The Physiological and Biochemical Outcomes Associated with a Reflexology Treatment: A Systematic Review

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Abstract

Background. Reflexology is one of the top forms of complementary and alternative medicine in the UK and is used for healthcare by a diverse range of people. However, it is offered by few healthcare providers as little scientific evidence is available explaining how it works or any health benefits it may confer.The aim of this review was to assess the current evidence available from reflexology randomised controlled trials (RCTs) that have investigated changes in physiological or biochemical outcomes. Methods. Guidelines from the Cochrane Handbook of Systematic Reviews of Interventions were followed: the following databases were searched from inception to December 2013:AMED, CAMQuest, CINAHL Plus, Cochrane Central Register of Controlled Trials, Embase,MedlineOvid, Proquest, and Pubmed. Risk of bias was assessed independently by two members of the review team and overall strength of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation guidelines. Results.Seventeen eligible RCTs met all inclusion criteria. A total of 34 objective outcome measures were analysed. Although twelve studies showed significant changes within the reflexology group, only three studies investigating blood pressure, cardiac index, and salivaryamylase resulted in significant between group changes in favour of reflexology. The overall quality of the studies was low.
LanguageEnglish
Article number502123
Pages1-16
Number of pages17
JournalEvidence-Based Complementary and Alternative Medicine
VolumeVolume
DOIs
Publication statusPublished - 5 May 2014

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Massage
Complementary Therapies
Randomized Controlled Trials
Guidelines
Insurance Benefits
Therapeutics
PubMed
Health Personnel
Outcome Assessment (Health Care)
Databases
Blood Pressure
Delivery of Health Care

