Volume 4, Issue 2 (Spring 2018 -- 2018)                   JCCNC 2018, 4(2): 96-103 | Back to browse issues page

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1- Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. , bastani.f@iums.ac.ir
3- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Abstract:   (3553 Views)
Background: Restless Leg Syndrome (RLS) is a common disorder in the elderly, especially older women, which causes sleep disorders and endangers the elderly with increase in the risk of falling, memory disturbances, and eventually, poor quality of life. Today, non-pharmacological approaches, including reflexology massage, are considered along with pharmaceutical methods for improving sleep quality. This study aims to examine the effect of foot reflexology massage on the sleep quality of the elderly women with RLS.
Methods: The was a non-randomized clinical trial with a control group (quasi-experimental design) conducted on 67 elderly women with RLS resident in nursing homes located in Fars Province of Iran. Samples were selected using convenience sampling method. By tossing a coin, some elderlies were selected and allocated in the control and test groups. Foot reflexology intervention comprised eight 20-minute sessions (10 min for each foot) for 4 weeks. Pittsburgh Sleep Quality Index (PSQI) and a demographic questionnaire were used for collecting data which were administered before and after the intervention. The collected data were analyzed in SPSS V. 16 using descriptive statistics and inferential statistics such as Independent t test, paired t test, Fisher exact test, and Chi-squared test at a significance level of P<0.05.
Results: The Mean±SD ages of the participants in test and control group were 71.43±6.25 and 72.6±4.67 years, respectively and both groups were matched in terms of age (P=0.389). There was no significant difference in sleep quality of the control group before and after the intervention (P=0.013 or 0.13), while in the test group the difference was statistically significant (P<0.001). In addition, the difference in RLS pain scores before and after the intervention was significantly lower in the test group compared to the control group (P<0.001).
Conclusion: Foot reflexology massage had a positive effect on the sleep quality of the elderly women with RLS. Caregivers and nurses of the elderly are recommended to learn and use this easy and almost cost-free intervention for their patients.
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● Foot reflexology massage improves sleep quality of the elderly women with restless legs syndrome.
● Elderly often suffer from many physical complications including restless legs syndrome.
● Foot reflexology can be used as a safe and non-medicinal intervention in older women with restless legs syndrome.
Plain Language Summary
This paper reports the effect of foot reflexology massage on sleep quality of the elderly women with Restless Legs Syndrome (RLS). This syndrome causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them. It is a common neurological movement disorder that its prevalence increases with age. Women are twice as likely to develop RLS. Symptoms commonly occur in the late afternoon or evening hours, and are often most severe at night when an older adults are resting or lying in bed. On the other hand, sleep quality changes as a function of normal aging, both in terms of decreased duration and consolidation, and it plays a critical role in promoting good health. Unfortunately, sleep quality is usually worse at night in older adults with RLS. Because of the effects of RLS on the life of older adults, treatment plan to relieve RLS symptoms is important. Leg massage is an easy and relaxing treatment that could ease RLS symptoms. Reflexology as a foot massage involves application of pressure to the feet with specific thumb, finger, and hand techniques without the use of oil or lotion. The results showed that the foot reflexology massage had a positive effect on the sleep quality of the elderly women with RLS. It is recommended that

Type of Study: Research | Subject: Special
Received: 2017/11/25 | Accepted: 2018/03/13 | Published: 2018/05/1

1. Asltoghiri, M. & Ghodsi, Z., 2012. The effects of Reflexology on sleep disorder in menopausal women. Procedia-Social and Behavioral Sciences, 31, pp. 242-246. [DOI:10.1016/j.sbspro.2011.12.049] [DOI:10.1016/j.sbspro.2011.12.049]
2. Beyrami, M., et al., 2014. [Comparing sleep quality and general health among the elderly living at home and at nursing home (Persian)]. Iranian Journal of Ageing, 8(4), pp. 47-55.
