The Effect of Foot Reflexology in Women With Migraine

The Effect of Foot Reflexology on Pain, Anxiety, Kinesiophobia, and Postural Control in Women With Migraine

This prospective randomized controlled study aims to investigate the effects of foot massage on pain, anxiety, kinesiophobia, and postural control in women aged 18-45 years diagnosed with migraine who attend the Neurology Outpatient Clinic of Karabük University Karabük Training and Research Hospital. Participants who meet the inclusion and exclusion criteria will be randomly allocated into either a foot massage group or a control group using a simple randomization method. The foot massage group will receive a total of 10 sessions of foot massage over 5 weeks, with two sessions per week, while no massage intervention will be applied to the control group. All participants will be assessed at baseline, immediately after the intervention period, and two weeks following the completion of treatment. The findings of this study are expected to provide evidence regarding the effectiveness of foot massage in the management of symptoms in women with migraine.

Study Overview

• Status: Not yet recruiting
• Conditions: Pain; Migraine; Anxiety; Kinesiophobia; Postural Control; Reflexology
• Intervention / Treatment: Procedure: foot reflexology

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Nurcan Contarli, Doctor; Phone Number: +90370 418 9171; Email: nurcancontarli@karabuk.edu.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being a woman between the ages of 18 and 45
• Having been diagnosed with migraine by a neurologist according to the International Headache Society (IHS) criteria
• Volunteering to participate in the study
• Being literate
• Not having entered menopause

Exclusion Criteria:

• Having any neurological disease other than migraine
• Having a psychiatric illness
• Smoking
• Having a musculoskeletal disease affecting the head and neck area
• Having a history of cervical or cranial surgery
• Having irritation or ulceration in the skin area to be massaged
• Receiving migraine treatment other than pharmacological treatment (acupuncture, dry needling, cupping, etc.)
• Having diabetic foot
• Having open wounds on the foot
• Pregnant individuals or individuals who become pregnant during the study period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: control group; The control group will not receive any foot reflexology therapy or other treatment intervention.
Experimental: Migraine group; Before starting foot reflexology treatment, patients will be informed about the treatment process. The treatment will be performed by a physiotherapist twice a week, with each session lasting 30 minutes, for a total of 10 sessions.	Procedure: foot reflexology; Before the treatment program begins, participants will be informed about the treatment procedure. The intervention will be administered by a physiotherapist certified as a Reflexology Practitioner, who has received formal training in reflexology. The treatment will consist of 10 sessions delivered over 5 weeks, with two 30-minute sessions per week. Each session will begin with several passive ankle movements to promote relaxation of the foot and ankle region. Reflexology treatment will be applied first to the right foot and then to the left foot. Target areas on the right foot: Brain, pineal gland, pituitary gland, hypothalamus and thalamus, temples, eye region and optic nerve, ear region, middle ear and balance point, and neck. Additional areas treated on the right foot: Thyroid and parathyroid glands, lungs, liver, facial region, speech center, thymus gland, teeth, diaphragm, vertebral column, and extremities. Areas treated on the left foot: Kidneys, diaphragm, intestines, n

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Headache Impact Test (HIT-6)	The Headache Impact Test (HIT-6) is a self-report questionnaire designed to assess the impact of headache on quality of life. In 2021, Dikmen et al. conducted a study on the reliability and validity of the Turkish version of the Headache Impact Test (HIT-6) in migraine patients. The test items assess areas such as vitality, pain, and psychological distress, as well as sociability, role, and cognitive functioning. Three of the six items specifically address the previous four weeks, while the remaining three items do not have a defined time frame. Each item is answered using a 5-point Likert scale (6=never, 8=rarely, 10=sometimes, 11=very often, 13=always). The final score is calculated by summing the scores from all six items, ranging from 36 to 78 points. Impact is categorized on a scale of ≤49 points (very little or no impact), 50-55 points (some impact), 56-59 points (significant impact), and ≥60 points (strong impact), with higher scores indicating a greater impact.	2 days
Migraine Disability Assessment Scale	The Migraine Disability Assessment Scale was used to measure the impact of migraine on a patient's life. This scale, consisting of 5 questions and 4 disability levels from I to IV (no or little disability, moderate, severe disability), was completed by patients during assessments one week before the injection, and during assessments 4 weeks (+7 days) and 12 weeks (+7 days) after the injection. Patients were asked questions about their work/school activities. The total score ranged from 0 to 27. Scores of 0-5 were classified as Level I, 6-10 as Level II, 11-20 as Level III, and scores above 21 as Level IV.	2 days
International Physical Activity Questionnaire-Short Form	The International Physical Activity Questionnaire - Short Form is a reliable and valid self-report questionnaire developed to assess individuals' levels of physical activity. Recommended by the World Health Organization, this tool is widely used, particularly in epidemiological studies. The seven-question questionnaire provides information on time spent walking, moderate-to-vigorous, and vigorous activities. Time spent sitting is assessed as a separate question. Scoring involves summing the duration (minutes) and frequency (days) of walking, moderate-to-vigorous activity, and vigorous activity. A score of "MET-minutes" is obtained from these calculations. One MET-minute is calculated by multiplying the number of minutes spent on the activity by the MET score.	2 days
Beck Anxiety Scale	The Beck Anxiety Scale (BAS) was developed to measure characteristic anxiety and worry symptoms in patients. This 21-item scale, with scores ranging from 0 to 63 (higher scores indicating severe anxiety), was completed by patients during assessments one week before the injection, and again four weeks (+7 days) and twelve weeks (+7 days) after the injection. The control group completed the scale once. For each item, patients selected one of the following options: 0 = none, 1 = mild, 2 = moderate, and 3 = severe, resulting in a total score ranging from 0 to 63. Scores of 0-7 were considered normal, 8-15 mild, 16-25 moderate, and 26-63 severe.	2 days
Assessment of postural control	Postural balance will be assessed using a device that measures body sway by sensing foot pressure. The platform on the device detects body sways. The platform consists of a hard surface, but a soft surface can be achieved by placing a foam cushion on it. The platform must be placed on a flat surface so that it does not move. Through the platform, the individual's center of pressure is visualized, and oscillations occurring in the anteroposterior (AP) and mediolateral (ML) directions can be monitored. Changes occurring on the platform are displayed on a computer screen using Bertec Workbook software.	2 days
Tampa Kinesiophobia Scale	The Tampa Kinesiophobia Scale (TMS) is a self-report scale developed to assess individuals' levels of avoidance of movement due to fear of pain or re-injury. Kinesiophobia is a significant psychological factor, particularly prevalent in individuals with chronic pain, and can lead to functional limitations by restricting participation in physical activity. The TMS consists of 17 items and is scored using a 4-point Likert scale; higher scores indicate a high level of fear of movement. The Turkish validity and reliability study was conducted by Yılmaz et al., and the scale is widely used in clinical and research settings.	2 days

Collaborators and Investigators

• Sponsor: Karabuk University

Study record dates

Study Major Dates

• Study Start (Estimated): June 18, 2026
• Primary Completion (Estimated): July 28, 2026
• Study Completion (Estimated): July 30, 2026

Study Registration Dates

• First Submitted: June 10, 2026
• First Submitted That Met QC Criteria: June 11, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 16, 2026
• Last Update Submitted That Met QC Criteria: June 11, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Mental Disorders; Headache Disorders, Primary; Headache Disorders; Phobic Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Kinesiophobia; Pain; Anxiety Disorders; Migraine Disorders
• Other Study ID Numbers: KBU-FTR-NC-10

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data are available from the corresponding author on reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No