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@article{15caad493e6c4de8b62ca4ec0731531f,
title = "The Physiological and Biochemical Outcomes Associated with a Reflexology Treatment: A Systematic Review",
abstract = "Background. Reflexology is one of the top forms of complementary and alternative medicine in the UK and is used for healthcare by a diverse range of people. However, it is offered by few healthcare providers as little scientific evidence is available explaining how it works or any health benefits it may confer.The aim of this review was to assess the current evidence available from reflexology randomised controlled trials (RCTs) that have investigated changes in physiological or biochemical outcomes. Methods. Guidelines from the Cochrane Handbook of Systematic Reviews of Interventions were followed: the following databases were searched from inception to December 2013:AMED, CAMQuest, CINAHL Plus, Cochrane Central Register of Controlled Trials, Embase,MedlineOvid, Proquest, and Pubmed. Risk of bias was assessed independently by two members of the review team and overall strength of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation guidelines. Results.Seventeen eligible RCTs met all inclusion criteria. A total of 34 objective outcome measures were analysed. Although twelve studies showed significant changes within the reflexology group, only three studies investigating blood pressure, cardiac index, and salivaryamylase resulted in significant between group changes in favour of reflexology. The overall quality of the studies was low.",
author = "{Mc Cullough}, Julie and Diane Liddle and Sinclair, {Marlene .} and Ciara Close and Ciara Hughes",
note = "Reference text: [1] “House of lords select committee on science and technology sixth report (2000),” 2012, http://www.publications.parliament .uk/pa/ld199900/ldselect/ldsctech/123/12301.htm. [2] J. Lee, M. Han, Y. Chung, J. Kim, and J. Choi, “Effects of foot reflexology on fatigue, sleep and pain: a systematic review and meta-analysis,” Journal of Korean Academy of Nursing, vol. 41, no. 6, pp. 821–833, 2011. [3] J. Jones, P. Thomson, W. Lauder, K. Howie, and S. J. Leslie, “Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: a double-blind randomised controlled trial,” Complementary Therapies in Clinical Practice, vol. 18, pp. 204– 211, 2012. [4] S. McDonough, P. Devine, and D. Baxter, “Research update: complementary and alternative medicine: patterns of use in Northern Ireland,” 2007, http://www.ark.ac.uk/publications/updates/ update50.pdf. [5] C. L. Ventola, “Current issues regarding complementary and alternative medicine (CAM) in the United States—part 1: the widespread use of CAM and the need for better-informed health care professionals to provide patient counseling,” Pharmacy andTherapeutics, vol. 35, no. 8, pp. 461–468, 2010. [6] NIFAB-unders{\o}kelsen 2007, http://www.nifab.no/om alternativ behandling/tall og fakta/nifab undersoekelsen 2007. [7] DanishMinistry ofHealth, Knowledge and Research Center for Alternative Medicine, 2012, http://www.srab.dk/uk/alternative +medicine/reflexology. [8] British Library, http://www.bl.uk/bipc/aboutus/news/comptherapy. html. [9] H. Hodgson, “Does reflexology impact on cancer patients’ quality of life?” Nursing Standard, vol. 14, no. 31, pp. 33–38, 2000. [10] L. Mollart, “Single-blind trial addressing the differential effects of two reflexology techniques versus rest, on ankle and foot oedema in late pregnancy,” ComplementaryTherapies inNursing and Midwifery, vol. 9, no. 4, pp. 203–208, 2003. [11] N. L.N. Stephenson and J.A.Dalton, “Using reflexology for pain management. A review,” Journal of Holistic Nursing, vol. 21, no. 2, pp. 179–191, 2003. [12] G.Wyatt, A. Sikorskii, M. A. Rahbar, D. Victorson, and M. You, “Health-related quality-of-life outcomes: a reflexology trial with patients with advanced stage breast cancer,” Oncology Nursing Forum, vol. 39, no. 6, pp. 568–577, 2012. [13] D. Botting, “Review of literature on the effectiveness of reflexology,” Complementary Therapies in Nursing & Midwifery, vol. 3, no. 5, pp. 123–130, 1997. [14] E. Ernst and K. K¨oder, “An overview of reflexology,” European Journal of General Practice, vol. 3, no. 2, pp. 52–57, 1997. [15] M.