Methods: A sample of 50 volunteers, virgin females diagnosed as premenstrual syndrome was selected from the stu- dents of Faculty of Physical Therapy, Cairo University. Their age was ranged between 19 to 23 years with mean value of (21.53±2.27 yrs) and BMI was ≤28 Kg/m² with mean value of (24.04±2.41 Kg/m²).A detailed medical history was obtained to screen other pathological conditions that may affect the results. Females were randomly assigned into two equal groups. Group (A) consisted of 25 subjects who received footreflexology in addition to relaxation training techniques twice a week for 8 weeks. Group (B) consisted of 25 patients, who received relaxation training techniques only twice a week for 8 weeks. Assessment of all subjects in both groups was carried out before and after the treatment program through heart rate, respiratory rate in addition to plasma cortisol level and daily symptoms report chart. Results: Showed a statistical highly significant decrease (p<0.001) in heart rate, respiratory rate, plasma cortisol level as well as daily symptoms report score in group (A) while there was a statistical significant decrease (p<0.05) in all variables in group (B).
Saeed Babajani et al., (2014) conducted a randomized clinical study to determine the effect of footreflexology on the level of pain during chest tube removal after open heart surgery in Baqiyatallah Medical Sciences University among ninety samples. Pain level was measured through Numerical Rating Scale (NRS). In the experimental group, centre of the anterior one-third of the left foot and in the placebo-treated group, posterior one-third of the left foot was being massaged for ten minutes before chest tube removal. Pain was not increased due to the chest tube removal in the experimental group (p=0.08), while placebo- treated and control groups had significant increase of the pain (p=0.001 and p=0.000 respectively). It was concluded that footreflexology was a useful nursing intervention in reducing pain in subjects during chest tube removal after open heart surgery.
hypertension induced insomnia problem can be brought under control by a mechanism of increased bio-magnetism existing in every human being. This concept of bio-magnetism is a new phenomenon explained very clearly by swami Vethathiri maharishi. According to him, the bio-magnetism is a fundamental vital force which determines the Physical health of the human being, depletion of which below a critical level will result in the development of various kinds of diseases including hypertension and insomnia problem .The bio-magnetism thus depleted below a certain minimum critical level can be enhanced to above the minimum critical level by strictly regulating the quantity and quality of food, work, sleep, sexual gratification and thought force which is otherwise called as five factors limit and method. In addition to the above, the Biomagnetism can also be boosted to above minimum critical level by a continuous practice of Simplified NINE types of Physical Exercises, namely Hand exercises, Leg exercises, Neuro -muscular breathing exercises, Eye exercises, Kapalapathi, Makarasana Part 1 & 2,Acu- pressure14 points exercise, out of these nine exercise the important in being given to leg exercise particularly footreflexology and Acupressure 14 points exercise which come under the broad spectrum of sky yoga principles, which also includes Kayakalpa yoga, meditation and introspection methods as explained in SKY yoga. However our study is confined to footreflexology and acupressure 14 points exercise only. 
Overall, the findings of this study supported the hy- pothesis of the research that footreflexology is effective on improving the sleep quality of the elderly women with RLS. Therefore, caregivers and nurses of the elder- ly are recommended to learn and use footreflexology as a non-invasive and non-pharmacological approach that is easy to administer and almost cost-free. In this study, no complications due to footreflexology was observed. Reflexology, with regard to its beneficial effects, is of particular interest to treatment staff, especially nurses. These interventions reduces the use of sleeping pills, while protecting the elderly from the phenomenon of polypharmacy. Therefore, the present study may be im- portant in introducing a “nursing care with no medica- tion use” to improve the quality of sleep in the elderly with RLS. It is suggested that this type of intervention be used in health centers. Obviously, this objective can be achieved only through proper planning by relevant au- thorities and nursing managers.
