A randomised-controlled trail examining the effects of reflexology of patients with chronic obstructive pulmonary disease (COPD)

doi:10.1016/j.ctcp.2005.10.004

Complementary Therapies in Clinical Practice

Volume 12, Issue 2, May 2006, Pages 141-147

https://doi.org/10.1016/j.ctcp.2005.10.004 Get rights and content

Summary

It is known that many patients with obstructive pulmonary diseases use a number of complementary and alternative medicines (CAM). There has been a great deal of interest into the CAM recently, with the House of Lords select committee for science and technology's report suggesting randomised-controlled trials are the best means of researching the area. There is very little research into the effects of reflexology specifically on the effects it has on COPD. As such a randomised-controlled trial was set up to examine the effects of reflexology treatments on COPD. Results were qualitative and quantitative and showed that there are a number of areas of possible benefit for patients with COPD, but a larger scale study with a longer time frame is needed for a full evaluation of these effects.

Introduction

It is known that many patients with obstructive pulmonary diseases use a number of complementary and alternative medicine (CAM).1, 2, 3, 4, 5, 6 There is very little research into the effects of these CAM's on the disease severity and the well-being of the patient. Of late there has been a great deal of interest into the world of CAM and this has led to the house of lords select committee for science and technology producing a report assessing the world of CAM.⁷ This report states that the most productive method of researching these areas (including reflexology) is with randomised controlled trials.7, 8

Currently there is no recorded literature examining the effects of reflexology on patients who are suffering from chronic obstructive pulmonary disease (COPD). A randomised-controlled trial was designed with the aim of analysing the effects of reflexology in patients with chronic obstructive pulmonary disease.

Reflexology can be defined as a “system of massage of the feet based on the idea that there are invisible zones running vertically through the body, so that each organ has a corresponding location in the foot. It has been claimed to stimulate blood supply and relieve tension”.⁷

Section snippets

Method

This study was conducted at St George's Hospital, Tooting, in southwest London, UK. Twenty Patients were randomly selected from hospital records, all of whom had a confirmed diagnosis of stable, moderate to severe, COPD and were under long-term follow up by the chest physicians/nurses at St George's hospital. The group of patients were separated into two according to gender ( $m = 10$ ; $f = 10$ ) and then randomised to a treatment group or a control group.

Results

Of the 20 patients that were originally recruited for the study, 17 took part; one of these 14 patients completed all of the study. The demographic composition of the two randomly assigned groups is shown in Table 1.

It is possible to see from Table 1 that the two groups were not perfectly matched, with male/female ratios and the smoking history of the two groups differing slightly.

Discussion

The analysis has four strands to it: the physiological measurements and diary cards (which are both quantitative), and the quality of life questionnaires and evaluation questionnaire (which are qualitative). The evaluation questionnaire completed at the end of the study, gave patients a greater freedom to express how they felt about the sessions, and the study in general.

Conclusion

The data suggests that the reflexology group appeared to become more relaxed throughout the treatment then the control group, however this was only a short-term effect and did not continue until the next treatment. We cannot make any comment based on our data as to the effect of an increased frequency of treatment on the longevity of the improvement. There was no evident change in the patient's quality of life when assessed by the quality of life questionnaires, though the evaluation

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The effects of foot reflexology on anxiety and physiological parameters among candidates for bronchoscopy: A randomized controlled trial
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Citation Excerpt :
Reflexology, particularly foot reflexology (FR), is one of the non-pharmacological remedies which is widely used for pain and anxiety management [10]. Not only FR reduces stress and tension, improves tissue perfusion, and promotes homeostasis, but also it is considered as a strategy to strengthen nurse-patient relationship [11]. In FR, a healer uses his/her fingers to press reflex points on the feet in order to restore patients’ health and promote homeostasis [12].
Patients who are about to undergo invasive diagnostic procedures are usually anxious and worried. High levels of anxiety can interfere with the successful implementation of procedures and threaten patient well-being. Foot reflexology has been shown to be effective in alleviating anxiety and stabilizing physiologic status among different patient populations. Nonetheless, there is inadequate evidence regarding the effects of the technique on patients who are candidates for bronchoscopy. The aim of this study was to assess the effects of foot reflexology on anxiety and physiological parameters among the candidates for bronchoscopy.
This study was a randomized controlled trial on 80 candidates about to undergo a bronchoscopy. Subjects’ anxiety, heart rate, respiratory rate, diastolic and systolic blood pressures, and arterial oxygen saturation were measured thrice, i.e. before foot reflexology, immediately after reflexology, and immediately before bronchoscopy.
Contrary to the control group, variations of anxiety, heart rate, respiratory rate, diastolic and systolic blood pressures, and arterial oxygen saturation were statistically significant in the reflexology group (P < 0.05).
Foot reflexology alleviates anxiety and improves physiological parameters among the candidates for bronchoscopy. Consequently, it may be used as a non-invasive non-pharmacological remedy for subjects who are on the waiting lists for invasive diagnostic procedures such as bronchoscopy.
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Following screening of study titles and abstracts, 305 were considered to be unrelated to the review objectives, and 186 remained for full-text analysis. Of these, 70 articles were excluded, leaving a total of 116 articles11,12,16,21–133 for inclusion in this review. The study flow and reasons for exclusion are shown in Figure 1.
The objectives of this systematic review were to synthesize the literature on measures of activities of daily living (ADLs) that have been used in individuals with COPD and to provide an overview of the psychometric properties of the identified measures and describe the relationship of the disease-specific instruments with other relevant outcome measures for individuals with COPD and health-care use.
Studies that included a measure of ADLs in individuals with COPD were identified using electronic and hand searches. Two investigators performed the literature search. One investigator reviewed the study title, abstract, and full text of the articles to determine study eligibility and performed the data extraction and tabulation. In cases of uncertainty, a second reviewer was consulted.
A total of 679 articles were identified. Of those, 116 met the inclusion criteria. Twenty-seven ADLs instruments were identified, of which 11 instruments were respiratory disease-specific, whereas 16 were generic. Most instruments combined instrumental ADLs (IADLs) with basic ADLs (BADLs). The majority of the instruments were self-reported; only three instruments were performance based. Twenty-one studies assessed psychometric properties of 16 ADLs instruments in patients with COPD.
Although several ADLs instruments were identified, psychometric properties have only been reported in a few. Selection of the most appropriate measure should focus on the target construct (BADLs or IADLs or both), type of test (disease-specific vs generic and self-reported vs performance-based), depth of information obtained, and psychometric properties of the instruments. Given the relevance of ADLs to the lives of patients with COPD, its assessment should be more frequently incorporated as a clinical outcome in their management.
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A randomised-controlled trail examining the effects of reflexology of patients with chronic obstructive pulmonary disease (COPD)

Summary

Introduction

Section snippets

Method

Results

Discussion

Conclusion

Complement Ther Med

Respir Med

Chest

Complement Ther Nurs Midwifery

J Emerg Nurs

Use of complementary therapy by adolescents with asthma

Arch Pediatr Adolesc Med