-Y. Wang, P.-S. Tsai, P.-H. Lee, W.-Y. Chang, and C.-M. Yang, “The efficacy of reflexology: systematic review,” Journal of Advanced Nursing, vol. 62, no. 5, pp. 512–520, 2008. [16] E. Ernst, “Is reflexology an effective intervention? A systematic review of randomised controlled trials,” Medical Journal of Australia, vol. 191, no. 5, pp. 263–265, 2009. [17] E. Ernst, P. Posadzki, and M. S. Lee, “Reflexology: an update of a systematic review of randomised clinical trials,” Maturitas, vol. 68, no. 2, pp. 116–120, 2011. [18] J. Jones,P.Thomson, K. Irvine, andS. J. Leslie, “Is there a specific haemodynamic effect in reflexology? A systematic review of randomised controlled trials,” The Journal of Alternative and Complementary Medicine, vol. 19, no. 4, pp. 319–328, 2013. [19] J. I. Kim, M. S. Lee, J. W. Kang, D. Y. Choi, and E. Ernst, “Reflexology for the symptomatic treatment of breast cancer: a systematic review,” Integrative CancerTherapies, vol. 9, no. 4, pp. 326–330, 2010. [20] D. Tiran and H. Chummun, “The physiological basis of reflexology and its use as a potential diagnostic tool,” Complementary Therapies in Clinical Practice, vol. 11, no. 1, pp. 58–64, 2005. [21] E. Ingham, Stories the Feet Can Tell Thru Reflexology, Stories the Feet Have Told Thru Reflexology, Ingham Publishing, St Petersburg, Fla, USA, 1984. [22] I. Sudmeier, G. Bodner, I. Egger, E. Mur, H. Ulmer, and M. Herold, “Changes of renal blood flow during organ-associated foot reflexologymeasured by colour doppler sonography,” Forschende Komplementarmedizin, vol. 6, no. 3, pp. 129–134, 1999. [23] K. Dalal, D. Elanchezhiyan, R. Das et al., “Noninvasive characterisation of foot reflexology areas by swept source-optical coherence tomography in patients with low back pain,” Evidence- Based Complementary and Alternative Medicine, vol. 2013, Article ID 983769, 11 pages, 2013. [24] UniversalCollege of Reflexology, 2012, http://www.universalreflex. com/article.php/20040309175204417. [25] C. M. Hughes, S. Krirsnakriengkrai, S. Kumar, and S. M. McDonough, “The effect of reflexology on the autonomic nervous system in healthy adults: a feasibility study,” Alternative Therapies in Health and Medicine, vol. 17, no. 3, pp. 32–37, 2011. [26] D. Sliz, A. Smith, C. Wiebking, G. Northoff, and S. Hayley, “Neural correlates of a single-session massage treatment,” Brain Imaging and Behavior, vol. 6, no. 1, pp. 77–87, 2012. [27] H. Poole, S. Glenn, and P. Murphy, “A randomised controlled study of reflexology for the management of chronic low back pain,” European Journal of Pain, vol. 11, no. 8, pp. 878–887, 2007. [28] D. Tiran, Reflexology in Pregnancy and Childbirth, Churchill Livingstone Elsevier, London, UK, 2010. [29] H.G.Guyatt, A. D. Oxman, G. E. Vist et al., “GRADE: an emerging consensus on rating quality of the evidence and strength of recommendations,” British Medical Journal, vol. 336, no. 7650, pp. 924–926, 2008. [30] J. Jones, P. Thomson, W. Lauder, K. Howie, and S. J. Leslie, “Reflexology has no immediate haemodynamic effect in patients with chronic heart failure: a double-blind randomised controlled trial,” Complementary Therapies in Clinical Practice, vol. 19, pp. 133–138, 2013. 