Reflexology is a common choice of women with breast cancer as supportive care during treatment. It involves stimulation of specific locations of the feet called reflexes using a specialised walking motion with the thumb of the reflexologist.
Reflexology has shown potential for the successful management of cancer and treatment related symptoms and improvement in physical functioning; however, to date, the mechanism of action for these improvements is unknown.
One confounder to the study of reflexology is the ‘human factor’. To study the effects of the stimulation of the reflexes independent of the ‘human factor’, there is a need for an alternative method for the delivery of reflexology.
Introduction – Aim
The purpose of this work was to begin to uncover the specific components of reflexology which may or may not play a role in symptom management and improvements in physical functioning among cancer patients. Testing against hands-on reflexology is planned in the future, as the device may provide an alternative for some cancer patients who are homebound. The intent of this line of work is not to replace a therapist, but rather to advance the science by isolating the key active ingredients of reflexology, and in the long run possibly offer in-home or in-clinic options for some patients.
While multiple studies have investigated the effect of reflexology on HRQOL of cancer patients, there is no single scientifically established mechanism of action for how reflexology affects HRQOL outcomes including symptoms and function. One theory suggests that the mechanism of action is that the nerve endings in the feet connect with different areas of the body, and the direct pressure on a specific nerve ending of the foot stimulates the corresponding area of the body for symptomatic relief (Hodgson 2000). According to this theory, specific areas of the foot (reflexes) correspond to specific organs or systems of the body (Fig. 1), and thus manipulation of these specific areas can lead to the improvement in symptoms. A protocol that targets reflexes tied to symptoms of breast cancer and its treatment has been developed (Wyatt et al.2005).
In addition to the stimulation of specific reflexes, the ‘human factor’ is also thought to influence outcomes of reflexology. The human factor includes the experience of the reflexologist in finding and stimulating specific reflexes. The interpersonal style of the reflexologist during the session may also be a confounding human factor. In addition, the human touch by itself may have a therapeutic effect, and the touch produced by different reflexologists may be different (e.g. different motion patterns or methods of force application).This variability in the delivery of reflexology that is due to human factor may explain some of the variable effects on patient outcomes.
Thus, to understand the role of stimulation of the reflexes in reflexology, removing the human factor is necessary. One of the ways to remove the human factor is to stimulate the reflexes using a mechanical device.