Table 1.

Characteristics of included studies.

Authors, year, country	Main characteristics of studied population	Sample characteristics (sample size, mean age)	Sex difference	Intervention group. vs. comparison group	Outcome measurement tools	Outcomes
Valizadeh et al., 2015, Iran	Participants between the age of 60–75 y/o independently performing daily activities and having mental health based on health records available in the health center	69, G1 = 23, G2 = 23, G3 = 23 mean age: G1 = 66.82 y/o (SD = 4.80), G2 = 67.69 y/o (SD = 4.28), G3 = 66.82 y/o (SD = 3.84)	Male: 69 Female: 0	G1 = foot reflexology G2 = footbath G3 = control group	Pittsburgh Sleep Quality Index (PSQI)	The total score of PSQI improved: no statistically significant finding G1 vs. G3 (P < 0.05) G1 = 6.08 (5.27), G1∗ = 3.91 (4.04) G3 = 4.69 (0.51), G3∗ = 5.69 (3.08)
Lee et al., 2011, Taiwan	Postpartum women have given birth vaginally without postpartum complications and concurrent medical conditions with poor sleep condition (PSQI ≥ 5)	68, G1 = 34, G2 = 34 mean age: G1 = 32.0 y/o (SD = 2.8), G2 = 31.2 y/o (SD = 2.8) (3 drop out)	Male: 0 Female: 68	G1 = foot reflexology G2 = control group	Pittsburgh Sleep Quality Index (PSQI)	The total score of PSQI improved: G1 vs. G2 (P < 0.001) G1 = 9.94 (2.61), G1∗ = 3.97 (1.26) G2 = 9.45 (2.59), G2∗ = 6.24 (1.68)
Bakir et al., 2018, Turkey	Voluntary participants aged ≥18 y/o diagnosed with rheumatoid arthritis, at least, 1 year with VAS-Pain (visual analogue scale for pain) of 4 or greater	60, G1 = 30, G2 = 30 mean age: G1 = 50.83 y/o (SD = 12.0), G2 = 49.50 y/o (SD = 16.4) (5 drop out)	Male: 14 Female: 46	G1 = foot reflexology G2 = control group	Pittsburgh Sleep Quality Index (PSQI)	The total score of PSQI improved: G1 vs. G2 (P = 0.001) G1 = 16.20 (3.70), G1∗ = 13.16 (3.57) G2 = 16.75 (3.64), G2∗ = 19.03 (3.05)
Unal et al., 2016, Turkey	Patients between the age of 18–60 y/o who received hemodialysis therapy twice a week without any communication problems	105, G1 = 35, G2 = 35, G3 = 35 mean age: G1 = 51.74 y/o (SD = 12.2), G2 = 53.89 y/o (SD = 13.1), G3 = 54.33 y/o (SD = 12.9)	Male: 55 Female: 50	G1 = foot reflexology G2 = back massage G3 = control group	Pittsburgh Sleep Quality Index (PSQI)	The total score of PSQI improved: G1 vs. G3 (P < 0.05) G1 = 11.09 (3.18), G1∗ = 5.54 (2.15) G3 = 9.20 (2.42), G3∗ = 11.88 (2.47)
Zengin et al., 2018, Turkey	Participants with cancer have received at least their first session of chemotherapy and have no diagnosis of sleep disorder	167, G1 = 84, G2 = 83 mean age: G1 = not mentioned G2 = not mentioned (9 drop out)	Male: 78 Female: 89	G1 = foot reflexology G2 = control group	Pittsburgh Sleep Quality Index (PSQI)	The total score of PSQI improved: G1 vs. G2 (P < 0.001) G1 = 12 (2.7), G1∗ = 5.5 (2.1) G2 = 11.3 (1.9), G2∗ = 13 (2.4)
