THE EFFECT OF FOOT SOLE REFLEXOLOGY MASSAGE ON THE LEVEL OF CONSCIOUSNESS AND HEMODYNAMIC INDICES OF PATIENTS WITH TRAUMATIC COMA

Traumatic brain injury (TBI) is one of the major health problems throughout the world. The hemodynamic indices of patients with head injuries change, and these changes can worsen the level of consciousness. The purpose of this study was to determine the effect of FSRM on the level of consciousness and hemodynamic indices in patients with traumatic coma. In this randomized clinical trial, 60 patients with traumatic coma admitted to the Intensive Care Units (ICU) of  Shohaday-e Haft-e Tir in Tehran, and Imam Hossein hospital in Shahrood were randomly selected in 2017.
They were randomly assigned to two groups (control and RFM groups) using a randomized block method. Patients in both groups received routine care. Additionally, in the experimental group, RFM was performed twice a day for two weeks each day for 30 minutes. The level of consciousness of the patients was evaluated and measured using the Glasgow Coma Scale (GCS) before, one week, and two weeks after entering the study. The hemodynamic indices were measured and recorded before, immediately after, 30 minutes, and 2 hours after the intervention on the first and second days of intervention by bedside calibrated the monitor. Data were analyzed using independent t-test, chi-square, Fisher's exact, and ANOVA tests with repeated measures using SPSS(version 21). The number of patients reaching complete consciousness in the intervention group was more than the control group (p=0.002). The number of days to reach complete consciousness was lower in RFM group (p=0.001). In the intervention group, immediately after (p=0.017) and 30 minutes after intervention (p=0. 016), the systolic blood pressure decreased substantially compared to the control group. In the intervention group, immediately after the intervention, hemodynamic indices were lower compared to other measurement times. Based on the results, FSRM increased the level of consciousness of the patients and reduced the duration of coma. The results showed the immediate effect of intervention on reducing hemodynamic indices. The nurses in ICUs are recommended to use this easy and inexpensive method to perform sensory stimuli in patients with coma to improve their level of consciousness and enhance their hemodynamic parameters.