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The Effects of Aroma Foot Reflex Massage on Mood States and Brain Waves in Women Elderly with Osteoarthritis
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Research

The Effects of Aroma Foot Reflex Massage on Mood States and Brain Waves in Women Elderly with Osteoarthritis

In Sook Kim1, Hee Jeong Yang2, Eun Seon Im2, Hee Young Kang1
Korean Journal of Adult Nursing 2013;25(6):644-654.
Published online: December 18, 2012

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Corresponding author: Kang, Hee Young Department of Nursing, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759, Korea. Tel: +82-62-230-6323, Fax: +82-62-230-6329, E-mail: moohykang@naver.com

© 2012 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to examine the effects of aroma foot reflexology massage on mood states specifically depression and brain waves of elderly women with osteoarthritis.
  • Methods
    The study was a nonequivalent control group non-synchronized design. The participants were 62 elderly women with osteoarthritis. The instruments were the Korean-Profile of Mood States-Brief for mood states and 8-channel EEG (Electroencephalogram) system for brain waves. Data were collected from March to May, 2012. Twenty-six participants were assigned to the treatment group and twenty-six to the comparison group. The data were analyzed using SPSS/WIN 17.0 version program, and included descriptive statistics, t-test, and ANCOVA. The intervention was conducted three times a week for two weeks.
  • Results
    There were significantly improvement in reported depression. s. Brain waves (EEG) increased significantly in F3, T3 of ⍺ wave and in F4, T3, and P4 of β wave between the two groups.
  • Conclusion
    Aroma foot reflexology massage can be utilized as an effective intervention to decrease depression of mood states, increase of ⍺, and β brain wave on woman elderly with osteoarthritis.
  • Key Words: Aromatherapy; Reflexology; Massage; Mood; Brain wave
Table 1.
Homogeneity Test for General Characteristics of Participants (N=62)
Characteristics Categories Exp. (n=31) Cont. (n=31) x2 p
n (%) n (%)
Age (year) 70~79 7 (22.6) 14 (45.2) 4.31 .116
80~89 22 (71.0) 14 (45.2)    
≥90 2 (6.5) 3 (9.7)    
Education None 22 (71.0) 15 (48.4) -1.03 .072
≥Elementary school 9 (29.0) 16 (51.6)    
Spouse† Yes 4 (12.9) 1 (3.2)   .354
NO 27 (87.1) 30 (96.8)    
Number of children ≤3 13 (41.9) 8 (25.8) 3.18 .204
4~6 13 (41.9) 20 (64.5)    
≥7 5 (16.2) 3 (9.7)    
Allowance† (10,000 won) ＞10 30 (96.8) 28 (90.3)   .612
≤10 1 (3.2) 3 (9.7)    
Religion Yes 23 (74,2) 27 (87.1) 1.65 .199
No 8 (25.8) 4 (12.9)    
Occupation† Yes   1 (3.2)   1.000
No 31 (100.0) 30 (96.8)    
Hours of sleep ≤8 20 (64.5) 26 (83.9) 3.03 .082
≥9 11 (35.5) 5 (16.1)    

Exp.=experimental group; Cont.=control group.

†Fisher's exact test.

