Comparing the impact of foot and hand reflexology on anxiety and physiological indices in colonoscopy candidates: A randomized clinical trial

Authors: Golitaleb Mohamad, Safdari Ali, Rafiei Fatemeh, Yaghoobzadeh Ameneh, Mohamadi Najmeh, Mokhtari RaziehJournal: Contemporary clinical trials communicationsPublished: April 1, 2025DOI: 10.1016/j.conctc.2025.101449

Moderate EvidenceRandomized Controlled Trialn=105 participants

Anxiety High Blood Pressure

In Plain Language: reflexology for anxiety, explained

Colonoscopy is a standard diagnostic procedure, yet pre-procedural anxiety remains a prevalent concern. While pharmacological interventions are available, non-pharmacological approaches such as reflexology offer a promising alternative. Despite its therapeutic potential, comparative evidence on foot and hand reflexology in this setting is limited. This study aimed to evaluate their effects on pre-colonoscopy anxiety and physiological parameters. This randomized clinical study was conducted from November 2022 to August 2023 at the Amir al-Momenin Educational and Therapeutic Center in Arak, Iran. A total of 105 patients were randomly assigned to three equal-sized groups (n = 35) using block randomization: foot reflexology, hand reflexology, and a control group. Patients in the intervention groups received a 30-min reflexology session. Anxiety levels were assessed using the Spielberger State-Trait Anxiety Inventory (STAI-Y1), a validated tool for measuring situational anxiety. Physiological indices, including systolic and diastolic blood pressure, heart rate, and arterial oxygen saturation (SpO2), were measured immediately before and after the intervention. There were no significant differences in clinical outcomes among the groups at baseline (p > 0.05). However, following the intervention, the mean anxiety scores in both reflexology groups (foot reflexology: 44.39 ± 5.21; hand reflexology: 45.6 ± 4.49) were significantly lower than that of the control group (48.05 ± 4.81) (p = 0.008), as determined by one-way analysis of variance (ANOVA). The anxiety reduction was more pronounced in the foot reflexology group than the hand reflexology group, although this difference did not reach statistical significance (p > 0.05). Additionally, post-intervention assessments revealed significant differences in systolic blood pressure (foot reflexology: 123.48 ± 16.40 mmHg;

Key Findings: what this randomised trial found about anxiety

✓Both foot and hand reflexology were evaluated as non-pharmacological interventions to reduce pre-colonoscopy anxiety in a randomized clinical trial with 105 patients divided into three equal groups.
✓A single 30-minute reflexology session was administered to intervention participants, with anxiety levels measured using the Spielberger State-Trait Anxiety Inventory (STAI-Y1) to assess situational anxiety before the colonoscopy procedure.
✓The study compared the relative effectiveness of foot reflexology versus hand reflexology in managing pre-procedural anxiety and physiological parameters in colonoscopy candidates.

What This Means for You

If you're anxious about an upcoming colonoscopy, reflexology may help reduce your anxiety and calm your physiological responses, though results are most reliable when compared to no treatment.

What This Means for Practitioners

This study provides moderate evidence that both foot and hand reflexology effectively reduce pre-procedure anxiety in clinical settings, supporting reflexology's use as a complementary approach in medical environments.

Study Design: how this randomised trial was run

Sample Size

105 participants

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Reflexology for anxiety: common questions

Does reflexology help with anxiety?

If you're anxious about an upcoming colonoscopy, reflexology may help reduce your anxiety and calm your physiological responses, though results are most reliable when compared to no treatment.

What did this study find?

Both foot and hand reflexology were evaluated as non-pharmacological interventions to reduce pre-colonoscopy anxiety in a randomized clinical trial with 105 patients divided into three equal groups. A single 30-minute reflexology session was administered to intervention participants, with anxiety levels measured using the Spielberger State-Trait Anxiety Inventory (STAI-Y1) to assess situational anxiety before the colonoscopy procedure. The study compared the relative effectiveness of foot reflexology versus hand reflexology in managing pre-procedural anxiety and physiological parameters in colonoscopy candidates.

How strong is this evidence?

This is a randomised trial and we rate its evidence moderate. It covers 105 participants. It was published in Contemporary clinical trials communications. Reflexology is a complementary therapy, not a replacement for medical treatment.