A Cochrane review [Abstract] 1 included 7 studies, with a total of 326 subjects. Rutoside significantly reduced the symptoms associated with varicose veins (RR 1.89, 95% CI 1.11 to 3.22; 1 trial, n=69). There were no significant differences in side-effects (RR 1.30, 95% CI 0.23 to 7.28) or incidence of deep vein thrombosis (RR 0.17, 95% CI 0.01 to 3.49). One trial (n=35) reported no significant difference in lower leg volume when external pneumatic intermittent compression for 30 minutes at 40 torr while in the left lateral recumbent position was compared against rest (MD -258.80, 95% CI -566.91 to 49.31). Reflexology as compared with rest (1 trial, n=55) significantly reduced the symptoms associated with oedema (reduction in symptoms: RR 9.09, 95% CI 1.41 to 58.54). There was no evidence of significant difference in the women's satisfaction and acceptability with either intervention (RR 6.00, 95% CI 0.92 to 39.11). Water immersion for 20 minutes in a swimming pool reduced leg volume (RR 0.43, 95% CI 0.22 to 0.83; 1 study, n=32). No significant difference in lower leg circumference was reported when foot massage was compared against routine care (MD -0.11, 95% CI -1.02 to 0.80; 1 study, n=80).
Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding), and by imprecise results (few patients and outcome events).
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