Foot reflexology in the management of functional constipation: A systematic review and meta-analysis

The Effect of Reflexology Socks in the Management of Opioid-Induced Constipation: A Randomized Controlled Trial

BACKGROUND

Constipation is an important symptom that is common in patients using opioids and leads to major health problems among patients. Reflexology is one of the approaches utilized to manage constipation.

OBJECTIVE

To examine the effect of reflexology socks on constipation in patients with opioid-induced constipation.

METHODS

This study was designed as a single-blind, randomized, controlled experimental trial. The study was conducted with the participation of a total of 101 patients who were suffering from cancer and other noncancer diseases, using opioids, and complaining of constipation. The patients in the intervention group (n = 51) were advised to walk with reflexology socks for 4 weeks, whereas the patients in the control group (n = 50) were advised to walk only.

RESULTS

It was found that the severity of opioid-induced constipation was lower in the intervention group than in the control group at the end of the fifth week ( P < .05). Additionally, after the application, the quality-of-life mean score was lower in the intervention group (mean, 48.46 ± 24.66) compared with control group (mean, 109.88 ± 10.62), and reflexology socks were effective in enhancing quality of life in the intervention group ( P < .05).

CONCLUSIONS

This study concluded that reflexology socks were an effective approach to the management of constipation.

IMPLICATIONS FOR PRACTICE

Reflexology socks may be more useful for patients to manage constipation because it is difficult to find a reflexologist, and reflexology sessions are charged and expensive. In this way, patients will wear reflexology socks comfortably and easily at home, and the severity of constipation will be alleviated.

The Effect of Magnetic Therapy on Postoperative Urinary Retention in Patients Undergoing Surgery: A Randomized Clinical Trial

Background

Urinary retention is a postoperative problem that causes pain and discomfort for patients, even when catheters are used. The potential role of magnetic therapy in treating postoperative urinary retention through acupuncture points remains uncertain. This research aims to assess the impact of magnetic therapy on urinary retention in patients undergoing surgery.

Materials and Methods

This single-blind clinical trial study was conducted in a recovery department within an operating room and subsequently in the Surgery Department of Amin Hospital. The study took place in Isfahan in 2022, with a sample of 64 patients selected using a simple random sampling method and divided equally into two groups. In the intervention group, magnet plates were applied, while the control group received iron plates at seven specific points for duration of 35 ± 5 minutes. Demographic information, the type of urinary excretion, the duration of urinary retention, and the volume of excreted urine were recorded using a researcher-made checklist for both intervention and control groups. These data were compared and subjected to descriptive and analytical statistical analysis.

Results

Among the participants (N = 64), the majority were male (N = 37, 57.80%), and the mean age was 40.17 years. The Chi-square analysis revealed no significant difference between the intervention and control groups in terms of the type of urinary excretion (p = 0.106). However, the Mann-Whitney U-test demonstrated significant difference between the two groups regarding the duration required to eliminate urinary retention and the volume of excreted urine (F2,41 = 62 and F1,76 = 62; p < 0.001).

Conclusions

The use of a novel approach involving magnetic therapy applied to acupuncture and reflexology points has been shown to reduce the time required for the first urination and increase the volume of urine in post-surgery patients.

Effects of natural products on functional constipation: analysis of active ingredient and mechanism

Constipation is a prevalent clinical ailment of the gastrointestinal system, yet its pathogenesis remains ambiguous. Despite the availability of numerous treatment modalities, they are insufficient in resolving the issue for patients. This work conducted a comprehensive review of the existing literature pertaining to the utilization of natural products for the treatment of constipation, with a focus on the efficacy of natural products in treating constipation, and to provide a comprehensive summary of their underlying mechanisms of action. Upon conducting a thorough review of the extant literature, we found that natural products can effectively treat constipation as modern synthetic drugs and compounded drugs with acetylcholinesterase (AChE) effects, rich in fiber and mucus, and the effects of increasing the tension of the ileum and gastrointestinal tract muscle, mediating signaling pathways, cytokine, excitability of the smooth muscle of the gastrointestinal tract, and regulating the homeostasis of intestinal flora. However, there is a wide variety of natural products, and there are still relatively few studies; the composition of natural products is complex, and the mechanism of action of natural products cannot be clarified. In the future, we need to further improve the detailed mechanism of natural products for the treatment of constipation.

Effects of non-pharmacological interventions on pain in wound patients during dressing change: A systematic review

BACKGROUND

Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may cause problems or even impede wound healing. There is no systematic study of non-pharmacologic therapies for pain during wound dressing changes, despite the gradual promotion of non-pharmacologic pain reduction methods.

OBJECTIVES

To give clinical wound pain management a new direction, locating and assessing non-pharmacological interventions regarding pain brought on by wound dressing changes are necessary.

METHOD

The researchers conducted a comprehensive literature review on non-pharmacological interventions for pain during wound dressing changes across five databases: PubMed, Web of Science, Medline, Embase, and the Cochrane Library spanning the period from January 2010 to September 2022. The evaluation of literature and data extraction was carried out independently by two researchers, and in cases of disagreement, a third researcher participated in the deliberation. To assess the risk of bias in the literature, the researchers utilised the Cochrane Handbook for Reviews of Interventions, version 5.1.0.

RESULTS

In total, 951 people were involved in 11 investigations covering seven non-pharmacological therapies. For pain triggered by dressing changes, virtual reality (VR) distraction, auditory and visual distractions, foot reflexology, religious and spiritual care, and guided imaging demonstrated partially positive effects, with hypnosis therapy and jaw relaxation perhaps having a weak effect.

CONCLUSION

The key to managing wounds is pain management. According to our review, there is some indication that non-pharmacologic interventions can help patients feel less discomfort when having their wound dressings changed. However, the evidence supporting this view is weak. It needs to be corroborated by future research studies with multicentre and large samples. To promote and use various non-pharmacologic interventions in the future, it is also necessary to build standardised and homogenised paths for their implementation.

Improving Quality of Life in The Constipated Older Person: Reflexology or Abdominal Massage? A Two-Group, Randomized Comparative Trial

This study is a randomized comparative trial designed to determine the effects of reflexology and abdominal massage on the improvement of constipation and quality of life of older persons. Participants were randomized to the reflexology group ( n = 50) or abdominal massage group ( n = 50). Data were collected by using a descriptive information form, the Standardized Mini-Mental Test (SMMT), the Katz Daily Life Activity Scale (Katz ADL), the Constipation Severity Scale (CSS), and the Constipation Quality of Life Questionnaire (CQOLQ). The comparison of the mean scores of participants from the total CSS and the total CQOLQ before and after reflexology and abdominal massage application indicated that the mean post-intervention scores on the total CSS and the total CQOLQ decreased significantly compared with preintervention scores ( p < .05). When the mean scores of the reflexology and abdominal massage groups for the total CSS and the total CQOLQ were compared, there was no significant difference between the groups ( p < .05). Both interventions improved the constipation problem of these older persons and their quality of life. The effects of both reflexology and abdominal massage were similar in improving constipation and quality of life in older persons.

The effects of reflexology on symptoms in pregnancy: A systematic review of randomized controlled trials

Objective

This review assessed the effects of reflexology on symptoms in pregnancy.

Methods and analysis

PubMed, Embase, Springer, Web of Science, the Cochrane Library, and reference lists of previous systematic reviews were searched for the eligible randomized controlled trials (RCT) from the inception date of each predefined database up to May 31st, 2023. Data were extracted, and methodological quality was evaluated by the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2). The efficacy of treatment was assessed using pooled effect sizes (Hedges' g) and 95% confidence intervals (CI). Meta-analysis was performed using the RevMan 5.4 manager, and publication bias was evaluated by Begg's test.

Results

The included a total of 13 RCTs in this review, of eleven was high risk of bias and two were low, reported the effects of reflexology on low back and/or pelvic pain (LBPP), labor pain, duration of labor, anxiety, fatigue, sleep quality, constipation symptoms, and ankle and foot edema in pregnancy. The effect sizes (Hedges' g) for reflexology in labor pain, duration of labor, anxiety, fatigue, and sleep quality showed statistical significance, which the meta-analysis also confirmed except for fatigue and sleep quality due to insufficient studies.

Conclusion

Reflexology is probably effective and safe for labor pain, duration of labor, and anxiety in pregnancy, while the evidences for reflexology in LBPP, fatigue, sleep quality, constipation symptoms, and ankle and foot edema during pregnancy were insufficient. Based on the low to high quality of included studies, strong supportive evidence is not yet available. Rigorous-design and large-scale clinical trials should be conducted to provide higher-quality, reliable evidence.

