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[(sign)7.1(icant)5.9(ly)-333.6(red)5.9(uced)]TJ T* -.0001 Tc [(in)-327.9(the)-331(intervention)]TJ T* 0 Tc [(grou)8.2(p)-331.7(per)-332.3(session)]TJ 0 -1.131 TD (\()Tj /F10 1 Tf .4837 0 TD (p)Tj /F8 1 Tf .6686 0 TD (=)Tj /F5 1 Tf .7184 0 TD [(0.01)7.3(\))]TJ -80.1935 -1.1239 TD [(Mc)8.3(Vicar)-332.2(et)-333.9(al.,)]TJ 1.1239 -1.1239 TD [(2006)-326(\(24\))]TJ 7.1558 1.1239 TD [(RC)8.3(T)]TJ 1.1239 -1.1239 TD [(cros)7.8(sover)]TJ 7.9027 1.1239 TD [(Weak)-3227.4(30)-330.2(heal)7.1(thy)]TJ 6.8713 -1.1239 TD [(volu)6.7(nteers,)]TJ T* [(165)8.3(9)-332.2(years)]TJ T* (old)Tj 7.9027 3.3716 TD [(Reex)5.9(ology)-328.5(appli)7.3(ed)]TJ 1.1239 -1.1239 TD [(to)-332(both)-331.9(feet)]TJ 9.4036 1.1239 TD -.0002 Tc [(Angela)-328.4(Ruskin)-327.4(University)]TJ 1.1239 -1.1239 TD 0 Tc [(reexol)6.3(ogy)-332.5(style)-329.7(and)]TJ T* -.0002 Tc [(caterpi)5.4(llar)-331.5(technique)]TJ T* [(cited,)-334.1(gen)5.6(tle)-330.5(pressure)]TJ T* 0 Tc (used)Tj 12.4053 4.4955 TD -.0002 Tc 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[(One)-647.5(a)-2.2(rticle)-641.2(speci)6.4()-5.7(ed)-644.3(Angela)-647.1(Ruskin)-644.7(Un)-6.1(i-)]TJ -6.1522 -1.2203 TD .0244 Tc [(ve)5.5(rs)4.1(ity)-555.4(r)4.7(eexology)-555.4(a)-.4(s)-558.6(t)5(he)-557.2(int)5(e)-.8(rv)4.7(ent)5(i)1.9(on)-560.7(ty)7.3(pe,)]TJ 6.7246 0 0 5.9768 253.7574 510.5762 Tm .0227 Tc (24)Tj 8.9663 0 0 8.9663 265.8897 506.6077 Tm .023 Tc [(and)-555.4(o)1.3(ne)]TJ -22.7372 -1.2203 TD [(described)-416.3(t)3.6(he)-419.5(therapy)-417.7(s)2.7(tyle)-413.2(as)-414.6(United)-410(K)-5.1(i).5(ng)5.9(do)-5.1(m)-410.8(s)-3.6(tyle)-413.2(re-)]TJ 0 -1.2266 TD .0227 Tc (exology.)Tj 6.7246 0 0 5.9768 102.3874 488.6361 Tm .0311 Tc (33)Tj 8.9663 0 0 8.9663 112.8189 484.6676 Tm .0225 Tc [(Neither)-370.2(o).8(f)-370(t)3.1(hese)-369.4(articles)-370.8(described)-366.2(h).2(ow)-371.1(these)]TJ -5.6653 -1.2203 TD .0238 Tc [(te)4.9(chniqu)3.5(es)-325.3(diff)4.4(ere)4.9(n)1.4(tia)5.3(t)-2(ed)-327(f)4.4(r)-2.2(om)-321.5(ot)4.4(her)-324.7(f)-2(or)4.1(ms)-331.6(of)-324.4(re)4.9(exology,)]TJ T* .0226 Tc [(nor)-490.3(i).1(ndicated)-492.6(whether)-490.3(e)-2.6(ach)-486.6(h)-6.1(ad)-492.6(its)-490.9(o).9(wn)-486.6(individualized)]TJ 0 -1.2266 TD .0211 Tc [(f)-4.7(oot)-409.3(map)-5.5(.)-405.5(Of)-403(t)-4.7(h)-1.3(e)-408.8(r)1.4(e)-4.1(m)-1.8(ain)-7.6(i)-1.4(ng)-407(ar)-4.9(tic)-3.5(l)-1.4(es)-5.5(,)-405.4(s).8(e)-4.1(v)-4.9(en)-405.9(ga)-3.7(ve)-408.7(no)-405.3(in)-7.6(di-)]TJ 0 -1.2203 TD .0221 Tc [(cation)-291.1(of)-294.5(type)-293.9(of)-288.2(reexolo)-6(gy)-292.1(style)-287.6(o).4(r)-294.7(v)2.4(ariatio)-6(n)-284.8(o)-6(f)-288.2(foot)-288.2(map)]TJ T* [(us)-4.6(ed.)]TJ 6.7246 0 0 5.9768 83.9622 433.8707 Tm .0311 Tc [(19)8.4(22,)-5.5(2)8.4(5)0(,)-5.5(2)0(6)8.4(,)-5.5(34)]TJ 