Monday, February 22, 2021

Roots of Research- Neural Pathways of Applied Reflexology

Roots of Research

Neural Pathways of Applied Reflexology

Over the millennial, with a history dating back thousands of years, reflexologists have produced results, creating healthy outcomes.

It’s now research time, time to answer questions about why this would be.

For us it’s been forty years in the making but it’s a goal all reflexologists want. At least that was what 100% of those responding to a questionnaire said when asked. Forty years ago reflexologists said, yes, about the statement, “They could discover how reflexology works if they tried.” It’s about to happen.


We are pleased to work with Dr. Stefan Posse, neuroscientist at the Human Brain MR Imaging Research Laboratory University of New Mexico School of Medicine, to explore the “Neuro Pathways of Applied Reflexology,” exploring proving the concept of reflexology, using fMRI (functional Magnetic Resonance Imaging) brain scan. The research is administered by the non-profit University of New Mexico Foundation.

The intended research is a search for an honest, straight forward answer to why reflexologists create such results.

We’ve been looking for the answer for years, decades actually our entire careers. Our interest is to close the circle on a search that started early in our reflexology careers. One event lead to our dedication to the search. See below.

Dr. Posse’s interest? Just as we reflexologists are interested in the foot and what it has to say, neuroscientists are interested in the brain and what it has to say. The brain scan provides such information.

In technical terms Dr. Posse notes:

“There is an urgent need to characterize the biological substrates (the part of the central nervous system, i.e., brain and spinal cord that underlies a specific behavior, cognitive process, or psychological state)* and mechanisms of reflexology. Functional MRI is uniquely positioned to answer questions about brain regions stimulated during reflexology, synchronization of brain activity and the role of the limbic system in conveying benefits to the patient. (The limbic system is a set of structures in the brain that deal with emotions and memory. It regulates autonomic or endocrine function in response to emotional stimuli and also is involved in reinforcing behavior.)*

“The real-time fMRI technology developed at the University of New Mexico in the Human Brain Imaging Research Laboratory is uniquely suitable for mapping with high sensitivity and specificity the entire connectome (the system of neural pathways in a brain or nervous system, considered collectively)* associated with the application of reflexology. This includes brain activation and brain connectivity and changes thereof during stimulation of different body parts using reflexology. Mapping activation and connectivity during the fMRI scan enables monitoring of data quality and experimental feedback to the subject with the goal of enhancing the effectiveness of the treatment.”

*Material in parentheses is our addition.

Roots of Research

The roots of this project for us date to forty years ago and our work with a paralyzed clientele.

“Jimmy, are you moving your fingers?” It was a question asked of a client during the course of simultaneous hand and foot reflexology sessions.

His answer was, “No, Kevin is.”

For any client this was a different response to reflexology work. Since Jimmy was a quadriplegic, this, movement of fingers, was not supposed to happen under any circumstances. And why would he say Kevin had caused it?

It turned out, Kevin’s reflexology work on a particular reflex area of the left foot had prompted movement of the fingers of Jimmy’s right hand.

Jimmy’s answer lead us to a search for answers and an eventual hypothesis for the question, how does reflexology work and, many years later, research with Dr. Posse.

Why would this be?

The question became why: why would movement of fingers be prompted by reflexology work? A similar phenomena was observed as we worked with two additional paralyzed clients both paraplegic. The movement prompted by reflexology work to the same reflex area of the foot was of the opposite foot. Also observed with all three clients were effects on the internal workings of the body: sweating, grumbling of the intestines and shivering with reports of no sensation of cold.

As we would discover, pressure whether prompted by a footstep or reflexology technique application creates a reflex response throughout the body. Such a simple answer now adopted as a cornerstone the the reflexology definition. It was a year in the making.

Kevin had been studying in detail how a footstep happens. Barbara was studying the nervous system.

Kevin recognized the change in movement by the paraplegic clients as time went on. After six months both clients reflexology work prompted movement of their feet as a segment of taking a footstep.

Barbara discovered the concept of proprioception. Proprioception is the body’s ability to sense pressure, stretch and movement. Especially important is deep pressure to the bottoms of the feet. It was a Eureka moment.

Putting the two together, the footstep and the ability of the foot to sense pressure, we saw our reflexology work had tapped into deep pressure sensors in the bottoms of the feet, stimulating a part of the body’s walking mechanism.

As we found out, internal organs work together with pressure sensors in the feet. Think of the fight or flight response. In time of danger, the adrenal glands respond as do other activities of the internal mechanism. The feet stand ready to do their part. Such responses go on day and night as our bodies respond to what we do. Pressure sensors in the feet contribute to whole body communication whether one is sitting or standing or walking, each requiring a different level of energy expenditure.

