Warm Foot Baths

September 4, 2014 Written by JP    [Font too small?]

One of the joys of my work is being able to share information about little known healing options. My exuberance only increases when the remedies I write about are inexpensive, non-toxic and widely accessible. So today is a very happy day for me! The following is positive research on a humble, traditional remedy that could help me, you and many people we know.

Several studies presented in peer-reviewed, scientific journals reveal that warm foot baths (WFB) can be powerful medicine. For starters, they acutely reduce arterial stiffness and promote improved blood flow to the heart. These effects have been documented in healthy adults and in those with coronary artery disease. WFBs also improve the quality of life of cancer patients by decreasing sympathetic activity (stress) while providing natural pain relief. Additionally, one trial found that warm foot bathing reduces fatigue and insomnia in those undergoing chemotherapy.

In short, WFBs benefit those with or without serious medical conditions. What’s more, these benefits can be applied quite easily. All that’s called for is to submerge your feet and lower legs in water for about 20 – 30 minutes. However, longer dunks may afford additional benefits, such as regulating skin temperature in seniors with compromised circulation. The water temperature used in most of the published research ranges from approximately 104°F – 109 °F. In comparison, a hot tub or jacuzzi typically maintains a water temperature of about 104°F. So, perhaps they should be renamed “hot body baths”? And, now if you’ll excuse me, my (hot) foot bath awaits!

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Acute Effects of Warm Footbath on Arterial Stiffness in Healthy Young (link)

Study 2 – A Warm Footbath Improves Coronary Flow Reserve in Patients w/ Mild- (link)

Study 3 – Physiological & Psychological Evaluation of the Wrapped Warm Footbath (link)

Study 4 – The Effects of Warm-Water Footbath on Relieving Fatigue and Insomnia (link)

Study 5 – Autonomic, Neuro-Immunological & Psychological Responses to Wrapped (link)

Study 6 – A Warm Footbath Before Bedtime and Sleep in Older Taiwanese with (link)

Study 7 – Effect of Foot Bathing on Distal-Proximal Skin Temperature Gradient in (link)

Warm Foot Baths May Improve Sleep Quality

Source: Res Nurs Health. Oct 2008; 31(5): 514–528. (link)


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Posted in Alternative Therapies, Heart Health, Mental Health

13 Comments & Updates to “Warm Foot Baths”

  1. JP Says:

    Update: Also of interest:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663437/

    Clin Interv Aging. 2013;8:543-8. doi: 10.2147/CIA.S44005. Epub 2013 May 16.

    Effect of a steam foot spa on geriatric inpatients with cognitive impairment: a pilot study.

    Koike Y1, Kondo H, Kondo S, Takagi M, Kano Y.

    PURPOSE:

    To investigate whether a steam foot spa improves cognitive impairment in geriatric inpatients.

    METHODS:

    Geriatric inpatients with cognitive impairment were given a steam foot spa treatment at 42°C for 20 minutes for 2 weeks (5 days/week). Physiological indicators such as blood pressure, percutaneous oxygen saturation, pulse, tympanic temperature, and sleep time and efficiency were assessed. Cognitive function and behavioral and psychological symptoms of dementia were assessed using the Mini-Mental State Examination, Dementia Mood Assessment Scale, and Dementia Behavior Disturbance scale.

    RESULTS:

    Significant decreases in systolic (P < 0.01) and diastolic blood pressure (P < 0.05) along with a significant increase in tympanic temperature (P < 0.01) were observed after the steam foot spas. A significant improvement was seen in the Mini-Mental State Examination score (P < 0.01) and the overall dementia severity items in Dementia Mood Assessment Scale (P < 0.05). LIMITATIONS: Japanese people are very fond of foot baths. However, it is difficult to understand why inpatients cannot receive steam foot baths. In this study, a control group was not used. Raters and enforcers were not blinded. CONCLUSION: The results of this pilot study suggest that steam foot spas mitigate cognitive impairment in geriatric inpatients. Be well! JP

  2. JP Says:

    Update 07/13/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134151/

    J Caring Sci. 2013 Nov 30;2(4):305-11.

