Effect of Foot Massage on Physiologic Indicators in Critically Ill Patients Admitted in the I.C.U

Intensive care unit is one of the most stressful wards for patients and it is estimated that 30 to70 percent of patients experience severe physiologic stress during admission. Some of the physiologic responses to stress include increase in metabolic rate with consequent increase in body temperature, increase in cardiac output and contraction power and subsequently increase in blood pressure, heart rate and sodium accumulation, bronchodilation and increase in respiration rate. Control of homodynamic condition and vital signs is an essential and important practice in intensive care units for stabilizing physiologic indicators. Massage is one of the methods that can be used for this purpose. The purpose of this research was to determine the effect of foot massage on physiologic indicators including pulse, respiration rate, mean arterial pressure, temperature and arterial blood oxygen saturation.

46 patients with brain stroke who were hospitalized in the intensive care unit of Tajrish Shohada hospital were studied.The validity of information record form was determined with content validity and the validity of instruments was established using valid marks. The reliability of instruments was assessed with test-re-test after calibration. Information was collected on second, third and fourth days after ICU admission at 4 to 6 pm. For this purpose, the physiologic indicators were controlled and after 10 minute, the patients underwent 5-minute foot stroke massage and then at 10 and 30-minute intervals, physiologic indicators were controlled again. Data was analyzed by ANOVA statistical method.

Findings showed that pulse rate, respiratory rate and mean arterial blood pressure significantly decreased after 5 minute foot massage (p< 0.001) and the value of these indicators 10 minutes after foot massage was less than the values 10 minute before massage. Also, arterial oxygen conc. 10 minute after foot massage was more than the conc.10 minutes before massage and values at 30 minutes after foot massage were more than the values10 minutes before and 10 minutes after foot massage (p<0.001), Decrease in temperature on third and fourth days of ICU admission 10 minutes and 30 minutes after foot massage as compared to 10 minutes before massage was significant, but alterations were little and clinically, we can say that body temperature did not alter and approximately remind constant. Data analysis also showed that alterations in values of physiologic indicators during the three days of manipulation were the same and there was no difference between the alterations on different days (p<0.001).

In general, parasympathetic activity after foot massages results in alteration of body physiologic responses. Decrease in heart rate, mean arterial pressure and respiratory rate along with increase in arterial oxygen concentration showed that patients were less anxious and more relaxed.