Table 3 Short Evidence table
From: Reflexology in oncological treatment – a systematic review
Reference | Study type | n/ cancer type/ Drop Out / m/f (%) | Intervention/ Duration | Endpoints | Outcomes |
|---|---|---|---|---|---|
Mantoudi (2020) | RCT | n = 83 / Reflexology n = 40, Relaxation n = 40 / Dropout n = 3 / Cancer type: lung, prostate, urogenital, gastrointestinal / m (21%) vs. f (79%) Other therapies: [Arm A vs. B (%)]: Radiotherapy (32,5% vs. 52,5%), Chemotherapy (35% vs. 60%) | Reflexology vs. Relaxation 1 × 30 min per week for 6 weeks | 1. Pain 2. Anxiety 3. Depression 4. Quality of life | 1. Pain: Change from baseline to 4th week: n.s Change from baseline to 6th week: n.s 2. Anxiety: Change from baseline to 4th week: n.s Change from baseline to 6th week: n.s 3. Depression: Change from baseline to 4th week: Reflexology -13.61 SD ± 10.93 and relaxation -6.49 SD ± 11.50, p = 0.006, Eta2 = 0.094 Change from baseline to 6th week: Reflexology -19.58 SD ± 12.89 and relaxation -9.06 SD ± 13.76, p = 0.001, Eta2 = 0.138 4. Quality of Life: Physical component summary score: Change from baseline to 4th week: n.s Change from baseline to 6th week: Reflexology 20.75% SD ± 27.69 and relaxation 1.48% SD ± 13.23, p < 0.001, Eta2 = 0.168 Mental component summary score: Change from baseline to 4th week: n.s Change from baseline to 6th week: Reflexology 13.57% SD ± 14.93 and relaxation 5.72% SD ± 13.72, p = 0.017, Eta2 = 0.071 |
Göral Türkcü, Özkan (2021) | RCT | n = 68 / reflexology n = 31, control n = 31 / Dropout n = 6 / gynecological cancers / f (100%) Other therapies: Chemotherapy | Reflexology 3x/week for two weeks, 30–45 min Control group received standard care | 1. Anxiety 2. Depression 3. Quality of life | 1. Anxiety: Baseline: Reflexology 42.45 SD ± 9.49 vs. Control 43.77 SD ± 5.59, p = 0.71 After 4 weeks: Reflexology 32.94 SD ± 8.42 vs. Control 45.29 SD ± 5.32, p < 0.001 2. Depression: Baseline: Reflexology 36.26 SD ± 9,41 vs. Control 35.81 SD ± 7.70, p = 0.83 After 4 weeks: Reflexology 29.65 SD ± 8.51 vs. Control 40.52 SD ± 4.62, p < 0.001 3. Quality of Life: Global QoL: Baseline: Reflexology 46.77 SD ± Control 12.67 vs. 42.47 SD ± 11.05, p = 0.09 After four weeks: Reflexology 60.22 SD ± 17.17 vs. Control 40.59 SD ± 9.06, p < 0.01 Functional scale: Baseline: Reflexology 28.29 SD ± 12.68 vs. Control 23.10 SD ± 10.87, p = 0.08 After 4 weeks: Reflexology 39.53 SD ± 9.24 vs. Control 17.56 SD ± 6.99, p < 0.001 Symptoms scale: Baseline: Reflexology 71.02 SD ± 11.87 vs. Control 68.00 SD ± 12.21, p = 0.32 After four weeks: Reflexology 60.49 SD ± 7.01 vs. Control 72.66 SD ± 10.36, p < 0.001 |
Wyatt (2021) | RCT | n = 347 / Reflexology n = 150, Meditative Practices n = 150, Control n = 47 / Dropout n = 126 / Cancer type: breast, lung, colon, prostate, other / m (23%) vs. f (77%) | Caregivers were trained to provide reflexology (4x/week for 15 min) and meditative practices (4x/week for 30 min) at home After 4 weeks: nonresponding patients were randomized 1:1 to either the same group or the other group Responding patients continued their treatment for another four weeks Control group received standard care | 1. Fatigue 2. Summed Symptom Severity 3. Anxiety and Depression | 1. Fatigue: No significant group differences for all randomizations 2. Summed Symptom Severity: No significant group differences for all randomizations 3. Anxiety and Depression: No significant group difference for all randomizations |
Murat-Ringot (2021) | RCT | n = 80 / reflexology n = 40, control n = 40, Dropout: n = 16 / cancer type: lung or digestive (stage II-IV) / sex (m/f) Reflexology: 67%/33% Control: 58%/42% Type of Chemotherapy: Carboplatin (moderately emetogenic) [Reflexology (37%), Control (37%)], Oxaliplatin (moderately emetogenic) [Reflexology (32%), Control (35%)], Cisplatin (highly emetogenic) [Reflexology (30%), Control (27%)] | Four sessions of reflexology (30 min each) every 2–3 weeks during chemotherapy infusion depending on the chemotherapy protocol for 4 cycles Control group received standard care | 1.Chemotherapy induced nausea and vomiting (CINV) 2.Delayed CINV 3.Quality of Life 4.Anxiety 5.Self-esteem | 1. CINV: per ITT: increase of VAS ≥ 2: reflexology 6/40 vs. control 13/40; p = 0.20 2. Delayed CINV: Across all cycles significant decrease in the use of antiemetic drugs (p = 0.04) Decrease in delayed nausea: n.s Difference in delayed vomiting: n.s 3. Quality of life: n.s 4. Anxiety: n.s 5. Average Body Image Score decrease: n.s |
