Can foot reflexology be a complementary therapy for sleep disturbances? Evidence appraisal through a meta-analysis of randomized controlled trials

J Adv Nurs. 2021 Apr;77(4):1683-1697. doi: 10.1111/jan.14699. Epub 2020 Dec 8.


Aims: To systematically summarize and quantify the effects of foot reflexology on improvements in sleep disturbances.

Design: Systematic review and meta-analysis.

Data sources: Datasets including PubMed, Web of Science, Scopus, EMBASE, Cochrane Library, Google Scholar, CINAHL and two Chinese electronic databases (i.e., AiritiLibrary and China National Knowledge Infrastructure) were used to search from their inception to 31 January 2019.

Review methods: Studies which were randomized controlled trials that reported changes in sleep disturbances after the intervention among adults over 18 years old and written in the English or Chinese language were included. Two reviewers' independently assessed the eligibility, extracted data, and conducted a quality assessment. Based on the extracted data, two separate meta-analyses were performed.

Results: Forty-two articles with a total sample of 3,928 participants were included in the systematic review and were eligible for the meta-analysis. The most commonly employed outcome measurement tool was the Pittsburgh Sleep Quality Index, followed by the therapeutic effect between the intervention and control groups (as evaluated by participants with sleep problems compared with those without sleep problems in each group after the intervention). Results revealed that foot reflexology resulted in a greater reduction in the sleep quality score compared with the controls (Hedges' g = -1.37; 95% confidence interval (CI) = -1.81~-0.94). As for the therapeutic effect, participants in the intervention group were less likely to have sleep problems than those in the control group (pooled odds ratio = 0.25; 95% CI = 0.19 ~ 0.31).

Conclusion: The findings suggested that foot reflexology produced significant improvements in sleep disturbances.

Impact: Foot reflexology is a non-invasive and convenient intervention and regularly receiving foot reflexology can be considered complementary therapy to improve the sleep quality of adults with sleep disturbances. Furthermore, healthcare providers can actively press the solar plexus and heart zones to alleviate sleep disturbances when performing foot reflexology.

目的: 系统化总结和量化足部反射疗法对改善睡眠障碍的作用。 设计: 系统化评估和荟萃分析。 设计来源: 检索了从数据集开始发布到2019年1月31日的数据集 (数据集包括PubMed、科学引文索引、Scopus、EMBASE、Cochrane Library、Google Scholar、CINAHL和两个中文电子数据库 (即AiritiLibrary和中国知识基础设施工程) ) 。 评估方法: 纳入的研究均为随机对照试验, 报告了18岁以上成年人经过干预后睡眠障碍的变化, 并以英文或中文编制研究资料。两位评估者独立评价了研究资格, 提取了数据, 并进行了质量评估。根据提取的数据, 开展了两项独立的荟萃分析。 结果: 系统化评估中纳入了42篇文章, 总样本量为3,928名参与者, 并有资格进行荟萃分析。最常用的结果测量工具是匹兹堡睡眠质量指数, 其次是干预组和对照组之间的治疗效果 (干预后每组有睡眠问题的参与者与无睡眠问题的参与者比较评估) 。结果显示, 与对照组相比, 足部反射疗法使睡眠质量评分下降幅度更大 (Hedges'g=-1.37;95%置信区间 (CI)=-1.81~-0.94) 。在疗效方面, 与对照组的参与者相比, 干预组的参与者出现睡眠问题的可能性更小 (合并比值比=0.25;95%CI=0.19~0.31) 。 结论: 研究结果表明, 足部反射疗法可以显著改善睡眠障碍。 影响: 足部反射疗法是一种无创、方便的干预措施, 定期接受足部反射疗法可以被视为是改善有睡眠障碍的成年人睡眠质量的辅助疗法。此外, 医疗服务提供者在进行足部反射疗法时, 可以主动按压太阳神经丛和心脏区, 以缓解睡眠障碍。.

Keywords: foot reflexology; meta-analysis; sleep disturbances; sleep quality; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • China
  • Complementary Therapies*
  • Humans
  • Musculoskeletal Manipulations*
  • Randomized Controlled Trials as Topic
  • Sleep
  • Sleep Wake Disorders* / therapy