3. Brunner, L. S., 2010. Brunner & Suddarth's textbook of medical-surgical nursing. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins.
4. Buysse, D. J., et al., (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), pp. 193-213. [DOI:10.1016/0165-1781(89)90047-4] [DOI:10.1016/0165-1781(89)90047-4]
5. Celle, S., et al., 2010. Prevalence and clinical correlates of restless legs syndrome in an elderly French population: The synapse study. The Journals of Gerontology Series A, 65(2), pp. 167-73. [DOI:10.1093/gerona/glp161] [PMID] [DOI:10.1093/gerona/glp161]
6. Chavoshi, F., et al., 2015. Prevalence and sleep related disorders of restless leg syndrome in hemodialysis patients. Nephro-Urology Monthly, 7(2), pp. 246-53. [DOI:10.5812/numonthly.24611] [DOI:10.5812/numonthly.24611]
7. Cuellar, N. G., Rogers, A. E. & Hisghman, V., 2007. Evidenced based research of Complementary and Alternative Medicine (CAM) for sleep in the community dwelling older adult. Geriatric Nursing, 28(1), pp. 46-52. [DOI:10.1016/j.gerinurse.2006.07.001] [PMID] [DOI:10.1016/j.gerinurse.2006.07.001]
8. Çurgunlu, A., et al., 2012. Prevalence and Characteristics of Restless Legs Syndrome (RLS) in the elderly and the relation of serum ferritin levels with disease severity: Hospital-based study from Istanbul, Turkey. Archives of Gerontology and Geriatrics, 55(1), pp. 73-76. [DOI:10.1016/j.archger.2011.06.002] [PMID] [DOI:10.1016/j.archger.2011.06.002]
9. Ernst, E., Posadzki, P. & Lee, M., 2011. Reflexology: An update of a systematic review of randomised clinical trials. Maturitas, 68(2), pp. 116-120. [DOI:10.1016/j.maturitas.2010.10.011] [PMID] [DOI:10.1016/j.maturitas.2010.10.011]
10. Farrahi, J., et al., 2009. Psychometric properties of the persian version of the Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A). Sleep and Breathing, 13(3), pp. 259. [DOI:10.1007/s11325-008-0233-3] [DOI:10.1007/s11325-008-0233-3]
11. Fereshtehnejad, S. M., et al., 2017. Prevalence and associated comorbidities of Restless Legs Syndrome (RLS): Data from a large population-based door-to-door survey on 19176 adults in Tehran, Iran. PloS One, 12(2), p. e0172593. [DOI:10.1371/journal.pone.0172593] [DOI:10.1371/journal.pone.0172593]
12. Gade, K., et al., 2013. Uremic Restless Legs Syndrome (RLS) and sleep quality in patients with end-stage renal disease on hemodialysis: Potential role of homocysteine and parathyroid hormone. Kidney and Blood Pressure Research, 37(4-5), pp. 458-63. [DOI:10.1159/000355727] [PMID] [DOI:10.1159/000355727]
13. Ghanei, R., et al., 2011. [Restless legs syndrome and the quality of sleep in type II diabetes (Persian)]. Feyz Journal of Kashan University of Medical Sciences, 15(3), pp. 240-6.
14. Goldman, L. & Schafer, A. I., 2016. Goldman-Cecil Medicine. Amsterdam: Elsevier.
15. Habibzadeh, H., Lazari, N. & Ghanei Gheshlagh, R., 2013. Relationship of restless legs syndrome and sleep quality in he-modialysis patients. Medical-Surgical Nursing Journal, 2(1), pp. 57-62.
16. International Restless Legs Syndrome Study Group, 2012. 2012 revised IRLSSG diagnostic criteria for RLS [Internet]. Viewed 17 July 2017, http://irlssg.org/diagnostic-criteria/
17. Khojandi, S., et al., 2015. [Comparison the effect of two methods of reflexology massage and stretching exercises on the severity of restless leg syndrome among patients undergoing hemodialysis (Persian)]. Iranian Journal of Nursing Research, 10(1), pp. 86-94.