The results produced by the work of reflexologists over millennia is created by this coordination within the nervous system of the internal organs (autonomic nervous system) and the ability to move (motor nervous system).

This was and is our hypothesis. The word pressure has subsequently been adopted into many definitions of reflexology. Effects on the autonomic nervous system is seen as a viable model of how reflexology works. After more than forty years we look forward to seeing it tested

Join Us: Research Proving the Concept of Reflexology

 





Join Us: Research Proving the Concept of Reflexology

Imagine it’s 2323 BCE and a pictograph of reflexology is being carved into the Physician’s Tomb in Saqqara Egypt. 

Imagine a few thousand years later and it’s 32 BCE. Mark Anthony is being criticized by historian Ovid for working on the feet of Cleopatra at a dinner party.

Imagine today and 21st century technology is being used to prove the reflexology concept that’s been around for thousands of years.

Research is being launched using fMRI brain imaging to prove the concept of reflexology. “Neural Pathways of Applied Reflexology” will study what happens in the brain and spinal cord as reflexology is applied.

We seek to raise US$150,000 to fund the study. Join us as we seek to move into the future an idea that lives in the hearts and minds of millions around the world and throughout history. Here’s your chance to join the reflexology revolution, becoming a part of those who believe in reflexology and its use in health, wellness and medicine.

The research will be lead by Dr. Stefan Posse, internationally recognized neuroscientist at the University of New Mexico (UNM) Medical School’s Human Brain Imaging Research Laboratory. (https://vivo.health.unm.edu/display/n302957944). Internationally recognized reflexology authorities Barbara and Kevin Kunz will provide the reflexology knowledge and application. All three are volunteering their efforts. All donations will be administered by the non-profit UNM Foundation. (https://www.unmfund.org/fund/npar-fund/)

Study participants will have reflexology applied to a specific reflex area of their feet as real time fMRI imaging records what happens in the brain and in the spinal cord. Neuroscientists will then assess the resulting images to determine which parts of the participants’ brains and spinal cords respond to the stimulation of reflexology. In a second clinical phase of the research, the same procedure will be followed with study participants who experience a specific health concern.

Imagine: we could be able to peer inside the brain and spinal cord to map reflexology’s path in the body, continuing a trail from humankind’s past into its future. What treasures might we find? Where could new discoveries lead?

Join us. https://www.unmfund.org/fund/npar-fund/


Human MR Imaging Research Laboratory

  

Monday, January 25, 2021

Reflexology research for hospitalized patients

 Reflexology research for hospitalized patients supported by mechanical ventilation:

Potential General Impact of a Single Reflexology Session on Physiologic Parameters


Research shows that reflexology effects a variety of physical and psychological concerns. Research also demonstrates what a single reflexology session reflexology can do for the reflexology client:

• creates relaxation
• reduces anxiety
• diminishes pain
• improves blood flow to the kidneys, intestines, and feet
• improves blood flow to parts of the brain related to the reflex area
• decreases heart rate and blood pressure
• increases oxygen saturation and lowers respiratory rate (functions of the lungs)

Can a single reflexology session make a difference for hospitalized patients, especially for those in the most serious of circumstances, supported by mechanical ventilation?  Findings in research show possibilities. 


Further, what can such findings mean for the providing of reflexology services for the benefit of reflexology clients? 


While multiple variables can influence the results of a reflexology session, three studies of patients supported by mechanical ventilation demonstrate key issues. In the studies, the length of time reflexology is applied and reflex areas to which technique is applied potentially made a difference in positive results.


At issue for the reflexologist and client: can applying technique to a limited number of reflex areas for the duration of a session provide specific benefits?


The three studies investigated physiologic parameters of patients following open heart surgery as well as length time for weaning from mechanical ventilator support. Stabilization of physiologic parameters and length of time on mechanical ventilation are both important to a successful outcome for patients.


The best results among the three studies were achieved in a study where 30 to 40 minutes of reflexology work was applied to solar plexus, heart and lung reflex areas of study participants. Following reflexology work, statistically significant differences were found in physiologic parameters (heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and oxygen saturation) for intervention participants compared to those in the control group. (17a/29)


No significant differences were found for physiologic parameters in a study where 20 minutes of foot reflexology was applied to the heart and lung reflex areas  of study participants.


No significant differences were found for physiologic parameters in a study where 20-30 minutes of foot reflexology was applied to the solar plexus, respiratory, circulatory, urinary, lymphatic reflex areas of study participants.


All three studies demonstrated shorter weaning times from mechanical ventilators: 165 minutes for the first noted above; 39 minutes less for the second and 100 minutes less for the third. 