8.9663 0 0 8.9663 132.4913 429.9023 Tm .0222 Tc [(Only)-405.9(o)-5.9(n)-.2(e)-407.7(s)1.9(pecied)-404.4(t)-3.6(he)-407.7(ex)-5.2(act)-408.2(a)-2.6(natomical)]TJ -7.8594 -1.2266 TD [(location)-322.5(for)-319.8(b)-1.1(oth)-322.5(t)-3.5(he)-319(intervention)-322.5(and)-322.1(c)-2.3(ontrol)-322.7(areas)-320.4(o)-5.8(f)-319.6(t)2.9(h)-6.4(e)]TJ 0 -1.2203 TD .0257 Tc [(fe)6.8(et,)]TJ 6.7246 0 0 5.9768 79.4834 411.9306 Tm .0227 Tc (25)Tj 8.9663 0 0 8.9663 88.9511 407.9621 Tm .024 Tc [(a)5.5(n)1.6(d)-263.5(o)2.3(nly)-258.6(o)2.3(ne)-260.4(pr)4.3(ov)4.3(ided)-257.2(a)-260(d)2(et)4.6(aile)5.1(d)-263.5(p)3.7(rot)4.6(o)-4.1(c)5.8(o)2.3(l)-264.1(s)3.7(equenc)5.8(e)]TJ -3.0034 -1.2203 TD .0222 Tc [(for)-332.6(t)-3.6(he)-331.8(reexology)-336.3(interven)-6.5(tion.)]TJ 6.7246 0 0 5.9768 194.3999 400.9889 Tm .0311 Tc (19)Tj /F9 1 Tf 8.9663 0 0 8.9663 62.022 375.0802 Tm 0 Tc [(Methodological)-277.6(approaches)-278.7(to)-273.5(isolating)-277.2(specic)-275.8(versus)]TJ T* [(nonspecic)-333.3(effects)]TJ /F5 1 Tf 1.1128 -1.8336 TD [(Ten)-404.6(of)-401.6(the)-408.4(12)-403.7(studies)-402.9(delivered)-412.5(the)-402.1(reexology)-409.3(interven-)]TJ -1.1128 -1.2203 TD [(tion)-339(as)-335.9(a)-334.6()55(whole)-341.9(system)56.4()-337(complex)-341.7(treatment,)-340.4(making)-335.3(no)-335(at-)]TJ 0 -1.2266 TD [(tempt)-581.5(to)-584.9(control)-588.3(for)-579.3(nonspecic)-586.3(hemodynamic)-583.4(effects)-589.8(in)]TJ 0 -1.2203 TD [(order)-342.2(to)-344.7(isolate)-339.8(any)-342.4(active)-338.6(specic)-342.8(hemodynamic)-343.1(ingredient)]TJ T* [(said)-374.1(to)-382.6(be)-371(inherent)-381.4(in)-380(the)-376.8(therapy.)-379.4(Control)-374.2(comparisons)-380.2(in-)]TJ 0 -1.2266 TD [(cluded)-414.7()55(friendly)-419.2(chat)-420(sessions)52.8()]TJ 6.7246 0 0 5.9768 187.8802 296.9007 Tm (19)Tj 8.9663 0 0 8.9663 198.3117 292.8755 Tm [(or)-414.5()55(symptom)-418.3(discussion)46.9()]TJ -15.2003 -1.2203 TD [(sessions)-419.5(for)-414.9(the)-421.1(same)-415.6(duration)-413.1(as)-418.1(the)-414.7(reexology)-421.9(interven-)]TJ T* (tion,)Tj 6.7246 0 0 5.9768 79.6535 274.9606 Tm (21)Tj 8.9663 0 0 8.9663 91.1055 270.9921 Tm [(progressive)-522.5(muscle)-527.7(relaxation)-521.3(training,)]TJ 6.7246 0 0 5.9768 250.5826 274.9606 Tm (23)Tj 8.9663 0 0 8.9663 261.9779 270.9921 Tm [(foot)-525(mas-)]TJ -22.3009 -1.2267 TD (sage,)Tj 6.7246 0 0 5.9768 81.6378 264.0188 Tm (18)Tj 8.9663 0 0 8.9663 91.1622 259.9936 Tm [(sitting)-314.3(in)-310.4(quiet)-313.2(room,)]TJ 6.7246 0 0 5.9768 174.9543 264.0188 Tm (24)Tj 8.9663 0 0 8.9663 184.4787 259.9936 Tm [(sitting)-314.3(in)-310.4(a)-309.3(relaxing)-308(chair,)]TJ 6.7246 0 0 5.9768 285.959 264.0188 Tm (20,22)Tj 8.9663 0 0 8.9663 313.0582 725.7825 Tm [(and)-290.4(resting)-291.9(in)-285.1(bed.)]TJ 6.7246 0 0 5.9768 387.2125 