Effects of plantar reflexology on sleep and quality of life in patients with breast cancer undergoing chemotherapy and hormonal therapies.

Background: In the last decade, several studies have shown the role that integrative therapies (e.g. acupuncture, herbal medicine, body-mind practices) can play to relieve symptoms related to cancer and its mainstream treatment. However, conclusive evidence about the value of Plantar Reflexology (PR) on side effects management in breast cancer patients is still lacking. Methods: Forty-four breast cancer patients, treated at Catholic University Hospital’s Breast Unit, were enrolled and invited to complete the Pittsburgh Sleep Quality Index (PSQI) and the Quality of Life index (QL). Afterward, they were randomized into two groups: 23 patients were treated with 6 weekly sessions of PR (1 hour each) conducted by a specialist (experimental arm), while the other 21 underwent standard medical treatment alone (control arm). At the end of treatment sessions, PSQI and QL were re-administered in both groups. Results: A Multivariate Analysis of Covariance (MANCOVA) was conducted, including the participation to experimental vs. control group as an independent variable, PSQI and QL post-test scores as dependent variables, PSQI and QL pre-test scores and patients’ age as covariates. Results showed that PR improved significantly the quality of sleep [F(1, 39) = 4.94, p < .05)], but no significant effects emerged on the quality of life. A further MANCOVA, conducted on the subscales of the PSQI, showed significant mean differences in sleep disturbances [F(1, 34) = 4.38, p < .05), sleep latency [F(1, 34) = 4.88, p < .05) and sleep quality [F(1, 34) = 6.92, p < .05) in favor of the experimental group. Conclusions: Results suggest that PR may relieve sleep difficulties typically linked to mainstream therapies for breast cancer. No effects of PR emerged for patients’ quality of life, although the small sample tested does not allow to draw any definitive conclusion. These promising results encourage further investigations about the beneficial role of PR. In our initial experience, PR appears as easy, well-tolerated and safe procedure, that can play a role in the management of symptoms that are poorly controlled by conventional pharmacological treatments.