Reflexology was shown to reduce stress in nursing home residents with mild-to-moderate stage dementia, according to a recent study.

In the study “The Clinical Efficacy of Reflexology in Nursing Home Residents with Dementia,” 21 nursing home residents diagnosed with mild-to-moderate stage dementia were selected to take part in a repeated measure, crossover design study to examine the efficacy of weekly reflexology treatments in reducing physiologic stress, pain and improving affect. Each participant received four weeks of reflexology treatments and four weeks of friendly visits, which served as the control factor in the study.

All participants were older than age 75, had lived in the nursing home for more than six months and had a diagnosis of dementia. Residents were excluded if they had any of the following conditions: epilepsy, bile or kidney stones, history of deep-vein thrombosis, use of a pacemaker, fever, open foot wounds or foot fractures. Residents were also excluded if they had been hospitalized within a month prior to the study or if they received massage therapy within two weeks prior to the study.

Participants were divided into two groups. The first group received reflexology treatments once per week for four weeks followed by the control factor of having a friendly visit once per week for four weeks. In the second group, the treatments and visits were provided in reverse order, with the friendly visits occurring in the first four weeks followed by four weeks of reflexology treatments. Both the reflexology treatments and friendly visits were conducted by a single, certified reflexology provider.

Reflexology treatments were given on the same day of the week at the same time of day and lasted for 30 minutes. The treatments started with progressive relaxation techniques and light stretching of the feet and hands. Next, a series of reflexology techniques were applied to participants’ feet and hands following a protocol designed by a certified reflexologist. The number and duration of the treatments were the same for every participant.

The friendly visits also lasted for 30 minutes. The visit began with five minutes of progressive relaxation techniques followed by 25 minutes of companionship and conversation, including such activities as watering the residents’ plants and conversing about the weather and current events.

To gauge participants’ stress levels, several types of data were collected, including saliva samples, observations of affect and observations of pain.

The saliva samples measured alpha amylase, which is predictive for the presence of stress hormones. Observations of affect were measured using the Apparent Affect Rating Scale (AARS), which provides readings of depression, anxiety, anger, pleasure and interest. Pain was measured using a checklist of nonverbal pain indicators (CNPI).
Data collected from the completion of the study showed the residents receiving reflexology had a significant decline in the levels of stress hormones and pain compared to the control condition. The data from the observation of affect showed only a borderline improvement in sadness from the control.

“These findings support preliminary evidence that reflexology treatment may be beneficial in the management of distress in nursing home residents with mild-to-moderate stage dementia,” say the study’s authors.

Sources: Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, Pennsylvania; and Polisher Research Institute, North Wales, Pennsylvania.

Authors: Nancy Hodgson, Ph.D., R.N., and Susan Andersen, B.S., C.H.E.S. Originally published in The Journal of Alternative and Complementary Medicine, April 1, 2008, 14(3): 269-275.

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