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Δευτέρα, 6 Οκτωβρίου 2014

Determination of Efficacy of Reflexology in Managing Patients with Diabetic Neuropathy: A Randomized Controlled Clinical Trial


Background. The restricted usage of existing pharmacological methods which do not seem to provide the treatment of diabetic neuropathy may lead to exploring the efficacy of a complementary therapy. In this context, this paper was devoted to evaluate the efficacy of foot reflexology. This health science works on the hypothesis that the dysfunctional states of body parts could be identified by observing certain skin features and be rectified by stimulating certain specific areas mapped on feet. Method. Subjects (N = 58) with diagnosed diabetic neuropathy were randomly distributed into reflexology and control groups in which both group patients were treated with ongoing pharmacological drugs. Reflexology group patients were additionally treated holistically with the hypothesis that this therapy would bring homeostasis among body organ functions. This was a caregiver-based study with a follow-up period of 6 months. The outcome measures were pain reduction, glycemic control, nerve conductivity, and thermal and vibration sensitivities. The skin features leading to the detection of the abnormal functional states of body parts were also recorded and analyzed. Results. Reflexology group showed more improvements in all outcome measures than those of control subjects with statistical significance. Conclusion. This study exhibited the efficient utility of reflexology therapy integrated with conventional medicines in managing diabetic neuropathy.

2.9. Study Design for Reflexology Group Patients

A foot reflexology therapy application protocol was developed to treat the patients holistically. A step-by-step procedure was followed uniformly to stimulate the following RAs: energy balance [], lymphatic system, solar plexus [], adrenal glands, spine, urinary system, digestive system, brain, other endocrine glands, sciatic nerve, knee and hip. The hypothesis of this protocol was that stimulations on these specific areas would establish homeostasis in the functional status of the lymphatic, urinary, digestive and immunity systems together with releasing the mental stress, improving the diabetic control [] and increasing the lower limb activities. The maps of the reflexology areas for these target body parts located on the feet had been followed as per the standard descriptions of various publications [], Indian school of reflexology practice [], and in-house data records.
Moderate pressure, in the range of 30 N/cm2 to 35 N/cm2 as recorded using pedography system, Emed-AT/2, Novel GmbH (Germany) [], with tolerable tenderness was used to generate stimulations. The areas were lubricated with cream of milk without any additive before applying stimulation in order to avoid any adverse effect on the skin due to friction. Each reflexology area was stimulated (average) 15 times of ~20 seconds duration per session with the understanding that stimulations on a particular RA < 10 times did not produce any therapeutical effect and a RA would be overstimulated with continuous stimulations >20 times. One therapy session took ~1/2 hour duration and there were 2 therapy sessions per day.