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Comparison Of The Effect Of Reflexologic Massage With Stroke Massage On Blood Oxygen Saturation of
Myocardial Infarction Patients

Medrech

ISSN No. 2394-3971

Original Research Article

COMPARISON OF THE EFFECT OF REFLEXOLOGIC MASSAGE WITH STROKE
MASSAGE ON BLOOD OXYGEN SATURATIONOF MYOCARDIAL INFARCTION
PATIENTS
Parvin Taghizadeh1, HivaAzami1*, Shadi Khakpoor1, Khadije ChaleChale2, Maryam
Janatolmakan2, Fatemeh Rostami3

1. Msc of critical care nursing. Kermanshah University of medical scinces.Imam Reza hospital.
Kermanshah. Iran 2. Msc of medical surgical nursing, Kermanshah University of medical
sciences, Imam Reza hospital. Kermanshah, Iran 3.Bsc of Nursing, Kermanshah University of
medical sciences, Imam Reza hospital. Kermanshah, Iran,

Abstract:
Introduction: Today, in many countries, the massage is used as a complementary therapy to
reduce stress. In this study we evaluate the effect of reflexologic massage in comparison with
stroke massage on physiological parameters of myocardial infarction patients.
Materials and Methods: This clinical trial was performed in 2012 on 105 patients who were
randomly divided into three groups: reflexologic massage, stroke massage and control groups
(each group with 35 patients). In the intervention groups each patient took massages for 15
minutes in morning and afternoon in one day. Vital signs and arterial O2 saturation were
measured before and after the massage by blood pressure cuff, thermometer, and pulse oxymeter.
Paired T test and 2 test were used to analyze data
Results: in stroke massage group, significant differentiation evaluated in oxygen saturation and
with (p =0.002) in morning and afternoon in a day. No significant differences in blood oxygen
saturation were seen in both reflexive massage group and control group.
Conclusion: stroke massages is effective on blood oxygen saturation and its so helpful for this
patients.
Keywords: reflexive massage, stroke massage, SpO2, complementary therapy
Introduction:
and mortality in Iran (2). The environment
Myocardial infarction is the major
of intensive care unit (ICU) is potentially
consequence of coronary heart disease. Its
stressful to patients due to either noises of
Complications and psychological problems
equipment and devices and 24-hour lighting
particularly have been considered (1). The
or lack of significant stimulations such as
incidence of coronary diseases in Iran per
touch and communication [1 and 2]. In such
hundred
thousand
is
181/4
and
an environment, patients not only show
cardiovascular diseases cause 46% of deaths
psychological symptoms of anxiety, but also

Taghizadeh P. et al., Med. Res. Chron., 2015, 3 (1), 102-109

Medico Research Chronicles, 2016

Submitted on: February 2016

Accepted on: February 2016
For Correspondence
Email ID:

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may develop physical problems (3).

Disorientation to time and place which is
highly prevalent in ICU is affected by
factors such as sensory overload or
deprivation.
Sensory
overload
and
deprivation are so severe among intensive
care patients that about 75% of them
experience sensory perception disorders.
Studies showed that the incidence of
disorders such as delusion and hallucination
among intensive care patients, particularly
those undergoing neurosurgeries, is up to
30%40% [35]. Changes in the physiologic
function of the body are associated with
changes in vital signs such as temperature,
heart rate (HR), blood pressure (BP), and
respiratory rate (RR) (6). Normally, vital
signs fluctuate during the day and also
during the courses of health and illness.
Therefore, monitoring and documenting
them at the time of admission can provide a
basis for subsequent comparisons. Using
medications for managing health problems
are usually associated with side effects such
as nausea, vomiting, muscular weakness,
urinary tract infection, venous stasis, and
increased healthcare costs. These side
effects highlight the necessity for using
other therapies for managing stress and
anxiety [13]. Consequently, the use of
complementary therapies is increasing
worldwide. Studies conducted by clinical
nurses in the United States, Canada,
Australia, Britain, and Palestine showed that
68%70% of patients use these therapies.
Complementary therapies include a wide
range of techniques such as soft music,
guided
imagery,
therapeutic
touch,
acupuncture, homeopathy, massage therapy
and so on [1 and 911]. One of the
commonest complementary therapies and
nursing procedures is massage therapy [1

