Quality of sleep improved significantly for postpartum women who received five half-hour sessions of foot reflexology, according to a recent study. Prior to the reflexology intervention, the women had reported poor quality of sleep.

The study, “Randomized controlled trial of the effectiveness of using foot reflexology to improve quality of sleep among Taiwanese postpartum women,” involved a total of 65 postpartum women, all of whom reported poor sleep quality in the days following childbirth.

The women were randomly assigned to the intervention group, which received reflexology and standard care, or the control group, which received standard care alone. The average age of the women was roughly 32 years, and nearly all of them had given birth vaginally. For each subject, the study period began on postpartum day nine and ended five days later, on postpartum day 13. However, the study itself spanned from July to December 2007.

Baseline measures were taken at the start of the study, on postpartum day nine, and at the end of the study, on postpartum day 13. The main outcome measure was quality of sleep, as evaluated by the Pittsburgh sleep-quality index, on which higher scores correlate with poorer quality of sleep.

This sleep-quality index looks at seven aspects of sleep, including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleeping medication and daytime dysfunction.

During the study, women in the control group continued to receive standard postpartum care, while women in the intervention group received standard care along with foot reflexology.

Reflexology sessions took place once a day for five days at the same time in the evening. One touch therapist, who is a certified nurse and reflexologist, performed each intervention, providing 15 minutes of reflexology per foot for a total of 30 minutes per session.

According to the study’s authors, the intervention protocol was developed by reflexology experts, based on the Ingham method. The sequence focused on stimulating those areas of the feet believed to help regulate sleep and influence hormonal gland secretions, along with the reproductive system.

The sessions stimulated those areas of the feet that are believed to correspond with the head and brain; the pituitary, parathyroid, thyroid and adrenal glands, as well as the ovaries; abdominal and pelvic organs; and the coeliac plexus.

By postpartum day 13, mean quality of sleep scores had declined for both the intervention and control groups. However, the quality-of-sleep scores for the reflexology group were significantly lower.

“This study revealed that poor postpartum sleeping in the reflexotherapy group improved significantly compared with the control group,” state the study’s authors. “Health professionals involved in maternity care should evaluate maternal [quality of sleep] and design early intervention programs to improve [quality of sleep], in order to increase maternal biopsychosocial well-being.”

Authors: Chia-Yen Li, Su-Chiu Chen, Chung-Yi Li, Meei-Ling Gua and Chiu-Mieh Huang.

Sources: Department of Nursing, Tri-Service General Hospital; Exercise and Health Science Department, Department of Health Management and Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing; and School of Nursing, National Yang-Ming University, Taiwan. Originally published in Midwifery (2009).

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