The effects of reflexology techniques on foot edema

in pregnancy

English for biomedical scienceMTEB 2105

SHUKRI BIN JAFFARMEB040045

CONTENTS

PAGES

1. Abstract 2

2. Introduction 3

3. Discussion 6

4. Conclusion 9

5. Recommendations 9

6. References 10

7. Appendix 12

ABSTRACT

Traditionally, reflexology have subscribed as a natural ancient therapy with the

concept that all body organs and glands. The purpose of this study was to identify effect

of reflexology technique on foot edema in pregnancy. Forty-five healthy pregnant women

were recruited for this study.

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Single-blind randomised controlled trial was used to differential effects of two

different foot reflexology techniques; the relaxing reflexology techniques and lymphatic

reflexology technique. Each participant was gave reflexology for 15 minute with pre- and

post- therapy and foot circumference measurements and participant questionnaire.

The findings suggest that lymphatic technique reflexology was statistically shown

significant in group mean circumference measurements. Therefore, the lymphatic

reflexology was preferred as therapy for relieving an edema.

INTRODUCTION

Reflexology is define as a therapeutic technique based on the premise that areas

exist in the hands or feet that correspond to the organs and systems of the body and that

stimulation of these areas by pressure can affect the corresponding [1].

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By applying strong pressure, the reflexologist uses a specific thumb and finger

pressure technique to elicit areas of potential or actual disorders. [2, 3, 4, and 5].

Therefore it heals the damaged areas and rejuvenating one’s mental, emotional and

physical well-being and health. Now this, there are many different styles and approaches

used in reflexology, however the basic principle is constant.

Reflexology is an ancient healing art that has been around for thousands of year,

practiced throughout history by many cultures [6]. Originating in China, around 3000

B.C. it has existed in various forms in ancient Egypt, India and Japan.

Footwork is depicted in relic of the past including a pictograph from an Egyptian

tomb dating to 2350 B.C. Reflexology as a theory called Zone therapy, conceived by an

American physician named Dr. William Fitzgerald in the early 1900s.

He suggested that the foot could be mapped to other areas of the body to diagnose

or treat medical conditions. He divided the body into ten vertical zones and labeled the

parts of the foot that he believed controlled each zone.

These zones were alleged tp correspond to the fingers and toes and taught that

“bioelectrical energy” flowed through these zones to “reflex points” in the hands and

feet. His method of treatment involved the fastening of wire springs

around toes [7].

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Eugnice Ingham

In the 1930s and 1940s , Eugnice Ingham, a nurse and physiotherapist, furhter

developed these maps to include specific reflex points. At that time, zone therapy was

renamed reflexology [8]. Regular reflexology has many beneficial and lasting effects.

Some are of a more general nature, blancing and restoring systems for bettter function,

and some are quite specific.

Edema it defines the presence of abnormally large amounts of fluid in the

intercellular tissue spaces of the body, usually referring to demonstrable amounts in the

subcutaneous tissues [1]. During pregnancy, this is most common and normal

physiological symptom [9, 10 and 11].

Although edema is not dangerous, it can result in discomfort, feelings of

heaviness, night cramps and painful paraesthesia [12]. If edema is present along with

high blood pressure it may indicate the presence of pre-eclampsia.

Most cases of edema are mild and have not specific treatment than to control

physiological edema such as support stockings, bed rest and diuretics. The diuretics

practices are longer advocated for pregnancy edema as any treatment in pregnancy

because it fails to remove extravascular fluid without disturbing the intravascular

components [13].

Edema in pregnancy is only a short-term strategy as the hormones of pregnancy

will continue their effects of fluid retention on the body until the birth of the baby.

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Therefore an effective therapy would provide symptom relief primarily and short-term

edema relieving effects.

One therapy or treatment for relief this condition is by complementary therapies

such as foot reflexology [14 and 15]. Although reflexology should not be considered as a

diagnostic tool [16 and 17], in isolation, these changes may represent altered physiology

or pathology, potentially contributing towards the formulation of a working diagnosis for

the basis of treatment [18].

DISCUSSION

As to study the effectiveness of reflexology technique, L. Mollart (2003) study

was used which are the lymphatic reflexology techniques and the relaxing reflexology

techniques. Forty-five women was randomised chosen into the trial by follow the criteria

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which are, the normal pregnancy at 30 weeks gestation, a visible edema on feet, able to

speak, read and write English and attending the clinic for pregnancy care.

The single-blind randomised was used because it gave the reflexologists to know

whether they are giving true or placebo therapy [19] and each from the participants was

randomly allocated into two groups experimental.

The experimental therapy group 1 is received the relaxing foot reflexology

techniques with the 20 participants. While, experimental therapy group 2 is gave a

lymphatic foot reflexology technique with 25 participants. The reflex zones of the therapy

group 1 are includes to the reflex zones of chest, abdomen, spine, pelvis and head and for

the therapy group reflex zones are lymphatic system, liver, gastrointestinal tract and

kidney [14 and 20]. In addition, the lymphatic foot reflexology technique was used

because the technique it mimic with the lymphatic action of the body.

Each therapy session take about 15 minute with includes the circumference

measurement of foot and self-questionnaires. The self-questionnaires are includes the

knowledge of reflexology; pre- and post-therapy levels of stress, tension, anxiety and

discomfort. All analysis data was quantitative by using the Student t-test for identify the

foot measurement. This picture below showed the measurement of foot circumference.

