Tag Archives: reflexology

‘More junk getting through to the keeper*’

The whole idea of the peer review process prior to publication is to weed out the junk, so it does not get published. One thing that the alternative therapies have in common is that their journals let a lot of junk science through. Too many studies get published in those journals that should never see the light of day, let alone been conducted so badly in the first place. There are ethical issues at stake in this and the editors of those journals would do well to apprise themselves of publication ethics. Institutional ethics committees or review boards also have a responsibility to prevent bad science from even getting off the ground.

What spurred that little rant was this publication today on ‘The effect of reflexology on the quality of life with breast cancer patients‘ published in the journal, Complementary Therapies in Clinical Practice. They do not get much worse than this one.

It was a study that supposedly randomized 60 people with breast cancer into two groups; one group the control and one group getting reflexology; the aim being to see how it affected their quality of life and symptoms. Sounds good on the surface, but:

They ended up with exactly 30 in each group and reading what they did, they did not randomise – even though they said they did! They just allocated them to different groups depending on the day of the week. The assumption of the statistical tests used are that proper randomization is used. Epic Fail. How can the reviewers and editor not see that randomisation did not take place? Regardless of the results of the study, stop there as without proper randomisation the results are meaningless and can not be trusted. As the study was approved by the “Ethical Committee of the Health Science Institute¬†of Ataturk University”, then that ethics committee needs to look at its decision-making process, as all the work that went into this study and the voluntary participation of the participants was wasted.

I have already blogged about reflexology studies almost always ending up with the exact same number in each group when they are supposed to be randomised and this study just confirms that problem.

And while we could stop there as the data can not be trusted, they then went on and did 38 within groups t-tests! Seriously? DId the authors, peer reviewers and editor of the journal not see an alarm bell go of with that?

  • it was a within groups analysis rather than a between groups analysis
  • do that many t-tests, just by chance you will get a statistically significant result
  • no hints of a Bonferroni correction because of the multiple tests.

The author’s conclusion of¬†Reflexology was found to reduce the symptoms experienced by breast cancer patients, while at the same time increasing the functional and general health status simply can not be supported by the data from this study … yet it still made it through to the keeper.

Having said that, a damn good foot massage will probably make anyone with a chronic illness feel better; it is that, that is NOT reflexology and that is NOT supported by the results of this study.

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*for those not familiar with the metaphor: “through to the keeper”; it comes from cricket when the batsman does not even attempt to play at the ball and lets it pass through to the wicket keeper unchallenged.


Craig Payne
University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger, dad. Follow me on Twitter, Facebook and Google+

Reflexology Clinical Trials

Reflexology is just made up mythology. There is no known physiological link between parts of the foot and organ systems in the body, let alone any involvement in these disease processes. Every single meta-analysis and systematic review of all the clinical trials of it have concluded the same thing: it does not work. It is no better than a placebo. The only clinical trials that show it works are in low quality, low or no impact factor journals and have serious methodological flaws. The most common methodological flaw is the lack of a control group. Most of those studies were not even on reflexology, but were on nothing more than a damn good foot massage. Everyone, regardless of what medical condition they have is probably going to feel better after a damn good foot massage!

Over on Podiatry Arena, there is a thread: Reflexology is not an effective treatment for any medical condition that started over 7 years ago and continues to be added to with more research and reading it you can see the obvious issues with the overall poor quality of research on reflexology that claims it works. None of the studies that are of high quality show that it works. That pattern is so typical and so familiar to anyone who follows the pseudosciences.

One thing that i did start to notice in that thread and commented on several times is that the number of times that a clinical trial on reflexology (and you see the same pattern in other alternative and complementary medicine studies) is the authors claim that they used randomization of the subjects to the different groups, yet they end up with the exact same number in each group. Randomization is the cornerstone of the randomized controlled trial as it is how you ensure that the subjects in each group are nearly identical in characteristics.

When you randomize subjects to different groups, you almost never get the same number in each group. Very occasionally you do (by random chance). Just pick up any selection of high quality journals and look at the randomized trials in them and you will almost never see one in which the numbers in each group are the same.

Now have a look at that thread on Podiatry Arena (all 6 pages of it). Its is amazing how many clinical trials that claimed that they used randomization end up with the exact same number in each group. You see the same pattern in a lot of clinical trials on alternative medicine topics. One can only conclude that the researchers did not do what they claim they did. They did not randomize them and used some other method of allocation to the groups, which further undermines the credibility of clinical trials on reflexology. Fail.

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Craig Payne
University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger, dad. Follow me on Twitter, Facebook and Google+