and 7]. The benefits of massage include, but

not limited to, reduced fatigue and anxiety,
whole body and muscular relaxation,
increased endorphin production, better sleep
quality, relief of pain and muscular cramp,
heightened sense of well-being, behavior
reinforcement, and reduced need for
sedation [3, 5, 12, 13, and 15]. In addition,
studies have pointed out that most patients
with coronary artery disease due to lack of
awareness, drug side effects, high cost and
long duration of drug treatment, ignored
using the medication. However, with proper
management and treatment of high blood
pressure we can reduce the risk of stroke by
40% and heart attack by 25 per cent (8).
There are many forms of massage
movements are used on different parts of the
body. Massage stroke is one of these types.
This type of massage first produced by
Elizabeth that in slow motion, light and
elegant palms on the patient's back, moving
at a steady pace for 60 minutes with gentle
pressure for 3 to 10 minutes has been
introduced. This effect is quite intuitive
movement and relaxation in patients is very
beneficial effect (7).Reflexology are also
hundreds of years as a useful treatment in
China, Egypt and India. Reflexology is
based on the principle that energy through
vertical areas throughout the body, circulate
from the feet to the head. So the pressure on
the foot can be a point of reflection on all
organs, including the lymph nodes, bones
and muscles (8-10).This study is to
Comparison the effect of reflexologic
massage with stroke massage on blood
oxygen saturation of myocardial infarction
patients, So if we see a difference in the
interpretation of these two types of massage
on blood oxygen saturation, a more effective
approach to the community Medical

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Comparison Of The Effect Of Reflexologic Massage With Stroke Massage On Blood Oxygen Saturation of
Myocardial Infarction Patients

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introduction and clients benefit from its

advantages.
Methods:
This clinical trial is based on the sample size
in previous studies (5) and sample size
formula for comparison, the average before
and after, On 105 patients with heart failure
at year 2012 was performed. First, patients
randomly divided into three groups by
lottery to three groups: stroke massage,
reflexology and control groups (each group
35 persons), on the basis of purposive
sampling and matched by age and gender
and inclusion criteria. Inclusion criteria
included a diagnosis and hospitalization due
to heart failure, according to the doctor,
complete intelligence and the ability to
communication, lack of fractures, wounds
and skin problems on-site massage. In the
absence of a condition of entry or patient
refusal or continue working with him, death
or discharge samples were excluded from
the study. Patients except conventional
therapy were not under other treatments
such
as
relaxation
therapy
and
psychotherapy. Samples before and after the
intervention,
did
not
receiving
antihypertensive
medications
and
antiarrhythmic
infusion.
Ambient
temperature and the amount of coverage was
the same and none of the samples before and
after the intervention had no fever or
hypothermia. All samples were low-salt diet.
Data
collection
tools
included
a
questionnaire on demographic information,
finger pulse oximeter medical (Rose Mask)
was made in Taiwan. All patients in the
study received medical treatment routine
myocardial infarction, and therapeutic
massage intervention along with their usual
treatment was performed. In the first group,
stroke massage for 15 minutes in the

morning (9-11 hours) and evening (17-19

hour) was conducted, And in the second,
reflexology massage for 15 minutes in the
morning (9-11) and age (17-19) was
performed. In the third group, except for
routine maintenance and measurement of
vital signs, we did not perform massage. The
study was double blind, meaning that the
patient, doctor and massage Executive
colleagues were unaware of the type of
massage. Average indices measured in both
groups of patients before and after the
massage, paired t-test and analysis of
variance with repeated measures by SPSS
version 17 was analyzed. The method was as
stroke massage, hands warm olive oil, and
the man was sitting positions. The masseur
was behind the patient and the put District of
his/her palms and fingers to the patients
occupant, one hand, to the lower body,
parallel to the backbone, with low pressure
and moves the surface to reach the sacral
area. The secondhand, was similarly moved,
and the first hand returns to the starting
point. And this trend continued during the
massage. In reflexology, a reflection of the
heart is in the chest of legs and bottom of the
fourth finger of the left foot. With the right
hand bend the toes, place thumb of left hand
under the soft soles of the feet, straight
down the leg fourth finger, Thumb in a
circular motion, pressing gently reflection
point for seven times. The patient was told
to set up his/her breathing and inspirate
when masseur pushes reflection point and
expirate when the pressure cuts.
Findings:
105 patients with myocardial infarction with
an average age of (60/20 12/07) were
studied. 66 person were male (62/9%) and
39 (37/1%) female. 103 person were married
(98/1%) and 2 were single (1/9%) table

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Comparison Of The Effect Of Reflexologic Massage With Stroke Massage On Blood Oxygen Saturation of
Myocardial Infarction Patients

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Comparison Of The Effect Of Reflexologic Massage With Stroke Massage On Blood Oxygen Saturation of
Myocardial Infarction Patients

number 1. Chi-square test results showed no

significant differences between sex, marital
status, and place of birth, occupation, and
education level, type of heart attack, history
of smoking and history of hospitalization.
This means that these three groups did not
differ in terms of these variables. Analysis
(ANOVA) showed that the average age,
income, number of days of hospitalization,
the number of smokers were not
significantly different among the three
groups. This means that the three groups
were similar in terms of the variables that
mentioned. The results show that in stroke
massage group average arterial oxygen
saturation was increased in both the morning

and evening (p= 0/002). Significant

differences in arterial oxygen before and
after the massage stroke was observed in the
afternoon. There was no significant
difference
between
arterial
oxygen
saturation values before and after reflexive
massage in both morning and evening, Table
number 2. By comparing the average arterial
oxygen in this study, we see the better effect
of stroke massage on the mean arterial
oxygen than reflexive massage. In the
control group that only routine interactions
was done, no significant difference was
found between mean arterial oxygen of the
patient.

