Foot Reflexology and Pain Intensity Among Patients with Advanced Cancer: A Systematic Literature Review
DOI:
https://doi.org/10.30683/1929-2279.2025.14.08Keywords:
Cancer pain, Foot reflexology, CAM, Effectiveness, Systematic ReviewAbstract
Managing pain for cancer patients is a critical issue that requires investigations of complementary interventions to achieve comprehensive pain management. This study investigates whether foot reflexology, as a complementary intervention, has an effect on pain intensity management amongst patients with advanced cancer. A systematic literature review focusing on articles published during the period 2019 to 2024, include adult patients with advanced cancer, and implemented foot reflexology for cancer-related pain management was undertaken using different databases. The studies were screened, and eleven studies, including (2396 patients), were eligible for this review published in PubMed, Google Scholar, PsycINFO, and Cochrane Library databases. Critical appraisal of the studies was conducted using JBI Critical Appraisal Checklist and the risk assessment was undertaken based on RoB 2, ROBIS, and adapted ROBINS-I tools. Feasibility studies showed that patients generally accept foot reflexology to help with cancer-related pain. Also, foot reflexology is reported to be effective and has significant effects on reducing cancer-related pain for patients with cancer. The results also indicated that the selection of pain assessment tools should consider the specific clinical context and assessment objectives. In addition, there are some discrepancies in the foot reflexology procedures followed by different researchers; nonetheless, the effectiveness of foot reflexology was demonstrated in all the studies. Foot reflexology is appropriate and can be incorporated to complement cancer patients’ pain management plans. Existing evidence is limited by study designs and implementation procedures. Further research should address these limitations through specific implementation procedures, incorporating diverse populations.
References
World Health Organization. Cancer 2023. Available online: https://www.who.int/news-room/fact-sheets/detail/cancer#: ~: text=Tobacco%20use%2C%20alcohol%20c (accessed 23 October 2024).
Siegel RL, Giaquinto AN, Jemal A. Cancer statistics. CA Cancer J Clin 2024; 74(1): 12-49. DOI: https://doi.org/10.3322/caac.21820
Basch E, Schrag D, Henson S, Jansen J, Ginos B, Stover AM, et al. Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer: A Randomized Clinical Trial. JAMA 2022; 327(24): 2413-2422. DOI: https://doi.org/10.1001/jama.2022.9265
Trayes KP, Cokenakes SEH. Breast Cancer Treatment. American family physician 2021; 104(2): 171-178.
Burguin A, Diorio C, Durocher F. Breast Cancer Treatments: Updates and New Challenges. Journal of Personalized Medicine 2021; 11(8): 808. DOI: https://doi.org/10.3390/jpm11080808
Suleiman K, Suhair AL. Hope in Cancer: Concept Analysis. International Journal of Cancer Research 2014; 48(1): 1224.
Ośmiałowska E, Misiąg W, Chabowski M, Jankowska-Polańska B. Coping Strategies, Pain, and Quality of Life in Patients with Breast Cancer. J Clin Med 2021; 10, 4469. DOI: https://doi.org/10.3390/jcm10194469
Snijders RAH, Brom L, Theunissen, M, van den Beuken-van Everdingen MHJ. Update on Prevalence of Pain in patients with Cancer 2022: A systematic literature review and Meta-analysis. Cancers (Basel) 2023; 15(3). DOI: https://doi.org/10.3390/cancers15030591
Roberto A, Deandrea S, Greco MT, Corli O, Negri E, Pizzuto M, Ruggeri F. Prevalence of Neuropathic Pain in Cancer patients: Pooled estimates from a systematic review of published literature and results from a Survey conducted in 50 Italian Palliative Care centers. J Pain Symptom Manage 2016; 51(6): 1091-1102e1094. DOI: https://doi.org/10.1016/j.jpainsymman.2015.12.336
Alhazmi LSS, Bawadood MAA, Aljohani AMS, Alzahrani AAR, Moshref L, Trabulsi N, Moshref R. Pain Management in Breast Cancer Patients: A Multidisciplinary Approach. Cureus 2021; 13(6): e15994. DOI: https://doi.org/10.7759/cureus.15994
Edwards Price S. The long and winding road to reflexology: A post-structural narrative inquiry 2021; PhD. Thesis.
