Change of Dyspnea in Cancer Patients on Autonomic Nerve Activity and Subjective Indexes with Foot Reflexology

Abstract

Abstract

In contrast to cancer pain, no standard treatment has been established for dyspnea, which is a high frequency symptom in cancer patients. Because there are differences between individuals in the sensation of dyspnea, subjective indicators are mainly used for evaluation. This study examined the usefulness of autonomic nerve activity as an evaluative indicator of dyspnea. This was accomplished by investigating changes from a subjective and physiological standpoint in cancer patients with dyspnea treated with reflexology. This study included eight advanced cancer patients with dyspnea, who were divided into foot reflexology （intervention） and bed-rest （non-intervention） groups. Treatment was administered for three days and applied for 20 minutes each session, with 10 minutes of bed rest before and after treatment. Both the intervention and non-intervention groups were monitored using an experimental total-excursion heart rate meter, and heart rate vali ability analysis was conducted, which enabled separate evaluations of sympathetic and parasympathetic nerve activity. The measured items were in the areas of subjective evaluation （dyspnea, sense of relaxation, and drowsiness） and autonomic nerve activity （heart rate and HF・LF/HF）. We found that although no significant differences were observed between the two groups, dyspnea in the intervention group decreased significantly （p = 0.034） because of the treatment. Corresponding to a significant increase in relaxation and drowsiness （commensurate with the effect of comfort on the autonomic nervous system exerted by pressure stimulus），a significant decrease in the heart rate （p = 0.008），which is the reference indicator for autonomic nerve activity, and a significant post-treatment increase （p = 0.045） in the HF （the reference indicator for parasympathetic nerve activity），were observed. The correlation coefficient of dyspnea and autonomic nerve activity showed 0.25–0.80. These results suggest that autonomic nerve activity can be an evaluative indicator for dyspnea in cancer patients.