729.751 Tm (17)Tj 8.9663 0 0 8.9663 396.5101 725.7825 Tm [(Only)-286.3(two)-289.4(studies)-289.1(attempted)-293.5(to)-287.8(isolate)-289.2(a)]TJ -9.3073 -1.2203 TD [(specic)-532.5(hemodynamic)-532.8(effect)-537.9(by)-527.3(contrasting)-531.4(massage)-534.7(to)-528(a)]TJ 0 -1.2266 TD [(specic)-355.4(area)-353.7(of)-351(the)-357.8(foot)-354.2(whilst)-349(measuring)-359.4(the)-351.5(associated)-352.1(or-)]TJ 0 -1.2203 TD [(gan)-317.1(perfusion)-324.6(rates)-318(compared)-313.9(with)-318.8(massage)-319.7(to)-319.4()55(non-active)52.3()]TJ T* [(areas)-336(of)-338.4(the)-332.5(feet)-335.9(as)-335.9(the)-332.5(control.)]TJ 6.7246 0 0 5.9768 435.855 685.9274 Tm (25,26)Tj /F9 1 Tf 8.9663 0 0 8.9663 313.0582 660.0187 Tm (Dosage)Tj /F5 1 Tf 1.1128 -1.8336 TD [(Reexology)-627.8()55(dosage)54.9()-621.5(appeared)-624.9(to)-622.9(differ)-627.7(considerably.)]TJ -1.1128 -1.2203 TD [(Five)-444.9(studies)-440.8(used)-435.5(a)-442.1(single)-439.7(reexology)-440.9(treatment)-445(as)-437.1(the)-440(in-)]TJ T* (tervention.)Tj 6.7246 0 0 5.9768 355.6913 625.6628 Tm (18,20,22,24,34)Tj 8.9663 0 0 8.9663 402.8597 621.6943 Tm [(Four)-761.7(used)-758(a)-758.3(series)-765.4(of)-755.7(reexology)]TJ -10.0155 -1.2266 TD [(treatment)-533.5(sessions)-533.3(to)-521.7(form)-532.6(a)-524.3(combined)-526(measurable)-532.5(inter-)]TJ 0 -1.2203 TD (vention.)Tj 6.7246 0 0 5.9768 345.0897 603.7227 Tm [(17,19)-9.4(,21,23)]TJ 8.9663 0 0 8.9663 380.5794 599.7542 Tm [(One)-385.7(study)-383.6(used)-384.9(both)-384.1(a)-385.2(single)-389.1(visit)-382.6(and)-385.3(an)]TJ -7.5306 -1.2203 TD [(aggregated)-503.1(series)-506.2(of)-502.8(treatments)-503.2(as)-506.7(two)-498.1(separate)-508.5(measure-)]TJ 0 -1.2266 TD [(ment)-500.8(points.)]TJ 6.7246 0 0 5.9768 364.3085 581.8392 Tm (23)Tj 8.9663 0 0 8.9663 375.5338 577.814 Tm [(Two)-500.6(used)-498.8(a)-492.7(mechanical)-502.1(reexology)-504.1(device)]TJ -6.9678 -1.2203 TD [(\()48.2(Massager-Scroller)50.9(\))-476.6(to)-471.1(massage)-471.4(a)-473.7(single)-471.3(area)-473.8(of)-471.1(the)-478(foot)]TJ T* (only.)Tj 6.7246 0 0 5.9768 332.7873 559.899 Tm (20,22)Tj /F9 1 Tf 8.9663 0 0 8.9663 313.0582 533.9904 Tm (Duration)Tj /F5 1 Tf 1.1128 -1.8336 TD [(The)-455.2(length)-457.7(of)-452.2(the)-459(intervention)-458.5(also)-456.1(varied)-456.3(considerably,)]TJ -1.1128 -1.2203 TD [(ranging)-651.6(between)-648.2(8-minute)-644.8(treatment,)]TJ 6.7246 0 0 5.9768 469.644 510.5762 Tm (25)Tj 8.9663 0 0 8.9663 482.1731 506.6077 Tm [(10)-644(minutes,)]TJ 6.7246 0 0 5.9768 530.8156 510.5762 Tm (34)Tj 8.9663 0 0 8.9663 543.3447 506.6077 Tm -.055 Tc [()-55(a)]TJ -25.6837 -1.2203 TD 0 Tc [(short)-482.9(massage)-477.8(\(10)-480(minutes\))-482.2(and)-480.1(a)-473.7(long)-482(massage)-477.8(\(20)-480(min-)]TJ 0 -1.2266 TD [(utes\),)48.6()]TJ 