Sikorskii (2020) | RCT | n = 256, Reflexology n = 128, control n = 128, Dropout: n = 47, Breast cancer (stage III-IV), female Other therapies: Chemotherapy or targeted therapy (with or without hormonal): 188 patients Hormonal therapy only: 41 patients | Reflexology: receiving four weeks of home-based, lay caregiver–delivered (at least one per week) foot reflexology (following a 30-min foot reflexology protocol), and symptom assessment calls Control: receiving four weekly symptom assessment calls only | 1.Severity of symptoms (pain, fatigue, disturbed sleep, shortness of breath, difficulty remembering, decreased appetite, dry mouth, numbness/tingling, vomiting/nausea) 2. Depression | 1. Severity of symptoms: Significantly better results than attention control in pain [OR = 1.84, 95% CI (1.05, 3.23), p = 0.03] Any of the other symptoms: n.s 2. Depression: n.s The probability of intervention success was smaller with comorbidities [OR = 0.87, 95% CI (0.80, 0.94), p < .01] and higher CES-D at baseline [OR = 0.96, 95% CI (0.94, 0.99), p < .01] Older age was associated with significantly higher response rates to reflexology in terms of remembering [OR = 1.05, 95% CI (1.00, 1.11), p = 0.04] and disturbed sleep [OR = 1.06, 95% CI (1.01, 1.10), p = 0.02] |
Sikorskii (2018) | RCT | n = 256, Reflexology n = 128, control n = 128, Dropout: n = 49, Breast cancer (stage III-IV), female | Reflexology: receiving four weeks of home-based, lay caregiver–delivered (at least one per week) foot reflexology (following a 30-min foot reflexology protocol), and symptom assessment calls Control: receiving four weekly symptom assessment calls only | 1.Physical function 2.Pain 3.Fatigue 4.Sleep 5.Depression/mental health 6.Anxiety 7.Social functioning Comparison between different measurement tools | At Baseline values are given as Mean (SD) of all patients while at the follow up values are given as least square (SE) T0: Baseline T1: Week 5 (one week after intervention) 1.Physical function: n.s 2.Pain: T0: PROMIS-29 pain interference profile v1.0: (55.80 SD ± 9.47), SF-36 bodily pain (45.01 SD ± 10.35), PROMIS-29 pain severity profile v1.0 (3.60 SD ± 2.71), MDASI pain severity (3.57 SD ± 3.16) T1: PROMIS-29 pain interference profile v1.0: n.s SF-36 bodily pain: n.s PROMIS-29 pain severity profile v1.0: Significant difference between reflexology (2.87 SD ± 0.22) and control (3.51 SD ± 0.21), ES = 0.31, p = 0.04 MDASI pain severity: Significant difference between reflexology (2.09 SD ± 0.22) and control (3.06 SD ± 0.21), ES = 0.46, p < 0.01 3.Fatigue: T0: PROMIS-29 fatigue profile v1.0 (58.76 SD ± 8.98), SF-36 vitality (43.92 SD ± 10.29), MDASI fatigue severity (5.83 SD ± 2.73) T1: PROMIS-29 fatigue profile v1.0: n.s SF-36 vitality: n.s MDASI fatigue severity: Significant difference between reflexology (3.52 SD ± 0.24) and control (4.24 SD ± 0.23), ES = 0.31, p = 0.03 4.Sleep: n.s 5. Depression/mental health: T0: PROMIS-29 depression profile v1.0 (50.46 SD ± 8.10), CES-D (15.13 SD ± 10.52), MDASI sadness severity (3.22 SD ± 3.13), MDASI distress severity (3.80 SD ± 3.05), SF-36 mental health (49.62 SD ± 9.30) T1: PROMIS-29 depression profile v1.0: n.s CES-D: Significant difference between reflexology (11.76 SD ± 0.77) and control 814.09 SD ± 0.74), ES = 0.32, p = 0.03 MDASI sadness severity: n.s MDASI distress severity: Significant difference between reflexology (1.68 SD ± 0.23) and control (2.35 SD ± 0.22), ES = 0.31, p = 0.04 SF-36 mental health: Significant difference between reflexology (53.76 SD ± 0.76) and control (50.08 SD ± 0.73), ES = 0.51, p < 0.01 6.Anxiety: T0: PROMIS-29 anxiety profile v1.0 (52.69 SD ± 8.82), State anxiety (34.33 SD ± 11.67) T1: PROMIS-29 anxiety profile v1.0: Significant difference between reflexology (50.40 SD ± 0.71) and control (52.42 SD ± 0.67), ES = 0.30, p = 0.04 State anxiety: Significant difference between reflexology (30.93 SD ± 0.84) and control (34.05 SD ± 0.80), ES = 0.39, p = 0.01 7.Social functioning: T0: PROMIS-29 satisfaction with participation in social roles profile v1.0 (45.13 SD ± 8.40), SF-36 social functioning (43.79 SD ± 10.88) T1: PROMIS-29 satisfaction with participation in social roles profile v1.0: n.s SF-36 social functioning: Significant difference between reflexology (47.99 SD ± 0.88) and control (45.41 SD ± 0.85), ES = 0.31, p = 0.04 |