16 Evidence-Based Complementary and Alternative Medicine [31] N. A. Hodgson and D. Lafferty, “Reflexology versus Swedish massage to reduce physiologic stress and pain and improve mood in nursing home residents with cancer: a pilot trial,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 456897, 5 pages, 2012. [32] E. Ruiz-Padial, N. Torres-Lopez, J. Luna-Bujald´on, I. Espadas- Villanueva, and G. R. del Paso, “Cardiovascular effects of reflexology in healthy individuals: evidence for a specific increase in blood pressure,” Alternative Medicine Studies, vol. 2, no. e4, pp. 10–17, 2012. [33] W.A. Lu, G. Y. Chen, and C. D. Kuo, “Foot reflexology can increase vagal modulation, decrease sympathetic modulation, and lower blood pressure in healthy subjects and patients with coronary artery disease,” Alternative Therapies in Health and Medicine, vol. 17, no. 4, pp. 8–14, 2011. [34] M.Moeini, L. S. Kahangi,M. Valiani, and R. Heshmat, “The effect of reflexotherapy on patients’ vital signs before coronary artery bypass graft surgery,” Iranian Journal of Nursing and Midwifery Research, vol. 16, no. 1, pp. 8–12, 2011. [35] V. L. Green, A. Alexandropoulou, M. B. Walker et al., “Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage,” Experimental and Therapeutic Medicine, vol. 1, no. 1, pp. 97–108, 2010. [36] J. Holt, J. Lord, U. Acharya et al., “The effectiveness of foot reflexology in inducing ovulation: a sham-controlled randomized trial,” Fertility and Sterility, vol. 91, no. 6, pp. 2514–2519, 2009. [37] P. A. Mackereth, K. Booth, V. F. Hillier, and A. L. Caress, “Reflexology and progressive muscle relaxation training for people with multiple sclerosis: a crossover trial,” ComplementaryTherapies in Clinical Practice, vol. 15, no. 1, pp. 14–21, 2009. [38] N. A. Hodgson and S. Andersen, “The clinical efficacy of reflexology in nursing home residents with dementia,” Journal of Alternative and ComplementaryMedicine, vol. 14,no. 3, pp. 269– 275, 2008. [39] T. J. Gunnarsdottir and H. Jonsdottir, “Does the experimental design capture the effects of complementary therapy? A study using reflexology for patients undergoing coronary artery bypass graft surgery,” Journal of Clinical Nursing, vol. 16, no. 4, pp. 777–785, 2007. [40] A. J.Mc Vicar, C. R. Greenwood, F. Fewell, V. D’arcy, S. Chandrasekharan, and L. C. Alldridge, “Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: a pilot study in healthy individuals,” Complementary Therapies in Clinical Practice, vol. 13, no. 3, pp. 137–145, 2007. [41] I. S. A. Wilkinson, S. Prigmore, and C. F. Rayner, “A randomised- controlled trail examining the effects of reflexology of patients with chronic obstructive pulmonary disease (COPD),” ComplementaryTherapies in Clinical Practice, vol. 12, no. 2, pp. 141–147, 2006. [42] B. S. M. Frankel, “The effect of reflexology on baroreceptor reflex sensitivity, blood pressure and sinus arrhythmia,” ComplementaryTherapies in Medicine, vol. 5, no. 2, pp. 80–84, 1997. [43] D. Moher, A. Liberati, J. Tetzlaff, and D. G. Altman, “Preferred reporting for systematic reviews and meta-analyses,” PLoS Medicine, vol. 6, no. 7, Article ID e10000097, 2009. [44] J. P. T. Higgins and S. Green, Eds., Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0,The Cochrane Collaboration, Oxford, UK, 2011, https://www.cochranehandbook. org. [45] T. Brygge, J. H. Heinig, P. Collins et al., “Reflexology and bronchial asthma,” Respiratory Medicine, vol. 95, no. 3, pp. 173–179, 2001. [46] J. Bradt and C. Dileo, “Music for stress and anxiety reduction in coronary heart disease patients,” Cochrane Database of Systematic Reviews, no. 2, Article ID CD006577, 2009. [47] H. Marquardt, Reflex ZoneTherapy of the Feet: A Comprehensive Guide forHealth Professionals,Healing Arts Press, Rochester,Vt, USA, 2007. [48] D. Tiran and P. A. Mackereth, Clinical Reflexology: A Guide for Integrated Practice, Churchill Livingstone Elsevier, Edinburgh, Scotland, 2011. [49] National Institute for Health and Care Excellence (NICE), “Clinical guidelines hypertension: clinical management of primary hypertension in adults,” 2013, http://publications.nice.org .uk/hypertension-cg12",
year = "2014",
month = "5",
day = "5",
doi = "10.1155/2014/502123",
language = "English",
volume = "Volume",
pages = "1--16",
journal = "Evidence-Based Complementary and Alternative Medicine",
issn = "1741-427X",