As noted by the first study:

“Statistically significant differences from patients in the control groups were found in heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and oxygen saturation. As noted by researchers: “The findings of this study support the hypothesis that foot reflexology positively affects the stabilization of physiological indicators of critically ill patients and decreases ventilation dependence as compared with patients who did not receive foot massage.” 


Length of time and reflex areas were deliberately chosen. Length of time for technique application was chosen from three previous studies. “Based on the claim of reflexologists (three studies as well as Kunz and Kunz, Complete Reflexology for Life), the points on the plantar surface of the foot which may be responsible for stabilization of physiological indicators and reduction of ventilation dependence were chosen. … “The steps of foot reflexology technique were adopted from Kunz and Kunz (Complete Reflexology for Life)”


Additional research demonstrated positive results in two studies of physiologic parameters following coronary artery bypass surgery.


30 minutes of foot reflexology applied to solar plexus, hypothalamus, pituitary, lung, adrenal gland, heart (left foot only) reflex areas  of study participants resulted in greater improvement than the control group to physiologic parameters (respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation, heart rate)

Also improved to a level greater than other the control group was patients’ anxiety. Patients’ agitation showed significantly higher reduction. Extubation time was significantly shorter.


30 minutes of foot reflexology applied to solar plexus, hypothalamus, pituitary, lung, adrenal gland, heart (left foot only) reflex areas  of study participants was shown to result in a significant difference in physiologic parameters (respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation). No significant difference was shown for heart rate. A significant difference was seen in patients’ anxiety levels.



Books by Kunz and Kunz

Research Books

Medical Applications of Reflexology: Findings in Research About Post-operative care, Maternity Care and Cancer Care
Evidenced Based Reflexology Research: For Health Professionals and Researchers
Medical applications of Reflexology:: Findings in Research about Cancer Care

Bestselling Books


 Reflexology: Hands-on Treatment for Vitality and Well-being
Complete Reflexology for Life: Your Definitive Photographic Reference to the Best Techniques and Treatments  
 

Intermittent Moving Books

Intermittent Moving: How I Lost My Pants and Mastered My Weight
Un-Sit Your Life: The Reflex "Diet" Solution













Thursday, September 24, 2020

Reflexology, Possible Therapeutic Approach to Alzheimer’s

US National Institute on Aging, Alzheimer's Disease Education and Referral Center / Public domain

Part 3 of 3

Could a reflexology technique serve as a therapeutic approach for those with Alzheimer’s?  The possibility exists that a targeted reflexology technique could mirror the researched effects of targeted light and sound techniques to help dissipate tangled amyloid plaque areas commonly found in the brains of those with Alzheimer’s. Linking sight, sound and the pressure techniques of reflexology is the sensory experience provided by each. 

Exposure of “Alzheimer’s mice” to specific sound and light has been demonstrated by MIT researchers to increase activity of gamma brain waves and, as a result, lessen amyloid plaque areas in the mice brains. (1) (2)

Pull Quote

“Gamma (brain wave) activity represents an important marker of successful memory formation, episodic recall and other behavioral and cognitive functions. Sensorimotor, learning memory, information processing, and behavioral functions are important in everyday life of humans and are also integral in execution of life processes.” (3)

Gamma brain waves are known to decrease in activity for those with Alzheimer’s. In both the light and sound studies it was found, “Once the brain is flushed with gamma waves, two effects come into play: fewer amyloid plaques are produced and more of these existing plaques are cleared out by immune cells known as microglia.” 

MIT researchers found specific light exposure created change in brain waves of the visual cortex of the brain while specific sound exposure created change in the auditory cortex as well as a nearby area, the hippocampos. Further areas of the brain were found to be effected by exposure to light over a longer period of time. 

The researchers hypothesize that other sensory experiences could impact further areas of the brain. ‘If we can activate gamma (brain waves) in many different brain regions, perhaps we can get a huge area of the brain involved,’ says (MIT researcher Dr. Li-Huei), Tsai. ‘Treating the whole brain will be important for people with Alzheimer’s disease.’” (1)

MIT researchers would like to determine “whether other modes of sensory stimulation, such as sound or touch, have similar effects on the regions of the brain that process those inputs. Ultimately, the goal is to find multiple ways to noninvasively stimulate the brain so that the induced gamma waves propagate strongly throughout it.”

