- Original article
- Published:
Effect of foot reflexology adjunct to paced respiration on vasomotor symptoms during menopause: randomized-controlled trail
Bulletin of Faculty of Physical Therapy volume 23, pages 77–84 (2018)
Abstract
Background
The most common vasomotor symptoms (VMS) are hot flashes and night sweats, which occur in as many as 68.5% of women as a result of menopause. Symptoms caused by fluctuating levels of estrogen may be alleviated by hormone therapy (HT), but a marked global decline in its use has resulted from concerns about the risks and benefits of HT. Consequently, many women in the postmenopausal period search for alternative natural treatment options to manage menopause. As large numbers of women are choosing not to take HT, it is increasingly important to identify evidence-based foot reflexology with paced respiration that has the potential to reduce vasomotor menopausal symptoms.
Aim
To examine the combined effect of foot reflexology with paced respiration versus paced respiration on VMS in symptomatic menopausal women.
Patients and methods
A total of 50 women of menopausal age, 45–55 years were studied; their BMI was less than 30 kg/m2. They were allocated randomly to two groups with equal numbers of participants (A and B). The participants in group A received foot reflexology in addition to paced respiration, whereas the participants in group B received the paced respiration training only. The treatment program was conducted three times per week for 8 weeks. Assessment of all participants in both groups (A and B) was carried out before and after the treatment program throughout by determining blood cortisol level in addition to the use of the menopause rating scale (MRS).
Results
Both groups (A and B) showed a significant reduction in their blood cortisol and MRS values after the end of the 8 weeks of the training program. The mean values of blood cortisol after treatment were 15.40±1.47, 16.32±1.70 in both groups A and B, respectively. The mean values of total MRS were 8.12±2.19, 12.56±2.96 in both groups A and B, respectively.
However, the participants who received foot reflexology plus paced respiration, group A, showed a greater reduction in the blood cortisol value and total MRS (P<0.001 and <0.001), respectively.
Conclusion
It could be concluded that foot reflexology in addition to paced respiration are more effective than paced respiration only in decreasing blood cortisol level as well as VMS in symptomatic menopausal women.
References
Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, et al. Executive summary: stages of reproductive aging workshop (STRAW). J Womens Health Gend Based Med 2001; 10:843–848.
The North American Menopause Society. Estrogen and progestogen use in postmenopausal women: 2010 position statement of the North American Menopause Society. Menopause 2010; 17:242–255.
Gold EB, Colvin A, Avis N, Bromberger J, Greendale GA, Powell L, et al. Longitudinal analysis of vasomotor symptoms and race/ethnicity across the menopausal transition: study of Women’s Health Across the Nation (SWAN). Am J Public Health 2006; 96:1226–1235.
North American Menopause Society (NAMS). Menopause core curriculum study guide. 2nd ed. Mayfield, OH: NAMS; 2002.
Freeman RR. Physiology of hot flushes. Am J Human Biol 2001; 13:453–464.
Randolph JF, Sowers M, Bondarenko I, Gold B, Greendale GA, Bromberger JT, et al. The relationship of longitudinal change in reproductive hormones and vasomotor symptoms during the menopausal transition. J Clin Endocrinol Metab 2005; 90:6106–6112.
Powell LH, Lovallo WR, Matthews KA, Meyer P, Midgley AR, Baum A, et al. Physiologic markers of chronic stress in premenopausal, middle-aged women. Psychosom Med 2002; 64:502–509.
Kudielka BM, Gierens A, Hellhammer DH, Wüst S, Schlotz W. Salivary cortisol in ambulatory assessment-some dos, some don’ts, and some open questions. Psychosom Med 2012; 74:325–326.
Vgontzas AN, Bixler EO, Lin HM, Prolo P, Mastorakos G, Vela-Bueno A, et al. Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications. J Clin Endocrinol Metab 2001; 86:3787–3794.
Kumari M, Badrick E, Ferrie J, Perski A, Marmot M, Chandola T. Self-reported sleep duration and sleep disturbance are independently associated with cortisol secretion in the Whitehall II study. J Clin Endocrinol Metab 2009; 94:4801–4809.
Leproult R, Van Cauter E. Role of sleep and sleep loss in hormonal release and metabolism. Endocr Dev 2010; 17:11–21.
Swartzman LC, Edelberg R, Kemmann E. Impact of stress on objectively recorded menopausal hot flushes and on flush report bias. Health Psychol 1990; 9:529–545.
Freeman EW, Sammel MD, Lin H, Gracia CR, Kapoor S, Ferdousi T. The role of anxiety and hormonal changes in menopausal hot flashes. Menopause 2005; 12:258–266.
Thurston RC, Blumenthal JA, Babyak MA, Sherwood A. Emotional antecedents of hot flashes during daily life. Psychosom Med 2005; 67:137–146.
Shifren JL, Desindes S, McIlwain M, Doros G, Mazer NA. A randomized, open-label, crossover study comparing the effects of oral versus transdermal estrogen therapy on serum androgens, thyroid hormones, and adrenal hormones in naturally menopausal women. Menopause 2007; 14:985–994.
Vamvakopoulos NC, Chrousos GP. Evidence of direct estrogenic regulation of human corticotropin-releasing hormone gene expression. Potential implications for the sexual dimophism of the stress response and immune/inflammatory reaction. J Clin Invest 1993; 92:1896–1902.