Samancioglu Baglama (2019 | RCT | n = 64 / Dropout: n = 4 / Reflexology n = 32, Control (reading session) n = 32 / Cancer type: hematologic, breast, lung, genitourinary, gastrointestinal (stages I-IV) / Sex (m/f): 53,3% / 46,7% Other therapies: cyclophosphamide + doxorubicin/epirubicin + cyclophosphamide (38,3%), cyclophosphamide, methotrexate, 5-FU (33,3%), 5-FU + doxorubicin + cyclophosphamide/5-FU + epirubicin + cyclophosphamide; 5-FU, 5-fluorouracil (28,3%) | 60-min teaching session for caregivers by a certified reflexologist Afterwards 60 min reflexology by caregivers a day and 60-min reading sessions for the control group for 15 days in total | 1.pain 2.anxiety 3.fatigue | 1.Pain No significant difference at the 1st day between intervention (5.86 SD ± 2.16) and control (5.56 SD ± 0.95), p = 0.645 Significant difference at the 15th day between intervention (4.70 SD ± 1.55) and control (6.36 SD ± 0.99), p = 0.000 The difference within the experimental group: n.s 2.Anxiety No significant difference at the 1st day between intervention (6.20 SD ± 2.65) and control (6.26 SD ± 1.36), p = 0.891 Significant difference at the 15th day between intervention (5.06 SD ± 1.59) and control (5.86 SD ± 1.27), p = 0.036 The difference within the experimental group was significant (p = 0.029) 3.Fatigue n.s The difference in the intervention group was significant (p = 0.005) |
Rambod (2019) | RCT | n = 72 / Reflexology n = 36, Control n = 36 / Cancer type: Hodgkin- and Non-Hodgkin lymphoma / Sex (m/f): Reflexology (69,4%/30,6%), control (75%/25%) Other therapies (Intervention vs. control): Prior chemotherapy (77,8% vs. 69,4%), receiving chemotherapy (19,4% vs. 27,8%), post chemotherapy (2,8% vs. 2.8%) | Reflexology was provided by a certified reflexologist over 5 consecutive days (15 min on each foot) for the intervention group Control group received standard care | 1.fatigue 2.pain 3.sleep | 1. Fatigue Multidimensional fatigue inventory: No significant differences before between intervention (62.55 SD ± 11.27) and control (67.00 SD ± 12.70), p = 0.10 Significant differences after between intervention [53.41 (10.78)] and control [68.88 (12.48)], p < 0.001. Within group difference is also significant for intervention (p < 0,001) and nonsignificant for control (p = 0,08) General fatigue: No significant differences before between intervention (13.52 SD ± 3.37) and control (14.36 SD ± 3.39), p = 0.26, significant differences after: intervention [12.30 (3.21)] and control [14.33 (3.28)], p = 0.006 Physical fatigue: No significant differences before between intervention (13.63 SD ± 3.48) and control (14.08 SD ± 4.01), p = 0.57, but significant differences after: intervention [12.88 (3.69)] and control [14.91 (3.60)], p = 0.01 Mental fatigue: n.s Reduced activity: No significant differences before between intervention (14.88 SD ± 4.29) and control (15.80 SD ± 3.72), p = 0.29, but significant differences after: intervention [14.25 (3.36)] and control [16.25 (3,37)], p = 0.01 Reduced motivation: No significant differences before between intervention (7.05 SD ± 2.30) and control (8.00 SD ± 2.60), p = 0.11, but significant differences after: intervention [6.72 (2.22)] and control [7.83 (2.58)], p = 0.05 2. Pain No significant differences before between intervention (3.83 SD ± 2.79) and control (3.88 SD ± 3.46), p = 0.87, but significant differences after: intervention [2.72 (2.30)] and control [4.33 (3.54)], p = 0.01 3.Sleep Total sleep quality: Significant difference before between intervention (10.11 SD ± 3.26) and control (11.80 SD ± 3.83), p = 0.05 and after: intervention [8.41 (2.98)] and control [11.83 (3.26)], p < 0.001 Subjective sleep quality: No significant difference before between intervention (1.44 SD ± 0.74)] and control (1.63 SD ± 0.76), p = 0.25, but significant differences after: intervention [1.13 (0.42)] and control [1.69 (0.74)], p < 0.001 Sleep latency: No significant difference before between intervention (1.97 SD ± 0.99) and control (2.27 SD ± 0.74), p = 0.13, but significant differences after: intervention [1.58 (0.93)] and control [2.30 (0.78)], p = 0.001 Sleep duration: n.s Daytime dysfunction: n.s Sleep disturbance: No significant differences before between intervention (1.88 SD ± 0.57) and control (1.86 SD ± 0.72), p = 0.84, but significant differences after: intervention [1.44 (0.50)] and control [1.80 (0.66)], p = 0.01 Sleep medication: n.s Sleep sufficiency: Significant differences before between intervention (0.72 SD ± 1.11) and control (1.27 SD ± 1.20), p = 0.03 and after: intervention [0.52 (.84)] and control [1.36 (1.22)], p < 0.001 |
Nourmohammadi (2019) | RCT | n = 60 / Reflexology n = 30, Control n = 30 / Dropout: n = 3 / Cancer type: breast cancer (stage I) / female | Reflexology group received intervention 2x/week (20 min per session) for four consecutive weeks Control group received standard care | 1.fatigue | 1. Fatigue No significant differences in fatigue before the intervention between reflexology (45.44 SD ± 5.30) and control (43.66 SD ± 7.68), p = 0.31 Follow up two months after the intervention: significant difference between reflexology (20.66 SD ± 4.54) and control (40.36 SD ± 9.58), p = 0.000 Difference within the reflexology group: significant (p = 0.000) Difference within the control group: nonsignificant (p = 0.16) |