Table 2.
Homogeneity Test of Dependent Variables (N=62)
Variables Categories Exp. (n=31) Cont. (n=31) t p
M±SD M±SD
Mood states Total 10.61±11.59 14.39±16.13 -1.06 .295
Tension 5.84±3.25 5.94±3.19 -0.12 .906
Depression 7.48±4.15 6.42±3.38 -1.11 .273
Anger 4.90±3.43 5.39±3.91 -0.52 .606
Vigor 18.97±1.92 15.81±3.10 4.82 ＜.001
Fatigue 7.61±3.18 5.58±3.53 2.38 .020
Confusion 4.81±1.38 5.81±2.90 -1.73 .090
Slow ⍺ power spectrum Fp1 0.20±0.10 0.24±0.15 -1.17 .247
Fp2 0.20±0.11 0.24±0.15 -1.08 .283
F3 0.23±0.11 0.27±0.16 -1.24 .222
F4 0.22±0.12 0.26±0.15 -1.04 .303
T3 0.19±0.08 0.22±0.11 -1.44 .156
T4 0.19±0.10 0.24±0.14 -1.77 .083
P3 0.31±0.15 0.32±0.18 -0.36 .721
P4 0.31±0.16 0.33±0.19 -0.46 .651
Fp1 0.05±0.02 0.06±0.02 -1.46 .149
β power spectrum Fp2 0.05±0.02 0.06±0.02 -1.13 .263
F3 0.07±0.03 0.09±0.05 -1.54 .147
F4 0.07±0.03 0.09±0.04 -1.55 .145
T3 0.06±0.02 0.08±0.03 -1.88 .067
T4 0.06±0.02 0.08±0.03 -1.58 .101
P3 0.07±0.04 0.09±0.03 -1.85 .069
P4 0.07±0.03 0.09±0.03 -1.25 .058

Exp.=experimental group; Cont.=control group; Fp1=left prefrontal; Fp2=right prefrontal; F3=left frontal; F4=right frontal; T3=left temporal; T4=right temporal; P3=left parietal; P4=right parietal.

Table 3.
Differences of Mood states between Experimental and Control Group (N=62)
Variables Groups Pretest Posttest Difference t p
M±SD M±SD M±SD
Total mood states Exp. 10.61±11.59 2.00±10.69 -8.61±10.51 -1.01 .319
Cont 14.39±16.13 1.68±17.06 -12.71±20.04    
Tension Exp. 5.84±3.25 3.87±3.04 -1.97±3.24 0.30 .768
Cont. 5.94±3.19 4.23±3.25 -1.71±3.62    
Depression Exp. 7.48±4.15 3.61±3.72 -3.87±5.04 -2.70 .009
Cont. 6.42±3.38 5.58±3.12 -0..84±3.70    
Anger Exp. 4.90±3.43 3.84±2.96 -1.06±3.50 -0.85 .397
Cont. 5.39±3.91 3.35±3.93 -2.03±5.25    
Vigor Exp. 18.97±1.92 18.16±2.45 0.81±2.04 -2.18 .034
Cont. 15.81±3.10 16.71±3.97 -0.90±3.86    
Fatigue Exp. 7.61±3.18 3.45±2.32 -4.16±2.79 2.24 .029
Cont. 5.58±3.53 3.45±3.50 -2.13±4.21    
Confusion Exp. 4.81±1.38 3.42±1.89 -1.39±2.12 -0.86 .395
Cont. 5.81±2.90 3.74±3.21 -2.06±3.85    

Exp.=experimental group. (n=31); Cont.=control group (n=31).