Reflexology technique application provides the sensory experience of pressure to the feet and hands. Kunz and Kunz posited this theory in 1981 following work with paralyzed individuals.  Pressure sensors in the feet communicate information about movement as well as activities throughout the body including mechanisms such as the autonomic nervous system. (3) 

Researchers working with healthy male subjects found that targeted reflexology work created increased gamma and beta brain wave activity in the frontal cortex of the brain. (1)  


“The frontal lobe (cortex) is the part of the brain that controls important cognitive skills in humans, such as emotional expression, problem solving, memory, language, judgment, and sexual behaviors. It is, in essence, the “control panel” of our personality and our ability to communicate.… “It is also responsible for primary motor function, or our ability to consciously move our muscles, and the two key areas related to speech, including Broca’s area.” (5)


What specific sensory experiences created increase in gamma brain waves? 


Exposing “Alzheimer’s mice” for an hour a day for a week to lights flickering at the speed of 40 hertz per second “sharply reduced” by half the build-up of beta-amyloid plaque in the visual cortex of mice brains. Longer term treatment showed 

MIT researchers also studied using sound to increase activity of gamma waves in the brain. Mice were exposed to sound at a hum of 40 hertz for an hour a day. Results were even more promising than those of the light study. Reduced was the plaque in not only the auditory cortex of the brain but a near-by area the hippocampos where memories are stored.

A reflex area reflecting the cortex of the brain located in the ball of the big toe was targeted by reflexology researchers. Five minutes of application to each big toe for seven consecutive days resulted in an increase in gamma brain waves.

Further implications for targeted reflexology 

Does reflexology effect amyloid plaque? Such research has not been conducted. (Amyloid imaging using the PET (positron emission tomography) has emerged as a method other than post mortem autopsy. (6)) The possibilities are intriguing. As noted below in more recent research at MIT, longer term application of sensory stimulation of light included effects beyond those noted above. 

Further results benefiting those with Alzheimer’s are possible. “… MIT researchers tested the effects of longer-term treatment by exposing mouse models with more advanced Alzheimer’s disease to up to 6 weeks of gamma entrainment by visual stimulation. Results showed stimulation increased gamma brain waves in the visual cortex and higher-order brain areas, including the hippocampus and prefrontal cortex. Continuing stimulation also preserved neuronal and synaptic density in these brain regions, improved performance on memory tasks, and reduced inflammation. Findings point to an overall neuroprotective effect, even in the later stages of neurodegeneration, the researchers reported.” (7)


(1) Dougherty, Elizabeth, “Seeing the Light, Aging Brain Initiative researchers discover a potential Alzheimer’s therapy,” Spectrum (MIT), Spring 2017

(2) “Low-Hum Therapy Seems to Counteract Alzheimer’s Symptoms in Mice” https://www.iflscience.com/health-and-medicine/low-hum-therapy-seems-to-counteract-alzheimer-s-symptoms-in-mice/

(3) Cevat Unal, Menizibeya O.Welcome, Mariam Salako, Faruk Abdullahi, Nuhu M. Abubakar, Vladimir A.Pereverzev, Siti Sugih Hartiningsih, Senol Dane, “The effect of foot reflexotherapy on the dynamics of cortical oscillatory waves in healthy humans: An EEG study,” Complementary Therapies in MedicineVolume 38, June 2018 , Pages 42-47

(4) Kunz, Barbara, Kunz, Kevin, The Complete Guide to Foot Reflexology (Third Edition), RRP Press, 2005

(5) https://www.healthline.com/human-body-maps/frontal-lobe#1

(6) Subapriya Suppiah, Melanie-Anne Didier, Sobhan Vinjamuri,” The Who, When, Why, and How of PET Amyloid Imaging in Management of Alzheimer’s Disease—Review of Literature and Interesting Images,”  Diagnostics (Basel). 2019 Jun; 9(2): 65., PMCID: PMC6627350, PMID: 31242587

(7) https://www.nia.nih.gov/news/noninvasive-brain-wave-treatment-reduces-alzheimers-pathology-improves-memory-mice


Books by Kunz and Kunz

Research Books

Medical Applications of Reflexology: Findings in Research About Post-operative care, Maternity Care and Cancer Care
Evidenced Based Reflexology Research: For Health Professionals and Researchers
Medical applications of Reflexology:: Findings in Research about Cancer Care

Bestselling Books


 Reflexology: Hands-on Treatment for Vitality and Well-being
Complete Reflexology for Life: Your Definitive Photographic Reference to the Best Techniques and Treatments  
 

Intermittent Moving Books

Intermittent Moving: How I Lost My Pants and Mastered My Weight
Un-Sit Your Life: The Reflex "Diet" Solution


Wednesday, September 23, 2020

Is There an Alzheimer’s Sign on the Foot?


Part 2 of 3

Could a part of the big toes associated with the cortex brain reflex area signal the presence of Alzheimer’s disease or the possibility for it? Would such an indicator on the foot have implications for diagnosis and treatment of Alzheimer’s? 