Hesami (2019) | RCT | n = 80 / Reflexology n = 40, Control n = 40 / Cancer type: Digestion system, blood & lymph system, other / Sex (m/f) Intervention ( 50%/50%), Control (45%/55%) | Foot reflexology for four consecutive days (30 min per session) Control group received standard care | 1.fatigue | 1. Fatigue: Before intervention: No significant difference between intervention (5.538 SD ± 1.041) and control (5.000 SD ± 1.398), p = 0.054 After the intervention: Significant difference in the intervention group (4.486 SD ± 1.040, p = 0.000) Significant difference in fatigue in the control group (5.180 SD ± 1.450, p = 0.036) Significant difference between groups after the intervention (p = 0.016) |
Dikmen (2019) | RCT | n = 140 / Intervention groups n = 100, Control n = 40 / Dropout: n = 60 / Cancer types: Uterine, ovarian, cervical (grade I-III) / no information on sex Other therapies: 2nd or 3rd cycle of chemotherapy | Reflexology: 2x/week (30 min per session) for 8 weeks applied by the researcher Progressive Muscle Relaxation Exercises: 2x/week (20 min per session) for 8 weeks under supervision of the researcher Reflexology + Progressive Muscle Relaxation Control group received standard care | 1.pain 2.fatigue 3.quality of life | T1: Admission to hospital (baseline) T2: week 3 T3: week 8 T4: week 12 (follow up) 1.Pain Significant differences between groups at baseline for pain severity (p = 0.001) and insignificant differences for the effects of pain on daily life (p = 0.225) Significant differences at 3rd week for pain severity (p = 0.001) and the effects of pain on daily life (p = 0.001) Significant differences at 8th week for pain severity (p = 0.001) and the effects of pain on daily life (p = 0.001) Significant differences at 12th week for pain severity (p = 0.013) and the effects of pain on daily life (p = 0.017) 2.Fatigue Insignificant differences between groups at baseline for fatigue severity (p = 0,218) and effects of fatigue on daily life (p = 0,065) Significant differences at 3rd week for fatigue severity (p = 0,001) and effects of fatigue on daily life (p = 0,001) Significant differences at 8th week for fatigue severity (p = 0,001) and effects of fatigue on daily life (p = 0,001) Significant differences at 12th week for fatigue severity (p = 0.039) and effects of fatigue on daily life (p = 0.001) 3.Quality of Life Insignificant differences between groups at baseline (p = 0.079) Significant differences at 3rd, 8th and 12th week (p < 0.05) |
Rezaei (2021) | RCT | n = 66 / Reflexology n = 33, Control n = 33 / Cancer Type: Breast cancer (stage 1–4) / Sex: female Current therapies: Chemotherapy (85.35%), chemotherapy and radiotherapy (48.48%) | Reflexology applied for 40 min twice in one day (morning and afternoon) Control group received standard care | 1.anxiety | 1. Anxiety n.s |
Jahani (2018) | RCT | n = 84 / Reflexology n = 42, Control n = 42 / Cancer type: Hematologic cancer with metastases / Sex (m/f): Reflexology (54,8% / 45,2%), Control (54,8% / 45,2%) | Reflexology performed on one day Control group received standard care | 1.pain 2.anxiety | 1. Pain T1: 3 days before treatment T2: 2 days before T3: 1 day before T4: 1 day after treatment T5: 2 days after T6: 3 days after T1: No significant difference between reflexology (5.86 SD ± 2.46) and control (5.48 SD ± 2.50), p = 0.45 T2: p-value not given T3: Significant difference between reflexology (4.12 SD ± 2.18) and control (6.57 SD ± 2.08), p = 0.001 T4: p-value not given T5: Significant difference between reflexology (3.88 SD ± 2.039) and control (5.67 SD ± 1.946), p = 0.001 T6: Significant difference between reflexology (2.83 SD ± 1.793) and control (6.4 SD ± 1.835), p = 0.001 Intervention group: significant difference between first day of testing and last day of testing (p = 0.001) 2.Anxiety T1:1 day before treatment T2: 3rd day after treatment T1: No significant differences between reflexology group (46.62 SD ± 18.314) and control group (44.69 SD ± 18.296), p = 0.59 T2: Significant difference after the treatment between reflexology (41.76 SD ± 17.442) and control group (44.29 SD ± 18.311), p = 0.04 Intervention group: Significant improvement to before the intervention (p = 0.008) Control group: n.s |
