Alternative Therapies In Health And Medicine

TABLE 5 The Percentage Changes in Heart Rate Variability
Measures After Foot Reflexology*
%X30 %X60
Control group (n = 17)
Mean RRI; % –0.6 (–4.0 to 4.8)‡ –4.2 (–9.1 to 0.9)
Heart rate; % 0.6 (–4.6 to 4.0)‡ 4.3 (–0.8 to 10.0)‡
SD RR
; % 0.0 (–10.4 to 6.5) –13.3 (–17.6 to –1.2)‡
CV RR
; % –0.5 (–8.7 to 8.1) –4.6 (–12.5 to 1.1)
TP; % –5.7 (–21.9 to 18.4) –28.0 (–36.0 to –8.4)‡
VLFP; % -12.2 (–38.6 to 3.6) –56.0 (–69.8 to –33.9)‡
LFP; % 0.0 (–15.7 to 19.1) –23.2 (–39.6 to 13.3)‡
HFP; % 3.6 (–9.1 to 30.2) –6.9 (–30.0 to 13.0)
nVLFP; % –9.3 (–42.5 to 1.1) –37.3 (–49.6 to –26.5)
nLFP; % 1.0 (–9.2 to 24.7) 14.1 (–2.9 to 23.5)
nHFP; % 9.9 (–0.0 to 41.3) 18.0 (7.8 to 52.0)
LFP/HFP; % –14.3 (–28.5 to 16.6) –5.7 (–23.2 to 7.9)
CAD group (n = 20)
Mean RRI; % 6.6 (3.1 to 11.1)† 10.9 (3.5 to 17.7)†
Heart rate; % –6.2 (–10.0 to –3.1)† –9.9 (–15.0 to –3.4)†
SD RR
; % 4.3 (–8.7 to 23.7) 3.8 (–6.6 to 11.0)†
CV RR
; % 0.0 (–12.8 to 12.4) –6.0 (–10.4 to –2.0)
TP; % 11.3 (–25.1 to 58.9) 14.5 (–13.3 to 38.5)†
VLFP; % –0.3 (–39.9 to 21.6) –14.5 (–40.6 to 10.3)†
LFP; % 7.6 (–22.3 to 72.8) 13.8 (–6.7 to 40.7)†
HFP; % 10.0 (–13.2 to 53.3) 32.4 (6.0 to 59.2)†
nVLFP; % –16.4 (–28.2 to –2.9) –18.4 (–40.6 to –4.5)
nLFP; % 0.5 (–6.7 to 7.1) 2.0 (–5.1 to 11.7)†
nHFP; % 8.9 (0.0 to 25.9) 15.1 (1.3 to 33.1)
LFP/HFP; % –11.2 (–23.3 to 2.1) –9.1 (–31.5 to 3.7)
*Values presented are medians (25-75 percentile).
†P < .05 between normal controls and patients with CAD.
‡P < .05 vs before FR.
§P < .05 vs 30 min after FR.
Abbreviations: CAD, coronary artery disease; RRI, RR intervals; SD RR , standard
deviation of RR; CV RR , coefficient of variation of RR; TP, total power;
VLFP, very low-frequency power; LFP, low-frequency power; HFP, high-frequency
power; nVLFP, normalized very low-frequency power; nLFP, normalized
low-frequency power; nHFP, normalized high-frequency power; LFP/HFP,
low-/high-frequency power ratio.
related to vagal modulation, last longer in patients with CAD than in
the controls. The mechanism responsible for this differential effect
was not clear at present because it was not investigated in this study.
We speculate that the FR-related autonomic nervous effect of increasing
vagal and decreasing sympathovagal balance may be more evident
in those patients who have depressed vagal modulation and
enhanced sympathetic modulation, such as patients with CAD.
Further studies are needed to disclose the underlying mechanism.