Clinical experience and research raise possibilities.

Our first inkling of such a possibility occurred some thirty years ago. One of the participants in a Winnipeg workshop stood to tell his story. He had observed a distinctive and similar appearance to twenty-one of twenty-three pairs of feet during a visit to his father and fellow residents. All lived in an Alzheimer’s ward. what he had observed was a fleshiness or protrusion on the ball of the big toe. For some individuals the protrusion created a flap of skin extending under the second toe on which they walked.

Years later there it was in a research report into reflexology work and brain wave activity related to Alzheimer’s: a black and white line drawing representing what was, in essence, the area of the big toe described years ago by the visitor to the Alzheimer’s ward. During the research reflexology work was applied to the broad central area of first segment of the big toe, a brain reflex area. The results showed gamma and beta brain waves significantly increased in activity following reflexology work. Gamma brain waves are known to decrease in activity for those with Alzheimer’s. (1)

“Gamma (brain wave) activity represents an important marker of successful memory formation, episodic recall and other behavioral and cognitive functions. Sensorimotor, learning memory, information processing, and behavioral functions are important in everyday life of humans and are also integral in execution of life processes.” (1)

Observation of this visual stress has been a part of Kevin’s practice since the Winnipeg class. When he sees a pronounced area on a client’s foot, he asks, Do you have memory problems? (2) One woman responded, only half joking, I forget where the kids are. He has observed the stress cue in mothers and in daughters, lessened with the younger woman but demonstrating the potential hereditary lineage of Alzheimer’s. One study found heredity to be 46% of the risk for Alzheimer’s.

Aside from serving as a possible indicator of memory problems and more, such a stress cue serves as a target area for reflexology work. It is a basic tenet of reflexology that such work creates change.

(1) Cevat Unal, Menizibeya O.Welcome, Mariam Salako, Faruk Abdullahi, Nuhu M. Abubakar, Vladimir A.Pereverzev, Siti Sugih Hartiningsih, Senol Dane, “The effect of foot reflexotherapy on the dynamics of cortical oscillatory waves in healthy humans: An EEG study,” Complementary Therapies in MedicineVolume 38, June 2018 , Pages 42-47

 

Books by Kunz and Kunz

Research Books

Medical Applications of Reflexology: Findings in Research About Post-operative care, Maternity Care and Cancer Care
Evidenced Based Reflexology Research: For Health Professionals and Researchers
Medical applications of Reflexology:: Findings in Research about Cancer Care

Bestselling Books


 Reflexology: Hands-on Treatment for Vitality and Well-being
Complete Reflexology for Life: Your Definitive Photographic Reference to the Best Techniques and Treatments  
 

Intermittent Moving Books

Intermittent Moving: How I Lost My Pants and Mastered My Weight
Un-Sit Your Life: The Reflex "Diet" Solution


Tuesday, September 22, 2020

Research Shows Possible Alzheimer’s Game Changer: Targeted Reflexology Technique


Part 1 of 3

Who wouldn’t want to think better as well as take possible preventive action against Alzheimer’s, dementia and a whole host of neurological and psychiatric disorders? That’s the promise of a recent reflexology study.

It’s all about brain wave activity and how reflexology can influence it. Previous studies have demonstrated that reflexology work applied to the whole foot creates a change in brain waves, activity of alpha brain waves shown when we’re relaxed. 

The current research shows that reflexology work targeting a brain reflex area significantly increased activity of gamma brain waves and beta brain waves. Gamma brain waves are associated with cognitive functions such as memory, perception, and attention. Beta brain waves are associated with stress, anxiety and motor control. (1)

Gamma brain waves are seen to decrease in those with Alzheimer’s. Gamma and/or beta activity is seen to be abnormal in those with a number of neurological or psychiatric disorders. (1)

Brain waves allow information to be shared among parts of the brain. When the rhythmic activity of brain waves is dysfunctional and information sharing is disrupted a number of conditions can result. With abnormal beta and/or gamma waves these include: autism, ADHD (Attention-Deficit Hyperactivity Disorder), Parkinson’s disease and epilepsy as well as chronic pain, schizophrenia, depression, anxiety, obsessive-compulsive disorder, irritability, agitation, insomnia, bipolar tendencies, and substance abuse and.