6.7246 0 0 5.9768 338.7401 488.6361 Tm (33)Tj 8.9663 0 0 8.9663 349.2849 484.6676 Tm [(20)-429(minutes,)]TJ 6.7246 0 0 5.9768 395.9999 488.6361 Tm (20)Tj 8.9663 0 0 8.9663 406.5448 484.6676 Tm [(30)-422.7(minutes,)]TJ 6.7246 0 0 5.9768 453.203 488.6361 Tm (19)Tj 8.9663 0 0 8.9663 463.7479 484.6676 Tm [(40)-429(minutes,)]TJ 6.7246 0 0 5.9768 510.4628 488.6361 Tm (23)Tj 8.9663 0 0 8.9663 521.0077 484.6676 Tm [(45)-422.7(min-)]TJ -23.1924 -1.2203 TD (utes,)Tj 6.7246 0 0 5.9768 331.4834 477.6943 Tm (18)Tj 8.9663 0 0 8.9663 344.8629 473.7259 Tm [(50)-738.8(minutes,)]TJ 6.7246 0 0 5.9768 394.3558 477.6943 Tm (21)Tj 8.9663 0 0 8.9663 407.7353 473.7259 Tm [(and)-745.7(60)-738.8(minutes,)]TJ 6.7246 0 0 5.9768 478.9416 477.6943 Tm (24)Tj 8.9663 0 0 8.9663 492.3211 473.7259 Tm [(with)-742.5(no)-739.6(clear)]TJ -19.993 -1.2203 TD [(rationale)-253.6(offered)-247.5(in)-240.9(any)-247.6(article)-247.2(as)-241.1(to)-249.8(how)-241.7(the)-250.3(treatment)-249(length)]TJ 0 -1.2266 TD [(was)-337.6(determined.)]TJ /F9 1 Tf 0 -2.4406 TD [(Common)-335.5(hemodynamic)-335.6(parameters)]TJ /F1 1 Tf 1.1128 -1.8336 TD [(Blood)-374.9(pressure.)]TJ /F5 1 Tf 8.0744 0 TD [(Two)-374.1(studies)-377.6(found)-377.7(signicant)-375.9(post-test)]TJ -9.1872 -1.2266 TD [(reductions)-350.8(for)-345.4(the)-345.2(reexology)-346(intervention)-351(group)-345.7(in)-342(systolic)]TJ 0 -1.2203 TD [(blood)-914.3(pressure)-910.7(but)-904.1(not)-910.8(for)-908.1(diastolic)-908.5(blood)-908(pressure)]TJ T* (\()Tj /F10 1 Tf .4932 0 TD (p)Tj /F8 1 Tf .6639 0 TD (=)Tj /F5 1 Tf .7208 0 TD (0.001\))Tj 6.7246 0 0 5.9768 352.97 384.5479 Tm (24)Tj 8.9663 0 0 8.9663 363.0046 380.5794 Tm [(and)-372.6(\()]TJ /F10 1 Tf 2.5418 0 TD (p)Tj /F8 1 Tf .6639 0 TD (=)Tj /F5 1 Tf .7208 0 TD (0.05\).)Tj 6.7246 0 0 5.9768 419.0172 384.5479 Tm (26)Tj 8.9663 0 0 8.9663 429.0518 380.5794 Tm [(One)-373.1(study)-377.3(found)-371.4(post-test)-375.3(sig-)]TJ -12.9367 -1.2203 TD [(nicant)-341.4(reductions)-338.2(in)-335.7(systolic)-339.1(blood)-339(pressure)-335.3(in)-342(both)-333.5(the)-338.9(in-)]TJ 0 -1.2266 TD [(tervention)-375.7(group)-364.7(\()]TJ /F10 1 Tf 8.3842 0 TD (p)Tj /F8 1 Tf .6639 0 TD (=)Tj /F5 1 Tf .7208 0 TD [(0.014\))-361.8(and)-366.3(control)-367(group)-364.7(\()]TJ /F10 1 Tf 11.944 0 TD (p)Tj /F8 1 Tf .6639 0 TD (=)Tj /F5 1 Tf .7208 0 TD (0.048\),)Tj 6.7246 0 0 5.9768 545.4424 362.6078 Tm (25)Tj 8.9663 0 0 8.9663 313.0582 347.6975 Tm [(and)-581.3(another)-585.5(found)-580.1(a)-574.9(signicant)-584.6(post-test)-583.9(difference)-579.6(irre-)]TJ 0 -1.2203 TD [(spective)-360.6(of)-363.6(treatment)-356.5(type)-360.2(\()]TJ /F10 1 Tf 12.5067 0 TD (p)Tj /F8 1 Tf .6702 0 TD (=)Tj /F5 1 Tf .7145 0 TD (0.0016\).)Tj 6.7246 0 0 5.9768 467.4329 340.7243 Tm (23)Tj 8.9663 0 0 8.9663 477.3542 