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Randomized Controlled Trial
. 2025 Jul 28;20(7):e0327865.
doi: 10.1371/journal.pone.0327865. eCollection 2025.

Effect of foot reflexology on chronic pain in Parkinson's disease: A randomized controlled trial

Karel Joineau  1 , Estelle Harroch  2 , Mathilde Boussac  1 , Margherita Fabbri  1   2 , Clémence Leung  2 , Fabienne Ory-Magne  1   2 , Vanessa Rousseau  2   3 , Patrice Peran  1 , Christine Brefel-Courbon  1   2 , Emeline Descamps  1   4
Affiliations
Randomized Controlled Trial

Effect of foot reflexology on chronic pain in Parkinson's disease: A randomized controlled trial

Karel Joineau et al. PLoS One. .

Abstract

Objectives: Effectiveness of Foot Reflexology (FR) on the pain intensity in Parkinson's disease (PD) compared with Sham Massage (SM).

Design: Monocentric, longitudinal, prospective, double-blind, randomized controlled trial. Randomization with a random number generator in the R software. Fixed-sized block randomization of 3 implemented into Clinsight.

Participants: Idiopathic PD patients with chronic pain (Visual Analogue Scale (VAS)≥4) were recruited from the Toulouse University Hospital between the 14th of April 2021 and the 25th of May 2025.

Intervention: Four one-hour long FR or SM sessions three weeks apart with the same specialized FR researcher.

Main outcome measure: Pain intensity change measured by the mean VAS before and after full completed interventions. The difference was compared between group using a Wilcoxon Mann Witney test. Exploratory outcome: brain functional connectivity.

Results: 30 PD patients were randomized and analyzed. Interventions were delivered as planned for all patients. Clinical variables did not significantly differed between FR and SM groups. Mean VAS decreased by -12.3 mm ± 15.2 in FR group (n = 15) and -17.9 mm ± 29.4 in SM group (n = 15). Analyses did not reveal any significant difference between the FR and SM groups (p-value = 0.88). There are different patterns in connectivity changes in the medial pain system between responders (at least 30% pain reduction) and non-responders to both therapies. There were no adverse events.

Conclusion: FR is not more effective than SM in relieving chronic pain in PD. The differences in connectivity patterns within the medial pain pathway may underlie the response to tactile stimulation (FR and SM).

Trial registration: ClinicalTrials.gov NCT04705207.

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Conflict of interest statement

There is no conflicts of interests relevant to this work. Financial Disclosures for the previous 12 months: KJ has nothing to declare. EH received support for attending meetings and/or travel from NHC. MB has nothing to declare. MF declares honoraria from LVL Medical, BIAL, AbbVie, and Orkyn for speaking and from consultancy work unrelated to this research. CL received support for attending meetings and/or travel from AbbVie, Elivie, Mertz, Ipsen, Medtronic, Orkyn, and NHC unrelated to this research. FOM served on boards for AbbVie, Aguettant, Elivie, and Orphalan and carried out consulting activities for Aguettant, Abbvie, Orkyn, and NHC. She received travel grants from AbbVie, all of which were unrelated to this research. VR has nothing to declare. PP has nothing to declare. CBC received a research grant from France Parkinson and fees for lectures and consultancy work for Aguettant, Orkyn, Zambon, NHC, and AbbVie, all of which were unrelated to this research. ED has nothing to declare.

Figures

Fig 1
Fig 1. CONSORT diagram showing the flow of participants through each stage of the DOREPAR randomized trial for the main outcome (change of VAS).
Fig 2
Fig 2. Changes in connectivity of the mPFC among responders and non-responders.
A) 3D representation of the cluster −16–26 + 12 formed of 168 voxels with 97 voxels covering 7% of the left thalamus and 71% covering a non-labelled area. size p-FDR = 0.011661, size p-unc = 0.001014. B) Boxplots of the connectivity between the mPFC and this cluster in responders and non-responders and at each visit. Dark green = responders; green = non-responders.
See this image and copyright information in PMC

References

    1. Beiske AG, Loge JH, Rønningen A, Svensson E. Pain in Parkinson’s disease: Prevalence and characteristics. Pain. 2009;141(1–2):173–7. doi: 10.1016/j.pain.2008.12.004 - DOI - PubMed
    1. Defazio G, Gigante A, Mancino P, Tinazzi M. The epidemiology of pain in Parkinson’s disease. J Neural Transm (Vienna). 2013;120(4):583–6. doi: 10.1007/s00702-012-0915-7 - DOI - PubMed
    1. Negre-Pages L. Douleur et anxiété dans la maladie de Parkinson. Université de Toulouse, Université Toulouse III - Paul Sabatier. 2008. http://thesesups.ups-tlse.fr/367/
    1. Buhmann C, Kassubek J, Jost WH. Management of Pain in Parkinson’s Disease. J Parkinsons Dis. 2020;10(s1):S37–48. doi: 10.3233/JPD-202069 - DOI - PMC - PubMed
    1. Edinoff A, Sathivadivel N, McBride T, Parker A, Okeagu C, Kaye AD. Chronic Pain Treatment Strategies in Parkinson’s Disease. Neurol Int. 2020;12(3):61–76. - PMC - PubMed

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