The effect of hand reflexology on anxiety in patients undergoing coronary angiography: A single-blind randomized controlled trial

BackgroundThis study aimed to evaluate effects of hand reflexology on anxiety level in coronary angiography patients.Materials and methodsThis clinical trial recruited 80 eligible patients >6 months. The patients were randomly assigned to receive routine care plus either hand reflexology or a simple hand massage. Data were collected using the Spielberger State-Trait Anxiety Inventory. Both groups' anxiety levels were measured before (T0) and 30 min (T1) and 1 h after the intervention (T2).FindingsThe mean anxiety level in the intervention group decreased from 57.54 at baseline to 55.47 after the intervention (P = 0.0001). The values in the control group were 54.27 and 51.4, respectively. The two groups had statistically significant differences in the mean scores of anxiety at T0 and T1 (P = 0.003), T1 and T2, and T0 and T2 (P = 0.0001).ConclusionHand reflexology could effectively decrease anxiety in coronary angiography patients.     

The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life

PurposeThis study aims to identify the effects of foot reflexology applied to women on their vasomotor complaints and quality of life.MethodsA randomised controlled study was conducted with 120 women. The experimental group received foot reflexology treatment, while the control group received nonspecific foot massage.ResultsThe mean scores for hot flashes, sweats, and night sweats, were lower in the reflexology group than the control group after the practice; and the difference between the groups was statistically significant (p < 0.001). The mean scores for the sub-groups of the MENQOL demonstrated improvements in both groups after the application (p < 0.001). As for the sexual domain, there was a significant improvement in the reflexology group (p < 0.05), but no improvements were found in the control group (p > 0.05).ConclusionResults showed that reflexology might be effective in decreasing vasomotor problems and increasing quality of life in women in the menopausal period.     

The effect of foot reflexology and back massage on hemodialysis patients' fatigue and sleep quality

ObjectiveThe aim of this study is to examine the effectiveness of foot reflexology and back massage on optimizing the sleep quality and reducing the fatigue of hemodialysis patients.MethodsThe study includes 105 volunteer patients who were registered at a private dialysis clinic and were receiving hemodialysis treatment. Foot reflexology and back massage were administered to the patients two times a week for four weeks. The Visual Analogue Scale for Fatigue and the Pittsburg Sleep Quality Index were used to collect data.ResultsThe differences between the pretest and posttest score averages of the patients on the Visual Analogue Scale for Fatigue and the Pittsburg Sleep Quality Index were statistically significant (p < 0.001).ConclusionFoot reflexology and back massage were shown to improve the sleep quality and reduce the fatigue of hemodialysis patients. Compared to back massage, foot reflexology was determined to be more effective.     

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

Reflexologists claim that massage to specific points of the feet increases blood supply to internal organs. This study measured changes in cardiovascular parameters in subjects receiving reflexology to areas of their feet thought to correspond to the heart (intervention) compared with other areas which are not (control).Method16 reflexology-naive healthy volunteers received an active and control reflexology treatment in an RCT, double-blind repeated measures study.Main outcome measures‘Beat-to-beat’ continuous measurement of selected cardiovascular parameters, State Anxiety Inventory.ResultsCardiac index decreased significantly in the intervention group during left foot treatment (LFT) (baseline mean 2.6; standard deviation (SD) 0.75; 95% CI ± 0.38 vs. LFT mean 2.45; SD 0.68; CI 0.35), effect size (p = 0.035, omega squared effect (w2) = 0.002; w = 0.045).ConclusionReflexology massage applied to the upper part of the left foot may have a modest specific effect on the cardiac index of healthy volunteers.     

Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial

ObjectiveThe present study was conducted to determine the effect of massage on post-cesarean pain and anxiety.MethodsThe present single-blind clinical trial was conducted on 156 primiparous women undergone elective cesarean section. The participants were randomly divided into three groups, including a hand and foot massage group, a foot massage group and a control group (n = 52 per group). The patients' intensity of pain, vital signs and anxiety level were measured before, immediately after and 90 min after the massage.ResultsA significant reduction was observed in the intensity of pain immediately and 90 min after massage (P < 0.001). Moreover, changes in some of the physiological parameters, including blood pressure and respiration rate, were significant after massage (P < 0.001); however, this change was not significant for pulse rate. A significant reduction was also observed in the level of anxiety (P < 0.001) and a significant increase in the frequency of breastfeeding (P < 0.001) after massage.ConclusionAs an effective nursing intervention presenting no side-effects, hand and foot massage can be helpful in the management of postoperative pain and stress.     

