Last week at Hearing International we reviewed the history of Reflexology. While the procedure has been around since ancient times, until recently there has been minimal research data on whether it works for various disorders, and specifically the auditory system. I became concerned about this area due to the testimonial published by Acorn (2014). The author suggests that she used Reflexology to cure a person’s deafness. As a result I became interested in looking at Reflexology, and specifically to see if there is any scientific basis for this treatment for hearing loss. This week we will look into the literature on Reflexology and review its short research history.
For most of the history of reflexology, the clinical results were anecdotal, consisting of a few accounts by the provider or the recipient of reflexology treatment describing the benefits of the procedure. Inquiring minds, however,want to know if these results are simply stories or if they translate into a procedure that could be beneficial for certain disorders. The Reflexology Association of America was established in 1995 as the national voice of Reflexology, but the campaign for research began in the 1980s with the following goals:
1. Modify the attitudes of the public, health care providers, and health insurance companies toward Reflexology.
2. Promote the acceptance of Reflexology as a discipline.
3. Provide research information on clinical effectiveness of Reflexology for specific disorders.
4. Improve procedural methods in the clinical application of Reflexology.
5. Insure high-quality research designs.
In the late 1980s and early 1990s, research projects began to provide data and seemed to present Reflexology in a different light. Studies in reflexology were funded by the National Cancer Institute and the National Institutes of Health in the United States as well as other sources worldwide. Results of these early studies indicated that Reflexology had promise as a method of reducing pain, enhancing relaxation, and sleep, and alleviating psychological symptoms such as anxiety and depression. Teagarden (2014) found that the most beneficial results appear to have been in the area of palliative treatment of cancer patients by Ernst, Posadzki, & Lee (2010). To some, this particular study presented quite a breakthrough for reflexology research, but others were not very complimentary.
The authors of the 2010 study concluded that “the best clinical evidence does not demonstrate reflexology to be an effective treatment for any medical condition convincingly.” Cooke (2014) says of this study that “…..although some of the existing literature indicates improved quality of life in cancer patients who receive reflexology, most of these studies have considerable methodological limitations. Evidence is, therefore, insufficient to document any effectiveness of reflexology.” She adds that blinding is very difficult to achieve in reflexology studies, which makes it difficult to evaluate the efficacy of this treatment modality.
Sone researchers support reflexology studies. However, these primarily Chinese and European studies suffer from the same issues discussed by Cooke (2014) in that the research designs are difficult to establish and to maintain.
Kunz and Kunz (2008) have developed a summary of 168 research studies and abstracts from journals and meetings from around the world. Many of these studies originated in peer-reviewed journals in China and Korea. They suggest that reflexology promotes relaxation, pain reduction, amelioration of health concerns, and improvement in blood flow and in post-operative recovery. Kunz and Kunz (2008) further suggest that reflexology impacts physiological measures such as blood pressure, while enhancing medical care; easing pregnancy, delivery and post-partum effects; improving mental health; and complementing cancer care. While there may be some reliable and valid reflexology studies, Teagarden (2014) writes that the “distinction between reflexology as an alternative treatment and a medical treatment is not yet clear, and that these differences should be more marked to avoid treatment errors and potential problems.”
Without solid research, the fact remains that any treatment benefits for deafness, tinnitus or other disorders are anecdotal, and anecdotal evidence is not science. We see this every day in television commercials, testimonials, and other non-scientific presentations of what is best for us. The mouthwash that kills more germs than the others, the car that rides the best or the best liked dog food are all anecdotal statements. While anecdotal evidence is often used in place of clinical or scientific evidence, it appears that reflexologists use anecdotes to make a hand or foot massage into a science. Anecdotal evidence is not necessarily designed to mislead people, but it is much easier to accept a recommendation for a good tailor than to conduct a double- blind, evidence-based study on who makes the best suits although the advice may or may not come from a expert source.
A popular site that reviews the pro and cons of various controversial issues, including Reflexology, is Quackwatch. In his (2004) literature review, Barret found that “the claims of reflexology are so far removed from scientific reality that testing them might seem a waste of time but a few competent researchers have conducted investigations.” Despite the work invested in these investigations, he concluded, “Reflexology is based on an absurd theory and has not been demonstrated to influence the course of any illness.” In 2014, there is no real evidence that would refute his 2004 assessment of the research base for Reflexology or support the claim that Reflexology could be a cure for Hearing Impairment.
Reflexology Association of America(2014). Our History. Retrieved October 19,2014: http://reflexology-usa.org/information/our-history/
Parr, Ben (2014). Ben Parr’s Musings. Retrieved October 19, 2014: http://benparr.com/2010/02/anecdotal-evidence/
Talk counseling services (2014), Retrieved October 19, 2014: http://www.talkcounselling.co.nz/2010/12/talkcounselling-personal-breakthrough-session/
The making of machines, Retrieved October 21, 2014: http://meaningmakingmachines.wordpress.com/2012/02/06/well-intentioned-but-misdirected-bad-research-design-means-bad-data/
Government Executive (2014). Retrieved October 21, 2014: http://cdn.govexec.com/interstitial.html?v=2.1.1&rf=http%3A%2F%2Fwww.govexec.com%2Fexcellence%2Fpromising-practices%2F2012%2F11%2F3-bad-research-techniques-will-ruin-your-work%2F59462%2F
Quick Quack Care Wash, Retrieved October 21, 2014: http://www.dontdrivedirty.com/media.php
Acorn, M., (2014). A day to remember. Treat your feet, Retrieved October 21, 2014: http://www.treatyourfeet.com/testimonials.html
Barret, S., (2004). Reflexology: A close look. Quackwatch, Retieved October 21, 2014: http://www.quackwatch.com/01QuackeryRelatedTopics/reflex.html
Cooke, H. (2014). Reflexology: Does it work? CAM-Cancer, Retrieved October 21, 2014: http://www.cam-cancer.org/CAM-Summaries/Manipulative-body-based/Reflexology/Does-it-work
Ernst, E., Posadzki, P., & Lee, M. (2010). Reflexology: an update of a systematic review of randomised clinical trials. Retrieved October 21, 2014: http://www.ncbi.nlm.nih.gov/pubmed/21111551
Tegarden, K., (2014). What does the research say about reflexology?, Retrieved October 21, 2014: http://www.takingcharge.csh.umn.edu/explore-healing-practices/reflexology/what-does-research-say-about-refloxology
Wise Geek (2014). The pros and cons of reflexology, Retrieved October 21, 2014: http://www.wisegeekhealth.com/what-are-the-pros-and-cons-of-reflexology-therapy.htm#