336.7558 Tm [(Four)-357(studies)-358.6(failed)]TJ -18.3238 -1.2266 TD [(to)-483.8(show)-477(any)-475.2(signicant)-483.4(hemodynamic)-482.2(effect)-481(pre-)-476.6(to)-477.5(post-)]TJ 0 -1.2203 TD [(treatment)-274.3(on)-259.1(systolic)-269.6(or)-262.7(diastolic)-269.9(blood)-263.1(pressure)-272.1(arising)-263(from)]TJ T* [(a)-334.6(reexology)-339.7(intervention.)]TJ 6.7246 0 0 5.9768 417.77 307.8424 Tm (18,19,21,33)Tj /F1 1 Tf 8.9663 0 0 8.9663 323.0361 281.9338 Tm [(Heart)-447.3(rate.)]TJ /F5 1 Tf 5.8803 0 TD [(One)-442.6(study)-446.8(found)-440.9(signicant)-451.8(post-test)-444.8(heart)]TJ -6.9931 -1.2203 TD [(rate)-443.2(reductions)-439.4(for)-433.9(both)-441(the)-433.7(treated)-440.2(\()]TJ /F10 1 Tf 17.0845 0 TD (p)Tj /F8 1 Tf .6639 0 TD (=)Tj /F5 1 Tf .7208 0 TD [(0.008\))-431.4(and)-435.9(control)]TJ -18.4692 -1.2267 TD [(group)-282.5(\()]TJ /F10 1 Tf 3.4333 0 TD (p)Tj /F8 1 Tf .6702 0 TD (=)Tj /F5 1 Tf .7145 0 TD (0.018\).)Tj 6.7246 0 0 5.9768 381.5999 264.0188 Tm (25)Tj 8.9663 0 0 8.9663 390.8408 259.9936 Tm [(A)-273.3(different)-283.7(one)-277.9(reported)-280.7(signicant)-281.1(post-)]TJ ET 62.022 215.093 490.167 .22675 re f 62.022 57.77 490.167 .22681 re f 62.022 186.123 490.167 .22682 re f BT /F7 1 Tf 8.9663 0 0 8.9663 184.3086 220.7622 Tm (Table)Tj /F5 1 Tf 3.0603 0 TD (3.)Tj /F7 1 Tf 1.2519 0 TD [(EPHPP)-332.4(Methodological)-340.1(Quality)-331.1(Review)-335.3(Scores)]TJ /F10 1 Tf -17.9507 -3.1551 TD (Study)Tj 14.96 1.1065 TD (Selection)Tj 1.018 -1.1065 TD (bias)Tj 4.8686 1.1065 TD (Study)Tj -.0822 -1.1065 TD [(design)-1897.3(Confounders)-1435.9(Blinding)]TJ 16.0033 1.1065 TD [(Data)-285(collection)]TJ 1.3531 -1.1065 TD (methods)Tj 5.9056 1.1065 TD (Withdrawals)Tj -.0885 -1.1065 TD [(and)-332(dropouts)]TJ 7.3219 1.1065 TD (Global)Tj .0569 -1.1065 TD (rating)Tj /F5 1 Tf -51.3167 -2.0992 TD [(Machi)-333.3(et)-335.5(al.)]TJ 6.7246 0 0 5.9768 108.7937 177.6755 Tm (33)Tj 8.9663 0 0 8.9663 193.2661 173.6503 Tm [(Weak)-2791.3(Weak)-2784.9(Weak)-3682.8(Weak)-2791.3(Strong)-4202.3(Weak)-4055.8(Weak)]TJ -14.6375 -1.1065 TD [(Wilkinson)-334.7(et)-335.5(al.)]TJ 6.7246 0 0 5.9768 124.6677 167.6976 Tm (21)Tj 8.9663 0 0 8.9663 193.2661 163.7291 Tm [(Moderate)-1086.3(Moderate)-1079.9(Weak)-3682.8(Weak)-2791.3(Moderate)-2869.3(Moderate)-2350.8(Weak)]TJ -14.6375 -1.1128 TD [(Joseph)-338(et)-335.5(al.)]TJ 6.7246 0 0 5.9768 110.4944 157.7196 Tm (22)Tj 8.9663 0 0 8.9663 193.2661 153.7511 Tm [(Weak)-2791.3(Weak)-2784.9(Weak)-3682.8(Weak)-2791.3(Weak)-4574.3(Weak)-4055.8(Weak)]TJ -14.6375 -1.1128 TD [(Zhang)-337.4(et)-335.5(al.)]TJ 6.7246 0 0 5.9768 110.0409 147.7417 Tm (34)Tj 8.9663 0 0 8.9663 193.2661 143.7732 Tm [(Weak)-2791.3(Weak)-2784.9(Weak)-3682.8(Weak)-2791.3(Strong)-4202.3(Moderate)-2350.8(Weak)]TJ -14.6375 -1.1128 