is that pressure to the feet impacts these behaviors and processes. Frankel's conclusion is that a neuro theory of reflexology should be considered. He states that "foot massage and reflexology could alter the baroreceptor sensitivity by stimulating the sensory nervous system in the feet." He suggests a mechanism in the nervous system by which reflexology and touch itself may be "therapeutic." The pressure sensors in the feet are linked to the same part of the brain as the baroreceptor reflex. He hypothesizes that this could be the point of influence.

Frankel, B. S. M., "The effect of reflexology on baroreceptor reflex sensitivity, blood pressure and sinus arrhythmia," Complementary Therapies in Medicine, Churchill, London, 1997, Vol. 5, pp. 80-84

16 cases of cerebral palsy ages 3 months to 3 years with Gessel growth rate scores of 41 to 55 were divided into two groups. The treatment group received foot massage for 30 days. In the treated group and there was an increase in growth quotient of 30-35 in those 3 to 9 months old and 10-15 with those form 1.5 to 3 years. In the control group the increase in growth quotient was 10-16 for 3-9 months and 9-15 for 1.5 to 3 years. It was suggested that the younger the patient, the better the effect.

Rong-zhi, Wang, "An Approach to Treatment of Cerebral Palsy of Children by Foot Massage," A Clinical Analysis of 132 Cases," (19)96 Beijing International Reflexology Conference (Report), China Preventive Medical Association and the Chinese Society of Reflexology, Beijing, 1996, p. 26

A total of 80 cases diagnosed with nerve root type or vertebral artery type of cervical spondylopathy were divided into a control group of 28 and a treatment group to 52. The control group was treated with traction while in a seated position "with the neck flexed anteriorly of 20-30 degrees in a traction frame with the occipus and maxilla fixed with bandage" for twenty minutes once a day. The treatment group received a 30 - 40 minute session of foot reflexology once a day for twelve days (except Sunday).

Results: There was no significant difference between the control (92.1% effectiveness) and treatment (98.1% effectiveness) groups for clinical effectiveness but the clinical cure rate was higher in the treatment group (48.1%) than the control group (28.95%). A difference was also found in free radicals in the two groups. Before the study the two groups showed no significant difference in blood SOD, GHtal anti-oxidation activities and MDA content. After treatment the parameters related to free radicals showed significant or quite significant in comparison of the treatment group to the control group. Of the 52 in the treatment group, 25 were cured of their cervical problem, 19 were significantly effected, 7 were effected and 1 experienced no effect.

Shouqing, Gui; Changlong, Zhang and Desheng, Luo, "A Controlled Clinical Observation on Foot Reflexology Treatment for Cervical Spondylopathy," 1996 China Reflexology Symposium Report, China Reflexology Association, Beijing, pp. 99-103

Margaret Berker, a qualified reflexologist and member of the British Reflexology Association conducted an interesting small-scale study at the Cardiac Unit of the Queen Elizabeth hospital, Birmingham, UK, into the effects of reflexology on a group of four patients suffering from chest pain.

The patients were obtained from a consultant; all had all experienced pain for periods ranging between 18 months and 13 years and, cardiac catheterizations revealed that none of the patients had any identifiable disease of the cardiac arteries. Furthermore, none of the patients had had reflexology treatment prior to the study, nor were they encouraged to believe that the treatment would 'cure' their condition.

Reflexology treatments were given weekly over a period of eight weeks and the patients were asked to keep a diary to record their chest pain before and after treatments which specified (a) the number of episodes, (b) the intensity of the pain and (c) the duration of the pain.

Analysis of the data revealed that all of the patients recorded positive results; three of the four experienced a complete relief from their original symptoms after nine months and the remaining patient reported a reduction in pain.