[Feet--a diagnostic tool?]
Limited EvidenceIn Plain Language
We wanted to test the specific theory behind foot reflexology. Three reflexotherapists examined 76 patients of whom they had no previous knowledge. They were to localize the patients' problems and complaints by examination of the foot soles only; they had no other information about the patients. Each patient and the therapist graded problems related to 13 different parts of the body. Interrater agreement, measured by weighted Kappa, ranged from 0.04 to 0.22, and was significantly better than chance (p < 0.05) for six parts of the body. The overall Kappa was 0.11 (95% CI: 0.08-0.14). A score based on a detailed examination of the "colon zone" showed no significant difference between patients with many or few distal intestinal complaints. Generally, the therapists tended to score higher than the patients, thus overdiagnosing problems. The statistical agreement may be better than pure chance, but is too low to be of any clinical significance.
Key Findings: what this observational study found
- ✓Reflexotherapists achieved only very low interrater agreement (overall Kappa 0.11) when attempting to diagnose patient health problems through foot sole examination alone.
- ✓While statistical agreement was significantly better than chance for six out of thirteen body parts examined, the agreement levels were too low to have any clinical significance.
- ✓Reflexotherapists tended to overdiagnose problems by scoring higher than patients reported, and examination of the 'colon zone' showed no significant correlation with patients' actual intestinal complaints.
What This Means for You
If you're considering reflexology for diagnosing health problems, be aware that this study found reflexologists cannot reliably identify medical conditions from foot examination alone.
What This Means for Practitioners
This study suggests that reflexology foot diagnosis has very poor inter-rater reliability and clinical validity, so practitioners should not rely on foot examination as a diagnostic tool and should avoid overestimating the significance of findings.
Study Design: how this observational study was run
Common questions about this study
What does this study mean in practice?
If you're considering reflexology for diagnosing health problems, be aware that this study found reflexologists cannot reliably identify medical conditions from foot examination alone.
What did this study find?
Reflexotherapists achieved only very low interrater agreement (overall Kappa 0.11) when attempting to diagnose patient health problems through foot sole examination alone. While statistical agreement was significantly better than chance for six out of thirteen body parts examined, the agreement levels were too low to have any clinical significance. Reflexotherapists tended to overdiagnose problems by scoring higher than patients reported, and examination of the 'colon zone' showed no significant correlation with patients' actual intestinal complaints.
How strong is this evidence?
This is a observational study and we rate its evidence limited. It covers 76 participants. It was published in Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke. This study is indexed here for context; it did not test reflexology itself.
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