    The effect of footbath on sleep quality of the elderly: a blinded randomized clinical trial.

    INTRODUCTION: The progressive increase in the elderly population of developing countries has drawn attention to their health. Sleep Pattern and quality can affect life quality in old people. We need more documents about footbath (a non-invasive method). The purpose of this research was to examine footbath on sleep quality of the elderly.

    METHODS: This study is a blinded, randomized, clinical trial on 46 old men that had health documents in health center, 2013. Participants in the research were divided into two groups. One group had footbath (experimental group) and another group did not have footbath (control group). The experimental group participants were asked to put their feet in warm water (41-42 ºC) for 20 minutes before sleeping for 6 weeks. The co-researcher completed the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention by individual interview. Data were analyzed by SPSS software.

    RESULTS: The comparison of changes in sleep quality score the old men showed the sleep duration and total sleep quality has significantly improved in the experimental group.

    CONCLUSION: According to the study results, the maximum effect of footbath was on sleep latency and sleep duration disturbances. In this study, the researchers had limited access to the elderly in Tabriz; therefore, it is recommended that future research be conducted in a higher number of health centers.

    Be well!

    JP

  3. JP Says:

    Updated 08/17/15:

    http://www.ncbi.nlm.nih.gov/pubmed/25735061

    Hiroshima J Med Sci. 2014 Sep;63(1-3):1-5.

    Thermographic study on the preservability of heat effects of footbath with salt.

    Infrared thermography provides a non-invasive and dynamic measure of heat. The thermal preservability effects of a salt footbath were evaluated by the infrared thermography technique. The subjects were 23 healthy college students. Feet were soaked for 10 min in a 40-42 degrees C normal footbath. Room temperature was set at 26.5-28 degrees C. At the same time on another day within 3 days of the normal footbath experiment, the same feet were soaked for 10 min in a 40-42 degrees C salt footbath. We measured blood pressure, heart rate and temperatures of the feet, second toes, hands and middle fingers, just before and after immersion and at 10-min intervals thereafter. Mean blood pressure changes showed no difference between the normal and the salt footbath. Mean heart rate changes were higher during the normal footbath than at 0, 15 and 20 min during the salt footbath, respectively (p < 0.05). Mean thermal preservability of the feet tended to be lower after the normal footbath than at 20 and 30 min, respectively, after the salt footbath, but these differences did not reach a statistical significance. Mean thermal preservability of the hands and middle fingers was significantly lower after the normal footbath than at 20 and 30 min, respectively, after the salt footbath (p < 0.05). The results suggest that stimulation by a salt footbath affects surface skin temperature, and that stimulation aimed at increasing skin thermal preservability shows a significant difference between normal and salt footbaths. Be well! JP

  4. JP Says:

    Updated 08/17/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363653/

    J Caring Sci. 2015 Mar 1;4(1):63-73.

    Effect of Lavender Cream with or without Foot-bath on Anxiety, Stress and Depression in Pregnancy: a Randomized Placebo-Controlled Trial.

    INTRODUCTION: Psychological disorders are associated with maternal and neonatal morbidities. We aimed to evaluate the effect of Lavender cream with or without foot-bath on depression, anxiety and stress of pregnant women.

    METHODS: In this trial, 141 women at 25 to 28 weeks gestation were randomly assigned into three groups (47 at each group); receiving Lavender cream with foot-bath, only Lavender cream, or placebo, 2g every night for two months. Depression, anxiety and stress were assessed at baseline, and 4(th) and 8(th) weeks after intervention, using DASS-21. General linear model was used to compare the groups.

