Sensory Stimulation versus Foot Reflexology for Consciousness Recovery and Physiological Stability in ICU Patients with Disorders of Consciousness: A Randomized Controlled Trial

Agari, Fatemeh; Aghajani, Mohammad; Mirbagher Ajorpaz, Neda; Rafiee, Saeedeh; Yousofian, Kimia

doi:10.30491/tm.2026.582216.1930

Sensory Stimulation versus Foot Reflexology for Consciousness Recovery and Physiological Stability in ICU Patients with Disorders of Consciousness: A Randomized Controlled Trial

Document Type : Original Article

Authors

Fatemeh Agari ¹

Mohammad Aghajani ²

Neda Mirbagher Ajorpaz ³

Saeedeh Rafiee ¹

Kimia Yousofian ¹

¹ Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.

² Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.

³ Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.

10.30491/tm.2026.582216.1930

Abstract

Background: To compare the effects of Dyang sensory stimulation (DSS) and foot reflexology (FR) on the level of consciousness and physiological parameters in intensive care unit (ICU) patients with disorders of consciousness (DOC).
Methods: This randomized controlled trial used a three-arm parallel design and included 60 adults in the ICU with disorders of consciousness (Glasgow Coma Scale [GCS] score ranging from 3 to 7) admitted to a university hospital in Iran (2024–2025). Patients were randomly allocated in a 1:1:1 ratio to receive Dyang sensory stimulation (DSS), foot reflexology (FR), or routine care using block randomization and allocation concealment. The interventions were provided for 10 minutes twice per day for 7 consecutive days. The primary outcome of the study was the improvement in the total GCS score from baseline to 7 days. GCS sub-scale scores and physiological parameters were recorded as secondary outcomes. A paired t-test, analysis of variance (ANOVA), and analysis of covariance (ANCOVA) were applied for data analysis using SPSS version 24, with a significance level set at α=0.05.
Results: It was observed that there was a great improvement in total GCS in all three groups: DSS (from 5.35±1.32 to 7.17±2.76; p=0.018), FR (from 4.57±1.30 to 6.84±2.71; p=0.002) and control group (from 5.45±1.46 to 6.65±2.51; p=0.008). Whereas some level of improvement in GCS was shown in all three groups, there was no significant difference between groups in mean GCS change (ANOVA p=0.420; ANCOVA p=0.602). The results indicate that there was a significant decrease in systolic BP in the FR group, but the difference between groups in systolic BP was not statistically significant. There were no adverse effects noted.
Conclusion: DSS and FR procedures were shown to be effective in the treatment of patients and led to visible improvements in GCS in patients in three groups during the study; however, neither group showed any type of advantage during the research. The results of the research create the basis for conducting further studies of the phenomenon.

Keywords

Disorders of Consciousness

Sensory Stimulation

Dyang Protocol

Foot Reflexology

Intensive Care Unit

Subjects