Massage and reflexology for post-operative cancer cystectomy patients: Evaluation of a pilot service

Backgroundand purpose: Radical cystectomy is a gold standard treatment for invasive bladder cancer. However the length of the operation is long and recovery is usually slow and painful. There is growing recognition of the importance of health related quality of life among patients undergoing invasive surgical procedures. In response, a massage and reflexology service was piloted and evaluated.Materials and methodsOne hour of massage, reflexology or a combination of both was provided twice to 38 cystectomy patients by a trained therapist in their acute post-operative phase (day one and day three). Self-reported concerns, well-being and pain were measured before and immediately after the therapy. Pain was measured once more in the early evening of each therapy day.ResultsSelf-reported concerns and pain were significantly reduced following the intervention on both days treatments were given. Pain was measured again on the evening of each of the intervention days, and this reduction was maintained on day one but not day three. Well-being scores were also significantly improved pre to post intervention on both day one and day three. Qualitative comments highlighted that this complementary therapy service was viewed both beneficial and relaxing. There were no significant differences between the different therapies used (massage, reflexology, or a combination of the two).ConclusionThe findings of this pilot evaluation very tentatively support the benefits of cancer cystectomy patients receiving massage and/or reflexology in their acute postoperative recovery period. There are many limitations to this evaluation. Further research utilising a randomised control methodology alongside medical, independent markers is warranted, and currently in development.     

Effect of massage therapy on pain,anxiety, and tension in cardiac surgical patients: A pilot study

ObjectivesTo assess the role of massage therapy in the cardiac surgery postoperative period. Specific aims included determining the difference in pain, anxiety, tension, and satisfaction scores of patients before and after massage compared with patients who received standard care.DesignA randomized controlled trial comparing outcomes before and after intervention in and across groups.SettingSaint Marys Hospital, Mayo Clinic, Rochester, Minnesota.SubjectsPatients undergoing cardiovascular surgical procedures (coronary artery bypass grafting and/or valvular repair or replacement) (N = 58).InterventionsPatients in the intervention group received a 20-minute session of massage therapy intervention between postoperative days 2 and 5. Patients in the control group received standard care and a 20-minute quiet time between postoperative days 2 and 5.Outcome measuresLinear Analogue Self-assessment scores for pain, anxiety, tension, and satisfaction.ResultsStatistically and clinically significant decreases in pain, anxiety, and tension scores were observed for patients who received a 20-minute massage compared with those who received standard care. Patient feedback was markedly positive.ConclusionsThis pilot study showed that massage can be successfully incorporated into a busy cardiac surgical practice. These results suggest that massage may be an important therapy to consider for inclusion in the management of postoperative recovery of cardiovascular surgical patients.     

Randomised controlled trial of reflexology for menopausal symptoms

Objective Clinical experience suggests that reflexology may have beneficial effects on the symptoms occurring in menopausal women, particularly psychological symptoms. This study aims to examine that effect rigorously.
Design Randomised controlled trial with two parallel arms.
Setting School of Complementary Health in Exeter, Devon, UK.
Sample Seventy-six women, aged between 45 and 60 years, reporting menopausal symptoms.
Methods Women were randomised to receive nine sessions of either reflexology or nonspecific foot massage (control) by four qualified reflexologists given over a period of 19 weeks.
Main outcome measures The Women's Health Questionnaire (WHQ), the primary measures being the subscores for anxiety and depression. Severity (visual analogue scale, VAS) and 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 (0.23) 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 flushes and night sweats. In the control group, 14/37 believed they had not received true reflexology.
Conclusion Foot reflexology was not shown to be more effective than non-specific foot massage in the treatment of psychological symptoms occurring during the menopause.     

The effect of inhalation aromatherapy with rose essential oil on the anxiety of patients undergoing coronary artery bypass graft surgery

Background and purposeAnxiety is one of the most common responses of patients awaiting coronary artery bypass graft (CABG) surgery to stressful conditions before surgery. This study is intended to examine the effect of inhalation aromatherapy with rose essential oil on the anxiety of patients undergoing CABG surgery.Materials and methodsThis was a single-blind randomized clinical trial of 66 patients undergoing CABG surgery. The experimental group inhaled three drops of 4% rose essential oil for 10 minutes one night and one hour before surgery. The control group did not receive any intervention from the research team.ResultsThe level of anxiety was measured before and 30 minutes after the intervention using the Spielberger's Anxiety Inventory. Prior to surgery, an independent t-test showed that the mean score of anxiety was not significantly different between the experimental and control groups (p = 0.41). Aromatherapy with rose essential oil did not cause any significant differences in state anxiety (P = 0.41), trait anxiety (P = 0.90), and total anxiety (P = 0.69).ConclusionOur results revealed that inhalation aromatherapy with rose essential oil could not significantly reduce anxiety in CABG patients. Future research with larger sample sizes and using different concentrations of rose essential oil are needed to achieve more definitive conclusions.     