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TY - JOUR

T1 - The Physiological and Biochemical Outcomes Associated with a Reflexology Treatment: A Systematic Review

AU - Mc Cullough, Julie

AU - Liddle, Diane

AU - Sinclair, Marlene .

AU - Close, Ciara

AU - Hughes, Ciara

N1 - Reference text: [1] “House of lords select committee on science and technology sixth report (2000),” 2012, http://www.publications.parliament .uk/pa/ld199900/ldselect/ldsctech/123/12301.htm. [2] J. Lee, M. Han, Y. Chung, J. Kim, and J. Choi, “Effects of foot reflexology on fatigue, sleep and pain: a systematic review and meta-analysis,” Journal of Korean Academy of Nursing, vol. 41, no. 6, pp. 821–833, 2011. [3] J. Jones, P. Thomson, W. Lauder, K. Howie, and S. J. Leslie, “Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: a double-blind randomised controlled trial,” Complementary Therapies in Clinical Practice, vol. 18, pp. 204– 211, 2012. [4] S. McDonough, P. Devine, and D. Baxter, “Research update: complementary and alternative medicine: patterns of use in Northern Ireland,” 2007, http://www.ark.ac.uk/publications/updates/ update50.pdf. [5] C. L. Ventola, “Current issues regarding complementary and alternative medicine (CAM) in the United States—part 1: the widespread use of CAM and the need for better-informed health care professionals to provide patient counseling,” Pharmacy andTherapeutics, vol. 35, no. 8, pp. 461–468, 2010. [6] NIFAB-undersøkelsen 2007, http://www.nifab.no/om alternativ behandling/tall og fakta/nifab undersoekelsen 2007. [7] DanishMinistry ofHealth, Knowledge and Research Center for Alternative Medicine, 2012, http://www.srab.dk/uk/alternative +medicine/reflexology. [8] British Library, http://www.bl.uk/bipc/aboutus/news/comptherapy. html. [9] H. Hodgson, “Does reflexology impact on cancer patients’ quality of life?” Nursing Standard, vol. 14, no. 31, pp. 33–38, 2000. [10] L. Mollart, “Single-blind trial addressing the differential effects of two reflexology techniques versus rest, on ankle and foot oedema in late pregnancy,” ComplementaryTherapies inNursing and Midwifery, vol. 9, no. 4, pp. 203–208, 2003. [11] N. L.N. Stephenson and J.A.Dalton, “Using reflexology for pain management. A review,” Journal of Holistic Nursing, vol. 21, no. 2, pp. 179–191, 2003. [12] G.Wyatt, A. Sikorskii, M. A. Rahbar, D. Victorson, and M. You, “Health-related quality-of-life outcomes: a reflexology trial with patients with advanced stage breast cancer,” Oncology Nursing Forum, vol. 39, no. 6, pp. 568–577, 2012. [13] D. Botting, “Review of literature on the effectiveness of reflexology,” Complementary Therapies in Nursing & Midwifery, vol. 3, no. 5, pp. 123–130, 1997. [14] E. Ernst and K. K¨oder, “An overview of reflexology,” European Journal of General Practice, vol. 3, no. 2, pp. 52–57, 1997. [15] M.-Y. Wang, P.-S. Tsai, P.-H. Lee, W.-Y. Chang, and C.-M. Yang, “The efficacy of reflexology: systematic review,” Journal of Advanced Nursing, vol. 62, no. 5, pp. 512–520, 2008. [16] E. Ernst, “Is reflexology an effective intervention? A systematic review of randomised controlled trials,” Medical Journal of Australia, vol. 191, no. 5, pp. 263–265, 2009. [17] E. Ernst, P. Posadzki, and M. S. Lee, “Reflexology: an update of a systematic review of randomised clinical trials,” Maturitas, vol. 68, no. 2, pp. 116–120, 2011. [18] J. Jones,P.Thomson, K. Irvine, andS. J. Leslie, “Is there a specific haemodynamic effect in reflexology? A systematic review of randomised controlled trials,” The Journal of Alternative and Complementary Medicine, vol. 19, no. 4, pp. 319–328, 2013. [19] J. I. Kim, M. S. Lee, J. W. Kang, D. Y. Choi, and E. Ernst, “Reflexology for the symptomatic treatment of breast cancer: a systematic review,” Integrative CancerTherapies, vol. 9, no. 4, pp. 326–330, 2010. [20] D. Tiran and H. Chummun, “The physiological basis of reflexology and its use as a potential diagnostic tool,” Complementary Therapies in Clinical Practice, vol. 11, no. 1, pp. 58–64, 2005. [21] E. Ingham, Stories the Feet Can Tell Thru Reflexology, Stories the Feet Have Told Thru Reflexology, Ingham Publishing, St Petersburg, Fla, USA, 1984. [22] I. Sudmeier, G. Bodner, I. Egger, E. Mur, H. Ulmer, and M. Herold, “Changes of renal blood flow during organ-associated foot reflexologymeasured by colour doppler sonography,” Forschende Komplementarmedizin, vol. 6, no. 3, pp. 129–134, 1999. [23] K. Dalal, D. Elanchezhiyan, R. Das et al., “Noninvasive characterisation of foot reflexology areas by swept source-optical coherence tomography in patients with low back pain,” Evidence- Based Complementary and Alternative Medicine, vol. 2013, Article ID 983769, 11 pages, 2013. [24] UniversalCollege of Reflexology, 2012, http://www.universalreflex. com/article.php/20040309175204417. [25] C. M. Hughes, S. Krirsnakriengkrai, S. Kumar, and S. M. McDonough, “The effect of reflexology on the autonomic nervous system in healthy adults: a feasibility study,” Alternative Therapies in Health and Medicine, vol. 17, no. 3, pp. 32–37, 2011. [26] D. Sliz, A. Smith, C. Wiebking, G. Northoff, and