Table 4.
Differences of Relative Slow ⍺ Wave between Experimental and Control Group (N=62)
Dependent variables     Pretest Posttest Difference t p
M±SD M±SD M±SD
⍺ power spectrum Fp1 Exp. 0.20±0.10 0.21±0.10 0.01±0.06 1.18 .243
  Cont. 0.24±0.15 0.22±0.14 -0.02±0.11    
Fp2 Exp. 0.20±0.11 0.21±0.09 0.00±0.06 0.46 .651
  Cont. 0.24±0.15 0.23±0.14 -0.01±0.11    
F3 Exp. 0.23±0.11 0.27±0.11 0.04±0.08 2.36 .022
  Cont. 0.27±0.16 0.26±0.16 -0.02±0.11    
F4 Exp. 0.22±0.12 0.24±0.11 0.02±0.08 1.24 .218
  Cont. 0.26±0.15 0.25±0.17 -0.01±0.11    
T3 Exp. 0.19±0.08 0.21±0.10 0.03±0.08 2.21 .031
  Cont. 0.22±0.11 0.20±0.12 -0.03±0.10    
T4 Exp. 0.19±0.10 0.20±0.10 0.01±0.10 1.40 .167
  Cont. 0.24±0.14 0.22±0.13 -0.02±0.10    
P3 Exp. 0.31±0.15 0.36±0.14 0.05±0.13 1.85 .069
  Cont. 0.32±0.18 0.31±0.19 -0.01±0.15    
P4 Exp. 0.31±0.16 0.32±0.14 0.01±0.11 0.90 .372
  Cont. 0.33±0.19 0.31±0.21 -0.02±0.15    
Fp1 Exp. 0.05±0.02 0.06±0.02 0.00±0.01 0.77 .446
  Cont. 0.06±0.02 0.06±0.02 -0.00±0.02    
β power spectrum Fp2 Exp. 0.05±0.02 0.05±0.02 0.00±0.01 0.35 .727
  Cont. 0.06±0.02 0.06±0.02 -0.00±0.02    
F3 Exp. 0.07±0.03 0.08±0.03 0.01±0.02 1.86 .067
  Cont. 0.09±0.05 0.09±0.04 -0.00±0.04    
F4 Exp. 0.07±0.03 0.08±0.03 0.01±0.02 2.14 .037
  Cont. 0.09±0.04 0.08±0.03 -0.01±0.03    
RLB_T T3 Exp. 0.05±0.02 0.06±0.02 0.01±0.02 3.45 .001
  Cont. 0.08±0.03 0.07±0.03 -0.013±0.02    
T4 Exp. 0.06±0.02 0.06±0.02 0.00±0.01 2.00 .051
  Cont. 0.08±0.03 0.08±0.03 -0.01±0.03    
P3 Exp. 0.07±0.04 0.07±0.04 0.00±0.02 1.35 .182
  Cont. 0.09±0.03 0.08±0.03 -0.01±0.03    
P4 Exp. 0.06±0.03 0.07±0.03 0.01±0.02 2.28 .026
  Cont. 0.08±0.03 0.07±0.03 -0.01±0.03    

Exp.=experimental group; Cont.=control group. RSA=relative slow alpha power spectrum; RLB=relative low beta power spectrum; Fp1=left prefrontal; Fp2=right prefrontal; F3=left frontal; F4=right frontal; T3=left temporal; T4=right temporal; P3=left parietal; P4=right parietal.

Table 5.
Analysis of Covariance (ANCOVA) on Mood States (N=62)
Variables Categories SS df MS F p
Mood states total Covariates 1577.02 1 1577.02 8.79 .004
Group 43.98 1 43.98 0.25 .622
Error 10581.75 59 179.35    
Total 12160.39 61      
Tension Covariates 104.37 1 104.37 12.55 .001
Group 1.540 1 1.54 0.19 .669
Error 490.53 59 8.31    
Total 596.86 61      
Depression Covariates 45.64 1 45.64 4.07 .048
Group 74.38 1 74.38 6.64 .013
Error 661.27 59 11.21    
Total 766.92 61      
Anger Covariates Group 36.12 5.30 1 1 36.12 5.30 3.09 0.45 .084 .503
Error 689.17 59 11.68    
Total 728.92 61      
Vigor Covariates 144.57 1 144.57 16.79 ＜.001
Group 2.26 1 2.27 0.26 .611
Error 508.01 59 8.61    
Total 685.24 61      
Fatigue Covariates 71.69 1 71.69 9.24 .004
Group 6.19 1 6.19 0.80 .375
Error 457.66 59 7.76    
Total 529.36 61      
Confusion Covariates 17.67 1 17.67 2.61 .112
Group 0.10 1 0.10 0.02 .902
Error 399.82 59 6.78    
Total 419.10 61      

Note. The covariates are vigor and fatigue. SS=sum of square; MS=mean square.