The effect of aromatherapy with peppermint essential oil on anxiety of cardiac patients in emergency department: A placebo-controlled study

IntroductionAnxiety is an unpleasant feeling that increases the myocardial oxygen demand in acute coronary syndrome. This study aimed to evaluate the effect of peppermint aromatherapy on anxiety in patients with acute coronary syndrome in the emergency department.Materials and methodsIn this clinical trial study, 64 patients with acute coronary syndrome were randomly divided into intervention and control groups. In the intervention group, a cotton ball was soaked in 100% peppermint essential oil and placed about 20 cm from the patient's nose for 1 h while in the control group, the cotton ball was soaked in water. Anxiety was measured before and after the intervention with The Spielberger state-trait anxiety inventory. The data were analyzed in SPSS ver.23 software.ResultsNo significant difference was observed between the two groups in terms of patients’ demographic data. The mean score of trait and state anxiety before the intervention was not significantly different between the two groups. After the intervention, anxiety was significantly lower in the intervention group (37.72 ± 10.41) compared to the control group (42.62 ± 5.99) (P = 0.021). Results indicated a significant decrease in anxiety after the intervention (P < 0.001) in the intervention group. Such a difference was not significant in the control group.ConclusionPeppermint essential oil inhalation significantly reduces anxiety of patients with acute coronary syndrome in emergency department.     

Reflexology has no immediate haemodynamic effect in patients with chronic heart failure: A double blind randomised controlled trial

AimsThis study measured the effects of reflexology in 12 reflexology-naive patients with chronic heart failure in a placebo-controlled, double blind randomised controlled study design.MethodOutcomes included ‘beat-to-beat’ non-invasive continuous measurement of cardiovascular parameters and measurement of state of anxiety and pain/discomfort.ResultsThere were no changes in any of the haemodynamic parameters measured (all p > 0.05). Perceived state of anxiety was significantly reduced post treatment in the control group only (p = 0.03).ConclusionsReflexology applied to the feet of patients with chronic heart failure appears to have no immediate haemodynamic effects. While any long term treatment effect is uncertain, it would appear that reflexology is safe for use in this patient group.     

Use of Music to Reduce Anxiety during Office Hysteroscopy: Prospective Randomized Trial

Study ObjectiveTo investigate the effects of music on anxiety and perception of pain during office hysteroscopy.DesignProspective randomized trial (Canadian Task Force classification I).SettingMajor university medical center.InterventionsThree hundred fifty-six patients were enrolled between July 2012 and January 2013. Hysteroscopy was performed in a dedicated ambulatory room, using vaginoscopy and without any type of anesthesia. A Bettocchi hysteroscope 5 mm in diameter was used. All procedures were performed by the same surgeon, a gynecologist with special interest in hysteroscopy.Measurements and Main ResultsData collected included age, body mass index, number of vaginal deliveries, educational achievement level, and history of endometrial surgery (curettage and/or hysteroscopy). For each patient, vital parameters such as blood pressure, heart rate, and respiratory rate were recorded 15 minutes before the procedure and during hysteroscopy after traversing the cervix. Wait time before surgery and the duration of the procedure were also recorded. A completed Italian version of the state anxiety questionnaire (State-Trait Anxiety Inventory) and a visual analog scale (VAS) were administered to each patient before and after the procedure. The t test and Mann-Whitney U test was used when appropriate to compare the 2 groups. Statistical significance was accepted at p = .05. During surgery, systolic blood pressure and heart rate were significantly lower in the music group compared with the no music group. Women in the music group experienced significantly lower anxiety after hysteroscopy and less pain during the procedure, and a significant decrease in both anxiety and pain scores after hysteroscopy. Postoperative State-Trait Anxiety Inventory form Y1 and VAS scores were significantly lower in the music group.ConclusionMusic can be useful as a complementary method to control anxiety and reduce perception of pain. The patient is more relaxed and experiences less discomfort.     