The primigravid women of the experimental group felt less pain perception and improved coping with the use of FootReflexology during the first stage of labour than the control group proving it to be effective to use. The intensity of labour pain, the length of time labour lasts and women’s response to the pain varies widely. The environment in which the women give birth and the support they receive from their care givers and companions will also affect their reaction to pain and their ability to cope. Many women opt to use some form of pain relieving method to help them cope during labour. Hence it becomes a necessity for the midwives to have adequate knowledge and skill about various non-pharmacological methods. Though there is availability of various non-pharmacological methods, FootReflexology technique is noninvasive, safe and effective. Thus nurses should use FootReflexology as noninvasive, safe and effective treatment modalities in their practices.
The child's demographic information questionnaire included information on age, gender, and the age of the diagnosis, which was recorded by interviewing the child's parent or checking medical record of the individual. To measure the patient's anxiety score, anxiety-based form was used based on the obsessive-compulsive behavioral observational scale (OSBD-R), which was completed before the implementation of footreflexology massage and after blood transfusion in the intervention group and before common massage and after transfusionin the placebo group. In the control group, the anxiety level was measured 20 minutes before transfusion in order to control the effect of time in all three groups; these rates were, again, measured after transfusion.
After the assessment of hospital anxiety and de- pression in the control group, at the same time as the reflexology group (i.e., in the morning shift and in the same environment), the control group only received routine care without footreflexology massage. Rou- tine care included hemodynamic measurements, drug therapy, physicians’ visit, and nursing care performed for patients admitted to the CCU. It should be noted that nursing duties and staffing patterns remained unchanged throughout the study process. Also, nurs- ing staff and the participants’ family members were requested not to enter the intervention room, so as to minimize disruptions and enhance the participants’ relaxation. No harm or side effects were reported throughout the trial.
Kannadi (2008) A quasi experimental research design was used with two month follow-up to measure the effect of footreflexology on pain and quality of life in thirty nine female adult osteoarthritis patients without deformity of bone or destruction of joints at osteoarthritis outpatient clinic at Zagazig University Hospitals. The patients with other chronic illness conditions such as diabetes, ischemic heart disease, chronic obstructive pulmonary disease, and stroke were excluded. Perceived pain and quality of life were assessed by using Bio-socio-demographic and disease characteristics, the osteoarthritis Quality of Life questionnaire, Numerical pain assessment Rating Scale questionnaire and Health assessment questionnaire. Eight week course of reflexology treatments were given. The study results revealed hands and footreflexology improved patient’s quality of life, pain and health status in the post-intervention and follow-up phase. These positive impacts are not affected by patient’s age and duration of illness. Therefore, reflexology must be considered as a complementary treatment modality in osteoarthritis. It should be introduced to nursing and medical students, and in postgraduate staff development programs.
Introduction: Thalassemia is the most common genetic disorder in the world. Children with major thalassemia face much lifelong stress and anxiety related to invasive methods of treatment including venipuncture and blood transfusion that cause discomfort and anxiety symptoms in children and changes their physiological indicators. Methods: The aim of this study was to evaluate the effect of footreflexology massage on vital signs and anxiety after blood transfusions in children with thalassemia. It was a quasi- experimental study, which conducted on 60 children with thalassemia who had inclusion criteria. Patients randomized into three groups of reflexology massage, regular massage, and control group. The level of anxiety in patients assessed by an anxiety measurement based on the Observational Scale of Behavioral
Foot ulcers are a typical inconvenience of diabetes. They are most predominant under your enormous toes and also the bundles of your feet. Ulcers structure as an aftereffect of skin tissue separating and uncovering fundamental layers. These bruises can influence your feet down to the bones. Reflexology is a well known comprehensive & reciprocal treatment that advantages and enhances general wellbeing and in addition assuaging push and agony in different parts of the body. Reiterative footreflexology graphs reflect your self-perception. These graphs are in light of zones to mirror your body in scaled down on your feet. In this paper a hybrid method which combines the reiterative foot chart with image processing technique is proposed. The image of affected foot is enhanced using colour image segmentation technique and then processed using reiterative foot chart.
