{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:50:30Z","timestamp":1791183030048,"version":"4.1.0"},"reference-count":73,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"vor","delay-in-days":258,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taoyuan Armed Forces General Hospital","award":["TYAFGH\u2212E\u2212109056"],"award-info":[{"award-number":["TYAFGH\u2212E\u2212109056"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evidence-Based Complementary and Alternative Medicine"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p><jats:italic>Objectives<\/jats:italic>. The aim of this study was to conduct a systematic review, meta\u2010analysis, and metaregression to determine the current best available evidence of the efficacy and safety of foot reflexology for adult depression, anxiety, and sleep quality. <jats:italic>Methods<\/jats:italic>. Electronic databases (PubMed, ClinicalKey, ScienceDirect, EMBASE, PsycINFO, and the Cochrane Library) were searched till August, 10, 2020, and the validity of the eligible studies was critically appraised. Randomized controlled trials comparing foot reflexology groups with control groups for adult depression, anxiety, and sleep quality were included. Twenty\u2010six eligible studies were included to assess the effect of foot reflexology intervention on the reducing symptoms of depression and anxiety and improving quality of sleep, respectively, as the primary outcome. <jats:italic>Results<\/jats:italic>. Twenty\u2010six randomized controlled trials involving 2,366 participants met the inclusion criteria. The meta\u2010analyses showed that foot reflexology intervention significantly improved adult depression (Hedges\u2019 <jats:italic>g<\/jats:italic>\u2009=\u2009\u22120.921; 95% CI: \u22121.246 to \u22120.595; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), anxiety (Hedges\u2019 <jats:italic>g<\/jats:italic>\u2009=\u2009\u22121.237; 95% CI \u22121.682 to \u22120.791; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and sleep quality (Hedges\u2019 <jats:italic>g<\/jats:italic>\u2009=\u2009\u22121.665; 95% CI \u22122.361 to \u22120.970; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Metaregression reveals that an increase in total foot reflexology time (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) and duration (<jats:italic>P<\/jats:italic>\u2009=\u20090.01) can significantly improve sleep quality. <jats:italic>Conclusions<\/jats:italic>. Foot reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance. However, high quality and rigorous design RCTs in specific population, along with an increase in participants, and a long\u2010term follow\u2010up are recommended in the future.<\/jats:p>","DOI":"10.1155\/2020\/2654353","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T23:31:53Z","timestamp":1600212713000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Effect of Foot Reflexology Intervention on Depression, Anxiety, and Sleep Quality in Adults: A Meta\u2010Analysis and Metaregression of Randomized Controlled Trials"],"prefix":"10.1155","volume":"2020","author":[{"given":"Wei-Li","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-Yuan","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Ren","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuang-Huei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szu-Nian","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Ming","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-1385","authenticated-orcid":false,"given":"Yuan-Yu","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.4040\/jkan.2006.36.1.179"},{"key":"e_1_2_10_2_2","volume-title":"Reflexology for Hands and Feet","author":"Evyapan T.","year":"2012"},{"key":"e_1_2_10_3_2","first-page":"71","article-title":"Complementary and alternative therapies in nursing: reflexology","volume":"29","author":"Cevik K.","year":"2015","journal-title":"International Journal of Nursing"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcme.2016.08.008"},{"key":"e_1_2_10_5_2","first-page":"32","article-title":"The effect of reflexology on the autonomic nervous system in healthy adults: a feasibility study","volume":"17","author":"Hughes C. 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