Investigation the effect of reflexology on fatigue, stress and cortisol level in women with multiple sclerosis

INTERVENTION: Intervention group: The patient is asked to lie down the bed in bed.Then, we perform foot reflexology for 15 minutes per leg.. CONDITION: Condition 1: Fatigue. Condition 2: Stress. Condition 3: Cortisol. PRIMARY OUTCOME: Cortisol. Timepoint: Befor the intervention, one month after the intervention, one month after the end of intervention. Method of measurement: At 8 o'clock in the morning, take the patient's blood sampl and It will be sent to the laboratory within one to one hour. Fatigue. Timepoint: Befor the intervention, one month after the intervention, one month after the end of intervention. Method of measurement: Fatigue score is obtained using the fatigue criterion.this tool consists of 9 questions with a grading scale of 1‐7. Stress. Timepoint: Befor the intervention, one month after the intervention, one month after the end of intervention. Method of measurement: Stress score is obtained by stress syndrome questionnaire.The questionnaire consists of 50 items that are based on a 6‐point Likert scale, and measures four subscales of physical, emotional, cognitive, and behavioral. SECONDARY OUTCOME: Cortisol level. Timepoint: Before the intervention, one month after the intervention, one month after the end of the intervention. Method of measurement: Patients' blood samples are taken from the patient at the time indicated, and then sent to the laboratory at ‐20 ° C after centrifugation. Fatigue rating based on fatigue severity questionnaire. Timepoint: Before the intervention, one month after the intervention, one month after the end of the intervention. Method of measurement: The questionnaire was used to measure the fatigue intensity of physical, psychological, emotional, behavioral, and social dimensions. This tool consists of nine questions ranging from one to seven. Exhaustion is considered to be a mild fatigue, moderate fatigue, severe fatigue. Stress score based on stress syndrome questionnaire. Timepoint: Before the intervention, one month after the intervention, one month after the end of the intervention. Method of measurement: Stress syndrome questionnaire consists of 4 subscales of physical, emotional, cognitive and therapeutic exercises and 50 items. Scoring this scale is based on a 6‐point Likert scale. INCLUSION CRITERIA: THe absence of the patient in the acute phase of the disease Age 20 to 40 years old Type of relapse‐suppression disease Having astrong companion Disability score rating 1‐4/5 Iranian nationality