TD [(McVicar)-339(et)-329.2(al.)]TJ 6.7246 0 0 5.9768 117.4677 137.8204 Tm (24)Tj 8.9663 0 0 8.9663 193.2661 133.7953 Tm [(Moderate)-1086.3(Strong)-2412.9(Weak)-3682.8(Moderate)-1086.3(Strong)-4202.3(Weak)-4055.8(Weak)]TJ -14.6375 -1.1065 TD [(Zhen)-339.7(et)-329.2(al.)]TJ 6.7246 0 0 5.9768 104.7685 127.8425 Tm (20)Tj 8.9663 0 0 8.9663 193.2661 123.874 Tm [(Weak)-2791.3(Strong)-2412.9(Weak)-3682.8(Weak)-2791.3(Strong)-4202.3(Moderate)-2350.8(Weak)]TJ -14.6375 -1.1128 TD [(Sudemeier)-339.4(et)-335.5(al.)]TJ 6.7246 0 0 5.9768 126.1984 117.8646 Tm (25)Tj 8.9663 0 0 8.9663 193.2661 113.896 Tm [(Weak)-2791.3(Moderate)-1079.9(Strong)-3310.8(Moderate)-1086.3(Strong)-4202.3(Strong)-3683.8(Moderate)]TJ -14.6375 -1.1128 TD (Frankel.)Tj 6.7246 0 0 5.9768 93.9401 107.9433 Tm (18)Tj 8.9663 0 0 8.9663 193.2661 103.9181 Tm [(Weak)-2791.3(Strong)-2412.9(Strong)-3310.8(Moderate)-1086.3(Strong)-4202.3(Strong)-3683.8(Moderate)]TJ -14.6375 -1.1065 TD [(Mur)-336(et)-335.5(al.)]TJ 6.7246 0 0 5.9768 101.537 97.9653 Tm (26)Tj 8.9663 0 0 8.9663 193.2661 93.9968 Tm [(Weak)-2791.3(Strong)-2412.9(Strong)-3310.8(Moderate)-1086.3(Strong)-4202.3(Moderate)-2350.8(Moderate)]TJ -14.6375 -1.1128 TD [(Gunnarsdottir)-284.9(and)-284.1(Jonsdottir)]TJ 6.7246 0 0 5.9768 176.8251 87.9874 Tm (17)Tj 8.9663 0 0 8.9663 193.2661 84.0189 Tm [(Moderate)-1086.3(Strong)-2412.9(Strong)-3310.8(Weak)-2791.3(Strong)-4202.3(Strong)-3683.8(Moderate)]TJ -14.6375 -1.1128 TD [(Hodgson)-340.1(and)-328.4(Anderson)]TJ 6.7246 0 0 5.9768 158.2299 78.0094 Tm (19)Tj 8.9663 0 0 8.9663 193.2661 74.041 Tm 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[(to)-332(be)-339.4(considered)-332.9(a)-334.6(distinct)-337.5(passive)-336.5(form)-336.6(of)-332(sham)-330.6(control.)]TJ 1.1128 -1.2203 TD [(Furthermore,)-463.7(this)-470.3(review)-461.6(has)-465.8(found)-466.2(that)-465.4(reexology)-459.9(re-)]TJ -1.1128 -1.2266 TD [(searchers)-353.8(do)-353.5(not)-348.1(appear)-356.4(to)-351(acknowledge)-350.5(the)-351.5(issue)-355.2(of)-351(reex-)]TJ 0 -1.2203 TD [(ology)-466.8(foot)-461.7(chart)-471.2(inconsistency)-468.6(and)-461.2(the)-465.3(effect)-468.4(that)-465.4(this)-470.3(can)]TJ T* [(have)-345(with)-350.5(regard)-349.7(to)-344.7(a)-347.3(rigorous)-346.4(standardization)-352.4(of)-344.7(the)-345.2(inter-)]TJ 0 -1.2266 TD [(vention)-716(and)-714.1(reproducibility)-721.7(of)-711.4(ndings.)]TJ 6.7246 0 0 5.9768 233.5747 280.4597 Tm (47)Tj 8.9663 0 0 8.9663 246.6708 276.4345 Tm (Reexologists)Tj -20.5937 -1.2203 TD 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5.9768 258.0094 192.7559 Tm (48)Tj 8.9663 0 0 8.9663 72 177.8456 Tm [(The)-303.5(lack)-303.9(of)-306.7(reexology)-301.8(foot)-310(map)-301.9(standardization)-308.2(presents)]TJ -1.1128 -1.2266 TD [(a)-467.4(serious)-466.1(research)-472.6(challenge)-472.1(in)-462.2(terms)-467.8(of)-471.1(how)-469.4(to)-464.8(tease)-469(out)]TJ 0 -1.2203 TD [(evidence)-471.2(of)-464.8(a)-461.1(specic)-469.2(hemodynamic)-463.3(effect)-468.4(on)-467.7(the)-465.3(internal)]TJ T* [(organs)-372.5(quite)-376.4(distinct)-375.4(from)-374.6(the)-370.5(hemodynamic)-374.7(effects)-381.2(of)-370(con-)]TJ 0 -1.2266 TD [(ventional)-402.9(foot)-398.5(massage.)