Table 1: Demographic information

Place of
birth
Massage
history
Anxiety
history

Yes

39

Percent
31/4
21/9
46/7
6/7
93/2
36/2
63/8

Type of
myocardial
infarction

Address
Admission
Marriage
status

37/1

gender

Cigarette
history

Variable

No

66

62/9

Yes
No
Inferior
Anterior
Antroseptal
Extensive
Without ST
elevation

38
67
33
28
22
4

36/2
63/8
31/4
26/7
21
3/8

6/7

Underlying
disease

Job

City
Town ship
village
Yes
No
Married
Single
Hypertensio
n
Diabetes
Hyper
lipidemia
Employee
Unemployed
housewife
Farmer
Free job

Taghizadeh P. et al., Med. Res. Chron., 2015, 3 (1), 102-109

Freque
-ncy
63
16
26
77
28
2
103

Percent
60
15/2
24/8
73/3
26/7
1/9
98/1

58

55/2

35

33/4

43

40/9

28
9
40
8
20

26/7
8/6
38/1
7/6
19

Medico Research Chronicles, 2016

City
Town ship
village
Yes
no
Yes
No

Frequ
-ency
33
23
49
7
98
38
67

Variable

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Comparison Of The Effect Of Reflexologic Massage With Stroke Massage On Blood Oxygen Saturation of
Myocardial Infarction Patients

Posterior
Un stable

5
6

4/8
5/7

Table 2: Comparing the average arterial oxygen level before and after the morning and evening
in groups reflexology and stroke
Type of
Pair T
variable
Time
Mean (SD)
P value
massage
test
Before morning
93/342 2/667
massage
-3.335
0/002
After morning
Arterial
95 2/786
Stroke
massage
blood
massage
Before evening
oxygen
94/228 2/197
massage
-3/417
0/002

Reflexive
massage

Arterial
blood
oxygen

Before morning
massage
After morning
massage
Before evening
massage
After evening massage

Discussion:
Patients who were admitted in ICU due the
nature of the ICU, as well as many voices as
possible Disassemble the physiological
rhythms such as sleep and exposed them to a
variety of physical and mental stress, and
disorder in the patient's hemodynamic and
respiratory status occurs (20-25). The
important role of nurses in this ward is to
moderating these stressful factors. There are
different methods for this, one of which is
used complementary medicine such as foot
massage these patients(19 and 26-27).The
study results showed that massage stroke
caused by a significant increase in mean
arterial blood oxygen (after massage
morning and evening) that consistent with
Khost and partners results(16). In the study,
Rahmani Anaraki also proved to be the case,
and then the SpO2 increased during massage

95/285 2/538
93/971 3/082
-0/134

0/894

-1/09

0/284

94/028 3/157
94/80 2/482
95/20 2/773

(28). Jassvir and colleagues in a study in

which short-term impact of foot massage on
patients in intensive care units that evaluates
physiological parameters, Found that foot
massage increase the SpO2 in his study with
(P=0.001) (28). Azami and colleague in his
study Short-term Effect of Foot Massage on
the Values of Arterial Oxygen Saturation in
Neurosurgical Patients Admitted to ICU
found that five minute foot massage could
increase SpO2 in neurosurgical patients
admitted to ICU with (P=0.001) (27).There
was no significant difference in reflexology
in the arterial blood oxygen saturation in
four innings. The studies in this regard by
Jones (23), Albert (24), Sherme M. (8) and
hogost are consistent and inconsistent with
Padyal studies (14) and Lu et al (25). The
mean arterial oxygen saturation in stroke

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After evening massage

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compared to reflexology massage is further

improved.
Conclusion:
Overall, our results show that reflexology
massage and stroke has a beneficial effect
on physiological parameters, but the extent
of this impact is more evident in the
massage stroke that may be due to a general
effect on the whole body massage stroke.
Acknowledgments:
Its necessary to respect and gratitude the
staff of post CCU Hospital Imam Ali (AS)
and Imam Reza (AS) Kermanshah.
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Myocardial Infarction Patients

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