Effect of Foot Reflexology on Anxiety

Participants aged 18-60 years with a clinical diagnosis of anxiety (DSM-5) are recruited and randomized 1:1 into two groups:

Experimental: standardized foot reflexology protocol targeting reflex points (solar plexus, CNS, pituitary, heart, diaphragm).

Sham comparator: foot manipulation and mobilization (sliding, flexion-extension, rotation, traction) without stimulation of reflex points.

Both interventions last approximately 15 minutes per session, 10 sessions total (twice per week for 5 weeks).

Assessments:

BAI at baseline, after 5 sessions, after 10 sessions, and 30-day follow-up. POMS (Tension-Anxiety subscale) immediately after each session (sessions 1-10). Checklist for adverse events (e.g., redness, pain, tingling, transient discomfort).

Blinding: Participants, care providers, outcome assessors, and statisticians are blinded to group allocation.

Inclusion criteria

• Age between 18 and 60 years.
• Clinical diagnosis of anxiety disorder confirmed by a healthcare professional (physician or psychologist).
• Score ≥ 11 on the Beck Anxiety Inventory (BAI) in the initial assessment.
• Availability to participate in the 10 proposed sessions.
• Signed informed consent.

Exclusion criteria

• Current use of benzodiazepines, antidepressants, or other psychotropic medications initiated less than 3 months ago.
• Associated diagnosis of psychotic disorder, bipolar disorder, or active suicidal ideation.
• Presence of serious or decompensated medical conditions (e.g., severe cardiovascular disease, uncontrolled epilepsy).
• Simultaneous participation in other complementary therapies (e.g., acupuncture, auriculotherapy, yoga, Reiki) during the study period.
• Pregnant or lactating women.
• Individuals with foot injuries, infections, or diseases that prevent foot reflexology.