18. Kocabicak, E., et al., 2014. Restless leg syndrome and sleep quality in lumbar radiculopathy patients. Behavioural Neurology, 2014, 245358. [DOI:10.1155/2014/245358] [PMID] [PMCID] [DOI:10.1155/2014/245358]
19. Lee, J., et al., 2011. Effects of foot reflexology on fatigue, sleep and pain: A systematic review and meta-analysis. Journal of Korean Academy of Nursing, 41(6), pp. 821-33. [DOI:10.4040/jkan.2011.41.6.821] [PMID] [DOI:10.4040/jkan.2011.41.6.821]
20. Li, C. Y., et al., 2011. Randomised controlled trial of the effectiveness of using foot reflexology to improve quality of sleep amongst Taiwanese postpartum women. Midwifery, 27(2), pp. 181-6. [DOI:10.1016/j.midw.2009.04.005] [PMID] [DOI:10.1016/j.midw.2009.04.005]
21. Mei, L., et al., 2017. Effectiveness of Chinese hand massage on anxiety among patients awaiting coronary angiography: A randomized controlled trial. Journal of Cardiovascular Nursing, 32(2), pp. 196-203. [DOI:10.1097/JCN.0000000000000309] [PMID] [DOI:10.1097/JCN.0000000000000309]
22. Miller, C. A., 2009. Nursing for wellness in older adults. Philadelphia: Lippincott Williams & Wilkins.
23. Nasiri, K., et al., 2015. [CompComparing the effects of reflexology and foot bath on sleep quality (Persian)]. Complementary Medicine Journal of faculty of Nursing & Midwifery, 5(1), pp. 1077-90.
24. Ray, M. B. S. & Natha, M. H., 2017. Foot reflexology: Effect on pain and anxiety in post oprative patient. International Education and Research Journal, 3(5), pp. 49-51.
25. Saiidi, M., et al., 2015. [Complementary medicine, alternative medicine and nurse's roles in them (Persian)], Tehran: Heydari Publisher.
26. Seyedrasooli, A., et al., 2013. [The effect of reflexology on sleep quality of elderly: A single-blind clinical trial (Persian)]. Medical-Surgical Nursing Journal, 2(1), pp. 11-8.
27. Shahgholian, N., et al., 2016. The effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among hemodialysis patients. Iranian Journal of Nursing and Midwifery Research, 21(3), pp. 219-24. [DOI:10.4103/1735-9066.180381] [PMID] [PMCID] [DOI:10.4103/1735-9066.180381]
28. Shin, H. Y., et al., 2013. Restless legs syndrome in Korean patients with drug-naive Parkinson's disease: A nation-wide study. Parkinsonism & Related Disorders, 19(3), pp. 355-8. [DOI:10.1016/j.parkreldis.2012.09.009] [PMID] [DOI:10.1016/j.parkreldis.2012.09.009]
29. Statistical Center of Iran., 2011. Detailed results of the general census of population and housing, the whole country. Tehran: Statistical Center of Iran.
30. Tarrasch, R., et al., 2017. The effect of reflexology on the pain-insomnia-fatigue disturbance cluster of breast cancer patients during adjuvant radiation therapy. The Journal of Alternative and Complementary Medicine, 24(1), pp. 62-8. [PMID] [DOI:10.1089/acm.2017.0023] [PMID]
31. Unal, K. S. & Akpinar, R. B., 2016. The effect of foot reflexology and back massage on hemodialysis patients' fatigue and sleep quality. Complementary Therapies in Clinical Practice, 24, pp. 139-44. [DOI:10.1016/j.ctcp.2016.06.004] [PMID] [DOI:10.1016/j.ctcp.2016.06.004]
32. World Health Organization, 2017. 10 facts on ageing and health [Internet]. Viewed 1 May 2017, http://www.who.int/features/factfiles/ageing/en/

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