Is short - term foot reflexology effective in treating constipation symptoms during pregnancy: a randomized controlled trial

Background: In spite of anecdotal claims for popularity of foot reflexology use in medical practices especially in midwifery fields such as a vomiting, nausea and low back pain, the clinical evidence for reflexology on the managing of constipation symptoms in pregnancy is rare. The mutual relation between constipation and anxiety, can exacerbate constipation symptoms during pregnancy which incorporated with negative outcomes and affects the well-being of mother and changes in fetal viability parameters. A two-armed, randomized controlled trial was conducted to determine changes in constipation, anxiety symptoms, and fetal activity outcomes after foot reflexology intervention.Method Seventy-four nulliparous volunteers experiencing constipation, were recruited between Oct.2017 and Dec. 2018, and randomly assigned (in a 1:1 ratio) two groups to receive either 12 minutes foot reflexology or standard care. A short course of foot reflexology treatment (weekly for six weeks) was given. Primary outcome included constipation score measured based on constipation assessment scale (CAS) questionnaire. For measuring secondary outcomes the State-Trait Anxiety Inventory (STAI) questionnaire and the checklist for fetal movement assessment were used. Outcome assessor was blinded about allocation and randomization of the groups.Results 72 (%97.3) women completed the intervention. 97.2 percent of women reported improvement in their CAS measures at the end of sixth weeks following reflexology. Mean scores of STAI at the end of sixth sessions of intervention were 38.5, 42.2 (State anxiety) and 39.1, 40.2 (Trait anxiety) in reflexology and control respectively and decreased by 7.1% for the reflexology group. Statistically significant difference in fetal movements between the two groups were seen only in the fourth and fifth weeks after intervention sessions. 66.7% of mothers were satisfied of reflexology intervention for their constipation symptoms improvement, and 33.3% of the rest were fully satisfied. No any harmful events or side effects of foot reflexology were reported among mothers.Conclusions Foot reflexology in this context may has potential healing benefits for treating constipation and associated anxiety in pregnant women. However, further investigation for antenatal reflexology is required.

Keywords:

Constipation , Foot reflexology , Foot massage , Anxiety , Pregnancy , Fetal movement , fetal activity.