During the research, reflexology work was applied to a broad central area of the first segment of the big toes, five minutes per toe for seven consecutive days. As measured by EEG (electroencephalogram) before and after the work, activity of gamma and beta waves increased significantly. (1)

“Gamma waves ripple across the brain about 40 times per second and appear when the brain is doing attentive work, such as forming memories or solving problems.” (2)

For those with Alzheimer’s gamma brain waves are known to slow down. Resulting is interruption in what gamma waves do. As noted by researchers: “Gamma activity represents an important marker of successful memory formation, episodic recall and other behavioral and cognitive functions. Sensorimotor, learning memory, information processing, and behavioral functions are important in everyday life of humans and are also integral in execution of life processes. Increase in gamma active (sic) is also associated with emotion.” The researchers concluded: “Thus reflexotherapy may serve as a technique that can be used to increase cognitive functions in humans.”(1)

The potential impact on lives can be imagined. Talk to almost anyone and you’ll find concern for the possibility of dementia or Alzheimer’s. For those with a family history of Alzheimer’s concern is increased. Could a simple reflexology technique, easy-to-do and with no cost associated, offer a preventive measure?

(1) Cevat Unal, Menizibeya O.Welcome, Mariam Salako, Faruk Abdullahi, Nuhu M. Abubakar, Vladimir A.Pereverzev, Siti Sugih Hartiningsih, Senol Dane, “The effect of foot reflexotherapy on the dynamics of cortical oscillatory waves in healthy humans: An EEG study,” Complementary Therapies in Medicine, Volume 38, June 2018 , Pages 42-47

(2) Dougherty, Elizabeth, “Seeing the Light, Aging Brain Initiative researchers discover a potential Alzheimer’s therapy,” Spectrum (MIT), Spring 2017

(3) https://www.centerforadd-az.com/resources/understanding-brainwaves


Books by Kunz and Kunz

Research Books

Medical Applications of Reflexology: Findings in Research About Post-operative care, Maternity Care and Cancer Care
Evidenced Based Reflexology Research: For Health Professionals and Researchers
Medical applications of Reflexology:: Findings in Research about Cancer Care

Bestselling Books


 Reflexology: Hands-on Treatment for Vitality and Well-being
Complete Reflexology for Life: Your Definitive Photographic Reference to the Best Techniques and Treatments  
 

Intermittent Moving Books

Intermittent Moving: How I Lost My Pants and Mastered My Weight
Un-Sit Your Life: The Reflex "Diet" Solution



Wednesday, August 26, 2020

Reflexology Research with Ventilator-Dependent Patients: Methods for Positive Results

Brian Hall / Public domain
How to get results. This is always a topic of interest to reflexologists. The discussion centers around where to apply technique, how frequently and for how long a period of time to apply technique. 


The same issue is important for researchers working with patients in a hospital setting. Setting such parameters is a part of establishing Method for a study. Defining Method in a study is critical to ascertain a potential future protocol that will create results. This is a part of evidence-based medicine. Here we consider the reflex areas and amount of time utilized in research with ventilator-dependent patients.


Following are synopses of research with ventilator-dependent patients. Some studies found positive results, others did not. As common with research, researchers cite and consider methods in similar studies seeking to understand reported results. Study (1), for example was criticized for using different reflexologists. As you look through the synopsis, consider the Method and positive or negative results.


Multiple studies show that reflexology helps in the treatment of patients on mechanical ventilators. Patients experience: Improved physiological parameters (positive results in (2) and (5), negative results in (1) and (3)); Lessened anxiety and agitation (positive results as well as better sleep and patient-ventilator synchrony (5), negative results (4); less use of drugs for sedation (5); shorter length of time on the ventilator (weaning time) (Positive results for all three studies1, 2, 3) and increased level of consciousness for those in a coma (6). Five of the six studies, noted  use of reflexology as “an effective nursing intervention,” recommended training in and use of foot reflexology for patients on mechanical ventilators. (1, 2, 3, 5, 6,7)


(1) Researched: Physiological parameters (Pulse rate, respiratory rate, systolic and diastolic blood pressures, mean arterial pressure, percutaneous oxygen saturation); Weaning time

Researchers Abbas Ebadi et al noted the method implemented in their research: Following open heart surgery (OHS), transfer to an OHS-ICU and placement on a mechanical ventilator (MV), 31 patients who had been randomly assigned to the study’s reflexology group received on each foot 7 to 10 minutes of reflexology work applied to the lung and heart reflex areas. Work was applied by same-gender nurses. Measured were pulse rate, systolic and diastolic blood pressure, mean arterial pressure and oxygen saturation. 

Results were reported as: “Study findings also showed that although reflexology had no significant effect on physiological parameters, it significantly reduced the length of MV weaning time. The mean of weaning time in the reflexology group was 39.11 min shorter than the control group.…

“Conclusion: Study findings indicate that foot reflexology is an effective nursing intervention for facilitating MV weaning after OHS. Given the simplicity, safety, and cost-effectiveness of foot reflexology, we recommend the development and implementation of reflexology training programs for both nursing and practicing nurses.”

