Effect of foot reflexology on sleep quality and severity of fatigue in patients with acute myocardial infarction: A double-blind randomized clinical trial

Introduction: Sleep disorders and fatigue are common problems in patients with acute myocardial infarction (AMI) which can lead to an increased incidence of recurrent myocardial infarction and arrhythmias. The aim of this study was to determine the effect of foot reflexology on sleep quality and fatigue severity in the AMI patients. Materials and Methods: In this double-blind randomized clinical trial, 90 AMI patients who had inclusion criteria were evaluated from cardiac care unit of Shahid Rajaee Hospital in Karaj, Iran from 30 may 2015 to 20 August 2016,  and were randomly assigned to 3 groups: Treatment (n=30), placebo (n=30), and control (n=30). Left foot reflexology in the treatment group and right foot reflexology were performed in the placebo group.The control group did not receive any intervention. Foot reflexology intervention was performed for 3 consecutive day’s for 20 minutes. The severity of fatigue was assessed in 3 groups of above, before, immediately and 20 minutes later of intervention by VAS. Sleep quality was assessed by Pittsburgh questionnaires and VAS, the day before and two consecutive days after intervention. Results: The fatigue intensity score of the treatment group immediately after intervention was not significantly different from the control (P=0.233) and placebo groups (P=0.903). Remarkably, the control group was not significantly different from placebo (P=1.00). The fatigue severity score in 20 minutes after intervention was significantly lower than the control group (P=0.003), but did not differ significantly from the placebo group (P=0.355). Also, fatigue severity score of the control group did not differ significantly from the placebo group (P=0.218). Sleep quality with VAS and Pittsburgh on first and second day after intervention wasn’t significantly different in the treatment  groups compared with the control and the placebo groups and in the control group than the placebo group (P>0.05). Conclusion: Findings showed that foot reflex massage 20minutes after intervention induced of significant reduction in fatigue severity in the AMI patients. Therefore, nurses can use this easy, non-pharmacological, non-invasive and low-cost method to improve severity of fatigue.