©2002 Kunz and Kunz
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Research methodology is once again an issue in reflexology research. Several recent studies have found reflexology not to be effective or as effective as nonspecific foot massage. A recent study (see below) on reflexology and menopause reported that foot reflexology was not found to be more effective than nonspecific foot massage. Nine reflexology or foot massage sessions were provided over 19 weeks. Chinese studies report effectiveness when reflexology was applied - daily. See below.
Chinese researchers have found how technique is applied to be important in obtaining results with reflexology. Frequency, duration and intensity of technique application were previously discussed in relationship to studies (See Jan. 2002 Reflexions.) Now strength of stimulation itself may be an issue in reflexology research. It should be considered in designing and reporting reflexology research.
One group of researchers found that the amount of pressure - "strength of stimulus" - utilized in reflexology work created different responses within the body. Pulse rate, respiration and oxygen saturation of blood were measured following the application of were measured (1) in a resting state, (2) with the application of low strength technique and (3) with the application of moderate strength. "The results of the experiments suggested that the effects on promoting pulse rate, and times of respiration, and the SPO2 level by stimulation of moderate strength were remarkable and more effective than those by stimulation of low strength. The difference between them was remarkable. … if improper strength of stimulation was applied, the following consequences might be induced: (1) If the strength of stimulation is too weak it won't be enough to induce the effective reaction of the body; (2) If the strength of stimulation is too strong, it could induce not only endurable pain, but also low cardiac output …" The researchers also note observations from their clinical experience. The client's sensitivity should be assessed according to sex, age, and "constitution," should be observed during the session and asked about his or her reaction. Feng Jinqi, Fan Chunmei, Feng Xingqian, Yang Lianming, "Exploration on the Effects of Pulse, Respiration and Oxygen Saturation of Blood by Different Strength of Stimulus," 1998 China Reflexology Symposium Report, China Reflexology Association, Beijing, pp. 94 - 96
A recent study considered menopause and the application of foot reflexology versus foot massage."Seventy-six women between 45 and 60 years, reporting menopausal symptoms.
"Methods: Women were randomised to receive nine session of either reflexology or nonspecific foot massage (control) by four qualified reflexologists over a period of 19 weeks.
"Main outcome measures: The Women's Health Questionnaire (WHQ), the primary measure s being the subscores for anxiety and depression. Severity (visual analog scale (VAS) a n frequency of flushes and night sweats.
"Results: Mean (SD) scores for anxiety fell from 0.43 (0.29) to 0.22 (0.25) in the reflexology group and from 0.37 (0.27) to 0.27 (0.29) in the control group over the course of treatment. Mean (SD) scores for depression fell from 0.37 (0.25) to 0.20 (0.24) in the reflexology group and from 0.36 (.023) to 0.20 (0.21) in the control (foot massage) group over the same period. For both scores there was strong evidence of a time effect (P<0.001) but no evidence of a time-group interaction (P>0.2). Similar changes were found for severity of hot flashes and night sweats. In the control group, 14/37 believed they had not received reflexology.
"Conclusion: Foot reflexology was not shown to be more effective than non-specific foot massage in the treatment of psychological symptoms occurring during menopause."
Williamson J, White A, Hart A, Ernst E., "Randomised controlled trial of reflexology for menopausal symptoms," British Journal Obstetrics and Gynecology, 2002 Sep; 109(9):1050-5
• Eighty-two women diagnosed with menopause were randomly divided into two groups. Forty-two women received foot reflexology and forty received foot reflexology with auricular point magnet adhesion. Thirty-minute sessions were provided daily for 60 days.
Among women provided with foot reflexology at the conclusion of the study, 17 (40.48%) of the women had fully recovered, 20 (47.62%) had significantly recovered, 4 (9.25%) had effective results and 1 had ineffective results.
Among women provided with foot reflexology and auricular magnet adhesion at the conclusion of the study, 9 (22.5%) of the women had fully recovered, 16 (40%) had significantly recovered, 9 (22.50) had effective results and 6 (15%) had ineffective results.
Sun Jianhua, "Observation of the Therapeutic Effect of 82 Cases of Climaterium Syndrome (Menopause) Treated with Reflexotherapy," 1998 China Reflexology Symposium Report, China Reflexology Association, Beijing, pp. 60-61
Peer review is utilized to review appropriateness of research. Peer review of reflexology research by reflexologists has yet to be created. If reflexology is to be given a fair trial in research studies, reflexologists have no choice but to voice an opinion on the methods applied to reflexology research. For example, the above British study utilized four qualified reflexologists - to apply both reflexology and foot massage. Would results have been the same if four qualified foot massagers had been recruited for the foot massage portion? What results would have been obtained if technique had been applied more frequently? What strength of stimulus was applied during foot reflexology? Foot massage? Why was there no report and no definition of (1) which method reflexologists practiced and (2) which reflex areas were worked and for how long? (No criticism is intended, merely an exact physical description of what exactly was studied.)
Reflexology will not receive a fair trail until and unless reflexologists participate in:
• Considering the methodology in research studies in which they participate including frequency of session, strength of stimulus and duration of stimulus.
• Demanding that research results include reports of the above.
• Creating a reflexologists' peer review of reflexology research.
Finally, is the real problem with reflexology research an inadequacy in describing what is being tested? To say "reflexology" is being tested without defining reflexology is unfair. A cause and effect relationship between the actions of the reflexologists and impact on the body must be described for testing to be accurate. Is it the application of pressure that causes an effect? If so, studies should target defined parameters of pressure. Is it the reflexologist's balancing of energy? If so, the physical parameters of technique application should be described during testing. Until and unless reflexologists resolve such issues, reflexology will be fair game for unfair testing.
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