-398.5(After)-395(all,)-401.5(the)-395.8(principal)-401.9(claim)-395.4(of)-395.3(re-)]TJ 0 -1.2203 TD [(exology)-471.9(is)-472.7(the)-471.6(existence)-477.7(a)-473.7(two-way)-472.5(relationship)-478.6(between)]TJ T* [(specic)-273.2(points)-265.7(or)-269(areas)-266.5(of)-268.8(the)-269.3(feet)-272.6(and)-265.1(the)-269.3(organs)-271.3(of)-268.8(the)-269.3(body)]TJ T* [(that)-351.6(allows)-353.7(the)-351.5(emergence)-359(of)-351(a)-353.6(specic)-349.1(hemodynamic)-355.8(effect)]TJ 0 -1.2266 TD [(to)-243.5(be)-238.3(revealed)-247.5(at)-240.2(the)-244(opposite)-247.4(organ)-238.4(end.)-243.2(The)-246.6(vast)-242.3(majority)-241.5(of)]TJ 0 -1.2203 TD [(published)-432.8(reexology)-428.2(studies)-428.2(do)-429.4(not)-430.3(give)-425.9(details)-428.6(of)-426.9(which)]TJ T* [(reexology)-491.5(map)-491.6(the)-490.6(intervention)-496.4(is)-485.4(founded)-494.4(upon,)-492.3(which)]TJ 0 -1.2267 TD [(means)-494.9(that)-497(some)-488.4(of)-496.4(the)-496.9(studies)-491.4(may)-494.7(be,)-494.1(in)-487.5(theory,)-495.1(using)]TJ 27.9978 74.5598 TD [(relatively)-420.9(different)-416.5(reexology)-415.6(charts)-415.7(on)-410.8(which)-415.9(to)-414.2(base)-409.8(the)]TJ 0 -1.2203 TD [(specic)-298.5(reex-point)-302.2(intervention.)-303.3(If)-299.8(this)-293.2(is)-295.7(the)-300.9(case,)-293.8(there)-301.5(is)-295.7(a)]TJ 0 -1.2266 TD [(lack)-645.4(of)-641.9(consistency)-651.4(in)-639.2(the)-648.7(active)-642.1(intervention)-648.1(approach,)]TJ 0 -1.2203 TD [(which)-346.3(arguably)-346.7(invalidates)-347.2(the)-345.2(validity)-341.2(and)-347.3(generalizability)]TJ T* [(of)-287.8(research)-289.2(ndings.)-284.2(This)-289.4(is)-283.1(a)-284(serious)-289.1(experimental)-290.1(challenge)]TJ 0 -1.2266 TD [(that)-345.3(reexology)-339.7(researchers)-341.7(must)-342.1(overcome)-338.7(in)-342(order)-335.9(to)-338.4(pro-)]TJ 0 -1.2203 TD [(duce)-338.7(results)-337.4(that)-332.6(are)-335.2(reliable)-337.5(and)-334.7(reproducible.)]TJ 1.1128 -1.2203 TD [(Other)-355.3(challenges)-347(include)-355.4(the)-351.5(question)-352.3(of)-344.7(how)-349.2(to)-351(isolate)-352.5(a)]TJ -1.1128 -1.2266 TD [(specic)-260.6(reexology)-257.5(effect)-253.4(without)-260.2(affecting)-258(its)-251.9()55(potency)47.9()-254.8(and)]TJ 0 -1.2203 TD [(how)-387.2(to)-388.9(measure)-385.9(an)-382.3(effect)-392.5(that)-383.2(uses)-389.6(unproven)-386.7(ideas)-386.6(of)-382.6()55(en-)]TJ T* [(ergy)51.9()-501.4(and)-505.4(no)-499.3(know)-505.4(means)-501.2(of)-502.8(a)-499(biological)-501.5(pathway.)