Whatley J, Perkins J, Samuel C. Reflexology: exploring the mechanism of action. Complementary Therapies in Clinical Practice 2022; 48: 101606. DOI: https://doi.org/10.1016/j.ctcp.2022.101606
Süzer A, Süzer NÜ, Şavkın R, Büker N. Popular Complementary and Alternative Therapy Methods in Different Conditions. International Journal of Traditional and Complementary Medicine Research 2022; 3(3): 201-211. DOI: https://doi.org/10.53811/ijtcmr.1197108
Penny J, Sturgeon R. Oncology Massage: An Integrative Approach to Cancer Care. Jessica Kingsley Publishers 2021; pp. 320.
Türkcü S, Özkan S. The effects of reflexology on anxiety, depression and quality of life in patients with gynecological cancers with reference to Watson's theory of human caring. Complementary Therapies in Clinical Practice 2021; 44: 101428. DOI: https://doi.org/10.1016/j.ctcp.2021.101428
Guerra-Martín, María Dolores, María Sandra Tejedor-Bueno, and Matías Correa-Casado. Effectiveness of Complementary Therapies in Cancer Patients: A Systematic Review. International Journal of Environmental Research and Public Health 2021; 18(3): 1017. DOI: https://doi.org/10.3390/ijerph18031017
Özdelikara A, Tan M. The effect of reflexology on the quality of life with breast cancer patients. Complementary Therapies in Clinical Practice 2017; 29: 122-129. DOI: https://doi.org/10.1016/j.ctcp.2017.09.004
Al-Omari A, Al-Qudimat M, Hmaidan AA, Zaru L. Perception and attitude of Jordanian physicians towards complementary and alternative medicine (CAM) use in oncology. Complementary Therapies in Clinical Practice 2013; 19(2): 70-76. DOI: https://doi.org/10.1016/j.ctcp.2013.01.002
Taheri H, Naseri-Salahshour V, Abedi A, Sajadi M. Comparing the Effect of Foot and Hand Reflexology on Pain Severity after Appendectomy: A Randomized Clinical Trial. Iranian Journal of Nursing and Midwifery Research 2019; 24(6): 451-456. DOI: https://doi.org/10.4103/ijnmr.IJNMR_85_18
Pereira EC, Caio FSP, Ricardo G, Carmen VMA, Ana CMBL-M, Arthur SF, Pamela GL, Mariana CS. Reflexology evidence map. Advances in Integrative Medicine 2024; In Press, Corrected Proof. DOI: https://doi.org/10.1016/j.aimed.2024.08.009
Cai DC, Chen CY, Lo TY. Foot Reflexology: Recent Research Trends and Prospects. Healthcare (Basel, Switzerland) 2022; 11(1): 9. DOI: https://doi.org/10.3390/healthcare11010009
Liberati, Alessandro, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009; 6(7): e1000100. DOI: https://doi.org/10.1371/journal.pmed.1000100
Thomas J, Kneale D, McKenzie JE, Brennan SE, Bhaumik S. Chapter 2: Determining the scope of the review and the questions it will address. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane 2024. Available from www.training.cochrane.org/handbook.
Burls A. Evidence-based medicine: what is critical appraisal? Int J Evid Based Pract Dent Hygienist 2015; 1 (2): 80-85. DOI: https://doi.org/10.11607/ebh.001516
Barker TH, Habibi N, Aromataris E, Stone JC, Leonardi-Bee J, Sears K, et al. The revised JBI critical appraisal tool for the assessment of risk of bias quasi-experimental studies. JBI Evid Synth 2024; 22(3): 378-88. DOI: https://doi.org/10.11124/JBIES-23-00268
Barker TH, Stone JC, Sears K, Klugar M, Tufanaru C, Leonardi-Bee J, Aromataris E, Munn Z. The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evidence Synthesis 2023; 21(3): 494-506. DOI: https://doi.org/10.11124/JBIES-22-00434
McArthur A, Klugarova J, Yan H, Florescu S. Chapter 4: Systematic reviews of text and opinion. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI 2020. DOI: https://doi.org/10.46658/JBIRM-17-04
Aromataris E, Fernandez R, Godfrey C, Holly C, Kahlil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an Umbrella review approach. Int J Evid Based Healthc 2015; 13(3): 132-40. DOI: https://doi.org/10.1097/XEB.0000000000000055
Sikorskii A, Niyogi PG, Victorson D, Tamkus D, Wyatt G. Symptom response analysis of a randomized controlled trial of reflexology for symptom management among women with advanced breast cancer. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer 2020; 28(3): 1395-1404. DOI: https://doi.org/10.1007/s00520-019-04959-y