    RESULTS: There were three losses to follow-up at the 4(th) and one more at the 8(th) week. Scores of all three outcomes in both Lavender and foot-bath and only Lavender groups were significantly lower than those in the placebo group at the 8(th) week; adjusted difference of depression score -3.3, 95% confidence interval -4.6 to -1.9;-2.4, -3.7 to -1.0, respectively, anxiety score -1.4, -2.6 to -0.2; -1.7,-2.9 to -0.5 and stress score -3.1, -4.7 to -1.5; -2.7, -4.3 to -1.1. At the 4(th) week, only score of anxiety in the lavender group (-2.3, -3.9 to -0.8) and stress in the both groups (-2.3, -4.1 to -0.5; -1.9, -3.7 to -0.1) were significantly less than those in the placebo group. There were not statistically significant differences between the two experimental groups in terms of the outcomes.

    CONCLUSION: Lavender cream with foot-bath or alone can be used for pregnant women for reducing their stress, anxiety and depression.

    Be well!

    JP

  5. JP Says:

    Updated 08/17/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270653/

    Iran Red Crescent Med J. 2014 Aug 17;16(9):e14455.

    Comparing the effects of aromatherapy with rose oils and warm foot bath on anxiety in the first stage of labor in nulliparous women.

    BACKGROUND: Anxiety is the most common emotional response in women during delivery, which can be accompanied with adverse effects on fetus and mother.

    OBJECTIVES: This study was conducted to compare the effects of aromatherapy with rose oil and warm foot bath on anxiety in the active phase of labor in nulliparous women in Tehran, Iran.

    PATIENTS AND METHODS: This clinical trial study was performed after obtaining informed written consent on 120 primigravida women randomly assigned into three groups. The experimental group 1 received a 10-minute inhalation and footbath with oil rose. The experimental group 2 received a 10-minute warm water footbath. Both interventions were applied at the onset of active and transitional phases. Control group, received routine care in labor. Anxiety was assessed using visual analogous scale (VASA) at onset of active and transitional phases before and after the intervention. Statistical comparison was performed using SPSS software version 16 and P < 0.05 was considered significant. RESULTS: Anxiety scores in the intervention groups in active phase after intervention were significantly lower than the control group (P < 0.001). Anxiety scores before and after intervention in intervention groups in transitional phase was significantly lower than the control group (P < 0.001). CONCLUSIONS: Using aromatherapy and footbath reduces anxiety in active phase in nulliparous women. Be well! JP

  6. JP Says:

    Updated 1/7/16:

    http://www.ncbi.nlm.nih.gov/pubmed/26734475

    Iran Red Crescent Med J. 2015 Nov 1;17(11):e20111.

    Comparing the Effects of Reflexology and Footbath on Sleep Quality in the Elderly: A Controlled Clinical Trial.

    BACKGROUND: Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality.

    OBJECTIVES: The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people.

    PATIENTS AND METHODS: This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process.

    RESULTS: The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01 , P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep.

    CONCLUSIONS: It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research.

    Be well!

    JP

  7. JP Says:

    Updated 04/15/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750306/

    J Neurosci Rural Pract. 2016 Jan-Mar;7(1):109-13.

    Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients.

    BACKGROUND: Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head) in migraine patients.

    METHODS: Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20) or conventional medication only (n = 20). Hydrotherapy group received treatment with hot arm and foot bath (103°F to 110°F) and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT), visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV) before and after intervention period.

    RESULTS: There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017), increase in high frequency (HF) (P = 0.014) and decrease in low frequency/HF ratio (P = 0.004) in add on hydrotherapy group.

    CONCLUSION: Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients.

    Be well!

    JP

  8. JP Says:

    Updated 06/14/16:

    http://www.psychiatricnursing.org/article/S0883-9417%2816%2900003-0/abstract

    Arch Psychiatr Nurs. 2016 Jun;30(3):375-81.

    Research on the Effect of the Foot Bath and Foot Massage on Residual Schizophrenia Patients.