(1) Abbas Ebadi, Parasoo Kavei, Seyyed Tayyeb Moradian, Yaser Saeid, “The Effect of Foot Reflexology on Physiologic Parameters and Mechanical Ventilation Weaning Time in Patients Undergoing Open-Heart Surgery: A Clinical Trial Study” Complement Ther Clin Pract 2015 Aug;21(3):188-92. PMID: 26256138 DOI: 10.1016/j.ctcp.2015.07.001


(2) Researched: Physiological parameters (Heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation), Weaning time, Sedation and analgesic drug use

Researchers Amira Elsayed et al noted the method implemented in their research. Monitored six times were: (a) heart rate, (b) respiratory rate, (c) systolic and (d) diastolic blood pressure, (e) mean arterial pressure and (f) oxygen saturation. Following open heart surgery and within 60 minutes of being admitted to the cardio-thoracic ICU, 40 patients who had been randomly assigned to the study’s reflexology group received on each foot 15 to 30 minutes of reflexology work applied to the lung and heart reflex areas. 


Results demonstrated reflexology work positively affects stabilization of physiological parameters. were reported. Compared to the patients in the control group patients in the reflexology group experienced a: (a) statistically significant decrease in heart rate,  (b) significantly lower respiratory rate, (c) statistical significant reduction in the systolic blood pressure, (d) statistically significant lower diastolic blood pressure, (e) statistically significant drop in mean arterial pressure and (f) statistical significant elevation in the oxygen saturation level. Weaning time from the mechanical ventilator for those in the reflexology group was 270 minutes while in the control group it was 435 minutes. 


“Based on the results of our study, we conclude that foot reflexology massage can significantly enhance the physiological indicators, and shorten MV weaning time in patients undergone OHS (Open Heart Surgery). Therefore, foot reflexology massage can be incorporated into daily patient care in cardiothoracic ICU. Training programs on applying foot reflexology for critical care nurses are needed. Future large scale studies on different patient population are also required in order to obtain a strong evidence to support this approach and enrich the body of knowledge in this area. … 


“Conclusion: Foot reflexology is an effective method for stabilizing physiological indicators and decreasing ventilator dependence among patients undergoing OHS. Therefore, it can be introduced as an adjunct to daily care of OHS patients in ICU.” 

(2) Elsayed, Amira, Kandeel, Nahed, El-Aziz, Wafaa, “The Effect of Foot Reflexology on Physiological Indicators and Mechanical Ventilation Weaning Time among Open-Heart Surgery Patients” American Journal of Nursing Research. 2019, 7(4), 412-419 DOI: 10.12691/ajnr-7-4-2

(Full study http://pubs.sciepub.com/ajnr/7/4/2/index.html)


(3) Researched: Heart rate, oxygen saturation; Weaning time

Researcher Kandmire noted the method of the study: a twenty-thirty-minute foot reflexology session was applied post operatively to 42 non-randomly selected open heart surgery patients.


Results: “(As compared to those in the control group) Reflexology did not have a significant effect on physiological parameters in patients receiving mechanical ventilation support. Shortening the weaning time from mechanical ventilation suggests that it might be applied effectively in patients receiving mechanical ventilation support in intensive care unit.”

(3) Didem Kandemir, “How Effective Is Reflexology on Physiological Parameters and Weaning Time from Mechanical Ventilation in Patients Undergoing Cardiovascular Surgery?,” European Journal of Integrative Medicine 26 · February 2019DOI: 10.1016/j.eujim.2019.01.008


(4) Researched: Anxiety, Agitation

Researchers Kavei et al describe a double blind three group randomized study. Following open heart surgery: “Foot reflexology massage for 20 minutes was provided to patients in the experimental group on the reflection points in the heart and lungs. The rate of anxiety and agitation based on Faces of Anxiety Scale (FAS) and the Richmond Agitation Scale (RSAS) were recorded in 6 stages.”


“Conclusion: Foot reflexology massage in reflection points of the heart and lung in patients after surgery did not reduce anxiety and agitation in patients.”