The effect of reflexology on the quality of life with breast cancer patients

BackgroundThis study aims to identify the effect of reflexology on the quality of life in patients with breast cancer.MethodsThe population of the study conducted comprised of 60 patients; 30 forming the control and 30 the experimental groups (30 experimental, 30 control). Patient identification forms and EORTC QLQC30 Quality of Life Scale were used to collect the data. Statistical analysis used: The data obtained as a result of the study were assessed via computer using ‘Statistical Package for Social Science 21.0’ software.ResultsThe results of the experiment demonstrated that the within-group symptom total score average of the patients in the experiment/treatment group decreased after the reflexology treatment; while the general health and functional total score averages in the treatment group increased; and the difference between pretest and posttest measurements was statistically significant (p = 0.000).Once symptom, functional, and general health total score averages from the posttest measurement are compared across treatment and control groups, symptom total score average of the patients in the treatment group turned out to be significantly lower than that of the patients in the control group (p = 0.001). In terms of functional and general health score averages, patients in the treatment group scored significantly higher than those in the control group (p = 0.000).ConclusionReflexology was found to reduce the symptoms experienced by breast cancer patients, while at the same time increasing the functional and general health status.     

The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women

ObjectiveTo assess the effects of breathing techniques training on anxiety levels of pregnant women and the duration of labor.Materials and methodsThe study utilizes a randomized controlled trial design. The pregnant women were divided into control (n = 35) or experimental group (n = 35) randomly. The experimental group received breathing techniques training in the latent phase and these techniques were applied in the following phases accordingly. The anxiety levels of pregnant women were evaluated three times in total. The duration of labor was considered as the duration of the first stage of labor and the duration of the second stage of labor.ResultsThere were significant differences between the two groups regarding the mean State Anxiety Inventory (SAI) and the mean duration of labor.ConclusionsThis study concludes that breathing techniques are an effective method in the reduction of anxiety and influence the duration of delivery during labor.     

A pilot study of the effectiveness of reflexology in treating idiopathic constipation in women

ObjectivesConstipation is a common problem in the UK, affecting up to 20% of the population. Reflexologists claim that reflexology can be beneficial in the treatment of constipation. The aim of this exploratory pilot study was to determine the effectiveness of reflexology in treating idiopathic constipation in women and it is the first study of the effectiveness of reflexology for the treatment of women with idiopathic constipation defined according to Rome II criteria.MethodsNineteen female patients referred to a specialist biofeedback service with idiopathic constipation defined by Rome II criteria were recruited. A course of reflexology treatment (weekly for six weeks) was given. Patients' subjective perception of constipation was recorded as well as the Hospital Anxiety and Depression Scale (HAD), the Short form 36 (SF36), whole gut transit and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) before and after the intervention.ResultsAll participants completed the intervention and none were lost to follow-up. Ninety-four percent of participants identified their constipation to be improved to some extent. Ten participants had improved colonic transit times and two patients had normalised colonic transit. Ten patients (53%, p = 0.19) demonstrated an improved anxiety score and 11 participants (58%, p = 0.14) demonstrated an improved depression score on the HAD scales. Improvement was seen in general health, mental health and vitality on the SF36 scale, with vitality improving significantly (p < 0.05). Sixty-three percent of participants had a more positive attitude (p = 0.03) towards CAM and holistic health following treatment.ConclusionsThis study shows that in this sample reflexology has potential benefit for treating idiopathic constipation in women. Further randomised trials are required.     

Anxiety reduction in patients undergoing cardiac catheterization following massage and guided imagery

ObjectiveThis study aimed to evaluate the effectiveness of massage with or without guided imagery in reducing anxiety prior to cardiac catheterization.MethodA total of 55 inpatients and outpatients received massage, guided imagery, or massage with guided imagery prior to cardiac catheterization. Self-reported anxiety levels and blood pressure (BP) and heart rate (HR) were evaluated in participants and a matched comparison group.ResultsMassage with and without guided imagery resulted in significant reductions in self-reported anxiety (p < 0.0001). Patients receiving intervention had lower diastolic BP and HR vs. the comparison group (p < 0.0001 and p < 0.05).ConclusionsMassage with or without guided imagery immediately reduced self-reported anxiety. This pilot study has certain limitations: a non-randomized, convenience sample and a matched control group that was created retrospectively. However, the study indicates a benefit to providing massage or massage with guided imagery prior to anxiety-inducing medical procedures such as cardiac catheterization.     