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      The Effects of Aroma Foot Reflex Massage on Mood States and Brain Waves in Women Elderly with Osteoarthritis
      Korean J Adult Nurs. 2013;25(6):644-654.   Published online December 31, 2013
      DOI: https://doi.org/10.7475/kjan.2013.25.6.644
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      The Effects of Aroma Foot Reflex Massage on Mood States and Brain Waves in Women Elderly with Osteoarthritis
      Korean J Adult Nurs. 2013;25(6):644-654.   Published online December 31, 2013
      DOI: https://doi.org/10.7475/kjan.2013.25.6.644
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      The Effects of Aroma Foot Reflex Massage on Mood States and Brain Waves in Women Elderly with Osteoarthritis
      The Effects of Aroma Foot Reflex Massage on Mood States and Brain Waves in Women Elderly with Osteoarthritis

      Homogeneity Test for General Characteristics of Participants (N=62)

      Characteristics Categories Exp. (n=31) Cont. (n=31) x2 p
      n (%) n (%)
      Age (year) 70~79 7 (22.6) 14 (45.2) 4.31 .116
      80~89 22 (71.0) 14 (45.2)    
      ≥90 2 (6.5) 3 (9.7)    
      Education None 22 (71.0) 15 (48.4) -1.03 .072
      ≥Elementary school 9 (29.0) 16 (51.6)    
      Spouse† Yes 4 (12.9) 1 (3.2)   .354
      NO 27 (87.1) 30 (96.8)    
      Number of children ≤3 13 (41.9) 8 (25.8) 3.18 .204
      4~6 13 (41.9) 20 (64.5)    
      ≥7 5 (16.2) 3 (9.7)    
      Allowance† (10,000 won) ＞10 30 (96.8) 28 (90.3)   .612
      ≤10 1 (3.2) 3 (9.7)    
      Religion Yes 23 (74,2) 27 (87.1) 1.65 .199
      No 8 (25.8) 4 (12.9)    
      Occupation† Yes   1 (3.2)   1.000
      No 31 (100.0) 30 (96.8)    
      Hours of sleep ≤8 20 (64.5) 26 (83.9) 3.03 .082
      ≥9 11 (35.5) 5 (16.1)    

      Exp.=experimental group; Cont.=control group.

      †Fisher's exact test.

      Homogeneity Test of Dependent Variables (N=62)

      Variables Categories Exp. (n=31) Cont. (n=31) t p
      M±SD M±SD
      Mood states Total 10.61±11.59 14.39±16.13 -1.06 .295
      Tension 5.84±3.25 5.94±3.19 -0.12 .906
      Depression 7.48±4.15 6.42±3.38 -1.11 .273
      Anger 4.90±3.43 5.39±3.91 -0.52 .606
      Vigor 18.97±1.92 15.81±3.10 4.82 ＜.001
      Fatigue 7.61±3.18 5.58±3.53 2.38 .020
      Confusion 4.81±1.38 5.81±2.90 -1.73 .090
      Slow ⍺ power spectrum Fp1 0.20±0.10 0.24±0.15 -1.17 .247
      Fp2 0.20±0.11 0.24±0.15 -1.08 .283
      F3 0.23±0.11 0.27±0.16 -1.24 .222
      F4 0.22±0.12 0.26±0.15 -1.04 .303
      T3 0.19±0.08 0.22±0.11 -1.44 .156
      T4 0.19±0.10 0.24±0.14 -1.77 .083
      P3 0.31±0.15 0.32±0.18 -0.36 .721
      P4 0.31±0.16 0.33±0.19 -0.46 .651
      Fp1 0.05±0.02 0.06±0.02 -1.46 .149
      β power spectrum Fp2 0.05±0.02 0.06±0.02 -1.13 .263
      F3 0.07±0.03 0.09±0.05 -1.54 .147
      F4 0.07±0.03 0.09±0.04 -1.55 .145
      T3 0.06±0.02 0.08±0.03 -1.88 .067
      T4 0.06±0.02 0.08±0.03 -1.58 .101
      P3 0.07±0.04 0.09±0.03 -1.85 .069
      P4 0.07±0.03 0.09±0.03 -1.25 .058

      Exp.=experimental group; Cont.=control group; Fp1=left prefrontal; Fp2=right prefrontal; F3=left frontal; F4=right frontal; T3=left temporal; T4=right temporal; P3=left parietal; P4=right parietal.