Foot circumference measurement

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This table 1 showed a descriptive data for two group’s techniques, means,

standard deviations and ranges.

Lymphatic reflexology (n=25)X Range SD

Age (Years) 28.6 22 – 40 5.15Gravidity 2 1 – 6 1.58Gestation 36.2 30 – 39 2.06

Relaxing reflexology (n=20)X Range SD

Age (Years) 27 18 – 36 5.66Gravidity 1.9 1 – 4 1.02Gestation 35.9 32 – 38 1.79

Mean wellbeing scores and mean difference scores across the two groups showed

in table 2. The score of the lymphatic reflexology has revealed the group significantly

increased wellbeing, compare to the relaxing reflexology group.

Mean wellbeing

score before

session

Mean wellbeing

score after

session

Mean wellbeing

difference scoreP Value

Relaxing

reflexology

(n=200

17.4 11.4 6<0.000

1

Lymphatic

reflexology (n=

25)

17.6 11.2 6.5<0.000

1

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Based on the findings, these indicate that the lymphatic reflexology techniques

have a significant clinical effect in reducing foot edema than the relaxing reflexology

techniques.

The lymphatic reflexology technique group also showed a consistent decrease in

all circumferences compared to the relaxing reflexology. From the participant viewpoint,

some realize that the lymphatic reflexology technique is more effective in relieving the

edema symptom.

The most apparent effect by the women receiving reflexology was felt relaxed,

sleepy or fell asleep during the reflexology session. On the other hand, this study only

concentrated on effect of reflexology as s therapy for edema.

CONCLUSION

In conclusion, the lymphatic reflexology techniques had showed overall a

significant than the relaxing reflexology techniques. Therefore, the lymphatic reflexology

technique was reliable technique for relief the edema in pregnant women.

RECOMENDATIONS

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As we know, reflexology techniques are well-known remarkable therapy for

diseases, where certain people chosen this therapy as conventional treatment. Even

though this technique seems to be widely known, there is limited scientific evidence

about safety or effectiveness of this technique. So, prolong research is needed to study the

effectiveness of this technique. As for this study, the measuring tool is required as the

circumference measurements were not able to record the decrease in skin tension and

swelling. Moreover, there is need an accurate method for quantifying the dependent

edema.

REFERENCES

1. Dorland’s illustrated medical dictionary, 30th edition (2003),Saunders: Phildelphia.

2. D. Tiran, The use of complementary therapies in midwifery practice: a focus on

reflexology. Complement Ther Nurs Midwifery 2 2 (1996), pp. 32–37.

3. L. Booth. Vertical reflexology: a revolutionary five minute technique to transform

your health, Piatkus Ltd, London (2000).

4. D. Botting, Review of literature on the effectiveness of reflexology. Complement

Ther Nursing Midwifery 3 (1997), pp. 123–130.

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5. Enzer S. Reflexology: a tool for midwives. Soul to Sole Reflexology, Sydney,

Australia. 2000.

6. Facts on Reflexology (Foot Massage) Regina Xavier Nursing Journal of India;

Jan 2007; 98, 1; Health & Medical Complete pg. 11.

7. Raso J. "Alternative" Healthcare: A Comprehensive Guide. Prometheus Books,

1994, p.126.

8. Eunice D. Ingham and the development of foot reflexology in the U.S.

(Benjamin) Massage Therap J, Winter, 1989.

9. M. Enkin, M. Keirse, M. Renfrew and J. Neilson. A guide to effective care in

pregnancy and childbirth, 2nd ed, Oxford University Press, Oxford (1995).

10. F. Cunningham, P. MacDonald, N. Gant, K. Leveno, L. Gilstrap, G. Hankins and

S. Clark. Williams Obstetrics, 20th ed, Prentice-Hall, Englewood Cliffs, NJ

(1997).

11. D. Reynolds, Severe gestational edema. J Midwifery Womens Health 48 2 (2003),

pp. 146–148.

12. Young G, Jewell D. Interventions for varicosities and leg oedema in pregnancy

13. Davidson J. Edema in pregnancy. Kidney Int 1997; 51:S50, S90–6.

14. Tiran D, Mack S, editors. Complementary therapies for pregnancy and childbirth,

2nd ed. Edinburgh: Bailliere Tindall; 2000.

15. Royal College of Midwives (RCM). Position Paper 10a: Complementary

Therapies. RCM Midwives J 1999;2(12):382–4.

16. D. Tiran, The use of complementary therapies in midwifery practice: a focus on

reflexology. Complement Ther Nurs Midwifery 2 2 (1996), pp. 32–37.

17. L. Booth. Vertical reflexology: a revolutionary five minute technique to transform

your health, Piatkus Ltd, London (2000).

18. Complementary Therapies in Clinical Practice Volume 11, Issue 1 , February

2005, Pages 58-6.

19. D. Botting, Review of literature on the effectiveness of reflexology. Complement

Ther Nursing Midwifery 3 (1997), pp. 123–130.

20. Royal College of Midwives (RCM). Position Paper 10a: Complementary

Therapies. RCM Midwives J 1999;2(12):382–4.

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APPENDIX

ZONE REFLEX THERAPY

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