This quasi-experimental study was conducted on four groups of male patients. A total of 140 subjects were selected from ACS patients admitted to the men’s ward in the CCU of Baqiyatallah Hospital (Tehran) using the convenience sampling method. The inclusion criteria were a confirmed diagnosis of ACS and the patient being alert and able to provide informed consent. Exclusion criteria were the presence of a skin disease, eczema or any wound on the area treated by massage and foot baths, diabetes or neuropathy, use of sedatives or general anesthesia within the previous 12 hours, ejection fraction (EF) of less than 40% and addiction to stimulatory drugs, alcohol, narcotics or sedatives. The subjects were randomly assigned to four groups of 35 persons. Group A received footreflexology massage, group B received foot bath, group C received a combination of the two methods, and group D was the control group without intervention. The interventions was began on the second night of hospitalization and continued for the third night for each group. Before intervention, patient demographic data was collected by self-administered questionnaires and the quality of patient sleep was determined using the Veran Snyder- Halpern subjective sleep quality questionnaire. 20 This scale is a 15 items scale
Jipi Varghese (2014) conducted a randomized control trial to determine the effect of footreflexology on intensity of pain and quality of sleep in post caesarean mothers. Samples were 60 post caesarean section mothers .30 Subjects each were assigned randomly to either an experimental or a control group. Intervention group received a single 15-minute footreflexology. After 5 days of treatment, intensity of pain was measured by visual analogue scale (VAS). The post test mean score of pain of an experimental group(47.5%) was significantly lower than of a control group (76.5%). Also, there was a significant difference between groups in terms of the pain intensity and requesting for analgesic (p < .001). The results proved that the footreflexology was effective in reducing the post operative pain among post caesarean mothers.
Introduction: Anxiety is a common phenomenon after all surgical operation. Complementary methods as footreflexology massage and Bensone relaxation cause comfort, tranquility, correction of physical function disorder, change of physiological responses and decrease of fear with signs of disease. Researchers purposed to study the effect of footreflexology massage and relaxation on decrease of anxiety.
Courneya et al., (2007) studied the clinical course and prognosis of physiological and psychological symptoms like pain, nausea, vomiting, hair loss, anxiety and depression over course of radiation therapy among 76 patients with breast cancer in Canada. Edmonton symptom assessment scale used from the time of treatment to 6 months post treatment to findout the symptoms. The findings revealed physiological and psychological symptoms increased over the course of treatment was highest at the last week of treatment and returned to pre treatment levels by 3 months after treatment. The second objective was to find out the effectiveness of footreflexology on physiological and psychological wellbeing among patient with cancer receiving radiation therapy in experimental group:
Ko YS, Park, MK. (2006) conducted a non-equivalent pretest-posttest quasi-experimental study in department of Nursing, Kwan yang Health College, Korea to know the effects of Self-footReflexology on Fatigue and Sleep States in Women Nurses. This study consist of 40 nurses who were assigned to an experimental group (EG, n=20) and to an control group (CG, n=20). The EG participated in SFR for a total of 40 minutes. The CG did not receive SFR during the research period. Findings shown that the score of fatigue in the EG was significantly lower than that of the CG and but the score of sleep states in the EG was significantly higher than that of the CG. Hence, it is very clear that the score of fatigue decreased and sleep states increased in the study. Therefore, it is considered that the SFR as an intervention on clinical nurses. However, it needs more intensive study.
Mahboubeh Valini et.al., (2010) conducted a study to assess the effect of reflexology on the pain and certain outcomes of the labour on primiparous women. Quasi- experimental design was adopted. 88 primiparous mothers referred to selected hospitals were selected using simple random sampling method and then randomized into two groups. Data collection tools were the demographic data questionnaires, profile & outcome of the labour and the short form of the Mc Gill questionnaire for pain rating index. The intervention was general & specific reflexology in the active phase of labour. PRI was assessed before the intervention and four times after the intervention (3-5cm; 6- 8cm and 9-10 cm dilatations & second stage of labour). In the reflexology group, there was a significant difference between the PRI before and after the 4 stages intervention (P<.001).PRI was different significantly between studied groups after intervention (P<.001). The study concluded that Reflexology can lead to decrease in the labour pain and it can be replaced as an alternative for pharmacological methods.
