Eighteen RCTs were included (n=949 participants). Sample size ranged from 12 to 243 and only five trials had more than 50 patients. The duration of follow-up, where reported, ranged from none to six months; in 13 trials it was three months or less.
Five trials suggested positive effects from reflexology, 12 found no evidence of effectiveness, and one trial's results were not clear. Methodological quality was generally poor. Two of the nine RCTs that scored three or more out of five on the Jadad scale reported positive effects for reflexology and seven reported no effects.
Three of the nine placebo-controlled trials reported positive effects of reflexology (control of premenstrual symptoms, improved quality of life in palliative cancer care, and improved multiple sclerosis symptoms); six trials did not report any therapeutic effect. The two largest trials (n=130 and 243) reported negative effects and no effects.
The results were contradictory for asthma and multiple sclerosis (one positive and one no-effect trial for each condition). Two of three trials of cancer suggested benefit and the other found no difference. Neither of the two trials of postoperative patients reported a positive effect.