Kravitz HM, Ganz PA, Bromberger J, Powell LH, Sutton-Tyrrell K, Meyer PM. Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause 2003; 10:19–28.
White AR, Williamson J, Hart A, Ernst E. A blinded investigation into the accuracy of reflexology charts. Complement Ther Med 2000; 8:166–172.
Williamson J. A guide to precision reflexology. Salisbury, Wilts: Quay Books; 1999.
Dobbs BZ. Alternative health approaches. Nurs Mirror 1985; 160:41–42.
North American Menopause Society. Menopause practice: a clinician’s guide 4. Mayfield Heights, OH: North American Menopause Society; 2010.
Marla Shapiro. The menopause guidebook 7. Mayfield Heights, OH: North American Menopause Society; 2012.
Clark ME, Hirschman R. Effects of paced respiration on anxiety reduction in a clinical population. Biofeedback Self Regul 1990; 15:273–284.
McCaul KD, Solomon S, Holmes DS. Effects of paced respiration and expectations on physiological and psychological responses to threat. J Pers Soc Psychol 1979; 37:564–571.
Heinemann K, Ruebig A, Potthoff P, Schneider HP, Strelow F, Heinemann LA, et al. The menopause rating scale (MRS) scale: a methodological review. Health Qual Life Outcomes 2004; 2:45.
Hughes CM, Krirsnakriengkrai S, Kumar S, McDonough SM. The effect of reflexology on the autonomic nervous system in healthy adults: a feasibility study. Altern Ther Health Med 2011; 17:32–37.
Jones S. Simply reflexology. 1st ed. New York, NY: Sterling Publishing Company Inc; 2009. 9–11.
Voda AM. Climacteric hot flash. Maturitas 1981; 3:73–90.
Politi MC, Schleinitz MD, Col NF. Revisiting the duration of vasomotor symptoms of menopause: a meta-analysis. J Gen Intern Med 2008; 23:1507–1513.
Rymer J, Morris EP. Menopausal symptoms. BMJ 2000; 321:1516–1519.
Zweifel JE, O’Brien WH. A meta-analysis of the effect of hormone replacement therapy upon depressed mood. Psychoneuroendocrinology 1997; 22:189–212.
Kunz B. 2003. Reflexology Health at Your Fingertips: Hands-on Treatment for Vitality and Well-being; Dorling Kindersely p. 160.
Gozuyesil E, Baser M. The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life. Complementary Ther Clin Pract 2016; 24:78–85.
McVicar AJ, Greenwood CR, Fewell F, D’Arcy V, Chandrasekharan S, Alldridge LC. Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: a pilot study in healthy individuals. Complement Ther Clin Pract 2007; 13:137–145.
Lee Y. Effect of self-foot reflexology massage on depression, stress responses and immune functions of middle aged women. TaehanKanho Hakhoe Chi 2006; 36:179–188.
Song R, Kim D. The effects of reflexology massage on sleep disturbance, depression disorder and the physiological index of the elderly. Taehan Kunho Hakhochi 2006; 36:15–24.
Lee Y. Effect of foot reflexology massage on climacteric symptom, fatigue and physiologic parameters of midologic parameters of middle aged women. J Korean Acad Adult Nurs 2006; 18:284–292.
Cade M. Reflexology. Kans Nurse 2002; 77:5–6.
Kunz K, Kunz B. Understanding the science and art of reflexology. Altern Complement Ther 1995; 1:183–186.
Stephenson NL, Dalton JA. Using reflexology for pain management. A review J Holist Nurs 2003; 21:179–191.
Huang AJ, Phillips S, Schembri M, Vittinghoff E, Grady D. Device-guided slow-paced respiration for menopausal hot flushes: a randomized controlled trial. Am J Obstet Gynecol 2015; 125:1130–1138.
Sood R, Sood A, Wolf SL, Linquist BM, Liu H, Sloan JA, et al. Paced breathing compared with usual breathing for hot flashes. Menopause 2013; 20:179–184.
Society NAM. Menopause practice: a clinician’s guide 4. Mayfield Heights, OH: North American Menopause Society; 2012.
Narkiewicz K, van de Borne P, Montano N, Hering D, Kara T, Somers VK. Sympathetic neural outflow and chemo reflex sensitivity are related to spontaneous breathing rate in normal men. Hypertension 2006; 47:51–55.
Raupach T, Bahr F, Herrmann P, Luethje L, Heusser K, Hasenfuss G, Bernardi L, Andreas S. Slow breathing reduces sympatho excitation in COPD. Eur Respir J 2008; 2:387–392.
Joseph CN, Porta C, Casucci G, Casiraghi N, Maffeis M, Rossi M, Bernardi L. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension 2005; 46:714–718.
Freedman RR, Woodward S, Sabharwal SC. Alpha 2-adrenergic mechanism in menopausal hot flushes. Obstet Gynecol 1990; 76:573–578.
Freedman RR, Dinsay R. Clonidine raises the sweating threshold in symptomatic but not in asymptomatic postmenopausal women. Fertil Steril 2000; 74:20–23.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Rights and permissions
About this article
Cite this article
El-Bandrawy, A., Kamal, W. & Ghareeb, H. Effect of foot reflexology adjunct to paced respiration on vasomotor symptoms during menopause: randomized-controlled trail. Bull Fac Phys Ther 23, 77–84 (2018). https://doi.org/10.4103/bfpt.bfpt_10_18
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/bfpt.bfpt_10_18