    Researchers performed foot baths and massages for residual schizophrenia patients to gauge the effects on psychiatric symptoms. Subjects were six residual schizophrenia patients hospitalized in a psychiatric hospital. Three times a week for 4weeks, they received an 8-minute effleurage massage to their legs after a 10-minute foot bath. The effect of physiological relaxation was identified by a significant decline in heart rate in all cases. The results of the Positive and Negative Symptom Scale are as follows: a mean score of 29.0 was measured before treatment, which lowered to 21.5 after treatment, indicating that foot care improved their negative symptoms (p<0.05).The results of the Quality of Life Scale before the foot care intervention, were 10.5 and increased to 34.0 after the intervention, indicating improvement in their quality of life (p<0.05). The results of the two measurements indicate that foot baths and massages were effective in improving psychiatric symptoms.

    Be well!

    JP

  9. JP Says:

    Updated 06/16/16:

    http://www.complementarytherapiesinmedicine.com/article/S0965-2299%2816%2930015-2/abstract

    Complement Ther Med. 2016 Jun;26:40-6.

    The effects of footbath on sleep among the older adults in nursing home: A quasi-experimental study.

    OBJECTIVES: To examine the long-term effects of foot-bathing therapy, using different water temperatures, on the sleep quality of older adults living in nursing homes.

    DESIGN: A quasi-experimental study design with non-equivalent control group.

    SETTINGS: Thirty participants were recruited from a nursing home in Gyeong-gi Province, South Korea.

    INTERVENTIONS: The participants were randomly assigned to experimental, placebo, and control groups. The foot-bathing therapy was performed for 30min daily for four weeks. Water at 40°C was used for the experimental group, while water at 36.5°C was used for the placebo group. The control group did not receive any intervention.

    MAIN OUTCOME MEASURES: The participants’ sleep patterns (total sleep amount, sleep efficiency, and sleep latency) and sleep-disturbed behaviors were compared based on group, using actigraphy and a sleep disorder inventory.

    RESULTS: The total amount of sleep and sleep efficiency were significantly different for the experimental group, especially those with poor sleep quality. There were no differences in sleep latency or sleep-disturbed behaviors among the groups. The long-term effect of the therapy decreased in the third week of the therapy.

    CONCLUSIONS: Daily, 30-min foot-bathing therapy sessions with water at 40°C were effective in improving sleep quality for older adults. The therapy was more effective for participants with poor sleep quality at baseline assessment than those with relatively good sleep quality. The long-term effects of foot-bathing therapy decreased three weeks after initiation; therefore, it might be desirable to deliver the therapy for two weeks, pause it for a week, and then resume it.

    Be well!

    JP

  10. JP Says:

    Updated 01/08/17:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5187550/

    J Caring Sci. 2016 Dec 1;5(4):299-306.

    Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome.

    Introduction: Many patients in coronary care unit (CCU) suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS). Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups of 35 subjects. The groups were foot reflexology massage, foot bath, a combination of the two and the control group. Sleep quality was measured using the Veran Snyder-Halpern questionnaire. Data were analyzed by SPSS version 13. Results: The mean age of the four groups was 61.22 (11.67) years. The mean sleep disturbance in intervention groups (foot reflexology massage and foot bath groups) during the second and third nights was significantly less than before intervention. The results also showed a greater reduction in sleep disturbance in the combined group than in the other groups when compared to the control group. Conclusion: It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders and there was a synergistic effect when used in combination. This complementary care method can be recommended to be implemented by CCU nurses.

    Be well!

    JP

  11. JP Says:

    Updated 03/30/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28351399

    BMC Complement Altern Med. 2017 Mar 28;17(1):172.

    Effects of hyperthermic baths on depression, sleep and heart rate variability in patients with depressive disorder: a randomized clinical pilot trial.

