J Korean Acad Nurs.  2011 Dec;41(6):821-833. 10.4040/jkan.2011.41.6.821.

Effects of Foot Reflexology on Fatigue, Sleep and Pain: A Systematic Review and Meta-analysis

• Lee J
• Han M
• Chung Y
• Kim J
• Choi J

• KMID: 1120115
• DOI: http://doi.org/10.4040/jkan.2011.41.6.821

Abstract

PURPOSE
The purpose of this study was to evaluate the effectiveness of foot reflexology on fatigue, sleep and pain.
METHODS
A systematic review and meta-analysis were conducted. Electronic database and manual searches were conducted on all published studies reporting the effects of foot reflexology on fatigue, sleep, and pain. Forty four studies were eligible including 15 studies associated with fatigue, 18 with sleep, and 11 with pain. The effects of foot reflexology were analyzed using Comprehensive Meta-Analysis Version 2.0. The homogeneity and the fail-safe N were calculated. Moreover, a funnel plot was used to assess publication bias.
RESULTS
The effects on fatigue, sleep, and pain were not homogeneous and ranged from 0.63 to 5.29, 0.01 to 3.22, and 0.43 to 2.67, respectively. The weighted averages for fatigue, sleep, and pain were 1.43, 1.19, and 1.35, respectively. No publication bias was detected as evaluated by fail-safe N. Foot reflexology had a larger effect on fatigue and sleep and a smaller effect on pain.
CONCLUSION
This meta-analysis indicates that foot reflexology is a useful nursing intervention to relieve fatigue and to promote sleep. Further studies are needed to evaluate the effects of foot reflexology on outcome variables other than fatigue, sleep and pain.

Keyword

Systematic review; Foot reflexology; Fatigue; Sleep; Pain

MeSH Terms

Databases, Factual
Fatigue/*therapy
Female
*Foot
Humans
Male
*Massage
Pain Management/*nursing
Sleep Initiation and Maintenance Disorders/*therapy

Figure

• 

  Figure 1 Foot reflexology: Flow diagram based on PRISMA (Moher et al., 2009).

• 

  Figure 2 Forest plot & funnel plot for patients and lay people: Fatigue, sleep & pain.

Reference

1. Cho KS. The effect of hand massage program on anxiety in cataract surgery under local anesthesia. Journal of Korean Academy of Nursing. 1999. 29:97–106. doi: 10.4040/jkan.2008.38.2.187.

2. Cohen J. Statistical power analysis for the behavioral sciences. 1977. 1st ed. New York: Academic Press.

3. Choi JS. Effect of foot reflex zone massage on hemodialysis patient stress, depression and fatigue. 2002. Chuncheon: Kangwon National University;Unpublished master's thesis.

4. Choi YJ, Jeong HW, Choi SY. A study on the use of alternative medicine for cancer patients admitted at a hospital. Journal of the Korean Public Health Association. 1998. 24:167–181.

5. Eisenberg D, Kessler RC, Foster G. Unconventional medicine in the United States: Prevalence, costs, and pattern of use. The New England Journal of Medicine. 1993. 328:246–252.

6. Evans D. Systematic reviews of nursing research. Intensive Critical Care Nursing. 2001. 17:51–57. doi: 10.1054/iccn.2000.1550.

7. Foltz V, St Pierre Y, Rossignol M, Bourgeois P, Joseois L, Adam V, et al. Use of complementary and alternative therapies by patients with self-reported chronic back pain: A nationwide survey of consumer opinion in Canada. Joint Bone Spine. 2005. 72:571–577. doi: 10.1016/j.jbspin.2005.03.018.

8. Higgins J, Green S, editors. Cochrane handbook for systematic review of interventions. 2008. West Sussex: Join Wiley & Sons.

9. Im ES, Nam MR. Effect of foot reflexo-massage on the mood, sleep and blood pressure of the women elderly. Journal of Mokpo Science College. 2005. 287–316.

10. Jeong HK. Heojun's Dong-eui-bogam. 2006. Hadong: Dongeuibogam Company.

11. Kim HJ, Lee KS, Lee MH, Jung DS, Yoo JS, Han HS, et al. An analysis of Korea research on complementary and alternative therapy. Journal of Chungju University. 2006. 41:529–539.

12. Kim KD. Meta-analysis on the foot reflexology intervention program. 2009. Daegu: Keongbuk University;Unpublished doctoral dissertation.

13. Kim MY. Meta-analysis of the effectiveness on foot reflexology for cancer patients. 2011. Seoul: Sahmyook University;Unpublished master's thesis.

14. Kim SJ. Foot management. 1999. Seoul: Telling of Love Company.

15. Kim YS. A theoretical analysis on the foot reflexology emerging as an alternative medicine. New Medical Journal. 2001. 44:87–94.

16. Lee CY. Room physiotherapy method of treatment to use this school register basic. 1992. Seoul: Iljungsa.

17. Lee YC, Park HS. Study on use of alternative therapy in chronic patients. Journal of Korean Academy of Fundamentals of Nursing. 1999. 6:96–113.

18. Min YC. A meta-analysis of intervention studies on cancer pain. 2011. Seoul: Sahmyook University;Unpublished master's thesis.

19. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic review and meta-analyses: The PRISMA statement. Annals of Internal Medicine. 2009. 151(4):264–269. doi: 10.1371/j.pmed1000097.

20. Nikolaos AP, Evangelos E, John PI. Sensitivity of between-study heterogeneity in meta-analysis: Proposed metrics and empirical evaluation. International Journal of Epidemiology. 2008. 37:1148–1157. doi: 10.1093/ije/dyn065.

21. Norred C, Zamudio S, Palmer SK. Use of complementary and alternatives medicine by surgical patients. The Journal of the American Association of Nurse Anesthetists. 2000. 68(1):13–18. doi: 10.1016/S0001-2092(06)61003-X.

22. Oh HG. Alternative medicine. 1994. Seoul: Academia.

23. Park KP, Kang MG, Kim CB, Kim KS, Jee SH. A meta-analysis on the risk factors of cerebrovascular disorders in Koreans. Journal of Preventive Medicine and Public Health. 1998. 31:27–48.

24. Park MK. Effects of tai chi on fall risk factors: A meta-analysis. 2011. Daejon: Chungnam National University;Unpublished Doctoral dissertation.

25. Scanlin A. Critical appraisal of systemetic reviews of nursing practice. The Australasian Journal of Neuroscience. 2006. 18:8–14.

26. Shin KR, Kim AJ. Alternative therapy and nursing. 2007. Seoul: Hyunmunsa.

27. Sutton AJ, Duval SJ, Tweedie RL, Abrams K, Jones DR. Empirical assessment of effect of publication bias on meta-analysis. British Medical Journal. 2000. 320:1574–1577. doi: 10.1136/bmj.320.7249.1574.

28. Song HH. Meta-analysis. 1998. Seoul: Chungmungak.

29. The Cochrane collaboration open learning material: Diversity and heterogeneity. The Cochrane Collaboration. 2002. Retrieved May 15, 2011. from http://www.cochrane-net.org/openlearning/HTML/mod13-3.htm.

30. Yang JH. The effect of foot reflexology on nausea, vomiting and fatigue of breast cancer patients undergoing chemotherapy. Journal of Korean Academy of Nursing. 2005. 35:177–185. doi: 10.4040/jkan.2008.38.2.187.