-506.4(Fur-)]TJ T* [(thermore,)-659.6(how)-659(to)-654.5(standardize)-652.5(the)-655(reexology)-662.2(treatment)]TJ 0 -1.2266 TD [(within)-414.3(a)-410.5(controlled)-411.4(environment)-420.4(so)-408.7(as)-411.8(to)-407.9(control)-411.3(the)-414.7()55(dos-)]TJ 0 -1.2203 TD [(age)51.2()-324.4(o)0(r)-325.9(active)-325.9(quantity.)-324(To)-328.2(meet)-326.6(these)-327.4(challenges)-328(and)-322.1(in)-323.1(the)]TJ T* [(process,)-344.7(become)-345.3(more)-342.4(evidence-based,)-343.6(reexology)-346(research-)]TJ 0 -1.2266 TD [(ers)-368.6(must)-361.1(develop)-365.3(experimental)-366(protocol)-367.7(guidelines)-365.3(in)-367.3(order)]TJ 0 -1.2203 TD [(to)-566(establish)-567.5(whether)-565.8(more)-563.7(or)-559.9(longer)-564.8(reexology)-567.3(sessions)]TJ T* [(equate)-524(to)-521.7(a)-518(higher)-521.2()55(dose,)55.9()-520.4(whether)-521.5(the)-522.2(specic)-519.8(hemody-)]TJ 0 -1.2266 TD [(namic)-502.8(effect)-506.3(is)-498(more)-506.8()55(pressure)52.9()-501.4(dependent)-507.5(than)-499.9(time)-501(de-)]TJ 0 -1.2203 TD [(pendent,)-349.4(and)-341(nd)-338.2(the)-345.2(means)-343.1(and)-341(methods)-343.5(of)-338.4(standardizing)]TJ T* [(and)-334.7(maintaining)-338.4(the)-332.6(dose)-335.8(potency.)]TJ 1.1128 -1.2203 TD [(Therefore,)-399.3(in)-392.6(order)-399.1(to)-388.9(rigorously)-398.6(evaluate)-396.9(the)-395.8(validity)-391.8(of)]TJ -1.1128 -1.2266 TD [(reexologists)-343.8(claims)-333.5(of)-338.4(a)-334.6(specic)-336.5(hemodynamic)-336.8(component)]TJ 0 -1.2203 TD [(in)-449.5(reexology,)-450.1(more)-449.9(innovative)-454.3(study)-446.8(designs)-453.1(are)-442.7(needed.)]TJ T* [(These)-285.7(designs)-276.1(must)-285.2(allow)-276.5(for)-282.2(a)-277.7(specic,)-276.1(reexology)-282.8(induced,)]TJ 0 -1.2266 TD [(and)-284.1(therapeutically)-286.4(benecial)-282(hemodynamic)-279.9(effect)-285(to)-281.4(be)-276.2(able)]TJ 0 -1.2203 TD [(to)-370(demonstrate)-369.4(itself)-369.6(over)-364.5(and)-366.3(above)-367.7(the)-370.5(nonspecic)-365(effects)]TJ T* [(involved)-340.1(in)-335.7(general)-333.8(massageand)-337.3(meet)-339.3(the)-332.5(methodological)]TJ 0 -1.2266 TD [(standard)-346(of)-344.7(the)-338.9(double-blind)-343.2(RCT.)-345.4(In)-340.6(future,)-342.3(reexology)-346(re-)]TJ 0 -1.2203 TD [(searchers)-296.9(need)-297(to)-287.8(develop)-295.7(a)-290.4(simple)-291.7(standardized)-295.1(reexology)]TJ T* [(intervention)-287.7(and)-277.8(a)-277.7(suitable)-279.6(form)-279.7(of)-275.1(control)-284.8(and)-277.8(identify)-278(clear)]TJ 0 -1.2266 TD [(and)-290.4(meaningful)-282.6(physiological)-286.3(outcome)-288.7(measures)-286.1(that)-288.4(can)-286.7(be)]TJ 0 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