Rambod et al., 2019, Iran	Patients with lymphoma aged ≥18 y/o, being able to speak Persian and being willing to participate in the study	72, G1 = 36, G2 = 36 mean age: G1 = 41.47 y/o (SD = 13.70), G2 = 46.90 y/o (SD = 15.40)	Male: 52 female: 20	G1 = foot reflexology G2 = control group	Pittsburgh Sleep Quality Index (PSQI)	The total score of PSQI improved: G1 vs. G2 (P < 0.05) G1 = 10.11 (3.26), G1∗ = 8.41 (2.98) G2 = 11.80 (3.83), G2∗ = 11.83 (3.26)
Malekshahi et.al., 2018, Iran	Patients between the age of 18–65 y/o who have sleeping problems on the basis of the Pittsburgh questionnaire, undergoing hemodialysis in the evening and night shifts	80, G1 = 40, G2 = 40 mean age: G1 = not mentioned G2 = not mentioned	Male: 53 female: 27	G1 = foot reflexology G2 = control group	Pittsburgh Sleep Quality Index (PSQI)	The total score of PSQI improved: G1 vs. G2 (P < 0.05) G1 = 11.79 (3.13), G1∗ = 6.32 (1.93) G2 = 10.94 (4.10), G2∗ = 12.47 (3.94)
Oshvandi et al., 2014, Iran	Patients between the age of 30–80 y/o who have ischemic heart disease hospitalized in the critical care unit	60, G1 = 30, G2 = 30 mean age: G1 = 64.17 y/o (SD = 12.04), G2 = 50.50 y/o (SD = 11.40)	Male: 34 Female: 26	G1 = foot massage G2 = control group	St. Mary's Hospital Sleep Questionnaire (SMHSQ)	The total score of SMHSQ improved: G1 vs. G2 (P < 0.05) G1 = 19.67 (6.25), G1∗ = 15.33 (4.87) G2 = 18.93 (5.87), G2∗ = 18.90 (5.66)
Samarehfekri et al., 2020, Iran	Patients undergoing kidney transplantation surgeries suffer from postoperative pain, fatigue, and sleep disorders	50, G1 = 25, G2 = 25 mean age: G1 = 38.12 y/o (SD = 12.87), G2 = 38.56 y/o (SD = 12) (3 drop out)	Male: 34 Female: 16	G1 = foot massage G2 = control group	The Verran and Snyder-Halpern Sleep Scale	The total score of the Verran and Synder-Halpern Sleep Scale improved: G1 vs. G2 (P < 0.05) G1 = 41.98 (SD = 13.92), G1∗ = 60.60 (SD = 10.75) G2 = 42.15 (SD = 11.78), G2∗ = 52.23 (SD = 11.76)
Toygar et al., 2020, Turkey	Aged 18 years and above, who are the primary informal caregivers of cancer patients (without any professional help)	66, G1 = 33, G2 = 33 mean age: G1 = 41.52 y/o (SD = 13.88), G2 = 39.02 y/o (SD = 12.80)	Male: 10 Female: 56	G1 = foot reflexology G2 = control group (shame intervention)	Richard–Campbell Sleep Questionnaire (RCSQ) state-trait anxiety inventory (STAI)	The total score of RCSQ improved: G1 vs. G2 (P < 0.05) G1 = 430.3 (SD = 43.46), G1∗ = 441.8 (SD = 35.51) G2 = 441.2 (SD = 35.18), G2∗ = 409.5 (SD = 50.08) the total score of STAI improved: G1 vs. G2 (P < 0.05) G1 = 46.67 (SD = 7.21), G1∗ = 38.91 (SD = 5.63) G2 = 47.94 (SD = 10.62), G2∗ = 46.30 (SD = 11.29)
Bahrami et al., 2019, Iran	A female patient aged ≥60 y/o diagnosed with acute coronary syndrome consisting of angina pectoris and myocardia infraction, no anxiolytics and sedative medications in the last four hours before the intervention	90, G1 = 45, G2 = 45 mean age: G1 = 72.86 y/o (SD = 7.98), G2 = 72.62 y/o (SD = 7.93)	Male: 0 Female: 90	G1 = foot reflexology G2 = control group	Hospital depression scale (HADS-D) hospital anxiety scale (HADS-A)	The total score of HADS-D improved: G1 vs. G2 (P < 0.05) G1 = 13.66 (SD = 4.64), G1∗ = 8.42 (SD = 3.62) G2 = 11.74 (SD = 4.29), G2∗ = 11.11 (SD = 3.42) the total score of HADS-A improved: G1 vs. G2 (P < 0.05) G1 = 13.77 (SD = 4.39), G1∗ = 8.53 (SD = 3.71) G2 = 11.66 (SD = 4.24), G2∗ = 11.06 (SD = 3.19)