Manipulative and body-based methods in chronic kidney disease patients: A systematic review of randomized controlled trials

Backgroundand purpose: Among chronic kidney disease (CKD) patients, manipulative and body-based methods (MBM) have demonstrated efficacy in improving symptoms such as fatigue. This review aims to summarize the efficacy and safety of MBM among CKD patients.MethodsA systematic review was performed in PubMed, Embase, Scopus, CINAHL, CENTRAL and PsycInfo. Randomised controlled trials (RCTs) which evaluated the use of MBM among adult CKD patients were included. The grading of recommendations, assessment, development, and evaluation (GRADE) approach was used to determine the risk of bias and certainty of evidence. The efficacy of each MBM was determined by reduction in symptom severity scores. All adverse reactions were documented.ResultsOf 8529 articles screened, 55 RCTs were included. Acupressure (n = 23), massage therapy (n = 17), reflexology (n = 6) and acupuncture (n = 5) were the most studied MBMs. Acupressure and reflexology were shown to reduce sleep disturbance and fatigue by 6.2–50.0% and 9.1–37.7% respectively. For uremic pruritus, acupressure and acupuncture reduced symptoms by 34.5–77.7% and 56.5–60.2% respectively. Common adverse reactions associated with acupressure included intradialytic hypotension (20.4%) and dizziness (11.1%) while that of acupuncture included elbow soreness (7.5%) and bleeding (7.5%). No adverse effects were reported for massage therapy, moxibustion, reflexology and yoga therapy.ConclusionAcupressure, reflexology and massage therapies were the most well-studied MBMs which have demonstrated efficacy in alleviating sleep disturbance, fatigue and uremic pruritus symptoms in CKD patients.     

The influence of early virtual reality intervention on pain,anxiety, and function following primary total knee arthroplasty

BackgroundTotal knee arthroplasty (TKA) is one of the most popular surgeries in the orthopedic field. One of the reasons for a failed TKA is pain and difficulty to return to normal function. A pain control method that is becoming more and more popular is the use of virtual reality (VR). We aimed to examine VR intervention in the immediate post-operative physiotherapy following TKA.MethodsThis prospective randomized-controlled study recruited a total of 55 patients undergoing primary TKA in a single institute, operated by three surgeons. They were assigned either study group or control group. Both groups were treated with conventional physiotherapy and CPM equipment (Continuous passive motion device), the study group received additional VR modality. Both groups completed a series of questionnaires prior and after the intervention: State-Trait Anxiety Inventory (STAI) questionnaire (used to diagnose anxiety), Visual analog scale (VAS) for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) (knee function score).ResultsThe average age was 70 years-old with equal distribution of male and female. Both groups showed a decrease in pain and anxiety following the intervention (p value < 0.05) but there was no difference between the groups (p value > 0.05 for all parameters). The was no difference in the WOMAC scores in the six-month post-operative examination between groups (p-value = 0.653).ConclusionsVirtual reality intervention in the immediate post-operative period following total knee arthroplasty decrease pain and anxiety but did not influence the pain, anxiety, and long-term function results more than conventional physiotherapy.     

Comparing the effects of auricular seed acupressure and foot reflexology on neonatal abstinence syndrome: A modified double blind clinical trial

BackgroundThe neonates of addicted women are at risk for neonatal abstinence syndrome. This study aimed to compare the effects of auricular seed acupressure and foot reflexology on neonatal abstinence syndrome among the neonates of addicted women.MethodsThirty one neonates of addicted women were purposively recruited and randomly allocated through coin flipping to receive either foot reflexology then seed acupressure or seed acupressure then foot reflexology. Interventions were performed in two successive days with a 12-h washout interval. Foot reflexology was applied for 15 min to the first horizontal zone of the sole while seed acupressure was applied for 24 h through attaching acupuncture-specific ear seeds to the posterior surface of the auricle on the SJ 17 acupoint. The symptoms of abstinence syndrome were assessed using Finnegan Neonatal Abstinence Scoring System before and after foot reflexology, and before, 15 min, and 24 h after the onset of the seed acupressure intervention. Symptom assessment was done by a research assistant who was blind to the study intervention.FindingsThe mean score of abstinence symptoms for the foot reflexology intervention significantly reduced from 10.32 ± 2.10 at pretest to 7.87 ± 2.04 at posttest (P < 0.001). Moreover, the mean score of abstinence symptoms for the seed acupressure intervention significantly reduced from 9.70 ± 2.10 to 8.70 ± 1.46 at the first posttest (P = 0.007) and 7.32 ± 1.42 at the second posttest (P < 0.001). The change in the mean score of the foot reflexology intervention was significantly greater than the change in the mean score at the first seed acupressure posttest (P < 0.001) but did not significantly differ from the change in the second seed acupressure posttest (P = 0.880).ConclusionBoth foot reflexology and auricular seed acupressure has significant effects on abstinence symptoms. Of course, 15-min seed acupressure is less effective than 15-min foot reflexology, while 24-h seed acupressure is as effective as 15-min foot reflexology in alleviating abstinence symptoms.