Other considerations include that the manipulation of FR on a
participant did not allow him or her to rest uninterruptedly. Thus, a
participant not receiving FR is not a good control to contrast the
effect of FR on that person. If a control is going to be used to contrast
the effect of FR, manipulating some area other than the foot that has
no reflex points on it for the same period of time may be a better
choice than a participant not receiving FR. According to the traditional
Oriental medicine, no area over the whole body can be found
TABLE 6 Effect of Beta-blockers on Heart Rate Variability in the
Control and Coronary Artery Disease (CAD) Groups*
Control Group (n = 17) CAD Group (n = 20)
Without beta-blockers (n = 12)
TP (ms2) 861.6 (696.0-9876.9) 1415.0 (467.0-2036.0)
VLFP (ms2) 312.0 (176.2-406.9) 218.0 (165.3-733.0)
LFP (ms2) 174.5 (158.5-255.1) 382.0 (127.7-641.2)
HFP (ms2) 373.3 (228.2-493.5) 460.5 (194.4-927.8)
nVLFP (nu) 36.0 (24.3-41.9) 31.2 (26.2-37.7)
nLFP (nu) 23.8 (20.2-29.2) 28.2 (26.4-31.3)
nHFP (nu) 42.9 (35.4-48.1) 37.7 (33.2-48.6)
LFP/HFP 0.53 (0.48-0.81) 0.82 (0.52-0.90)
With beta-blockers (n = 25)
TP (ms2) 1083.1 (827.2-2104.0) 962.5 (7484.1-1375.0)
VLFP (ms2) 311.9 (197.5-514.1) 288.4 (173.8-444.4)
LFP (ms2) 337.1 (177.9-413.1) 256.8 (219.4-437.9)
HFP (ms2) 354.1 (318.7-625.3) 480.2 (318.4-546.6)
nVLFP (nu) 33.0 (30.3-41.3) 30.5 (24.1-32.7)
nLFP (nu) 28.3 (21.5-30.1) 28.6 (25.2-32.4)
nHFP (nu) 38.5 (32.6-44.0) 43.2 (35.5-46.2)
LFP/HFP 0.74 (0.59-0.81) 0.65 (0.53-0.82)
*Values presented are medians (25-75 percentile).
Abbreviations: TP, total power; VLFP, very low-frequency power; LFP, lowfrequency
power; HFP, high-frequency power; nVLFP, normalized very lowfrequency
power; nLFP, normalized low-frequency power; nHFP, normalized
high-frequency power; LFP/HFP, low-/high-frequency power ratio.
that can be stimulated by pressure and massage without causing a
physiological response in the body. Therefore, the participant not
receiving FR in either group was not designed as a control to contrast
the effect of FR in this study.
To know the differences in the effects of FR on patients who are
on different medications and the effects of those medications on FR,
we chose to compare the effect of beta-blockers on the HRV measures
in both control and CAD groups. We found that there were no
significant differences in all HRV measures between participants
using or not using beta-blockers in either control or CAD group and
between the control and CAD groups whether they were using betablockers
or not (Table 6). Thus, there are no differences in the effects
of FR on CAD patients whether or not they are on beta-blocker medication,
and the beta-blockers do not significantly influence the effect
of FR on the autonomic nervous modulation of the participants.
In conclusion, a higher vagal modulation, lower sympathetic
modulation, and lower blood pressures can be observed following 60
minutes of FR in both angiographically patent controls and CAD
patients. Though the magnitude of change in the autonomic nervous
modulation of the CAD patients was slightly smaller than that of the
controls, FR is a complementary therapeutic method to allopathic
medical care that is simple and safe for almost everyone. FR requires
very little time and expense, no special equipment, and no medication
and can be performed practically anywhere. Since the mortality
risk due to acute myocardial infarction is lower in patients with higher
vagal modulation and is higher in patients with higher sympathetic
modulation, our research suggests that FR is a safe, low-cost adjunct
Foot Reflexology in Coronary Artery Disease
ALTERNATIVE THERAPIES, jul/aug 2011, VOL. 17, NO. 4 13