reflexology and stroke rehab

I saw a question on this on a UK forum and I had to do some research on it.
picture of foot points;
http://www.healthtohelp.com/Reflexology.html
Reflexology is the physical act of applying pressure to the feet and hand with specific thumb, finger and hand techniques without the use of oil or lotion. it is based on a system of zones and reflex areas that reflect an image of the body on the feet and hands with a premise that such work effects a physical change to the body.
You can see by looking at the picture that the first three toes represent the brain. If only it was that simple, I could massage my toes and make my brain all better. but your doctor knows better than I if or how this works so ask him/her.
the hand charts are here:
http://www.dorlingkindersley-uk.co.uk/static/cs/uk/11/features/reflexology/handchart.html
You can find the brain on these also.


http://www.koreamed.org/SearchBasic.php?RID=0116KJRN/2005.8.2.139&DT=1
The Effects of Foot Reflexology on ADL and Fatigue in Stroke Patients. 
Song MR, Song HM.
College of Nursing, Seoul National University, Korea. junhchoi@hanafos.com
Nursing Department, Dongshin Oriental Medicine Hospital, Korea.
Abstract
PURPOSE: This study was to examine the effects of foot reflexology on ADL and fatigue in stroke patients. METHOD: The subjects were 31 stroke patients hospitalized in the Oriental Medicine Hospital of D University from June to November, 2002. Foot reflexology was applied to the experimental group twice a week for 6 weeks, 40 minutes each. For the data analysis, chi2-test was conducted to verify the homogeneity of general characteristics and clinical characteristics, and t-test was done to verify the homogeneity of ADL and fatigue. To examine the relative efficacy of the intervention, ANOVA and ANCOVA were conducted. RESULTS: After foot reflexology, the subjects in the experimental group showed significant improvement in ADL. They also had less physical, psychological, and neurosensory fatigue, which are three areas of fatigue. CONCLUSION: The results suggest that foot reflexology is an effective intervention that helps the body work efficiently, eases stress and strain, and enhances the homeostasis of the body through stimulating the reflex zone of internal organs in the body. Therefore, it is necessary to develop foot reflexology as an unique nursing intervention.

 I really don't think the conclusions can be made from the points presented here.

http://www.positivehealth.com/article/reflexology/reflexology-for-stroke
Stroke is the biggest cause of severe disability in adult life in the UK and the third commonest cause of death in developed countries.[1] Every five minutes one person will suffer a first stroke, with about 10% of those people being under the age of 55.[2] In the elderly population, stroke remains a major cause of death.[3] The use of reflexology to aid the rehabilitation of people with stroke has been undertaken and people's intrinsic ability to self-heal combined with this gentle treatment encourages that process.[4]

Working a reflex point on the big toe
Most people are aware of reflexology as a complementary therapy whereby specific pressure is applied to the feet and sometimes the hands. Modern reflexology dates back to 1913 when Dr William Fitzgerald introduced 'zone therapy' to the Western world. Reflex areas on the feet and hands relate to areas within the same zone of the body and by working these areas in a specific way it can help to restore the body to its natural state. It is a balancing treatment that works on the body, mind and emotions, with people who receive treatment reporting a feeling of well-being and a reduction in a variety of symptoms relating to digestive disorders, headaches, muscular aches, fatigue, and a multitude of stress-related conditions. The importance of reflexology being 'complementary' means that it can be used alongside other orthodox medical treatments or complementary therapies.
Although I am concentrating on stroke in this instance, reflexology does not treat specific symptoms of disease but rather treats the whole person and as a result most people benefit from several sessions of reflexology adapted as a treatment plan tailored to the individual's needs.
Case Study - William
Aims of Treatment
The aims of treatment for my client, William, were first and foremost relaxation, enabling him to switch off from everyday stresses created by work and his lifestyle. Another main aim of the treatment was to ease the muscular ache in his shoulders, which was the result of the stroke. The antihypertensive and anticoagulant medication prescribed following the stroke reduced William's blood pressure to normal, as this was high preceding the stroke and diagnosed as a main contributing factor. William hoped that reflexology would help to stabilize his blood pressure further, so dependency on the drugs could be reduced (under GP supervision).
Other conditions noted during treatment and through the initial case history information showed that William had a tendency to feel discomfort and increased sensitivity in the gut, therefore alleviating the symptoms of this was also seen as a secondary aim of reflexology. However, this was not the reason that William undertook reflexology, as his primary aim was to alleviate the pain he felt in his shoulders.
How Did the Stroke Affect William?
Physically
Physical symptoms clear at the onset of William's stroke included problems with balance and co-ordination; paralysis on the right side of the face affecting the mouth, accompanied by dysarthria (slight slurring of speech); difficulty in swallowing for a few days following the stroke; pain in both shoulders particularly when the arms were lifted above shoulder height and when turning or stretching; and increased sensitivity to cold temperatures. This last observation may be due to the fact that he was prescribed medication with anticoagulant properties to reduce his blood pressure, in effect making him more susceptible to feeling the cold.
Mentally
The association of stroke with the brain is very relevant to the mental effect that it can have on the sufferer. William took one month off work at the recommendation of his doctor, which was totally out of character for him as he had rarely had a day off sick before this. William's acknowledgement of the effects of his stroke and his acceptance that he needed to relax highlighted the seriousness with which he addressed his state of health after the stroke.
Emotionally
Disturbances in mood will occur if specific parts of the brain are affected. A severe loss of appetite may follow a stroke, and the physical limitations brought about by stroke may lead to depression. William did not suffer severe symptoms such as these; however, his self-confidence was negatively affected by the loss of control he experienced after his stroke, i.e. not being able to drive or work. William was very positive once his condition had been diagnosed, as he regarded this as a warning sign for him to slow down.
Socially
Physical symptoms that continue for some time after the stroke will interrupt the social life of the person. For example, if the person has difficulty swallowing or paralysis of the face, it may be embarrassing for them to eat out socially or even be seen in public. There is also stigma attached to loss of bladder and bowel control, which could cause embarrassment and inconvenience to the stroke sufferer. William was slightly uncomfortable with the thought of eating out in a public place until his face had fully recovered, as he found it difficult to consume liquids without dribbling.
Initial Reflexology Consultation and Observation of the Feet
William suffered a minor stroke in January 1999, although he was originally informed that it might be Bell's palsy. His GP diagnosed hypertension and the results of a CT scan showed that he had suffered an acute ischaemic stroke; consequently he was signed off work for four weeks. He was told not to drive for at least one month and then to have a check-up with the doctor to ensure that he would be safe after this period of time. He believed that the onset of the stroke was caused by stress brought about by work pressures.
My initial consultation with William (aged 55) took place 15 months after the stroke occurred and gave me a clearer picture of different aspects of his life: past and present state of health, and his diet and lifestyle. At the time of taking the case history, William was still in a demanding job that involved a great deal of travelling by car. To this end, it was fair to say that he was under considerable pressure at work. William used to smoke 20-30 cigarettes a day when he was younger but gave up completely over 30 years ago. His exercise routine included walking at the weekends in addition to being physically active both in and out of work. He had been having difficulty sleeping preceding the stroke but noted that he had always been a light sleeper and easily woken. When asked what he did to relax he firstly said he didn't know but with further probing he said that he had a drink (alcohol) or watched TV.
His weight at 13 stone was also a contributing factor to the stroke and as a result William had already started to amend his diet. Although William claimed to have no known allergies, some foods caused him discomfort and it was evident that his digestive system was severely affected. William said that his current liquid intake was two pints of water per day, and six cans of cider plus two to three glasses of white wine per week.
I took William's blood pressure before and after the initial treatment and during the course of his reflexology treatments. His prescribed medication included Aspirin (75mg per day), Atenolol (50mg per day) and Amlodipine (10mg per day).
Observation of the feet is a major part of treatment to gain further information about the client and the condition of his health. William's feet were dry, cracked and scaly in texture with rippled, loose skin on the dorsal and plantar surfaces. There was a mixture of mottled tones, red and white denoting areas of inactivity and hypersensitivity. All his toenails were yellowing, with some blackened and very uneven, indicative of a weakened immune system. Calluses had formed on his upper fourth and fifth toes, inner big toe and inner heel. A noticeable tiny lump was felt beneath the surface of the skin on the left big toe, which is the reflex area associated with the brain.
The treatment plan involved working the areas of imbalance which were shown as marked sensitivity in all the toes with emphasis on the left big toe (brain reflex opposite side to paralysis), shoulders and spinal reflexes, the digestive system, solar plexus, heart and diaphragm.


After looking into reflexology on the Canada strokengine site, they classify it as massage with no verifiable benefit.
Personally I think it is good as a placebo if you believe in it it will help.
This is something that you definitely need to talk to your doctor about, It hasn't gotten to any Phase II or III trials so everything you are reading here has no scientific basis to back it up.

Here is a personal anecdote where there is confusion on cause and effect.
It doesn't work. Nothing scientific proven here.
 http://wendycoad.hubpages.com/hub/Reflexology-and-Stroke-A-Students-Story-about-her-Beloved-Dad