Foot reflexology in the management of functional constipation: A systematic review and meta-analysis
Section snippets
Background
Functional constipation (FC) is defined as a bowel symptom–based gastrointestinal disorder without an organic cause, which is a very common condition with varied prevalence among populations at different ages and in different geographic regions. Especially in children, the prevalence of FC worldwide ranges between 0.5% and 32.2%, with a pooled prevalence of 9.5% (95% CI 7.5–12.1) [1]. In the United States, FC accounts for 3%–25% of visits to a paediatric gastroenterologist [2]. In adults,
Methodology
This is a quantitative meta-analysis to determine the effectiveness of foot reflexology on patients with FC. The study followed a pre-specified study protocol registered in PROSPERO (CRD42018106589). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was adopted to guide the report of final results [28].
Included studies
The primary search detected 203 studies in total. After screening the titles and abstracts, 96 records that were not related to the topic and three duplicated articles were excluded. Sixteen articles on abdominal massage were also excluded. We removed 31 records for unqualified types of study design, such as review, case report, non-experimental research and RCT protocol. Through a full-text review, 24 articles that did not meet the inclusion and exclusion criteria were deleted because
Discussion
This systematic review and meta-analysis sought to explore the efficacy of foot reflexology in the management of FC. The meta-analysis of five randomised controlled trials indicated that foot reflexology would significantly increase the cure rate by improving stool frequency, stool consistency, difficult defaecation, incomplete evacuation, abdominal pain and bloating, with a pooled RR 1.27 (95% CI: 1.16, 1.40, p < 0.00001), which suggested that foot reflexology was an effective alternative
Conclusion
This study reviewed the efficacy of foot reflexology for the management of FC. A significant increase of the curative rate was found in meta-analysis, which indicated that foot reflexology is an effective complementary therapy for FC. However, the current evidence was insufficient to support the use of foot reflexology for decreasing constipation severity of its recurrence rate and improving the compliance with toilet training, diet and motivation, because of the small number of studies and
Authors’ contributions
Y.Z. and Y.Q.H. designed the research; Y.Q.H. and N.J. designed the search strategies and conducted the literature search; S.Q.W., S.X.C. and L.J.Z. evaluated the quality of included studies and extracted the data; Y.Q.H., Y.C. and X.J.Z. conducted the statistical analysis; Y.Q.H., N.J. and Y.L.W. were involved in the interpretation of the results. Y.Z. was responsible for the writing and critical revision of the manuscript. All authors read and approved the final manuscript.
Funding
The study was supported by the National Natural Science Foundation of China (General No. 71974142).
Declaration of competing interest
The authors declare no conflicts of interests.
Acknowledgment
Not applicable.
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