Kurt (2018) | RCT | n = 96 / Reflexology n = 46, Control n = 50 / Dropout: n = 36 / Cancer type: Breast, digestive system, other cancer / Sex (m/f): Reflexology (53,3% / 46,7%), Control (53,3% / 46,7%) Chemotherapy treatment: Eloxatin-based, Taxan-based, Platin-based, Taxan-Platin-based, Fluoracil-based | Reflexology 2x/day (20 min per session) for six weeks Control group received standard care | 1.quality of life 2.pain | T1: at first meeting T2: after 3 weeks T3: after 6 weeks 1.Quality of life: Sensory function: T1: No significant difference between Intervention (37.77 SD ± 19.46) and control (40.49 SD ± 21.87), p = 0.78 T2: n.s T3: Significant difference between intervention (22.83 SD ± 16.50) and control (34.44 SD ± 20.77), p = 0.024 Motor function: n.s Autonomic function: n.s 2.Pain General Activity: n.s Walking ability: n.s Normal Work: n.s Relations with other people: n.s Sleep: n.s Enjoyment of life: n.s |
Sharp (2010) | RCT | n = 183 / Reflexology n = 60, Scalp Massage n = 61, SIS n = 62 / Dropout n = 17 / Cancer type: Breast cancer: T1, T2 (< 3cm), N0, N1a, M0 / Sex: 100% female Current therapies: RTX n = 193, CTX n = 30 | Arm A: Reflexology 1h 1x/week for 8 weeks + SIS (self-initiated support) Arm B: Scalp Massage 1h 1x/week for 8 weeks + SIS Arm C: SIS | 1.Quality of Life (at T1) 2.Quality of Life (at T2) 3.Relaxation Scale with Mood Rating Scale 4. Other Scales with MRS 5.Quality of Life (physical, functional, emotional, social, additional concerns scales) 6.Anxiety and Depression 7.Complementary Therapies Questionnaire 8.Psychiatric Morbidity | T1: week 18 post surgery T2: week 24 post surgery [Mean (95% CI)] 1.Quality of Life at T1: Arm B significantly better than Arm C [Arm B: 73.06 (70.89,75.23), Arm C: 69.05 (66.90,71.21); p = 0.03] Other arms: n.s 2. Quality of Life at T2: Arm A significantly better than Arm C [Arm A: 74.82 (72.13,77.55), Arm C: 69.42 (66.75,72.09); p = 0.02] Other arms: n.s 3.Relaxation Scale with MRS: T1: Significantly better results for Arm A and B vs. Arm C [Arm A: 100.94 (91.36,110–53), Arm B: 100.23 (90.77,109.69), Arm C: 69.05 (66.90,71.21); p(AC) < 0.0005, p(BC) < 0.0005] T2: Significantly better results for Arm A vs. Arm C [Arm A: 107.30 (97.91,116.69), Arm C:89.07 (79.82,98.32); p = 0.02] Other arms: n.s 4.Other scales with MRS: T1: Significantly better results on “easy-goingness” scale for Arm A vs. Arm B and C [Arm A: 98.70 (90.12,107.27), Arm B: 113.98 (105.49,122.46), Arm C: 89.18 (80.73,97.63), p(AB) = 0.04, p(BC) < 0.0005] 5.Quality of Life: T1: n.s T2: Significantly better results for Arm A vs. C in total score and “functional wellbeing” subscale [total score: Arm A: 118.60 (114.93,112.26), Arm C: 111.70 (108.10,115.30); p = 0.03, „functional wellbeing “: Arm A: 23.17 (22.01,24.33), Arm C: 21.04 (19.90,22.17); p = 0.03] Other arms: n.s 6. Anxiety and Depression: n.s 7.Complementary Therapies Questionnaire: n.s 8. Psychiatric Morbidity: n.s |
Stephenson (2007) | RCT | n = 90 / Analysed: Reflexology n = 42, Control n = 44 / Dropout n = 4 / Cancer type: lung, breast, colorectal, head and neck, lymphoma / Sex: 51% female Other therapies: CTX, RTX, surgery (at least 6 weeks ago) | Arm A (Reflexology): 1 × 30 min by partner/family member (taught by certified reflexologist) Arm B (Control): 1 × 30 min reading session by partner/family member | 1.pain (BPI) 2.pain (McGill Pain Questionnaire) 3.anxiety | (adjusted mean difference pre/post) 1. or 2. (not clear) Pain: Significantly better results for Arm A vs. B (Arm A: 1.1, Arm B: 0.1; p = 0.001; = 0.12) Subgroup analysis: Significantly better results for Arm A vs. B for patients wit pain > 5 (Arm A: 2.7, Arm B: 0.5; p = 0.007; = 0.23) 3.Significantly better results for Arm A vs. B (Arm A: 3.1, Arm B: 1.3; p = 0.001; = 0.13) Subgroup analysis: Significantly better results for Arm A vs. B for all patients with anxiety > 5 (Arm A: 5.0, Arm B: 2.5; p = 0.006; = 0.15) |
Dyer (2013) | RCT | n = 115 / Aromatherapy massage n = 58, Reflexology n = 57 / Dropout n = 11 / Cancer type: breast, gastrointestinal, gynaecological, haemato-oncology, head and neck, lung, neurology, sarcoma, skin, urology, cancer of unknown primary / Sex: 93% female Other therapies: Aromatherapy massage: 17 CTX, 41 other, Reflexology: 14 CTX, 43 other | Arm A (aromatherapy massage): 4 × 1h (median length between first and last treatment: 10 weeks) Arm B (reflexology): 4 appointments (no further information) | 1.MYCaW (first concern scores) 2.MYCaW (second concern scores) 3.MYCaW (overall wellbeing scores) 4.change over time (from first to fourth session) in pre-session VAS relaxation score 5.change in pre to post-session VAS relaxation score 6.percentage of patients gaining benefit from the intervention 7.MYCaW follow up form patient’s written comments | 1.MYCaW (first concerns): Mean difference 0.453 (SE = 0.323) in favor of aromatherapy (p = 0.046) 2.MYCaW (second concerns): n.s 3.MYCaW (overall wellbeing score): n.s 4.Change over time in pre session VAS relaxation score: n.s 5.Change in pre to post session VAS relaxation score: n.s 6.Patients gaining benefit from the intervention: n.s 7.Most frequent answer for „What has been most important for you?” was “Relaxation and time for oneself” in both arms |
