A feasibility randomised controlled trial investigating reflexology in the management of low back and/ or pelvic pain during pregnancy: The CAM (Complementary and Alternative Medicine) in pregnancy trial

Abstract

Two thirds of pregnant women experience low back pain and one fifth experience pelvic pain that can adversely affect women’s lives. There is evidence demonstrating benefits of reflexology for managing general low back pain. Therefore, this research aimed to investigate the feasibility of conducting a randomised controlled trial (RCT) investigating reflexology in the management of low back and/ or pelvic pain (LBPP) during pregnancy.

Overall, 90 primiparous women (mean age 30.9 +/- 5.6 years) participated in a feasibility RCT in an inner-city maternity unit. Women were randomised to usual care, a reflexology or footbath intervention. Primary outcome measures were; the Visual Analogue Scale (VAS) for pain frequency and intensity. Qualitative data on women’s experience of the RCT and their experience of LBPP were collected via focus groups after the intervention period. Biochemical, physiological and labour data were also collected.

In total 64 women completed the study period; retention rates for the reflexology group were 80%, usual care group 83.33% and footbath group 50%. The reflexology group demonstrated a Mean Clinically Important Change (MCIC) in VAS pain frequency (1.64cm). Second stage of labour was shorter in the reflexology group (73.56 minutes +/-53.78) compared to the usual care group (117.92minutes +/-56.15), this was statistically significant (p=0.045). A lesser increase in cortisol and decrease in beta-endorphin were found in the reflexology group. There was a statistically significant reduction in systolic blood pressure (p=0.03) in the reflexology group and a significant increase in diastolic blood pressure (p=0.01) in the footbath group. Qualitative data indicate that women perceive health-professional management of pregnancy-LBPP as insufficient.

Results indicate it is feasible to conduct an RCT in this area, although a footbath is not suitable sham treatment. Reflexology may be helpful for pregnancy-LBPP; however to confirm this, a fully powered trial is required. Furthermore, management of pregnancy LBPP needs to be re-evaluated.

Date of Award	May 2015
Original language	English
Supervisor	Ciara Hughes (Supervisor), Dianne Liddle (Supervisor) & Marlene Sinclair (Supervisor)