      Differences of Mood states between Experimental and Control Group (N=62)

      Variables Groups Pretest Posttest Difference t p
      M±SD M±SD M±SD
      Total mood states Exp. 10.61±11.59 2.00±10.69 -8.61±10.51 -1.01 .319
      Cont 14.39±16.13 1.68±17.06 -12.71±20.04    
      Tension Exp. 5.84±3.25 3.87±3.04 -1.97±3.24 0.30 .768
      Cont. 5.94±3.19 4.23±3.25 -1.71±3.62    
      Depression Exp. 7.48±4.15 3.61±3.72 -3.87±5.04 -2.70 .009
      Cont. 6.42±3.38 5.58±3.12 -0..84±3.70    
      Anger Exp. 4.90±3.43 3.84±2.96 -1.06±3.50 -0.85 .397
      Cont. 5.39±3.91 3.35±3.93 -2.03±5.25    
      Vigor Exp. 18.97±1.92 18.16±2.45 0.81±2.04 -2.18 .034
      Cont. 15.81±3.10 16.71±3.97 -0.90±3.86    
      Fatigue Exp. 7.61±3.18 3.45±2.32 -4.16±2.79 2.24 .029
      Cont. 5.58±3.53 3.45±3.50 -2.13±4.21    
      Confusion Exp. 4.81±1.38 3.42±1.89 -1.39±2.12 -0.86 .395
      Cont. 5.81±2.90 3.74±3.21 -2.06±3.85    

      Exp.=experimental group. (n=31); Cont.=control group (n=31).

      Differences of Relative Slow ⍺ Wave between Experimental and Control Group (N=62)

      Dependent variables     Pretest Posttest Difference t p
      M±SD M±SD M±SD
      ⍺ power spectrum Fp1 Exp. 0.20±0.10 0.21±0.10 0.01±0.06 1.18 .243
        Cont. 0.24±0.15 0.22±0.14 -0.02±0.11    
      Fp2 Exp. 0.20±0.11 0.21±0.09 0.00±0.06 0.46 .651
        Cont. 0.24±0.15 0.23±0.14 -0.01±0.11    
      F3 Exp. 0.23±0.11 0.27±0.11 0.04±0.08 2.36 .022
        Cont. 0.27±0.16 0.26±0.16 -0.02±0.11    
      F4 Exp. 0.22±0.12 0.24±0.11 0.02±0.08 1.24 .218
        Cont. 0.26±0.15 0.25±0.17 -0.01±0.11    
      T3 Exp. 0.19±0.08 0.21±0.10 0.03±0.08 2.21 .031
        Cont. 0.22±0.11 0.20±0.12 -0.03±0.10    
      T4 Exp. 0.19±0.10 0.20±0.10 0.01±0.10 1.40 .167
        Cont. 0.24±0.14 0.22±0.13 -0.02±0.10    
      P3 Exp. 0.31±0.15 0.36±0.14 0.05±0.13 1.85 .069
        Cont. 0.32±0.18 0.31±0.19 -0.01±0.15    
      P4 Exp. 0.31±0.16 0.32±0.14 0.01±0.11 0.90 .372
        Cont. 0.33±0.19 0.31±0.21 -0.02±0.15    
      Fp1 Exp. 0.05±0.02 0.06±0.02 0.00±0.01 0.77 .446
        Cont. 0.06±0.02 0.06±0.02 -0.00±0.02    
      β power spectrum Fp2 Exp. 0.05±0.02 0.05±0.02 0.00±0.01 0.35 .727
        Cont. 0.06±0.02 0.06±0.02 -0.00±0.02    
      F3 Exp. 0.07±0.03 0.08±0.03 0.01±0.02 1.86 .067
        Cont. 0.09±0.05 0.09±0.04 -0.00±0.04    
      F4 Exp. 0.07±0.03 0.08±0.03 0.01±0.02 2.14 .037
        Cont. 0.09±0.04 0.08±0.03 -0.01±0.03    
      RLB_T T3 Exp. 0.05±0.02 0.06±0.02 0.01±0.02 3.45 .001
        Cont. 0.08±0.03 0.07±0.03 -0.013±0.02    
      T4 Exp. 0.06±0.02 0.06±0.02 0.00±0.01 2.00 .051
        Cont. 0.08±0.03 0.08±0.03 -0.01±0.03    
      P3 Exp. 0.07±0.04 0.07±0.04 0.00±0.02 1.35 .182
        Cont. 0.09±0.03 0.08±0.03 -0.01±0.03    
      P4 Exp. 0.06±0.03 0.07±0.03 0.01±0.02 2.28 .026
        Cont. 0.08±0.03 0.07±0.03 -0.01±0.03    