Noh et al., 2019, South Korea	Gynaecologic cancer patients receiving chemotherapy and hospitalized in the gynaecological ward, who received short-term chemotherapy (at least 2 weeks chemotherapy)	63, G1 = 32, G2 = 31 mean age: G1 = 56.34 y/o (SD = 9.04), G2 = 55.36 y/o (SD = 9.96) (1 drop out)	Male: 0 Female: 63	G1 = self-foot reflexology G2 = control group	Hospital depression scale (HADS-D); hospital anxiety scale (HADS-A)	The total score of HADS-D improved: G1 vs. G2 (P < 0.01) G1 = 9.31 (SD = 4.47), G1∗ = 8.03 (SD = 4.28) G2 = 8.58 (SD = 4.36), G2∗ = 9.48 (SD = 4.14) the total score of HADS-A improved: G1 vs. G2 (P < 0.01) G1 = 7.25 (SD = 4.05), G1∗ = 5.69 (SD = 3.46) G2 = 6.48 (SD = 3.06), G2∗ = 7.39 (SD = 3.23)
Mahdavipour et al., 2019, Iran	Women during their menopausal period, aged 40–60 y/o, diagnosis of depression by a psychiatrist based on DSM-IV, and the total depression score >14 based on the Beck Depression Inventory	90, G1 = 45, G2 = 45 mean age: G1 = 54.18 y/o (SD = 3.90), G2 = 52.23 y/o (SD = 11.6) (10 drop out)	Male: 0 Female: 90	G1 = foot reflexology G2 = control group	Beck Depression Inventory-second edition (BDI-II)	The total score of BDI-II improved: G1 vs. G2 (P < 0.001) G1 = 26.97 (SD = 4.47), G1∗ = 22.55 (SD = 5.18) G2 = 26.15 (SD = 5.01), G2∗ = 26.22 (SD = 5.14)
Soheili et al., 2017, Iran	Female patients aged 18–75 y/o, with a definite diagnosis of multiple sclerosis by a medicine specialist	75, G1 = 25, G2 = 25, G3 = 25 mean age: G1 = 34.4 y/o (SD = 6.6), G2 = 33.9 y/o (SD = 5.6) G3 = 34.0 y/o (SD = 7.7)	Male: 0 Female: 75	G1 = foot reflexology G2 = relaxation G3 = control group	Depression, anxiety and stress scale‐21 (DASS‐21)	The total score of DASS-21 depression improved: G1 vs. G3 (P = 0.03) G1 = 20.72 (SD = 7.56), G1∗ = 13.20 (SD = 6.16) G3 = 19.52 (SD = 6.06), G3∗ = 18.64 (SD = 6.99) the total score of DASS-21 anxiety improved: G1 vs. G3 (P = 0.03) G1 = 16.72 (SD = 6.66), G1∗ = 10.40 (SD = 7.37) G3 = 16.80 (SD = 6.90), G3∗ = 14.88 (SD = 6.50)
Vardanjani et al., 2013, Iran	The patients were candidates for their first elective coronary angiography without the symptoms of myocardial infarction	100, G1 = 50, G2 = 50 mean age: G1 = 52.6 y/o (SD = 7.8), G2 = 54.8 y/o (SD = 5.6)	Male: 100 female: 0	G1 = foot reflexology G2 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G2 (P = 0.0001) G1 = 53.24 (SD = 4.29), G1∗ = 45.24 (SD = 3.32) G2 = 49.62 (SD = 5.31), G2∗ = 43.70 (SD = 5.06)
Bagheri-nesami et al., 2014, Iran	Voluntary participants participate in the study for first nonemergency cardiac surgery by using a heart-lung machine	80, G1 = 40, G2 = 40 mean age: G1 = 58.75 y/o (SD = 8.69), G2 = 58.90 y/o (SD = 9.58)	Male: 40 female: 40	G1 = foot reflexology G2 = control group	Visual Analogue Scale of Anxiety (VAS-A)	The total score of VAS-A improved: G1 vs. G2 (P < 0.05) G1 = 1.93 (SD = 2.81), G1∗ = 1.45 (SD = 2.90) G2 = 1.78 (SD = 2.11), G2∗ = 2.00 (SD = 2.44)
