Efeitos da reflexologia podal sobre os pés de portadores de diabetes mellitus tipo 2: um ensaio randomizado

Abstract

Healthcare professionals, specifically nurses, plays a key role in the implementation of interventions that aim to control plantar changes arising from diabetes mellitus. In this context, appears to reflexology therapy, which by means of pressure points in the feet, may act to control or prevention of complications arising from the plantar disease. Therefore, the aim of this study was to evaluate the effect of reflexology on the feet of patients with diabetes mellitus type 2. This is a prospective clinical trial, randomized, controlled, masked, with anteroposterior design. The final sample consisted of 45 patients with type 2 diabetes mellitus for at least five years, registered in the System of Registration and Monitoring of Hypertensive Diabetics - HIPERDIA. Through stratified randomization, after the initial assessment, the volunteers were divided into two groups: Treated Group (n = 21) who received self-care guidelines with their feet and underwent 12 sessions of reflexology, and Control Group (n = 24) who received only self-care guidelines with their feet. All participants were evaluated by a trained evaluator, in three stages: first (before any intervention), after the sixth and twelfth session of foot reflexology. In the evaluation, the blood glucose at random was checked using a portable glucose meter, the temperature of the tissue with the legs thermography cutaneous plantar pressure engagement with the feet and baropodometry by a rating scale. Statistical analysis was performed by means of tests: Chi-square, Fisher exact test, Mann-Whitney, Wilcoxon, Logistic Regression and Log-Linear. The results show no significant differences between groups with respect to blood glucose, tissue temperature and plantar pressure. However, in some variables related to plantar pressure, more specifically the average pressure, maximum pressure distribution and center of gravity of the foot contact time with the ground, although they were not significant differences between groups at study the volunteers who received twelve sessions of therapy tested showed results closer to normality than those who were part of the control group. The patients in the intervention showed significant differences in some indicators related to the skin and, when compared to the control group. Accordingly, after six sessions of foot reflexology, the treated group showed better scores for hair growth / hair growth , elasticity / tugor , hydration , perspiration, texture and skin integrity / desquamation . Thus, it is believed that this study has contributed not only to the inclusion of reflexology in nursing care for patients with diabetes, but also to the knowledge of the technique and method of application to and use in many different health care services. Furthermore, it is expected that this research, by proposing tools that enable more precise analysis of plantar changes, have contributed to improving the assessment of the feet of people with diabetes. It is recommended, however, studies with a longer duration, in which the application of the intervention is more frequent and occurs in a larger sample, allowing the detection of small differences between the groups, allowing to confirm the effects of therapy and ensure the application of foot reflexology on foot care for patients with diabetes mellitus type 2.