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The effect of foot reflexology massage on delirium and sleep quality following cardiac surgery: A randomized clinical trial

Authors: Fazlollah Ahmad, Babatabar Darzi Hosein, Heidaranlu Esmail, Moradian Seyed TayebJournal: Complementary therapies in medicinePublished: August 1, 2021DOI: 10.1016/j.ctim.2021.102738
Q2 JournalSJR: 0.7h-index: 88SCImago
Moderate EvidenceRandomized Controlled Trialn=60 participants

In Plain Language: reflexology for sleep, explained

Delirium is the most common neurologic disorder after cardiac surgery and affects both short and long-term outcomes. This study was conducted to evaluate the effect of foot reflexology massage on the incidence of delirium and sleep quality in patients undergoing cardiac surgery. In this randomized clinical trial, 60 patients who were candidates for CABG surgery were randomly assigned into two equal groups (n = 30); intervention and control groups. In the intervention group, foot reflexology massage was done on each foot for 15 min, for two consecutive days. Delirium observation screening scale, the Richard Campbell sleep questionnaire (RSCQ), and pain intensity using VAS were compared. in the second postoperative day, delirium was observed in 8 (26.7 %) and 7 (23.3 %) of patients in the intervention and control groups, respectively (p > 0.05). The measured odds ratio for the effect of massage on delirium is 0.83 (95 %CI 0.71-2.69, p = 0.76). The difference in RSCQ scores was not significant between groups of intervention and control (68.32 ± 10.41 VS. 62.80 ± 11.86, P = 0.06). The pain intensity was lower in the intervention group (P < 0.001). Foot reflexology was not effective in reducing delirium and improving the sleep quality, but the pain intensity was decreased. It seems that the precise pathology and predicting model of delirium should be identified, and appropriate interventions should be planned accordingly.

Key Findings: what this randomised trial found about sleep

  • ✓Foot reflexology massage administered for 15 minutes on each foot for two consecutive days did not significantly reduce delirium incidence in cardiac surgery patients, with delirium occurring in 26.7% of the intervention group versus 23.3% of the control group (p > 0.05).
  • ✓The odds ratio for the effect of foot reflexology massage on delirium prevention was 0.83 (95% CI 0.71-2.69), indicating no statistically significant protective effect against postoperative delirium.
  • ✓Sleep quality and pain intensity were measured as secondary outcomes using the Richard Campbell sleep questionnaire and Visual Analog Scale, though specific results for these measures were not detailed in the provided summary.

What This Means for You

If you're considering reflexology after heart surgery to prevent confusion or improve sleep, current evidence suggests it may help with pain but is unlikely to address delirium or sleep issues specifically.

What This Means for Practitioners

While reflexology showed no benefit for post-surgical delirium or sleep quality in this trial, the significant pain reduction suggests reflexology may be valuable as a complementary pain management tool for cardiac surgery patients.

Study Design: how this randomised trial was run

Sample Size
60 participants
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Reflexology for sleep: common questions

Does reflexology help with sleep?

If you're considering reflexology after heart surgery to prevent confusion or improve sleep, current evidence suggests it may help with pain but is unlikely to address delirium or sleep issues specifically.

What did this study find?

Foot reflexology massage administered for 15 minutes on each foot for two consecutive days did not significantly reduce delirium incidence in cardiac surgery patients, with delirium occurring in 26.7% of the intervention group versus 23.3% of the control group (p > 0.05). The odds ratio for the effect of foot reflexology massage on delirium prevention was 0.83 (95% CI 0.71-2.69), indicating no statistically significant protective effect against postoperative delirium. Sleep quality and pain intensity were measured as secondary outcomes using the Richard Campbell sleep questionnaire and Visual Analog Scale, though specific results for these measures were not detailed in the provided summary.

How strong is this evidence?

This is a randomised trial and we rate its evidence moderate. It covers 60 participants. It was published in Complementary therapies in medicine, a Q2 journal. Reflexology is a complementary therapy, not a replacement for medical treatment.

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