Hodgson (2012) | RCT | n = 18 / Arm A = NI, Arm B = NI / Dropouts n = 0 / Cancer type: breast, prostate, colorectal, lung / Sex: 66% female Other therapies: Cancer treatment completed | Arm A: “friendly visits” for baseline assessments (week 1), Swedish massage of lower extremities (20 min 1x/week for 4 weeks); 1 week washout; foot reflexology (20 min 1x/week for 4 weeks) Arm B: “friendly visits” for baseline assessments (week 1), foot reflexology (20 min 1x/week for 4 weeks); 1 week washout; foot Swedish massage of lower extremities (20 min 1x/week for 4 weeks) | 1.5-min observation of affect (positive mood) 2. 5-min observation of affect (negative mood) 3.pain | 1.5-min observation of affect (positive mood): n.s 2. 5-min observation of affect (negative mood): n.s 3.Pain: n.s |
Özdelikara (2017): The Effect of Reflexology on Chemotherapy-induced Nausea, Vomiting, and Fatigue in Breast Cancer Patients | RCT | n = 60 / Arm A: Reflexology n = 30, Arm B: Control / Dropout: NI / Cancer type: breast (stage I-III) / Sex: 100% female Other therapies: CTX (Epirubicin/ Cyclophosphamid) | Arm A: Reflexology during 2nd to 4th CTX cycle (30–40 min during CTX) Arm B: CTX plus usual care | 1a. INVR: Subscale of experience 1b. INVR: Subscale of symptom development 1c. INVR: Subscale of distress development 2a. Fatigue severity 2b. Daily life activity exposure levels | Baseline: within 24h after first CTX cycle Posttreatment Assessments: 24h after 2nd to 4th CTX cycle Results of last assessment (24h after 4th CTX cycle) shown: 1a: INVR: subscale of experience: n.s 1b: INVR: subscale of symptom development: Significant difference of both arms to baseline (Mean [SD]: Arm A: 11.10 [4.74], Arm B: 6.76 [6.85]; p = < 0.05) Significant difference at last assessment between arms (Mean [SD]: Arm A: 2.50 [4.34], Arm B: 9.00 [5.29]; p = 0.000) 1c: INVR: subscale of distress development: Significant difference of both arms to baseline (Mean [SD]: Arm A: 6.90 [2.90];, Arm B: 4.2 [4.47]: p = < 0.05) Significant difference at last assessment between arms (Mean [SD]: Arm A: 1.40 [2.59];, Arm B: 5.73 [3.55]; p = 0.000) 2a: Fatigue severity: Significant difference of both arms to baseline (Mean [SD]: Arm A: 3.67 [1.94], Arm B: 1.97 [1.59]; p = 0.000) Significant difference at last assessment between arms (Mean [SD]: Arm A: 1.20 [1.44], Arm B: 2.33 [1.65]; p < 0.05) 2b: Daily life activity exposure levels: Significant difference of both arms to baseline (Mean [SD]: Arm A: 1.88 [1.26], Arm B: 1.01 [1.16]; p = < 0.05) Significant difference at last assessment between arms (Mean [SD]: Arm A: 0.41 [0.65], Arm B: 1.47 [1.52]; p = 0.001) |
Özdelikara (2017): The effect of reflexology on the quality of life with breast cancer patients | RCT | n = 60 / Arm A: Reflexology n = 30, Arm B: Control / Dropout: NI / Cancer type: breast (stage I-III) / Sex: 100% female Other therapies: CTX (Epirubicin/ Cyclophosphamid) | Arm A: Reflexology during 2nd to 4th CTX cycle (30–40 min during CTX) Arm B: CTX plus usual care | 1a. EORTC-QLQ-C30: General Health Score 1b: EORTC-QLQ-C30: Function Score 1c: EORTC-QLQ-C30: Symptom Scale | Baseline: within 24h after first CTX cycle Posttreatment Assessments: 24h after 2nd to 4th CTX cycle 1a: EORTC-QLQ-C30: General Health Score: Pretest: Mean (SD): Arm A: 55.55 (24.79), Arm B: 54.16 (21.74); p = NI Posttest: Mean (SD): Arm A: 78.61 (13.43), Arm B: 31.66 (18.62); p = 0.000 1b: EORTC-QLQ-C30: Function Score: Pretest: Mean (SD): Arm A: 71.25 (15.17), Arm B: 80.29 (14.32); p = NI Posttest: Mean (SD): Arm A: 89.92 (6.51), Arm B: 64.07 (17.52); p = 0.000 1c: EORTC-QLQ-C30: Symptom Scale: Pretest: Mean (SD): Arm A: 35.81 (14.35), Arm B: 21.02 (18.53); p = NI Posttest: Mean (SD): Arm A: 9.31 (7.54), Arm B: 39.23 (15.22); p = 0.000 |
Stephenson (2000) | RCT | n = 24 / Dropout n = 1 / Cancer type: breast, lung / Sex: 65% female Other therapies: NI | Arm A: Reflexology (1 × 30 min), at least 48h in between, passive control/no intervention (1 × 30 min) Arm B: passive control/no intervention (1 × 30 min), at least 48h in between, reflexology (1 × 30 min) | 1.anxiety 2.pain with SF-MPQ 3.pain intensity with SF-MPQ: PPI-scale 4.pain intensity with VAS | 1.Anxiety: Significantly better results after intervention compared to control (Mean difference = -21.83; p < 0.000) 2. Pain with SF-MPQ: Only breast cancer patients analysed: Significantly better results after intervention compared to control (Mean difference = -0.41; p < 0.05) 3. Pain intensity with SF-MPQ: PPI-scale: Only breast cancer patients analysed: n.s 4. Pain intensity with VAS: Only breast cancer patients analysed: n.s |
