Hemodynamic Changes and Anxiety-Related Outcomes Following Hand Reflexology in Patients with Acute Myocardial Infarction: A Randomized Controlled Trial

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Acute myocardial infarction (n=88). Intervention: Hand reflexology vs. Usual care. Primary outcome: Post-intervention systolic blood pressure (mmHg) (p=0.045 (within-group reflexology); 0.285 (within-group control)).

Yahia Falih Mohammad; Mohammed Ghalib Abdul-Hussein; Hadeer Naeem Abdul-Hussein; Wael Salim Lahmood Al-Naieli; Zainab Jaafar Shanshool; Bahaa Mirza Skal

doi:10.61838/ijbmc.v13i11.1574

November 1, 2026International journal of body, mind and cultureOpen Access

Hemodynamic Changes and Anxiety-Related Outcomes Following Hand Reflexology in Patients with Acute Myocardial Infarction: A Randomized Controlled Trial

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Key result

Hand reflexology is linked to a ~1-mmHg within-group reduction in systolic blood pressure.

P=0.045 (within-group reflexology); 0.285 (within-group control)
n=88

Why the study?

The hemodynamic changes and anxiety-related outcomes following hand reflexology in patients with acute myocardial infarction were examined.

Does hand reflexology improve hemodynamic parameters and reduce anxiety in hospitalized patients with acute myocardial infarction compared to usual care?

Key Points

To examine hemodynamic changes and anxiety-related outcomes following hand reflexology among patients hospitalized with acute myocardial infarction.
Parallel-group randomized controlled trial conducted at Al-Diwaniya Teaching Hospital in Iraq with 88 patients assigned to hand reflexology (n = 47) or usual care (n = 41).
Intervention comprised 15-minute hand reflexology sessions administered across three consecutive days.
Outcomes included pre- and post-intervention systolic blood pressure, diastolic blood pressure, heart rate, peripheral oxygen saturation, and anxiety-related scores assessed via Wilcoxon signed-rank and paired t tests.
Within the reflexology group, systolic blood pressure decreased from 134.91 to 133.49 mmHg (p = .045), diastolic pressure from 81.92 to 80.79 mmHg (p = .010), heart rate from 78.34 to 71.75 beats/min (p = .003), and oxygen saturation increased from 95.77% to 96.48% (p = .041).
Control-group within-group changes were nonsignificant for systolic blood pressure (141.30 to 138.24 mmHg, p = .285), diastolic blood pressure (84.36 to 82.58 mmHg, p = .262), heart rate (75.64 to 73.67 beats/min, p = .182), and oxygen saturation (95.39% to 96.82%, p = .301).
Anxiety-related scores increased from 2.5552 to 2.6371 in the reflexology arm (p = .024), but scoring direction was undefined, and no direct between-group comparative effect sizes were calculated.

Study Design

Type

RCT (n=88)

Randomization

Parallel-group using sealed envelopes containing color codes

Multicenter

No

Structured PICO

Does hand reflexology improve hemodynamic parameters and reduce anxiety in hospitalized patients with acute myocardial infarction compared to usual care?

P

Population

88 patients (mean age ~57 years, 28.4% female) with acute myocardial infarction hospitalized in a single coronary care unit in Iraq, without resuscitation-requiring complications or bradycardia (<60 beats/min), followed over 3 consecutive days.

I

Intervention

Hand reflexology comprising 15-minute sessions on each of 3 consecutive days (beginning with ~5 minutes of gentle warming massage of the hands including gliding strokes and light kneading, followed by moderate, comfort-adjusted thumb-walking pressure to palmar areas labeled solar plexus, pituitary, heart, and hip-joint reflex areas for ~2 minutes per area).

C

Comparator

Usual hospital medical and nursing care (including vital-sign monitoring, rest, and hygiene assistance) without reflexology.