Khaledifar et al., 2017, Iran	Participants aged ≥18 y/o, candidate for coronary angiography in hospital, absence of acute psychological disorders, or use of antistress drugs within recent 48 hours	75, G1 = 25, G2 = 25, G3 = 25 mean age: G1 = 67.2 y/o (SD = 11.8), G2 = 67.0 y/o (SD = 11.1) G3 = 64.7 y/o (SD = 12.1)	Male: 38 female: 37	G1 = foot reflexology G2 = massage therapy G3 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G3 (P < 0.05) G1 = 60.60 (SD = 7.20), G1∗ = 34.70 (SD = 4.70) G3 = 47.80 (SD = 9.60), G3∗ = 46.50 (SD = 9.20)
Saatsaz et al., 2016, Iran	Female, aged 20–35 y/o, being primiparous, giving birth to a living and healthy child, being conscious, and having junior high school or higher degree of education to comprehend the numerical pain scale	106, G1 = 52, G2 = 52, G3 = 52 mean age: G1 = 27.04 y/o (SD = 2.77), G2 = 26.73 y/o (SD = 3.81), G3 = 27.75 y/o (SD = 3.22)	Male: 0 Female: 106	G1 = foot massage G2 = foot and hand massage G3 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G3 (P < 0.05) G1 = 31.52 (SD = 9.93), G1∗ = 28.23 (SD = 8.88) G3 = 30.17 (SD = 6.98), G3∗ = 30.38 (SD = 6.93)
Pasyar et al., 2018, Iran	Patients who had undergone tibial shaft fracture surgery; aged ≥18 y/o; an open reduction and internal fixation surgery for a tibial fracture, hospital admission for at least 1 day after surgery	66, G1 = 33, G2 = 33 G1 = not mentioned G2 = not mentioned	Male: 53 female: 13	G1 = foot reflexology G2 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G2 (P < 0.05) G1 = 54.72 (SD = 7.36), G1∗ = 42.84 (SD = 6.50) G2 = 57.48 (SD = 9.14), G2∗ = 58.36 (SD = 10.37)
Koras et al., 2019, Turkey	Patients age ≥18 y/o who underwent laparoscopic cholecystectomy without any complication with pain severity greater than 4 on VAS (visual analogue scale) after surgery	167, G1 = 85, G2 = 82 mean age: G1 = not mentioned G2 = not mentioned	Male: 50 female: 117	G1 = foot massage G2 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G2 (P < 0.05) G1 = 49.74 (SD = 13.54), G1∗ = 28.67 (SD = 9.12) G2 = 43.67 (SD = 8.11), G2∗ = 51.84 (SD = 6.61)
Eguchi et al., 2016, Japan	Men and women aged 20 to 70 who lived in or near Matsuyama, Ehime Prefecture, Japan	55, G1 = 27, G2 = 28 mean age: G1 = 49.0 y/o (SD = 13.6), G2 = 48.8 y/o (SD = 11.4)	Male: 5 female: 50	G1 = foot reflexology G2 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G2 (P < 0.05) G1 = 41.1 (SD = 11.2), G1∗ = 38.0 (SD = 9.4) G2 = 40.6 (SD = 10.0), G2∗ = 40.0 (SD = 9.2)
Ozturk et al., 2018, Turkey	Voluntary participants who have undergone abdominal hysterectomy operation and reported postoperation pain of 3 or above according to visual analog scale	63, G1 = 32, G2 = 31 mean age: 47.23 y/o (SD = 4.71)	Male: 0 female: 63	G1 = foot reflexology G2 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G2 (P < 0.05) G1 = 58.87 (SD = 4.81), G1∗ = 45.75 (SD = 4.25) G2 = 57.32 (SD = 4.81), G2∗ = 55.96 (SD = 3.85)