Tsay (2008) | RCT | n = 62 / Reflexology n = 30, Control n = 31 / Dropout n = 1 / Cancer type: hepatocellular, gastric / Sex: 52.46% female | Arm A: Surgery + Reflexology (3 days following surgery) for 20 min Arm B: Surgery | 1.pain with VAS (baseline, T1-T3, follow up) 2.pain with SF-MPQ (baseline, follow up) 3.anxiety (baseline, follow up) 4.narcotic analgesia consumption (Demerol) | Baseline T0: day 2 surgery, T1-T3: day 2–4 surgery, Follow-up: day 5, 6 surgery 1.Pain with VAS: All points in time: On average significantly better (lower) results in Arm A compared to Arm B (βG = -21.22 (SE = 4.93); p < 0.001) 2.Pain with SF-MPQ: All points in time: On average no significant differences 3.Anxiety: All time points: On average no significant differences 4.Narcotic analgesia consumption: Significantly lower consumption in Arm A (mean = 39.59mg Demerol; p = 0.015) |
Uysal (2017) | RCT | n = 65 / Reflexology n = 21, Classical Massage n = 22, Control n = 22 / Dropout n = 5 / Cancer type: Colorectal (stage II and III) / Sex: 50% female Other therapies: CRT (5 weeks): CTX 5-Fluoruracil/ Capecitabine + RTX (1.8‐2 Gy/5 days) | Arm A: Reflexology (30 min 2x/week for 5 weeks in total) + CRT (chemoradiotherapy) Arm B: Classical Massage (20 min 2x/week for 5 weeks in total) + CRT Arm C: CRT + usual care | 1.QoL with EORTC QLQ C30 (function scale, symptom scale, global health scale) 2.QoL with EORTC QLQ CR29 3.Adverse effects | Measurements were taken at week 1, 3 and 5 1. QoL with EORTC QLQ C30: Function scale: Significantly better results in Arm A compared to Arm C in week 3 (Mean [SD]: A: 82.66 [4.42], C: 80.22 [8.64]; p < 0.000) and in week 5 (A: 81.98 [4.79]; C: 71.66 [9.34]; p < 0.000) Symptom scale: Significantly better results in Arm C compared to A in week 3 (Mean [SD]: A: 21.66 [22.36]; C: 20.00 [16.75]; p = 0.003) Significantly better results in Arm A compared to C in week 5 (A: 25.00 [32.21], C: 31.66 [29.56]; p < 0.000) Significantly better results in Arm B compared to C in week 5 (B: 26.66 [13.67]; C: 31.66 [29.56]; p < 0.000) Global health scale: Significantly better results in Arm A compared to C or B in week 1 (Mean [SD]: B: 68.33 [5.72], A:76.25 [9.85],,C: 68.33 [11.34]; p = 0.012) Significantly better results in Arm A compared to C or B in week 3 (B: 61.57 [8.56], A: 70.55 [8.56], C: 60.67 [8.76]; p < 0.000) Significantly better results in Arm A compared to C or B in week 5 (B: 57.08 [9.07], A: 69.16 [9.40], C: 54.16 [9.55]; p < 0.000) 2. QoL with EORTC QLQ CR29: No information 3.Adverse effects: Significantly less pain with grade 2 + in Arm A and B compared to Arm C in week 4 (A: 19.3%, B: 30.7%, C 50%; p = 0.002) Significantly less pain with grade 2 + in Arm A and B compared to Arm C in week 5 (A: 16,2%, B:35,4%, C: 43,4%; p < 0.001) Significantly less fatigue with grade 2 + in Arm A compared to Arm B and C in week 3 (A: 28%, B:36%, C:36%; p = 0.03) Significantly less fatigue with grade 2 + in Arm A compared to Arm B and C in week 4 (A: 28,6%, B:35,7%, C: 35,7%; p < 0.001) Significantly less fatigue with grade 2 + in Arm A compared to Arm B and C in week 5 (A: 30,4%, B:34,8%, C:34,8%; p = 0.036) Significantly lower urinary frequency with grade 1 + in Arm A compared to Arm C in week 5 (A:25%, C:37,5%; p = 0.044) Significantly less distension with grade 1 + in Arm A compared to C in week 4 (A:15,2%, C:42.4%; p < 0.000) and 5 (A:20%, C:56%; p < 0.000) Significantly more distension with grade 1 + in Arm B compared to C in week 2 (B:44.1%,C: 20.6%; p = 0.033) Significantly less distension in with grade 1 + in Arm B compared to C in week 5 (B: 24%, C:56%; p < 0.000) No significant differences between groups for nausea, vomiting, constipation, diarrhea and proctitis |