Effect of Reflexology on Decreasing Postoperative Pain and Anxiety After Total Abdominal Hysterectomy

Surgical patients experience both postoperative pain and anxiety, as they try to cope with pain. Despite technological advances, pharmacological methods are inadequate for decreasing postoperative pain and anxiety. Reflexology has been implemented and considered effective in these areas in many countries. The aim of this study was to determine the effect of reflexology on decreasing postoperative pain and anxiety after a hysterectomy. The study was an intervention randomized study. The population of the investigation is all patients who had a hysterectomy between February 2012 and December 2014 in the Istanbul University Obstetrics and Gynecology service. The sample was 100 women chosen after a power analysis (minimum: 74) (experimental: 54, control: 46) within the population of the investigation who agreed to participate in the study. Using a table of random numbers, patients in the sample were divided into groups. Data was collected using the patient information and vital signs form, State-Trait Anxiety Inventory (STAI-I), Visual Analog Scale (VAS) Pain and Anxiety Scales, and BRIEF pain inventory. All women in the groups had similar sociodemographic, obstetric, and pain characteristics, past experience of illness, and characteristics related to their hysterectomy. All of the patients in the reflexology group stated that reflexology helped them feel better. The reflexology group compared with the control group had lower than the average VAS pain and VAS and STAI anxiety at all assessment times. Reflexology is effective in reducing anxiety and pain.

The Effects of Foot Reflexology on Vital Signs: A Meta-Analysis of Randomized Controlled Trials

Introduction

We evaluated the effects of foot reflexology on bodily vital signs.

Methods

Randomized controlled trials (RCTs) evaluating the effects of foot reflexology on vital signs were collected for a meta-analysis. Statistical analysis was conducted using RevMan5.4 software and pooled estimates of the effects were reported as mean differences (MDs) with 95% confidence intervals (CIs).

Results

Thirteen studies, including 819 patients, met our inclusion criteria. Our results showed that systolic blood pressure (SBP) (MD = -4.62, 95% CI: -5.58 to -3.66; P < 0.00001), diastolic blood pressure (DBP) (MD = -3.32, 95% CI: -4.48 to -2.17; P < 0.00001), heart rate (HR) (MD = -4.76, 95% CI: -6.49 to -3.04; P < 0.00001), respiratory rate (RR) (MD = -0.77, 95% CI: -1.50 to -0.48; P < 0.00001), and pulse oxygen saturation (SpO₂) (MD = 0.95, 95% CI: 0.39 to 1.52; P = 0.0009) showed statistical significance in the foot reflexology group.

Conclusions

Short-term followup results showed that foot reflexology exerted positive effects on vital signs, reduced BP, HR, and RR and increased SpO₂.

Effect of konjac glucomannan on metabolites in the stomach, small intestine and large intestine of constipated mice and prediction of the KEGG pathway

The occurrence of constipation involves the whole gastrointestinal tract. Konjac glucomannan (KGM) has been clinically proven to alleviate constipation, but its mechanism has not been fully understood. The present study aimed to investigate the excretion-promoting effect of KGM on constipated mice and the underlying molecular mechanism. In this study, the UHPLC-QE orbitrap/MS method was used to determine the metabolic phenotypes of total gastrointestinal segments (i.e., the stomach {St}, small intestine {S}, and large intestine {L}) in constipated mice treated with KGM. The results showed that KGM improved the fecal water content, body weight growth rate, and serum gastrointestinal regulation related peptide levels. The metabolomics results revealed the decreased levels of amino acids, cholines, deoxycholic acid, arachidonic acid, thiamine and the increased levels of indoxyl sulfate, histamine, linoelaidic acid etc. The KEGG pathway analysis indicated that the relaxation effect of KGM supplementation was most likely driven by modulating the expression levels of various key factors involved in biosynthesis of amino acid (i.e., phenylalanine, tyrosine and tryptophan), linoleic acid metabolism, biosynthesis of secondary metabolites, and arachidonic acid metabolism signalling pathways. The results indicated that KGM alleviates constipation by regulating potential metabolite markers and metabolic pathways in different gastrointestinal segments.