      Exp.=experimental group; Cont.=control group. RSA=relative slow alpha power spectrum; RLB=relative low beta power spectrum; Fp1=left prefrontal; Fp2=right prefrontal; F3=left frontal; F4=right frontal; T3=left temporal; T4=right temporal; P3=left parietal; P4=right parietal.

      Analysis of Covariance (ANCOVA) on Mood States (N=62)

      Variables Categories SS df MS F p
      Mood states total Covariates 1577.02 1 1577.02 8.79 .004
      Group 43.98 1 43.98 0.25 .622
      Error 10581.75 59 179.35    
      Total 12160.39 61      
      Tension Covariates 104.37 1 104.37 12.55 .001
      Group 1.540 1 1.54 0.19 .669
      Error 490.53 59 8.31    
      Total 596.86 61      
      Depression Covariates 45.64 1 45.64 4.07 .048
      Group 74.38 1 74.38 6.64 .013
      Error 661.27 59 11.21    
      Total 766.92 61      
      Anger Covariates Group 36.12 5.30 1 1 36.12 5.30 3.09 0.45 .084 .503
      Error 689.17 59 11.68    
      Total 728.92 61      
      Vigor Covariates 144.57 1 144.57 16.79 ＜.001
      Group 2.26 1 2.27 0.26 .611
      Error 508.01 59 8.61    
      Total 685.24 61      
      Fatigue Covariates 71.69 1 71.69 9.24 .004
      Group 6.19 1 6.19 0.80 .375
      Error 457.66 59 7.76    
      Total 529.36 61      
      Confusion Covariates 17.67 1 17.67 2.61 .112
      Group 0.10 1 0.10 0.02 .902
      Error 399.82 59 6.78    
      Total 419.10 61      

      Note. The covariates are vigor and fatigue. SS=sum of square; MS=mean square.
      Table 1. Homogeneity Test for General Characteristics of Participants (N=62)

      Exp.=experimental group; Cont.=control group.

      Fisher's exact test.

      Table 2. Homogeneity Test of Dependent Variables (N=62)

      Exp.=experimental group; Cont.=control group; Fp1=left prefrontal; Fp2=right prefrontal; F3=left frontal; F4=right frontal; T3=left temporal; T4=right temporal; P3=left parietal; P4=right parietal.

      Table 3. Differences of Mood states between Experimental and Control Group (N=62)

      Exp.=experimental group. (n=31); Cont.=control group (n=31).

      Table 4. Differences of Relative Slow ⍺ Wave between Experimental and Control Group (N=62)

      Exp.=experimental group; Cont.=control group. RSA=relative slow alpha power spectrum; RLB=relative low beta power spectrum; Fp1=left prefrontal; Fp2=right prefrontal; F3=left frontal; F4=right frontal; T3=left temporal; T4=right temporal; P3=left parietal; P4=right parietal.

      Table 5. Analysis of Covariance (ANCOVA) on Mood States (N=62)

      Note. The covariates are vigor and fatigue. SS=sum of square; MS=mean square.

      Table 1.

      Table 2.

      Table 3.

      Table 4.

      Table 5.

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