Wyatt (2012) | RCT | n = 286 / Reflexology n = 95, Foot Massage n = 95, Control n = 96 / Dropout n = 27 / Cancer type: breast / Sex: 100% female Other therapies: Chemotherapie and/or hormonal therapy | Arm A: Reflexology 1x/week (30 min) for 4 weeks Arm B: Foot massage 1x/week (30 min) for 4 weeks Arm C: Control with conventional therapy | 1.Breast Cancer specific QoL with subscales (physical, emotional, social, functional) 2.Dyspnea 3.nausea 4.physical function 5.fatigue 6.interference of fatigue with activities of daily living 7.pain intensity 8.depression 9.anxiety | T0: Baseline T1: 1 week after intervention T2: 6 weeks after intervention 1.Breast Cancer specific QoL: n.s 2.Dyspnea: Significantly better outcome in Arm A compared to C (β = 0.39 [0.13]; p < 0.01, Arm A: M-T1 = 3.33, M-T2 = 3.36, Arm C: M-T1 = 3.1 M-T2 = 2.9, Effect T1 = 0.36, Effect T2 = 0.51) Significantly better outcome in Arm A compared to B (β = NI); p = 0.02, Arm B: M-T1 = 3.1, M-T2 = 3.03, Effect T1 = k.A., Effect T2 = NI) 3.Nausea: n.s 4.Physical function: Significantly better (higher) results for Arm a compared to C (ß = 5.527 [2.728]; p = 0.04, Arm A: M-T1 = 58.6, M-T2 = 59.2, Arm C: M-T1 = 54.9 M-T2 = 51.6, Effect T1 = 0.21, Effect T2 = 0.44) 5.Fatigue: n.s 6. Interference of fatigue with daily activities: n.s 7. Pain intensity: n.s 8. Depression: n.s 9. Anxiety: n.s |
Wyatt (2017) | RCT | n = 256 / Reflexology n = 128, Attention Control n = 128 / Dropout n = 76 / Cancer type: breast cancer (stage III-IV) / Sex: 100% female Other therapies: Chemotherapy or targeted therapy, hormonal therapy | Arm A: Reflexology by caregiver (30 min/1x/week for 4 weeks) Arm B. Attention Control Calls (1x/week for 4 weeks) | 1.Summed symptom severity 2.Interference of symptoms with daily life 3.Physical functioning 4.Satisfaction with participation in social roles 5.Quality of Life 6.Perceived social support 7.Quality of relationship between patient and caregiver | 1.Summed symptom severity: Significantly better (lower) results for Arm A compared to B (β = -4.34 [SE = 1.85]; p = 0.02) in week 2,3 and 5 (week 2: Arm A: M = 27.50 [SD = 1.53], Arm B M = 33.65 [SD = 1.55]; p < 0.01; week 3: Arm A: M = 25.50 [SD = 1.55], Arm B: M = 30.98 [SD = 1.55]; p = 0.01; week 5: Arm A: M = 24.64 [SD = 1.52], Arm B: M = 30.50 [SD = 1.48]; p < 0.01) 2. Interference of symptoms with daily life: Significantly better (lower) results for Arm A compared to B (β = -3.69 [SE = 1.39]; p < 0.01) in week 2,3 and 5 (week 2: Arm A: M = 14.60 [SD = 1.15], Arm B: M = 18.32 [SD = 1.17]; p = 0.02; week 3: Arm A: M = 11.84 [SD = 1.17], Arm B: M = 17.57 [SD = 1.17]; p < 0.01; week 5: Arm A: M = 12.30 [SD = 1.15]; Arm B: M = 16.60 [SD = 1.12]; p < 0.01) 3. Physical functioning: n.s 4. Satisfaction with participation in social roles: n.s 5.Quality of life: n.s 6. Perceived social support: n.s 7. Quality of relationship between patient and caregiver: n.s |
Anderson (2021) | RCT | n = 40 / Reflexology n = 20, Control n = 20 / Dropout n = 0 / Cancer type: Leukemia, lymphoma, brain, colon, multiple myeloma, lung, ovarian, sarcoma, pancreatic, other / Sex: 63% female Other therapies: Chemotherapy, Radiotherapy, other | Arm A: 1 Reflexology session of 20–25 min Arm B: 1 session of 20–25 min during which surveys were administered | 1.pain 2.nausea | 1.Significant improvement for intervention group from pre to post session (p < 0.0001) but not for control 2.No significant improvement for nausea in the intervention group from pre to postsession (p = 0.06) |
Ross (2002) | RCT | n = 26 / Reflexology n = 12, Foot Massage n = 14 / Dropout n = 9 / Cancer type: advanced cancer / Sex (only evaluated patients): 4 males, 13 females Other therapies: No ongoing anticancer therapies | Arm A: Reflexology 1x/week for 6 weeks Arm B: Basic foot massage 1x/week for 6 weeks | 1.Anxiety and Depression 2.Symptom distress score | 1.Anxiety and depression: No difference in the reflexology group from baseline [14.57 (SD 2.87)] to week 6 [14.29 (SD 2.59)] No difference in the massage group from baseline [13.90 (SD 1.82)] to week 6 [13.20 (SD 2.97)] 2.Symptom distress score: No difference between groups except a significantly greater improvement in appetite and mobility in the foot massage group |
Stephenson (2003) | RCT | n = 36 / Reflexology n = NI, Control n = NI / Dropout n = NI / Cancer type: lung, lymphoma, colorectal, other (all metastatic) / Sex: 55.6% female Other therapies: NI except opioid analgesics (parenteral morphine equivalent) | Arm A: Reflexology 2 × 24 h apart Arm B: Control | 1.Pain | 1.Pain: Directly after intervention: significantly lower pain levels in the intervention group compared to control (F[1, 29] 9.08, p < 0.01) No significant effect at 3 h after (p = 0.21) and at 24 h after (p = 0.14) intervention |
Hodgson (2000) | RCT | n = 12 / Reflexology n = 6, Placebo Reflexology n = 6 / Dropout n = 0 / Cancer type: various / Sex: 58% male Other therapies: NI | Both arms: roughly 40 min of either reflexology or placebo reflexology on day 1, 3 and 5 of hospital stay | 1.Quality of life | 1. significant differences in favor of the reflexology group post test for breathing with a mean improvement of 2.2 points on VAS (p = 0.026) and overall (p = 0.004) |