The effect of foot reflexology on constipation: A systematic review and meta-analysis

Context: Constipation is a prevalent symptom of gastrointestinal disorders, which has an annoying impact on health and quality
of life. On the other hand, reflexology is a popular type of complementary and alternative medicine in medical practices.
Objectives: The present study aimed to assess the effect of foot reflexology on constipation symptoms.
Methods: Nine databases were systematically searched to detect relevant Randomized Clinical Trials. The current used the Cochrane
Risk of Bias tool to evaluate the methodological quality of the included articles. The primary outcome was the improvement of
constipation symptoms. The Standardized Mean Difference (SMD) was measured, and random effects were reported instead of the
fixed effects due to the high heterogeneity.
Results: Out of the 693 articles retrieved from the databases and eight additional records identified through other sources, 496
titles, 48 abstracts, and 16 full-texts were reviewed, and 11 articles were included in this study, out of which nine articles entered the
meta-analysis. The findings of the meta-analysis indicated that foot reflexology had a significant effect on the constipation score
(SMD: -0.82; 95% CI: -1.47 to -0.17; P value = 0.0001; I2
= 93%)
Conclusions: Foot reflexology can effectively improve constipation symptoms; however, clinical trials with better designs are recommended.