S. Hayley, “Neural correlates of a single-session massage treatment,” Brain Imaging and Behavior, vol. 6, no. 1, pp. 77–87, 2012. [27] H. Poole, S. Glenn, and P. Murphy, “A randomised controlled study of reflexology for the management of chronic low back pain,” European Journal of Pain, vol. 11, no. 8, pp. 878–887, 2007. [28] D. Tiran, Reflexology in Pregnancy and Childbirth, Churchill Livingstone Elsevier, London, UK, 2010. [29] H.G.Guyatt, A. D. Oxman, G. E. Vist et al., “GRADE: an emerging consensus on rating quality of the evidence and strength of recommendations,” British Medical Journal, vol. 336, no. 7650, pp. 924–926, 2008. [30] J. Jones, P. Thomson, W. Lauder, K. Howie, and S. J. Leslie, “Reflexology has no immediate haemodynamic effect in patients with chronic heart failure: a double-blind randomised controlled trial,” Complementary Therapies in Clinical Practice, vol. 19, pp. 133–138, 2013. 16 Evidence-Based Complementary and Alternative Medicine [31] N. A. Hodgson and D. Lafferty, “Reflexology versus Swedish massage to reduce physiologic stress and pain and improve mood in nursing home residents with cancer: a pilot trial,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 456897, 5 pages, 2012. [32] E. Ruiz-Padial, N. Torres-Lopez, J. Luna-Bujald´on, I. Espadas- Villanueva, and G. R. del Paso, “Cardiovascular effects of reflexology in healthy individuals: evidence for a specific increase in blood pressure,” Alternative Medicine Studies, vol. 2, no. e4, pp. 10–17, 2012. [33] W.A. Lu, G. Y. Chen, and C. D. Kuo, “Foot reflexology can increase vagal modulation, decrease sympathetic modulation, and lower blood pressure in healthy subjects and patients with coronary artery disease,” Alternative Therapies in Health and Medicine, vol. 17, no. 4, pp. 8–14, 2011. [34] M.Moeini, L. S. Kahangi,M. Valiani, and R. Heshmat, “The effect of reflexotherapy on patients’ vital signs before coronary artery bypass graft surgery,” Iranian Journal of Nursing and Midwifery Research, vol. 16, no. 1, pp. 8–12, 2011. [35] V. L. Green, A. Alexandropoulou, M. B. Walker et al., “Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage,” Experimental and Therapeutic Medicine, vol. 1, no. 1, pp. 97–108, 2010. [36] J. Holt, J. Lord, U. Acharya et al., “The effectiveness of foot reflexology in inducing ovulation: a sham-controlled randomized trial,” Fertility and Sterility, vol. 91, no. 6, pp. 2514–2519, 2009. [37] P. A. Mackereth, K. Booth, V. F. Hillier, and A. L. Caress, “Reflexology and progressive muscle relaxation training for people with multiple sclerosis: a crossover trial,” ComplementaryTherapies in Clinical Practice, vol. 15, no. 1, pp. 14–21, 2009. [38] N. A. Hodgson and S. Andersen, “The clinical efficacy of reflexology in nursing home residents with dementia,” Journal of Alternative and ComplementaryMedicine, vol. 14,no. 3, pp. 269– 275, 2008. [39] T. J. Gunnarsdottir and H. Jonsdottir, “Does the experimental design capture the effects of complementary therapy? A study using reflexology for patients undergoing coronary artery bypass graft surgery,” Journal of Clinical Nursing, vol. 16, no. 4, pp. 777–785, 2007. [40] A. J.Mc Vicar, C. R. Greenwood, F. Fewell, V. D’arcy, S. Chandrasekharan, and L. C. Alldridge, “Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: a pilot study in healthy individuals,” Complementary Therapies in Clinical Practice, vol. 13, no. 3, pp. 137–145, 2007. [41] I. S. A. Wilkinson, S. Prigmore, and C. F. Rayner, “A randomised- controlled trail examining the effects of reflexology of patients with chronic obstructive pulmonary disease (COPD),” ComplementaryTherapies in Clinical Practice, vol. 12, no. 2, pp. 141–147, 2006. [42] B. S. M. Frankel, “The effect of reflexology on baroreceptor reflex sensitivity, blood pressure and sinus arrhythmia,” ComplementaryTherapies in Medicine, vol. 5, no. 2, pp. 80–84, 1997. [43] D. Moher, A. Liberati, J. Tetzlaff, and D. G. Altman, “Preferred reporting for systematic reviews and meta-analyses,” PLoS Medicine, vol. 6, no. 7, Article ID e10000097, 2009. [44] J. P. T. Higgins and S. Green, Eds., Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0,The Cochrane Collaboration, Oxford, UK, 2011, https://www.cochranehandbook. org. [45] T. Brygge, J. H. Heinig, P. Collins et al., “Reflexology and bronchial asthma,” Respiratory Medicine, vol. 95, no. 3, pp. 173–179, 2001. [46] J. Bradt and C. Dileo, “Music for stress and anxiety reduction in coronary heart disease patients,” Cochrane Database of Systematic Reviews, no. 2, Article ID CD006577, 2009. [47] H. Marquardt, Reflex ZoneTherapy of the Feet: A Comprehensive Guide forHealth Professionals,Healing Arts Press, Rochester,Vt, USA, 2007. [48] D. Tiran and P. A. Mackereth, Clinical Reflexology: A Guide for Integrated Practice, Churchill Livingstone Elsevier, Edinburgh, Scotland, 2011. [49] National Institute for Health and Care Excellence (NICE), “Clinical guidelines hypertension: clinical management of primary hypertension in adults,” 2013, http://publications.nice.org .uk/hypertension-cg12

