A female massage therapist applies pressure to a point on an elderly woman's forearm while the elderly woman lies in bed.

Acupressure and reflexology were studied in a population of heart patients.

One 20-minute session of either acupressure on both forearms or hand reflexology on both hands resulted in an equally significant reduction in anxiety among female patients in the hospital for coronary artery disease, according to recent research.

Study Design

The study, “Comparison of the Effects of Hand Reflexology versus Acupressure on Anxiety and Vital Signs in Female Patients with Coronary Artery Diseases,” involved 135 female patients with coronary artery disease, all of whom had been hospitalized in a cardiac care unit for more than two days.

The subjects were randomly assigned to one of three groups: hand reflexology, acupressure or placebo. Each patient received one intervention or placebo session, and all sessions were performed by the same researcher in the same setting. For the placebo intervention, 20 minutes of touch to the hands “without the stimulation of hand reflexology or acupressure was applied.”

For the 20-minute acupressure intervention, pressure was applied to point P6 on the inside of the forearm of the right arm, then the left arm. For the 20-minute hand reflexology intervention, the practitioner followed the Ingham method and applied reflexology massage at points corresponding to the solar plexus, pituitary gland and heart.

Study Outcomes

The main outcome measures in this study were anxiety and vital signs. Anxiety was evaluated via the Spielberger State-Trait Anxiety Inventory. Vital signs were recorded using monitors for respiratory rate, heart rate, blood pressure, mean arterial pressure and oxygen saturation. These outcome measures were assessed before, immediately after and a half-hour after the intervention or placebo session.

Results of the research showed hand reflexology and acupressure resulted in equally significant reductions in anxiety among the hospitalized patients both immediately after the intervention and a half-hour later. No statistically significant differences in vital signs were observed after the intervention or placebo sessions.


“According to this study, hand reflexology and acupressure had an equal effect on the reduction of anxiety in the women with [coronary artery disease] hospitalized in the [cardiac care unit],” conclude the study’s authors. “No adverse events due to these interventions were reported, indicating that these nonpharmacologic methods were safe.”

Authors: Zohre Rahmani Vasokolaei, Nahid Rejeh, Majideh Haravi Karimooi, Seyed Davood Tadrisi, Kiarash Saatchi, Zahra Poshtchaman, Christina Sieloff and Mojtaba Vaismoradi.

Sources: Department of Nursing, Faculty of Nursing and Midwifery, Elderly Care Research Center, Shahed University, Tehran, Iran; Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran; Iranian Scientific Acupuncture Association, Tehran, Iran; Department of Nursing, Sabzevar University of Medical Sciences, Sabzevar, Iran; College of Nursing, Montana State University, Bozeman, Montana; and Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway. Originally published online in February 2019 in Healthcare.