Ramezanibadr et al. 2018 Iran	Male candidates for undergoing coronary angiography, aged 40–80 y/o, had neither health problems nor arterial line in the feet, received no anxiolytic agent during the past 48 hours before the intervention	150, G1 = 50, G2 = 50, G3 = 50 mean age: 66.5 y/o (SD = 4.6)	Male: 150 Female: 0	G1 = foot reflexology G2 = placebo group G3 = control group	State-Trait Anxiety Inventory (STAI)	The total score of STAI improved: G1 vs. G3 (P < 0.05) G1 = 61.68 (SD = —), G1∗ = 45.58 (SD = —) G2 = 60.52 (SD = —), G2∗ = 59.14 (SD = —)
Shahsavari et al., 2017, Iran	Patients between the age of 18–60 y/o, no lesion or disorder on the feet and other conditions affecting the feet, no previous history of bronchoscopy, or participation in similar studies	80, G1 = 40, G2 = 40 mean age: G1 = 45.55 y/o (SD = 1.78), G2 = 48.23 y/o (SD = 1.72)	Male: 41 female: 39	G1 = foot reflexology G2 = control group	Visual Analogue Scale of Anxiety (VAS-A)	The total score of VAS-A improved: G1 vs. G2 (P < 0.05) G1 = 4.35 (SD = 2.08), G1∗ = 2.83 (SD = 1.45) G2 = 3.78 (SD = 1.83), G2∗ = 4.88 (SD = 2.15)
Abbaszadeh et al., 2018, Iran	Participants who had been diagnosed with coronary artery disease and were candidates for nonurgent CABG (coronary artery bypass graft)	120, G1 = 40, G2 = 40, G3 = 40 mean age: G1 = 55.90 y/o (SD = 8.31), G2 = 57.32 y/o (SD = 8.62) G3 = 56.30 y/o (SD = 7.11)	Male: 120 female: 0	G1 = foot reflexology G2 = placebo group G3 = control group	Short-form of Atate-Trait Anxiety Inventory (short-form of STAI)	The total score of STAI improved: G1 vs. G3 (P > 0.05) G1 = 8.25 (SD = 2.71), G1∗ = 6.21 (SD = 0.82) G2 = 10.81 (SD = 2.16), G2∗ = 7.80 (SD = 2.31)
Levy et al., 2020, Israel	Women aged over 18 years, hospitalization in obstetrics ward during labor, primiparity, with moderate to severe anxiety at admission Visual Analogue Scale (VAS) ≥4	189, G1 = 99, G2 = 90 mean age: G1 = 28.6 y/o (SD = 4.4), G2 = 27.9 y/o (SD = 4.5)	Male: 0 female: 189	G1 = foot reflexology G2 = control group	Visual Analogue Scale of Anxiety (VAS-A)	The total score of VAS-A improved: G1 vs. G2 (P < 0.05) G1 = 7.9 (SD = 1.8), G1∗ = 5.5 (SD = 2.4) G2 = 7.9 (SD = 2.0), G2∗ = 8.6 (SD = 2.4)

BDI-II = Beck Depression Inventory-second edition; CABG = coronary artery bypass graft; DASS‐21 = depression, anxiety, and stress scale‐21; DSM-IV = Diagnostic and Statistical Manual of mental disorders, 4^th edition; G1 = group 1, G2 = group 2, G3 = group 3; HADS-A = hospital anxiety and depression scale-anxiety; HADS-D = hospital anxiety and depression scale-depression; PSQI = Pittsburgh Sleep Quality Index; SMHSQ = St. Mary's Hospital Sleep Questionnaire; STAI = State-Trait Anxiety Inventory; RCSQ = Richard–Campbell Sleep Questionnaire; VAS-A = visual analogue scale for anxiety.