Ozdemir 2013.

Study characteristics
Methods	Study design Parallel RCT Study dates Duration of follow‐up: 1 week Time frame: not reported
Participants	Study characteristics Setting: multicentre (HD units of two institutions in the city of Gaziantep located in the Southeastern Anatolia region of Turkey) Country: Turkey Inclusion criteria: ≥ 18 years; full consciousness and orientation; did not have any communication problems; HD 3 times/week for at least 6 months; marked level of severity of fatigue, pain and cramp as at least 1 in VAS; volunteered to participate in the research Exclusion criteria: patients with open foot wound; suspicious fracture; burn; deep vein thrombosis; peripheral neuropathy Baseline characteristics Number (analysed/randomised): intervention group (not reported/40); control group (not reported/40) Mean age ± SD (years): intervention group (43.1 ± 15.8); control group (54.0 ± 12.8) Sex (M/F): intervention group (13/27); control group (17/23) Dialysis type: HD Dialysis vintage (years) (mean ± SD): not reported Comorbidities CVD: not reported Diabetes: not reported Hypertension: not reported Depression (clinician diagnosis): not reported
Interventions	Intervention classification Non‐pharmacological intervention Indication: study targeting fatigue Intervention group Foot reflexology for 30 minutes, 3 times/week for 1 week Control group No intervention Co‐interventions Not reported
Outcomes	Outcomes reported Fatigue outcome measures used: validation data available Fatigue PFS (Appendix 3) (assessed at baseline and after 1 week) Behavioural/severity Affective meaning Sensory Cognitive/mood Pain 10‐point VAS (Appendix 3): assessed at baseline and after 1 week Cramps 10‐point VAS (Appendix 3): assessed at baseline and after 1 week Laboratory results (Hb, HCT, albumin, URR): assessed at baseline and after 1 week Kt/V: assessed at baseline and after 1 week
Notes	Additional information Funding: not reported Conflicts of interest/disclosures: not reported Trial registration identification number: not reported A priori published protocol: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Randomization was performed by MedCalc software to give equal chance to each intervention group." Comment: Computer‐generation is considered as low risk of bias. No imbalance between intervention groups was apparent
Allocation concealment (selection bias)	Unclear risk	Method of allocation concealment was not reported in sufficient detail to permit judgement
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not reported. However, interventions were different and participants and/or investigators could be aware of the treatment assigned
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "The data of the intervention and control groups were collected by using the questionnaire, Piper Fatigue Scale and Visual Analogue Scale (VAS)." Comment: The outcomes were assessed with an appropriate measure, without differences between groups. However, subjective measures were used, it was not stated whether outcomes were assessed without knowledge of treatment allocation, and knowledge of treatment assignment may have influenced reporting. Participant beliefs about the superiority/inferiority of either intervention could have influenced their assessment of the outcome, but there was no evidence that this was likely. However, objective and subjective outcomes were assessed
Incomplete outcome data (attrition bias) All outcomes	High risk	The number of patients who completed the study was not clearly stated. It was unclear if there was evidence that the results were not biased by missing outcome data
Selective reporting (reporting bias)	High risk	Information about the protocol and the statistical analysis plan were not reported. Fatigue was reported using multiple eligible outcome measurements (scales, time points). Fatigue was reported in a format that was extractable for meta‐analysis. All outcomes that should be addressed (fatigue, cardiovascular disease, and death) were not reported
Other bias	Unclear risk	There was no evidence of different baseline characteristics, or different non‐randomised co‐interventions between groups. Funding and conflicts of interest were not reported