Foot being massaged on a medical table in a roomThe use of foot reflexology, foot bath or a combination of both resulted in significant improvements in sleep quality among hospitalized heart patients with acute coronary syndrome, according to recent research.


The study, “Comparing the effect of foot reflexology massage, foot bath and their combination on sleep quality of patients with acute coronary syndrome,” involved 140 males with acute coronary syndrome and a mean age of around 61 years. These subjects were patients in a hospital coronary care unit.

According to the study’s authors, “[A]cute coronary syndrome refers to all cardiac events caused by decreased blood flow to the coronary artery caused by atherosclerosis and acute arterial occlusion from thrombosis and embolism.”

foot bathThe Study

Subjects were randomly assigned to one of four groups: foot reflexology massage, foot bath, a combination of both, or a control group that received standard care alone. The three different interventions were performed on the second and third night of each patient’s hospital stay.

For the foot reflexology massage, “rotational massage of the solar plexus point was performed on both feet (between the upper third and lower two-thirds bottom of foot) for 10 minutes,” according to the researchers.

For the foot bath, each subject was in a semi-sitting position with his feet submerged in water up to 10 centimeters above the ankles. The water was heated to a temperature of 104 degrees Fahrenheit and the foot bath took place for 10 minutes.

In the group that combined both the foot reflexology massage and the foot bath, the massage was performed first, followed by the foot bath, for a total of 20 minutes using the protocols outlined above.

heart patient sleepingResults for Heart Patients

The main outcome measure in this study was sleep quality, which was assessed using the Veran Snyder-Halpern subjective sleep quality questionnaire. Designed to evaluate sleep quality among hospitalized heart patients, this questionnaire consists of 15 items ranging from sleep disturbance and ease of falling asleep, to daytime naps and vigor upon waking.

Subjects completed the questionnaire at baseline, before the start of the two-night intervention period. The same questionnaire was completed again at 8 a.m. the morning after each of the two intervention sessions. The researchers combined the scores from the two morning-after assessments to determine mean patient sleep quality before and after the intervention period.

Results of the research showed a significant decrease in mean sleep disturbance scores on the second and third nights in the hospital among subjects who received foot reflexology, foot bath or a combination of both. The decrease in sleep disturbance scores was greatest in the group that received both the foot reflexology massage and the foot bath.

“It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders,” state the study’s authors, “and there was a synergistic effect when used in combination.”

About the Study

Authors: Ali Rahmani, Mahdi Naseri, Mohammad Mahdi Salaree and Batool Nehrir.
Sources: Department of Nursing, Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Originally published in December 2016 in Journal of Caring Sciences, 5(4), 299-306.