(4) Kavei, P, Ebadi, A, Saeed Y, Moradian S. T., Sedigh Rahimabadi M, “Effect of Reflexology on Anxiety and Agitation in patients Under Mechanical Ventilation after Open Heart Surgery: A Randomized Clinical Trial Study,”  Journal of Clinical Nursing and Midwifery, Spring 2015, Volume 4, Number 1; Pages 16-26


(5) Physiological anxiety signs (Heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate) and Sedation Needs

Researchers Akin Korhan et al note their method: “… a single blinded, randomized controlled design with repeated measures was used in the intensive care unit of a university hospital in Turkey. Patients (n = 60) aged between 18 and 70 years and were hospitalized in the intensive care unit and receiving mechanically ventilated support. Participants were randomized to a control group or an intervention group. The latter received 30 minutes of reflexology therapy on their feet, hands, and ears for 5 days. …”


Results: “The reflexology therapy group had a significantly lower heart rate, systolic blood pressure, diastolic blood pressure, and respiratory rate than the control group. A statistically significant difference was found between the averages of the scores that the patients included in the experimental and control groups received from the agitation, anxiety, sleep, and patient-ventilator synchrony subscales of the American Association of Critical-Care Nurses Sedation Assessment Scale. … “Reflexology can serve as an effective method of decreasing the physiological signs of anxiety and the required level of sedation in patients receiving mechanically ventilated support. Nurses who have appropriate training and certification may include reflexology in routine care to reduce the physiological signs of anxiety of patients receiving mechanical ventilation.”

(5) Akin Korhan, Esra PhD; Khorshid, Leyla PhD; Uyar, Mehmet MD, “Reflexology: Its Effects on Physiological Anxiety Signs and Sedation Needs (in patients receiving mechanically ventilated support/ICU),” Holistic Nursing Practice: January/February 2014 - Volume 28 - Issue 1 - p 6–23 doi: 10.1097/HNP.0000000000000007


(6) Researched: Conscious level

“Methodology: The study group constituted (50) patient (adult mechanically ventilated patients hospitalized in ICU), who was received two reflexology session on feet and the control group constituted (50) patient who was received the routine care, GCS (Glasgow Coma Scale) measured before session, immediate after, post 2 hours and post 4 hours.” A 30-45 minute session was applied including “a mild massage will be done to the all feet and then pressure will be applied once to specified reflex points related to brain, heart, renal and respiratory systems.”


Result: No statistical difference was found in time on mechanical ventilator or days in ICU.  “The findings of the study revealed that there was effect of foot reflexology on the conscious level after the second session … “There was significant increase in GCS (Glasgow Coma Scale). So, because of the positive results of the intervention, the nurse practitioners may be trained about the technique of foot massage and reflexology.”

Maha Salah Abdullah Ismail, Manal S. Ismail, Amir M. Saleh “Effect of Foot Reflexology Treatment on Glasgow Coma Scoring Among Mechanically Ventilated Patients,”IJBPAS International Journal of Biology, Pharmacy and Allied Science), July, 2017, 6(7): 1384-1394, ISSN: 2277–4998; (Full Study available: https://ijbpas.com/pdf/2017/July/1498792891MS%20IJBPAS%202017%204209.pdf)


(7) Researched: Systolic and diastolic blood pressure, mean arterial pressure, heart rate, respiratory rate, percutaneous oxygen saturation, and anxiety

“Results showed a statistically significant difference between intervention and control groups in terms of the level of anxiety (p < 0.05). Also, results showed a statistically significant effect on all physiological parameters except heart rate (p < 0.05).”


“Today,  it  seems  that  non-pharmaceutical therapies such as complementary and alternative medicine (CAM) may be used to reduce anxiety [21,37e 40], prevent physiological reactions caused by anxiety [37, 40, 41], stabilize vital signs [42], and manage pain [43]. Since nurses play a key role in predicting psychological and physiological needs of patients and reducing their level of anxiety and stress [25], it seems that nurses can practice some CAMs to reduce stress, pain, and improve the health conditions of patients [44]. As a result, in addition to helping patients relax, nurses can lower the chance of complications by actively reducing the anxiety levels of their patients.””

Kavei, P, Ebadi, A, Saeed Y, Moradian S. T., Sedigh Rahimabadi M,, “Effects of Foot Reflexology on Anxiety and Physiological Parameters in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Clinical Trial,” Complement Ther Clin Pract. 2018 May;31:220-228. PMID: 29705459 DOI: 10.1016/j.ctcp.2018.02.018.


Books by Kunz and Kunz

Research Books

Medical Applications of Reflexology: Findings in Research About Post-operative care, Maternity Care and Cancer Care
Evidenced Based Reflexology Research: For Health Professionals and Researchers
Medical applications of Reflexology:: Findings in Research about Cancer Care

Bestselling Books


 Reflexology: Hands-on Treatment for Vitality and Well-being
Complete Reflexology for Life: Your Definitive Photographic Reference to the Best Techniques and Treatments  
 

Intermittent Moving Books

Intermittent Moving: How I Lost My Pants and Mastered My Weight
Un-Sit Your Life: The Reflex "Diet" Solution