Mollart 2003.

Methods	Randomised controlled trial comparing 2 types of reflexology (relaxing foot and lymphatic foot) with no reflexology (control).
Participants	Inclusion criteria: greater than 30 weeks' gestation with visible oedema of ankles and feet, able to speak, read and write English. Exclusion criteria: none stated.
Interventions	Random allocation of women into either: (i) relaxing foot reflexology technique to the reflex zones of the chest, abdomen, spine, pelvis and head (20 participants); (ii) lymphatic foot reflexology using grapeseed oil to reflex zones of the lymphatic system, liver, gastrointestinal tract and kidneys (25 participants); (iii) control group rested on a couch for equal time duration but received no reflexology (10 participants). Each session lasted 15 minutes approximately.
Outcomes	Objective ankle and foot circumference measurements, mean scores on stress, tension, anxiety, discomfort, irritability, pain and tiredness levels. Mean well being scores among the 3 groups were also assessed.
Notes	55 women finished session 1 with complete data, 39 completed session 2 and 20 participants completing session 3. As a result of the dwindling sample size only session 1 has been analysed and presented in the paper 3. Sample size: sample size calculation performed to identify moderate and severe ankle oedema and set at 120 women (40 per randomised group). However, due to limited sample at study hospital this was reset at 60 participants in total. Within the study 69 women were randomised, 7 withdrew after randomisation. Country: Australia. Study years: September 1999 ‐ August 2001.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Study described as randomised but sequence generation not described.
Allocation concealment (selection bias)	Unclear risk	Allocation concealment not described.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Study described as single‐blind; however, women randomised to either of the 2 groups of reflexology or control (no reflexology) would have been aware of treatment allocation.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Personnel were not blind to group assignment.
Incomplete outcome data (attrition bias) All outcomes	High risk	69 women were randomised. 7 withdrew after randomisation; 1 woman gave birth before the session, and 6 women had incomplete data. Data for 55 women who received at least 1 treatment session. 21% missing data.
Selective reporting (reporting bias)	Low risk	Selective reporting not apparent.
Other bias	Unclear risk	1. Authors state "circumference measurements were not able to record the decrease in skin tension and swelling as experienced by the participants". 2. Up to 4 reflexology sessions were planned, but by the third session only 20/69 women remained. Analysis was done on the results of the first session only.