Authors
1 Isfahan Neurosciences Research Centre, Department of Adult Health Nursing, School of Nursing and Midwifery
2 Isfahan Neurosciences Research Centre, Department of Neurology, School of Medicine
3 Department of Midwifery and Reproductive Health, Isfahan Neurosciences Research Centre, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Multiple sclerosis (MS) occurs with a variety of physical and psychological
symptoms, yet there is not a conclusive cure for this disease. Complementary medicine is a
current treatment which seems is effective in relieving symptoms of patients with MS. Therefore,
this study is aimed to determine and compare the effects of reflexology and relaxation on anxiety,
stress, and depression in women with MS. Subjects and Methods: This study is a randomized
clinical trial that is done on 75 women with MS referred to MS Clinic of Kashani Hospital. After
simple non random sampling, participants were randomly assigned by minimization method to
three groups: reflexology, relaxation and control (25 patients in each group). In the experimental
groups were performed reflexology and relaxation interventions within 4 weeks, twice a week for
40 min and the control group were received only routine treatment as directed by a doctor. Data
were collected through depression anxiety and stress scale questionnaire, before, immediately
after and 2 months after interventions in all three groups. Chi‑square, Kruskal–Wallis, repeated
measures analysis of variance and one‑way analysis of variance and least significant difference
post hoc test via SPSS version 18 were used to analyze the data (P < 0.05) was considered as
significant level. Results: The results showed a significant reduction in the severity of anxiety,
stress and depression during the different times in the reflexology and relaxation groups as
compared with the control group (P < 0.05). Conclusion: The results showed that reflexology
and relaxation in relieving anxiety, stress and depression are effective in women with MS. Hence,
these two methods, as effective techniques, can be recommended.
Keywords
Neurosurgical Nursing. Philadelphia: Lipincott Williams & Wikins;
2014.
2. Milo R, Kahana E. Multiple sclerosis: Geoepidemiology, genetics
and the environment. Autoimmun Rev 2010; 9: 387‑94.
3. Sureshjani SH, Eslami A. The quality of life among multiple sclerosis
patients in Isfahan. J Health Syst Res 2011; 7:571‑9.
4. Ghafari S, Ahmadi F, Nabavi M, Memarian R. The effects of
progressive muscle relaxation on depression anxiety and stress in
multiple sclerosis patients. J Med 2008; 1:45‑53.
5. Mahmoodi GH, Nasiri A, Niaazari K. Mental health in patients with
multiple sclerosis in Mazandaran in 2007. Mazandaran Univ Med
Sci J 2008; 18:70‑3.
6. Askey‑Jones S, Silber E, Shaw P, Gray R, David AS. A nurse‑led
mental health service for people with multiple sclerosis.
J Psychosom Res 2012; 72:463‑5.
7. Rigikouteh B, Yazdkhasti F, Etemadifar M. The effectiveness of
mental – Physical relaxation (Dohsa‑hou) on depression, anxiety
and stress in patients with multiple sclerosis (MS). Int J Humanit
Soc Sci Invent 2013; 2:4‑11.
8. Ziemssen T. Symptom management in patients with multiple
sclerosis. J Neurol Sci 2011; 311 Suppl 1:S48‑52.
9. Kargarfard M, Etemadifar M, Asfarjani F, Mehrabi M, Kordavani l.
Changes in quality of life and fatigue in women with multiple sclerosis
after 8 weeks of aquatic exercise training. J Fundam Mental Health
2010; 12:562‑73.
10. Payamani F, Nazari A, Ghadiriyan FN, Karami K. Complementary
therapy in patients with multiple sclerosis. Iran J Nurs 2012;
25:12‑20.
11. Wang MY, Tsai PS, Lee PH, Chang WY, Yang CM. The efficacy of
reflexology: Systematic review. J Adv Nurs 2008; 62:512‑20.
12. Safi Z, Sahami S. The effects of progressive muscle relaxation on
quality of life in women with multiple sclerosis. J Appl Psychol 2011;
5:71‑84.
13. Lee J, Han M, Chung Y, Kim J, Choi J. Effects of foot reflexology
on fatigue, sleep and pain: A systematic review and meta‑analysis.
J Korean Acad Nurs 2011; 41:821‑33.
14. Ernst E. Is reflexology an effective intervention? A systematic review
of randomised controlled trials. Med J Aust 2009; 191:263‑6.
15. Mackereth PA, Booth K, Hillier VF, Caress AL. Reflexology and
progressive muscle relaxation training for people with multiple
sclerosis: A crossover trial. Complement Ther Clin Pract 2009;
15:14‑21.
16. Leong EM, Semple SJ, Angley M, Siebert W, Petkov J, McKinnon RA.
Complementary and alternative medicines and dietary interventions
in multiple sclerosis: What is being used in South Australia and
why? Complement Ther Med 2009; 17:216‑23.
17. Elahi BE, Zali A, Hatami H. Pivotal study of ancestors (Traditional
medicine of Iran and the Islamic World). J Med Purif 2008; 68:8‑20.
18. Saghaei M. An overview of randomization and minimization
programs for randomized clinical trials. J Med Signals Sens 2011;
1:55‑61.
19. Jensen MP, Barber J, Romano JM, Molton IR, Raichle KA,
Osborne TL, et al. A comparison of self‑hypnosis versus progressive
muscle relaxation in patients with multiple sclerosis and chronic
pain. Int J Clin Exp Hypn 2009; 57:198‑221.
20. Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S,
Ebrahimi M, et al. Anxiety and depression in Iranian breast cancer
patients before and after diagnosis. Eur J Cancer Care (Engl) 2000;
9:151‑7.
21. Torabi M, Salavati M, Ghahrisorabi A, Pooresmail Z,
Akbarianbaghban A. Effects of foot reflexology and benson
relaxation on anxiety and physiological parameters in hospitalized
patients undergoing coronary angiography. Hamadan J Nurs
Midwifery 2013; 20:63‑71.
22. Mokhtarinouri J, Siratinir M, Sadeghisharme M, Ghanbari Z,
Babatabarzadi H, Mahmudi H. Comparison effect of foot reflexology
massage and benson relaxation on anxiety. J Behav Sci 2009;
3:159‑65.
23. Kashani F, Babaee S, Bahrami M, Valiani M. The Effects of Massage
Therapy and Relaxation on Depression, Anxiety and Stress in
Women who Underwent Mastectomy for Breast Cancer Admitted
to Sayed Alshohada Hospital. Isfahan Medical Science University.
Vol. 17. Master Thesis in Nursing; 2012. p. 30‑3.
24. Barzegarghazi K, Fouladinadinlouei A, Bahramkhani M, Zamani N.
The effectiveness of reducing muscular tension on decreasing the
perceived stress in patients with multiple. J Am Sci 2012; 8:9705‑9.
25. Williamson J, White A, Hart A, Ernst E. Randomised controlled trial
of reflexology for menopausal symptoms. BJOG 2002; 109:1050‑5.
26. Lee YM. Effect of self‑foot reflexology massage on depression,
stress responses and immune functions of middle aged women.
Taehan Kanho Hakhoe Chi 2006; 36:179‑88.
27. McVicara AJ, Greenwood CR, Fewell F, Arcy VD, 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; 13:137‑45.
)