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ALTERNATIVETHERAPIESjulaug2011VOL.17NO.413FootReFexologyinCoronaryArteryDiseaserelatedtovagalmodulationlastlongerinpatientswithCADthaninthecontrols.Themechanismresponsibleforthisdifferentialeffectwasnotclearatpresentbecauseitwasnotinvestigatedinthisstudy.WespeculatethattheFR-relatedautonomicnervouseffectofincreas-ingvagalanddecreasingsympathovagalbalancemaybemoreevi-dentinthosepatientswhohavedepressedvagalmodulationandenhancedsympatheticmodulationsuchaspatientswithCAD.Furtherstudiesareneededtodisclosetheunderlyingmechanism.OtherconsiderationsincludethatthemanipulationofFRonaparticipantdidnotallowhimorhertorestuninterruptedly.ThusaparticipantnotreceivingFRisnotagoodcontroltocontrasttheeffectofFRonthatperson.IfacontrolisgoingtobeusedtocontrasttheeffectofFRmanipulatingsomeareaotherthanthefootthathasnoreFexpointsonitforthesameperiodoftimemaybeabetterchoicethanaparticipantnotreceivingFR.Accordingtothetradi-tionalOrientalmedicinenoareaoverthewholebodycanbefoundthatcanbestimulatedbypressureandmassagewithoutcausingaphysiologicalresponseinthebody.ThereforetheparticipantnotreceivingFRineithergroupwasnotdesignedasacontroltocontrasttheeffectofFRinthisstudy.ToknowthedifferencesintheeffectsofFRonpatientswhoareondifferentmedicationsandtheeffectsofthosemedicationsonFRwechosetocomparetheeffectofbeta-blockersontheHRVmea-suresinbothcontrolandCADgroups.WefoundthattherewerenosigniEcantdifferencesinallHRVmeasuresbetweenparticipantsusingornotusingbeta-blockersineithercontrolorCADgroupandbetweenthecontrolandCADgroupswhethertheywereusingbeta-blockersornotTable6.ThustherearenodifferencesintheeffectsofFRonCADpatientswhetherornottheyareonbeta-blockermedi-cationandthebeta-blockersdonotsigniEcantlyinFuencetheeffectofFRontheautonomicnervousmodulationoftheparticipants.Inconclusionahighervagalmodulationlowersympatheticmodulationandlowerbloodpressurescanbeobservedfollowing60minutesofFRinbothangiographicallypatentcontrolsandCADpatients.ThoughthemagnitudeofchangeintheautonomicnervousmodulationoftheCADpatientswasslightlysmallerthanthatofthecontrolsFRisacomplementarytherapeuticmethodtoallopathicmedicalcarethatissimpleandsafeforalmosteveryone.FRrequiresverylittletimeandexpensenospecialequipmentandnomedica-tionandcanbeperformedpracticallyanywhere.SincethemortalityriskduetoacutemyocardialinfarctionislowerinpatientswithhighervagalmodulationandishigherinpatientswithhighersympatheticmodulationourresearchsuggeststhatFRisasafelow-costadjunctTABLE5ThePercentageChangesinHeartRateVariabilityMeasuresAfterFootReFexologyX30x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0X60Controlx0groupx0nx0x017MeanRRIx130.6x134.0to4.8x134.2x139.1to0.9Heartrate0.6x134.6to4.04.3x130.8to10.0SDRR0.0x1310.4to6.5x1313.3x1317.6tox131.2CVRRx130.5x138.7to8.1x134.6x1312.5to1.1TPx135.7x1321.9to18.4x1328.0x1336.0tox138.4VLFP-12.2x1338.6to3.6x1356.0x1369.8tox1333.9LFP0.0x1315.7to19.1x1323.2x1339.6to13.3HFP3.6x139.1to30.2x136.9x1330.0to13.0nVLFPx139.3x1342.5to1.1x1337.3x1349.6tox1326.5nLFP1.0x139.2to24.714.1x132.9to23.5nHFP9.9x130.0to41.318.07.8to52.0LFPHFPx1314.3x1328.5to16.6x135.7x1323.2to7.9CADx0groupx0nx0x020MeanRRI6.63.1to11.110.93.5to17.7Heartratex136.2x1310.0tox133.1x139.9x1315.0tox133.4SDRR4.3x138.7to23.73.8x136.6to11.0CVRR0.0x1312.8to12.4x136.0x1310.4tox132.0TP11.3x1325.1to58.914.5x1313.3to38.5VLFPx130.3x1339.9to21.6x1314.5x1340.6to10.3LFP7.6x1322.3to72.813.8x136.7to40.7HFP10.0x1313.2to53.332.46.0to59.2nVLFPx1316.4x1328.2tox132.9x1318.4x1340.6tox134.5nLFP0.5x136.7to7.12.0x135.1to11.7nHFP8.90.0to25.915.11.3to33.1LFPHFPx1311.2x1323.3to2.1x139.1x1331.5to3.7Valuespresentedaremedians25-75percentile.P.05betweennormalcontrolsandpatientswithCAD.P.05vsbeforeFR.P.05vs30minafterFR.AbbreviationsCADcoronaryarterydiseaseRRIRRintervalsSDRRstan-darddeviationofRRCVRRcoefEcientofvariationofRRTPtotalpowerVLFPverylow-frequencypowerLFPlow-frequencypowerHFPhigh-fre-quencypowernVLFPnormalizedverylow-frequencypowernLFPnormal-izedlow-frequencypowernHFPnormalizedhigh-frequencypowerLFPHFPlow-high-frequencypowerratio.TABLE6EffectofBeta-blockersonHeartRateVariabilityintheControlandCoronaryArteryDiseaseCADGroupsControlx0Groupx0nx0x017x0x0x0x0x0x0CADx0Groupx0nx0x020Withoutx0beta-blockersx0nx0x012TPms2861.6696.0-9876.91415.0467.0-2036.0VLFPms2312.0176.2-406.9218.0165.3-733.0LFPms2174.5158.5-255.1382.0127.7-641.2HFPms2373.3228.2-493.5460.5194.4-927.8nVLFPnu36.024.3-41.931.226.2-37.7nLFPnu23.820.2-29.228.226.4-31.3nHFPnu42.935.4-48.137.733.2-48.6LFPHFP0.530.48-0.810.820.52-0.90Withx0beta-blockersx0nx0x025TPms21083.1827.2-2104.0962.57484.1-1375.0VLFPms2311.9197.5-514.1288.4173.8-444.4LFPms2337.1177.9-413.1256.8219.4-437.9HFPms2354.1318.7-625.3480.2318.4-546.6nVLFPnu33.030.3-41.330.524.1-32.7nLFPnu28.321.5-30.128.625.2-32.4nHFPnu38.532.6-44.043.235.5-46.2LFPHFP0.740.59-0.810.650.53-0.82Valuespresentedaremedians25-75percentile.AbbreviationsTPtotalpowerVLFPverylow-frequencypowerLFPlow-frequencypowerHFPhigh-frequencypowernVLFPnormalizedverylow-frequencypowernLFPnormalizedlow-frequencypowernHFPnormalizedhigh-frequencypowerLFPHFPlow-high-frequencypowerratio.