FR-taVNS Tinnitus Tria

July 13, 2026 updated by: Chun Hou Huang, Tzu Chi University

Efficacy of Foot Reflexology and Transcutaneous Auricular Vagus Nerve Stimulation on Tinnitus in Non-Cancer Adult Populations

Tinnitus is a common neurosensory symptom affecting 12-30% of adults and is closely associated with anxiety, sleep disturbance, and autonomic dysregulation. Current pharmacologic treatments offer limited efficacy and notable side effects, prompting interest in non-pharmacological approaches. This randomized, single-blind, sham-controlled trial evaluates whether foot reflexology (FR), transcutaneous auricular vagus nerve stimulation (ta-VNS), and auricular acupressure (AA) improve tinnitus severity, psychological distress, sleep quality, and autonomic indicators (heart rate variability and salivary cortisol) in non-cancer adults with tinnitus, compared with usual care. Participants are randomized to a foot reflexology group, an auricular vagus nerve stimulation group (each with true and sham subgroups), or a usual-care control group, and are followed at baseline and weeks 2, 4, and 8.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This is a three-arm parallel, repeated-measures randomized controlled trial conducted in the otolaryngology outpatient and inpatient settings of Hualien Tzu Chi Hospital. Eligible non-cancer adults with tinnitus as the sole chief complaint and normal pure-tone thresholds are stratified by age and sex, then randomized by computer-generated random number tables to the FR group, the ta-VNS group, or the usual-care control group; the FR and ta-VNS groups are further randomized to true or sham subgroups. The foot reflexology intervention is delivered once weekly for 20 minutes over four sessions (one month) and comprises a relaxation phase, an inner-ear/autonomic regulation phase, and a circulation/detoxification phase; the sham condition applies light, non-specific touch. The ta-VNS intervention stimulates the left tragus, cymba conchae, and cavum conchae (pulse width 250 µs, 25 Hz, 0.5-5 mA individualized to a tingling sensation, 30 s on/off) once weekly for 20 minutes over four weeks; the sham condition stimulates the left earlobe at 0.5 mA. Auricular acupressure with magnetic beads is self-administered three times daily. Outcomes are assessed at T0 (baseline), T1 (week 2), T2 (week 4), and T3 (week 8). Data are analyzed with generalized estimating equation (GEE) models.

Study Type

Interventional

Enrollment (Estimated)

180

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Taiwan
      • Hualien City, Taiwan, 970
        • Recruiting
        • Hualien Tzu Chi Hospital, Department of Otorhinolaryngology
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 18-75 years, conscious, able to communicate and comprehend, and able to complete questionnaires and comply with study procedures
  • Tinnitus as the sole chief complaint, with pure-tone thresholds ≤25 dB HL bilaterally at 500, 1000, 2000, and 4000 Hz

Exclusion Criteria:

  • Objective tinnitus, peripheral vestibular disease, central nervous or cardiovascular causes, or other organic ear pathology
  • Open wounds or skin lesions of the foot or ear, lower-limb edema, history of deep vein thrombosis, or diabetes with most recent HbA1c >7.5%
  • Cardiac pacemaker or other implanted electronic device, or other severe cardiovascular disease
  • Foot reflexology or vagus nerve stimulation within the past 3 months
  • Pregnant or breastfeeding women
  • History of epilepsy or seizures
  • Physically frail condition

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm A: Foot Reflexology - True (n=36)
Procedure: True Foot Reflexology
Procedure: True Foot Reflexology
Once weekly, 20 min, 4 sessions over 1 month. Three phases: relaxation (diaphragm, brain, spine reflex zones, 3 min); inner-ear and autonomic regulation (inner ear, hypothalamus, cerebellum, brainstem, thyroid, adrenal zones, 10 min); circulation/detoxification (kidney, lymphatic zones, 7 min).
Sham Comparator: Arm B: Foot Reflexology - Sham (n=36)
Procedure: Sham Foot Reflexology
Procedure: Sham Foot Reflexology
Light touch on non-specific foot areas (dorsum, anterior ankle, foot margins) without effective pressure.
Experimental: Arm C: ta-VNS - True (n=36)
Device: True ta-VNS + Procedure: Auricular Acupressure
Device: True ta-VNS
Left tragus, cymba conchae, cavum conchae; 250 µs, 25 Hz, 0.5-5 mA individualized to tingling, 30 s on/off; once weekly, 20 min, 4 weeks. Device: Hong-Tai mid-frequency electrotherapy stimulator, model HT66B (TFDA license no. 000637), used off-label for auricular vagus nerve stimulation.
Procedure: True Auricular Acupressure
Magnetic beads (1-2 mm) at left tragus, cymba conchae, cavum conchae; pressed 3×/day, ~30 s per point; changed every 2-3 days.
Sham Comparator: Arm D: ta-VNS - Sham (n=36)
Device: Sham ta-VNS + Procedure: Sham Auricular Acupressure
Device: Sham ta-VNS
Left earlobe, 0.5 mA, otherwise identical parameters (250 µs, 25 Hz, 30 s on/off).
Procedure: Sham Auricular Acupressure
Beads at left earlobe (non-vagal regions), same frequency/duration.
Active Comparator: Arm E: Usual Care (n=36)
Other: Usual Care
Other: Usual Care
Standard tinnitus clinical care (pharmacologic and supportive); no study intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Tinnitus Handicap Inventory (THI) score
Time Frame: T0 baseline, T1 week 2, T2 week 4, T3 week 8
25-item scale across functional, emotional, and catastrophic subscales; total 0-100, higher = greater handicap.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in Tinnitus Functional Index (TFI) score
Time Frame: T0 baseline, T1 week 2, T2 week 4, T3 week 8
25-item scale; total 0-100, higher = greater impact.
T0 baseline, T1 week 2, T2 week 4, T3 week 8

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Distress Thermometer (DT)
Time Frame: T0 baseline, T1 week 2, T2 week 4, T3 week 8
0-10 single-item rating; >=4 indicates clinically significant distress.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in Pittsburgh Sleep Quality Index (PSQI)
Time Frame: T0 baseline, T1 week 2, T2 week 4, T3 week 8
19-item; total 0-21, >5 indicates poor sleep.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in Heart Rate Variability (HRV)
Time Frame: T0 baseline, T1 week 2, T2 week 4, T3 week 8
TS-0411 wrist device (HRV Master, TFDA license no. 001525), after 10-min rest, ~5-min wrist recording.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in salivary cortisol concentration
Time Frame: T0 baseline, T1 week 2, T2 week 4, T3 week 8
1 cc saliva, ELISA.
T0 baseline, T1 week 2, T2 week 4, T3 week 8

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tzu Chi University

Collaborators

Buddhist Tzu Chi Medical Foundation

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 28, 2026

Primary Completion (Estimated)

December 31, 2028

Study Completion (Estimated)

December 31, 2028

Study Registration Dates

First Submitted

July 13, 2026

First Submitted That Met QC Criteria

July 13, 2026

First Posted (Actual)

July 17, 2026

Study Record Updates

Last Update Posted (Actual)

July 17, 2026

Last Update Submitted That Met QC Criteria

July 13, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Tzu Chi University

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Tinnitus

Clinical Trials on True Foot Reflexology

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Rwanda

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe