Box Breathing Versus Foot Reflexology on Physiological and Psychological Stress Indicators in Emergency Physicians

NCT07705854 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006075
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare between the effect of box breathing and foot reflexology on physiological and psychological stress indicators in emergency physicians.

Conditions

Stress

Outcome Measures

Primary Outcomes (1)

• Salivary Cortisol Level

  Change in salivary cortisol concentration (µg/dL) from baseline to the end of the 4-week intervention period. Saliva samples will be collected before and after the intervention period and analyzed to determine changes in physiological stress.

  4 weeks

Secondary Outcomes (4)

• Heart Rate Variability (HRV)

  4 weeks

• Perceived Stress Scale (PSS)

  4 weeks

• Maslach Burnout Inventory (MBI)

  4 weeks

• Pittsburgh Sleep Quality Index (PSQI)

  4 weeks

Study Arms (3)

Box Breathing Group

EXPERIMENTAL

Participants will perform box breathing exercises daily for 4 weeks. Each session will last 5 minutes and will be performed three times per day. Participants will receive supervised sessions three days per week and will perform the remaining sessions as a home program. The box breathing technique consists of inhaling for 4 seconds, holding the breath for 4 seconds, exhaling for 4 seconds, and holding the breath again for 4 seconds, repeated in cycles with scheduled rest periods.

Other: Box Breathing

Foot Reflexology Group

EXPERIMENTAL

Participants will receive foot reflexology sessions three times per week for 4 weeks. Reflexology will be performed with the participant in a comfortable supine position and will include general stimulation of plantar reflex points followed by targeted pressure applied to the solar plexus and adrenal gland reflex areas of both feet.

Other: Foot Reflexology

Control Group

NO INTERVENTION

Participants will not receive box breathing exercises or foot reflexology during the 4-week study period. They will undergo the same baseline and post-intervention outcome assessments as the intervention groups.

Interventions

Box Breathing OTHER

Participants will perform box breathing exercises daily for 4 weeks. Each session will last 5 minutes and will be performed three times per day. Participants will receive supervised sessions three days per week and will perform the remaining sessions as a

Box Breathing Group

Foot Reflexology OTHER

Participants will receive foot reflexology sessions three times per week for 4 weeks. Reflexology will be performed with the participant in a comfortable supine position and will include general stimulation of plantar reflex points followed by targeted pressure applied to the solar plexus and adrenal gland reflex areas of both feet.

Foot Reflexology Group

Eligibility Criteria

• Age: 30 Years - 40 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Male emergency physicians aged 30-40 years.
• Body mass index (BMI) between 18.5 and 29.9 kg/m².
• Working 8-hour day shifts.
• Non-smokers.
• At least 1 year of professional experience.
• Able and willing to provide informed consent and comply with the study interventions and assessments.

You may not qualify if:

• Medical conditions that contraindicate participation in the interventions, including severe cardiovascular conditions or foot injuries that preclude foot reflexology.
• Use of medications that may affect hormonal or stress-related outcomes, including antidiabetic medications, thyroid medications, and antidepressants.
• Regular participation in stress-reduction techniques or relaxation programs.
• Working night shifts.
• BMI ≥30 kg/m² or \<18.5 kg/m².

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

EL-Zeiton district Hospitals

Cairo, Egypt

Location

Study Officials

• Hany Ezzat Obaya, PhD

  Professor, Cairo University

  STUDY CHAIR

• Mohamed Ahmed Khatab, PhD

  Professor, Ain Shams University

  STUDY DIRECTOR

• Salma Ibrahim Al Ghitany, PhD

  Lecturer, Cairo University

  STUDY DIRECTOR

Central Study Contacts

Sara Mohamed Ali Arafa, B.Sc

CONTACT

+20 11 13778146; sara3rafa96@gmail.com

Salma Ibrahim Al Ghitany, PhD

CONTACT

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 10, 2026
• First Posted: July 15, 2026
• Study Start: July 20, 2026
• Primary Completion (Estimated): September 20, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: July 15, 2026

Record last verified: 2026-07

Locations

EG (1)