O

Outcome

Pretest-posttest hemodynamic parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate, and peripheral oxygen saturation [SpO2]) and anxiety-related scores (assessed using the State-Trait Anxiety Inventory [STAI]) measured before and approximately 15 minutes after intervention across 3 days.surrogate

Main Result

Absolute Event Rate: 133.49% vs 138.24%

p-value: p=0.045 (within-group reflexology); 0.285 (within-group control)

Although within-group hemodynamic changes were observed after hand reflexology in patients with acute myocardial infarction, the lack of between-group statistical comparisons and unresolved anxiety scoring inconsistencies prevent establishing clinical efficacy over usual care.

Limitations

Single-center sample limiting generalizability
Incomplete documentation of sequence generation and allocation concealment
Blinding, practitioner training, concurrent medication changes, and adherence were not sufficiently characterized
No sham-touch or attention-matched control group to isolate specific reflexology effects
Absence of between-group treatment-effect estimates and confidence intervals
Undefined State-Trait Anxiety Inventory (STAI) subscale aggregation and scoring direction
Internal statistical inconsistencies in age summaries, anxiety control group denominators, and exploratory analyses
No between-group treatment-effect estimates or baseline-adjusted comparisons were reported, relying only on within-group tests.
Single-center sample with incomplete documentation of allocation concealment, sequence generation, blinding, and concurrent medication changes.
Lack of sham-touch or attention-matched control group to distinguish specific reflexology effects from rest, touch, and interpersonal attention.
Internal inconsistencies in data reporting, including incompatible age summaries and standard deviations, overlapping age bands, and an uncertain control denominator for anxiety (n=40 vs 41).
Undefined STAI subscale usage, item aggregation, and score direction, preventing reliable interpretation of anxiety changes.

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Answers are grounded in this paper and cite their sources.

Implication

Hand reflexology lacks demonstrated superiority to usual care in acute MI; leaves open its hemodynamic effects pending between-group data.

Abstract

Objective: This study examined hemodynamic changes and anxiety-related outcomes following hand reflexology among patients with acute myocardial infarction. Methods and Materials: A parallel-group randomized trial was conducted at Al-Diwaniya Teaching Hospital, Iraq. Of 104 patients assessed, 88 were allocated to hand reflexology (n = 47) or usual care (n = 41). Reflexology comprised 15-minute sessions on three consecutive days. Systolic and diastolic blood pressure, heart rate, oxygen saturation, and anxiety-related scores were assessed before and after intervention. Within-group differences were analyzed using Wilcoxon signed-rank and paired t tests. Findings: In the reflexology group, systolic blood pressure decreased from 134.91 to 133.49 mmHg (p = .045), diastolic pressure from 81.92 to 80.79 mmHg (p = .010), and heart rate from 78.34 to 71.75 beats/min (p = .003). Oxygen saturation increased from 95.77% to 96.48% (p = .041). Corresponding within-group changes in controls were nonsignificant (all p > .05). Anxiety-related scores increased from 2.5552 to 2.6371 in the intervention group (reported p = .024), although scoring direction was unclear. No between-group treatment-effect estimates were reported. Conclusion: Hand reflexology was associated with within-group hemodynamic changes, but comparative efficacy and anxiety reduction remain unestablished. Verified scoring and direct between-group analyses are required.

Discussion

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Cite This Study

Mohammad et al. (2026) conducted an RCT in Acute myocardial infarction (n=88). Hand reflexology vs. Usual care was evaluated on Post-intervention systolic blood pressure (mmHg) (p=0.045 (within-group reflexology); 0.285 (within-group control)). Hand reflexology was associated with within-group decreases in systolic blood pressure (134.91 to 133.49 mmHg, p=0.045) and heart rate (78.34 to 71.75 bpm, p=0.003), without between-group comparisons.

synapsesocial.com/papers/6aebc8cf3e63ca1b6c315ebc https://doi.org/10.61838/ijbmc.v13i11.1574

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Hemodynamic Changes and Anxiety-Related Outcomes Following Hand Reflexology in Patients with Acute Myocardial Infarction: A Randomized Controlled Trial

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Hemodynamic Changes and Anxiety-Related Outcomes Following Hand Reflexology in Patients with Acute Myocardial Infarction: A Randomized Controlled Trial

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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