    BACKGROUND: Despite advances in the treatment of depression, one-third of depressed patients fail to respond to conventional antidepressant medication. There is a need for more effective treatments with fewer side effects. The primary aim of this study was to determine whether hyperthermic baths reduce depressive symptoms in adults with depressive disorder.

    METHODS: Randomized, two-arm placebo-controlled, 8-week pilot trial. Medically stable outpatients with confirmed depressive disorder (ICD-10: F32/F33) who were moderately depressed as determined by the 17-item Hamilton Scale for Depression (HAM-D) score ≥18 were randomly assigned to 2 hyperthermic baths (40 °C) per week for 4 weeks or a sham intervention with green light and follow-up after 4 weeks. Main outcome measure was the change in HAM-Dtotal score from baseline (T0) to the 2-week time point (T1).

    RESULTS: A total of 36 patients were randomized (hyperthermic baths, n = 17; sham condition, n = 19). The intention-to-treat analysis showed a significant (P = .037) difference in the change in HAM-Dtotal score with 3.14 points after 4 interventions (T1) in favour of the hyperthermic bath group compared to the placebo group.

    CONCLUSIONS: This pilot study suggests that hyperthermic baths do have generalized efficacy in depressed patients.

    Be well!

    JP

  12. JP Says:

    Updated 04/19/17:

    https://www.ncbi.nlm.nih.gov/pubmed/27917792

    Clin Invest Med. 2016 Dec 1;39(6):27501.

    Potential beneficial effects of foot bathing on cardiac rhythm.

    PURPOSE: Foot bathing therapy is a simple technique that induces sensations of comfort and relaxation. The aim of this study was to examine the effect of foot bathing therapy on heart rate variability (HRV) parameters in a healthy population.

    METHODS: Participants were twenty healthy female subjects (median age=20.67 years, SD=1.04). The recording ECG was applied for 5 minutes before and for 5 minutes after foot bathing therapy of 10 minutes. Subjects rested for 10 minutes without recording ECG in order to stabilize autonomic parameters. The digital signals were then transferred to a laptop and analyzed using LabChart® software (MLS310/7 HRV Module).

    RESULTS: Almost all HRV parameters increased and heart (pulse) rate and LF/HF ratio decreased after foot bathing therapy compared with before foot bathing therapy.

    CONCLUSIONS: These results indicate for the first time in humans that foot bathing might induce a state of balance between sympathetic and parasympathetic systems and might be helpful to prevent possible cardiac arrhythmias.

    Be well!

    JP

  13. JP Says:

    Updated 10/30/18:

    https://journals.lww.com/jnnonline/Abstract/2017/12000/A_Feasibility_Randomized_Controlled_Crossover.9.aspx

    J Neurosci Nurs. 2017 Dec;49(6):380-385.

    A Feasibility Randomized Controlled Crossover Trial of Home-Based Warm Footbath to Improve Sleep in the Chronic Phase of Traumatic Brain Injury.

    INTRODUCTION: Sleep disturbance is a common complaint after traumatic brain injury (TBI). The aim of this study was to examine the effects of a home-based warm footbath intervention on sleep in patients with TBI.

    METHODS: This was a randomized controlled crossover study, and 23 adults with TBI were recruited and randomized to receive first a 30-minute, 41°C warm footbath and then a usual care, or vice versa, with each lasting 3 days and separated by a 3-day washout. Sleep efficiency, sleep onset latency (SOL), total sleep time, and wake after sleep onset (WASO) were assessed by actigraphy.

    RESULTS: We found that home-based warm footbath significantly had a reduced SOL (difference, -5.11 minutes) and a suppressed WASO (difference, -2.57 minutes) compared with those of usual care, but not in sleep efficiency and total sleep time. No adverse effect was reported.

    CONCLUSIONS: This study suggested that home-based warm footbath is practical and effective in relieving post-TBI sleep disturbances, particular in SOL and WASO. Nurses can use home-based warm footbath as an effective intervention for management of sleep disturbances after TBI.

    Be well!

    JP

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