Dikmen HA, Terzioglu F. Effects of Reflexology and Progressive Muscle Relaxation on Pain, Fatigue, and Quality of Life during Chemotherapy in Gynecologic Cancer Patients. Pain management nursing: official journal of the American Society of Pain Management Nurses 2019; 20(1): 47-53. DOI: https://doi.org/10.1016/j.pmn.2018.03.001
Najafpour Z, Shayanfard K. Effect of reflexology in treating cancer pain: A meta-analysis. International Journal of Cancer Management 2020; 13(7): 1-6. DOI: https://doi.org/10.5812/ijcm.102195
Zhang Y, Wang S, Ma X, Yuan Y, Cheng H, Lin L, Tian L. Massage therapy can effectively relieve cancer pain: A meta-analysis. Medicine 2023; 102(27): e33939. DOI: https://doi.org/10.1097/MD.0000000000033939
Langstone-Wring A, Whatley J. Patients’ experiences of clinical foot reflexology in a hospital cancer service. Cancer Nursing Practice 2023. DOI: https://doi.org/10.7748/cnp.2023.e1841
Rambod M, Pasyar N, Shamsadini M. The effect of foot reflexology on fatigue, pain, and sleep quality in lymphoma patients: A clinical trial. European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society 2019; 43: 101678. DOI: https://doi.org/10.1016/j.ejon.2019.101678
Anderson KD, Downey M. Foot Reflexology: An Intervention for Pain and Nausea Among Inpatients With Cancer. Clinical Journal of Oncology Nursing 2021; 25(5): 539-545.
Klaus M, Kutschan S, Männle H, Hübner J, Dörfler J. Reflexology in oncological treatment - a systematic review. BMC Complementary Medicine and Therapies 2024; (1): 32. DOI: https://doi.org/10.1186/s12906-023-04220-4
Chung JH, Kang DH, Jo JK, Lee SW. Assessing the quality of randomized controlled trials published in the Journal of Korean Medical Science from 1986 to 2011. Journal of Korean Medical Science 2012; 27(9): 973-980. DOI: https://doi.org/10.3346/jkms.2012.27.9.973
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng H-Y, Corbett MS, Eldridge SM, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Reeves BC, Shepperd S, Shrier I, Stewart LA, Tilling K, White IR, Whiting PF, Higgins JPT. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898. DOI: https://doi.org/10.1136/bmj.l4898
Stern JAC, Herńan MA, Reeves BC, Savoić J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of intervention. BMJ 2016; 355-i4919 DOI: https://doi.org/10.1136/bmj.i4919
Whiting P, Davies P, Savović J, Caldwell D, Churchill R. Evidence to inform the development of ROBIS, a new tool to assess the risk of bias in systematic reviews 2013. Available from http://www.robis-tool.info [accessed 20 December 2024]
Mao JJ, Ismaila N, Bao T, Barton D, Ben-Arye E, Garland EL, Greenlee H, Leblanc T, Lee RT, Lopez AM, Loprinzi C, Lyman GH, MacLeod J, Master VA, Ramchandran K, Wagner LI, Walker EM, Bruner DW, Witt CM, Bruera E. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology 2022; 40(34): 3998-4024. DOI: https://doi.org/10.1200/JCO.22.01357
Poquet N, Lin C. The Brief Pain Inventory (BPI). Journal of Physiotherapy 2016; 62(1): 52. DOI: https://doi.org/10.1016/j.jphys.2015.07.001
Anderson KD, Downey M. Foot Reflexology: An Intervention for Pain and Nausea Among Inpatients With Cancer. Clinical Journal of Oncology Nursing 2021; 25(5): 539-545. DOI: https://doi.org/10.1188/21.CJON.539-545
Molassiotis A, Dawkins B, Longo R, et al. Economic evaluation alongside a randomised controlled trial to assess the effectiveness and cost-effectiveness of acupuncture in the management of chemotherapy-induced peripheral neuropathy. Acupuncture in Medicine 2021; 39(1): 41-52. DOI: https://doi.org/10.1177/0964528420920285
Park J, Lee K, Ku Y, et al. Characteristics, Trends, and Quality of Systematic Review and Meta-Analysis in General Radiology between 2007 and 2015. Academic Radiology 2017; 24(8): 1013-1022. DOI: https://doi.org/10.1016/j.acra.2017.02.009
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71. DOI: https://doi.org/10.1136/bmj.n71
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
