Determination of Efficacy of Reflexology in Managing Patients with Diabetic Neuropathy: A Randomized Controlled Clinical Trial

Abstract

Background. The restricted usage of existing pharmacological methods which do not seem to provide the treatment of diabetic neuropathy may lead to exploring the efficacy of a complementary therapy. In this context, this paper was devoted to evaluate the efficacy of foot reflexology. This health science works on the hypothesis that the dysfunctional states of body parts could be identified by observing certain skin features and be rectified by stimulating certain specific areas mapped on feet. Method. Subjects (N = 58) with diagnosed diabetic neuropathy were randomly distributed into reflexology and control groups in which both group patients were treated with ongoing pharmacological drugs. Reflexology group patients were additionally treated holistically with the hypothesis that this therapy would bring homeostasis among body organ functions. This was a caregiver-based study with a follow-up period of 6 months. The outcome measures were pain reduction, glycemic control, nerve conductivity, and thermal and vibration sensitivities. The skin features leading to the detection of the abnormal functional states of body parts were also recorded and analyzed. Results. Reflexology group showed more improvements in all outcome measures than those of control subjects with statistical significance. Conclusion. This study exhibited the efficient utility of reflexology therapy integrated with conventional medicines in managing diabetic neuropathy.

Systematic review of treatments for diabetic peripheral neuropathy

“…The therapies evaluated by the remaining 16 trials were: Ponalrestat ICI 128436 , active analgesic controlled‐release oxycodone , vitamins and minerals , gabapentin enacarbil , neurotropic peptide ORG 2766 , Lipo‐PGE1 , QR‐333 topical cream , isosorbide dinitrate spray , clonidine gel , EMLA ® cream , reflexology and conventional therapy , photon stimulation 870 nm , magnetized foot insoles , transcutaneous electrical stimulation , unilateral surgical decompression , and Thai foot massage .…”

“…All included studies met our inclusion criteria and all were RCTs. For 22 of the 27 included studies, the quality scores showed a low risk of bias (high quality) [2][3][4][5][6][7][8][9][10][11][12][13][14][17][18][19][20][21][22][23][24][25]. Some articles provided limited information on the design of the study, which led to unclear risk of bias scores.…”

“…The majority of the articles were explanatory RCTs, which compared the efficacy of the intervention vs a placebo [2][3][4][5][6][7][8][9][10][11][12][13][14]17,18,[20][21][22][23][24][25][26][27][28][29]. Two studies were pragmatic RCTs [19,30]. There was a wide range in sample size (18-420 participants).…”

“…Six studies investigated the effect of different dosages and administration routes of ALA on diabetic peripheral neuropathy [3,11,12,24,25,28], three studies compared MIRE treatment with placebo therapy [17,18,21], and two studies investigated the effect of botulinum toxin A treatment [22,29]. The therapies evaluated by the remaining 16 trials were: Ponalrestat ICI 128436 [27], active analgesic controlledrelease oxycodone [5], vitamins and minerals [10], gabapentin enacarbil [4], neurotropic peptide ORG 2766 [9], Lipo-PGE1 [24], QR-333 topical cream [6], isosorbide dinitrate spray [7], clonidine gel [13], EMLA â cream [14], reflexology and conventional therapy [19], photon stimulation 870 nm [8], magnetized foot insoles [2], transcutaneous electrical stimulation [20], unilateral surgical decompression [30], and Thai foot massage [23].…”

“…Reflexology of the feet compared with pharmacological treatment, and Thai foot massage compared with health education, had significant positive effects on diabetic peripheral neuropathy symptoms [19,23].…”