hemodynamic status and reduced pain in patients. The results regarding the reduced systolic and diastolic BP after footreflexology in this study is consistent with the findings of Moeini et al (17), Kaur et al (18), and Eguchi et al (19). In contrast, Song et al (20) reported that footreflexology had no positive effect on systolic and diastolic BP. These contradictory results can be attributed to the differences in intervention programs and the sample size. Although the mechanism of footreflexology is not clearly known, relaxation and stress relief may be effective in lowering BP.
hemodialysis patients who were included in 2 intervention groups and one control group. The results demonstrated a significant difference among the three groups after the intervention so that the groups who received the back massage and the reflexology intervention experienced reduced fatigue while improved sleep quality compared to the control group. Further, reflexology had a greater effect on reducing fatigue whereas increasing energy compared to back massage, which could be due to the limited effect of back massage compared to reflexology; in fact, reflexology affects all parts of the body since different parts of the foot sole are connected to all parts of the body (34). Matin and Ozdemir assessed and compared the effects of aromatherapy massage and reflexology on pain and fatigue in patients suffering from rheumatoid arthritis. The results indicated that fatigue scores began to decrease from the fourth week of the study in the aromatherapy group while such a reduction was observed from the first week of the study in the reflexology group. This could be attributed to the effects of reflexology on the nerves and joints and that it stimulated the whole body of the patient after the intervention (35). Cassileth and Vickers investigated the effects of different types of massage therapy on cancer symptoms including pain, fatigue, anxiety, nausea, and depression in a major cancer center on hospitalized and unhospitalized patients. The greatest effect was observed on anxiety while the smallest changes were observed with respect to fatigue. Furthermore, the results represented that the effects of Swedish massage and gentle massage were greater compared to the foot massage. Regarding the difference between the results of the above-mentioned study and those of the present study in terms of fatigue, it can be claimed that fatigue requires more massage sessions to reduce compared to other symptoms of chemotherapy (16). Based on the results of a review study by Lee et al, footreflexology was more efficient on fatigue and sleep. Additionally, those massages which lasted 50 minutes or more were noticeably more effective compared to those which lasted 20 minutes or less. As a result, footreflexology seems an effective nursing intervention employed for decreasing fatigue whereas improving the quality of sleep (36). Finally, Ozdelikara and Tan reported the positive effect of reflexology on fatigue and thus, the quality of life, which is consistent with the result of the present study in this respect (37).
During their consultations with health professionals, participants found that individual information and edu- cation was often not provided as limited consultation time restricted them from asking questions. Individuals without foot pathology or few symptoms may not re- quest foot health information, as they perceive their needs to be minimal . However, within the context of a patient-centred consultation it is still important to identify their educational needs early in the disease . This view was strongly articulated by the participants, as they felt let down and un-prepared for the way in which RA affected their feet and thus their daily activities. The feet are often the first part of the body to be affected in RA  with most experiencing foot pain early in the dis- ease . It is therefore essential to provide foot health education in a timely and targeted way.
Participants described the experience of being ‘listened to’ more by female practitioners as resulting in positive outcomes. This perceived higher level of empathy was also identified in a study with practitioners, who found it easier to advise female patients on ‘difficult’ foot health issues such as foot wear styles . ‘Gender related com- munication skills’ , most notably ‘patient-centeredness’ , as opposed to gender alone, are thought to influence the development of a positive therapeutic relationship . Although female practitioners are more likely to exhibit such skills , this does not preclude male practitioners from developing and demonstrating them. Thorough as- sessment and developmental feedback in relation to communication skills at undergraduate level may ensure similarities in development by male and female practi- tioners. It should be taken into consideration that the participants and facilitators of this study and the study with practitioners  were all female. The fact that the group participants and facilitators were of the same gen- der could have influenced the results. The development of a dynamic discussion is more likely where there is group homogeneity from both a gender and shared ex- perience perspective . Further research, exploring the perspectives of men, could provide a more compre- hensive picture of the foot health education needs of people with RA.