Is it possible to foot reflexology for infants with sensorineural hearing loss?

Abstract

Foot reflexology is a non-invasive and safe complementary therapy that works by massaging the reflex zones of the feet and exerts systemic or whole-body regulation through meridian nerve conduction. This therapy is commonly used in the treatment of various conditions such as autism and Parkinson's disease. However, there is limited reporting on the use of foot reflexology therapy for infants with sensorineural hearing loss (SNHL). Currently, there is no definitive conclusion on how foot reflexology therapy can influence hearing. This editorial holds some guiding significance regarding this clinical issue. The aim is to present physiological evidence of how foot reflexology therapy can impact infants with SNHL, thereby enhancing clinician’s awareness of foot reflexology in treating infants with SNHL.

Key Words: Foot reflexology; Sensorineural Hearing Loss; Future perspectives; Limitations; Neural conduction

Core Tip: In this editorial, we have reviewed the case report by Lee et al. According to the authors, the purpose of presenting this case is to draw attention to the therapeutic effects and physiological evidence of foot reflexology in infants with sensorineural hearing loss (SNHL). While there is an increasing body of research and reports on the use of foot reflexology for pain relief, anxiety, and fatigue, this editorial article specifically focuses on the significance of foot reflexology in treating infants with SNHL.

INTRODUCTION

Definition of sensorineural hearing loss

Sensorineural hearing loss (SNHL) is a type of hearing impairment with an estimated prevalence of approximately 1-3 per 1000 live births[1]. The etiology of SNHL is still a matter of debate. It may be caused by abnormalities in the auditory nerve, neural pathways, cochlea, or central connections to the auditory cortex. Early detection and intervention during infancy and childhood are crucial as this period is optimal for auditory and speech development. Failure to timely identify and intervene can result in irreversible effects on a child's auditory and language abilities, leading to language disorders, physical disabilities, and intellectual impairments. In clinical practice, SNHL can be managed to some extent through drug therapy, hearing aids, and cochlear implants. However, these methods have certain limitations and cannot fundamentally solve the problem of hearing impairment. Therefore, exploring effective methods for treating SNHL in clinical settings is currently an urgent task.

Basic principles of foot reflexology

Foot reflexology therapy, based on the principle of neural reflex, exerts a systemic or whole-body regulatory effect on internal organs, making it a widely accepted low-cost, non-invasive intervention globally. According to the theory of foot reflexology, specific areas on the feet correspond to various organs and tissues in the body. By massaging these areas, it is possible to improve the function of the related organs, promote balance, and enhance overall health[2]. However, it is important to note that the efficacy and significance of foot reflexology therapy remain subject to debate. Most clinical studies have found that foot reflexology therapy can effectively alleviate pain, including postoperative pain[3], acute pain in infants[4], and pain from organ removal or transplant procedures[5]. Furthermore, foot reflexology therapy holds promise in addressing chronic visceral diseases, rheumatism[6], and other neurological and psychological conditions in humans such as depression[7,8].

Current status of the application of foot reflexology

In the early 20^th century, the concept of reflexology was introduced to the United States and Europe[9]. Reflexology was believed to help alleviate stress, reduce pain, improve blood circulation, and restore the psychological balance of the body[2]. Karatas et al[4] intervened in 45 infants with infantile colic through a randomized controlled trial, using data such as information sheets, infantile colic scale, and daily crying duration, and the results showed that the mean of infantile colic scale score and daily crying duration in the foot reflexology group was significantly lower than that in the placebo foot reflexology group. Additionally, Sayari et al[6] conducted a random sample of 90 patients with acute myocardial infarction and assessed chest pain and anxiety with a visual analogue scale through foot reflexology for three consecutive days, and the outcome revealed that the severity of chest pain in the treatment group was remarkably lower than that in the control group 20 minutes after the intervention, proving that foot reflexology was effective in relieving chest pain in patients with acute myocardial infarction. Despite its widespread application worldwide and several clinical studies demonstrating positive effects, the exact mechanism of its clinical effectiveness remains unclear. Furthermore, the physiological basis of reflexology is not fully understood.

Wattanaruangkowit et al[10] investigated the mechanism of foot reflexology therapy for smoking cessation by functional magnetic resonance imaging (fMRI). The results demonstrated that the activation signals extended beyond the respective motor and sensory cortices to include the contralateral frontal, parietal, occipital, and temporal cortices, as well as the thalamus. This indicates that foot reflexology therapy has a positive impact on brain function.

The application of reflexology in SNHL

Lee et al[11] have made commendable contributions by reporting a case of a 3-month-old infant with SNHL who underwent nine months of foot reflexology therapy. The foot treatment enhanced the activation of central language brain networks, such as the superior frontal gyrus, inferior frontal gyrus, and middle temporal cortex. The research findings suggest that foot stimulation helps improve pre-sound processing, phoneme analysis, and speech processing. To our knowledge, this is the first report providing physiological evidence of the impact of foot therapy on infants with SNHL. They have successfully sparked further consideration and exploration of using foot reflexology in the treatment of SNHL.

Unal et al[12] found through electroencephalography that foot reflexology therapy activates the beta and gamma waves in the frontal cortex of healthy individuals. Descamps et al[13] assessed the impact of foot reflexology therapy on the brain using resting-state fMRI. The study confirmed a correlation between cortical activity in the somatosensory regions and sensory stimulation of the foot reflexology area as observed through fMRI. These findings from functional neuroimaging studies have the potential to contribute to the understanding of the underlying mechanisms of foot reflexology therapy's therapeutic effects.

This is the first report to provide physiological evidence for foot reflexology treatment in infants with SNHL. Foot reflexology therapy for the treatment of hearing disorders is also gradually gaining attention. Therefore, it is necessary to further promote the application of foot reflexology in the treatment of SNHL infants in the future, to verify the efficacy of foot reflexology and develop new treatment methods for SNHL infants in the clinic.

LIMITATIONS AND FUTURE PROSPECTS

However, the study by Lee et al[11] has some limitations, such as the small sample size, the absence of a control group, and potential confounding factors (e.g., medications) during the reflexology treatment period. In the future, it is recommended that a prospective randomized controlled trial be conducted to compare the effectiveness of foot reflexology with sham interventions in infants with SNHL.

CONCLUSION

In conclusion, to improve the acceptance of clinical foot reflexology, it is necessary to report on the mechanisms of the corresponding foot reflexology treatments and to carry out a large number of prospective clinical studies to test their clinical significance in the treatment of infants with sensorineural hearing loss.