PY - 2014/5/5

Y1 - 2014/5/5

N2 - Background. Reflexology is one of the top forms of complementary and alternative medicine in the UK and is used for healthcare by a diverse range of people. However, it is offered by few healthcare providers as little scientific evidence is available explaining how it works or any health benefits it may confer.The aim of this review was to assess the current evidence available from reflexology randomised controlled trials (RCTs) that have investigated changes in physiological or biochemical outcomes. Methods. Guidelines from the Cochrane Handbook of Systematic Reviews of Interventions were followed: the following databases were searched from inception to December 2013:AMED, CAMQuest, CINAHL Plus, Cochrane Central Register of Controlled Trials, Embase,MedlineOvid, Proquest, and Pubmed. Risk of bias was assessed independently by two members of the review team and overall strength of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation guidelines. Results.Seventeen eligible RCTs met all inclusion criteria. A total of 34 objective outcome measures were analysed. Although twelve studies showed significant changes within the reflexology group, only three studies investigating blood pressure, cardiac index, and salivaryamylase resulted in significant between group changes in favour of reflexology. The overall quality of the studies was low.

AB - Background. Reflexology is one of the top forms of complementary and alternative medicine in the UK and is used for healthcare by a diverse range of people. However, it is offered by few healthcare providers as little scientific evidence is available explaining how it works or any health benefits it may confer.The aim of this review was to assess the current evidence available from reflexology randomised controlled trials (RCTs) that have investigated changes in physiological or biochemical outcomes. Methods. Guidelines from the Cochrane Handbook of Systematic Reviews of Interventions were followed: the following databases were searched from inception to December 2013:AMED, CAMQuest, CINAHL Plus, Cochrane Central Register of Controlled Trials, Embase,MedlineOvid, Proquest, and Pubmed. Risk of bias was assessed independently by two members of the review team and overall strength of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation guidelines. Results.Seventeen eligible RCTs met all inclusion criteria. A total of 34 objective outcome measures were analysed. Although twelve studies showed significant changes within the reflexology group, only three studies investigating blood pressure, cardiac index, and salivaryamylase resulted in significant between group changes in favour of reflexology. The overall quality of the studies was low.

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U2 - 10.1155/2014/502123

DO - 10.1155/2014/502123

M3 - Article

VL - Volume

SP - 1

EP - 16

JO - Evidence-Based Complementary and Alternative Medicine

T2 - Evidence-Based Complementary and Alternative Medicine

JF - Evidence-Based Complementary and Alternative Medicine

SN - 1741-427X

M1 - 502123

ER -