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Massage Studies Abstracts

Massage Studies | Massage Research | Benefits of Massage | Massage Abstracts

Links and Abstracts For Massage Studies and Research Detailing the Scientifically Proven Benefits and Efficacy for Specific Conditions Utilizing Massage Therapy

To search the abstracts referenced on this page, click on the 'Search Page' Button below, enter a keyword hit either the 'Search Previous' or 'Search Next' to highlight every occurance of that keyword in a Massage Study.

Massage and Agression

Massage and Alzheimer's

Massage and Anorexia

Massage and Anxiety

Massage and Arthritis

Massage and Asthma

Massage and ADHD/ADD

Massage and Autism

Massage and Back Pain

Massage and Behavioral Problems

Massage and Blood Flow

Massage and Blood Pressure

Massage and Breast Cancer

Massage and Bulimia

Massage in Burn Treatment

Massage in Cancer Treatment

Massage in Cardiovascular Health

Massage in Carpal Tunnel Syndrome

Massage in Cerebral Palsy

Massage - Chair Massage

Massage and Chronic Fatigue Syndrome

Massage and Chronic Illness or Chronic Pain

Massage and Cocaine Exposure

Massage and Cognition (Learning)

Massage and Constipation

Massage and Cystic Fibrosis

CranioSacral Therapy Studies

Massage and Depression

Massage and Dermatitis

Massage and Diarrhea

Massage and Down Syndrome

Massage and Drug Addiction

Massage and the Elderly

Massage and Enuresis (Bedwetting)

Massage and Exercise

Massage and Fibromyalgia

Massage and Gastrointestinal Motility>

Massage and Headaches

Massage and Hospice Care

Massage and General Health Benefits

Massage and HIV/ AIDS

Massage and High Blood Pressure

Massage and Immunity

Massage For Infants and Children

Massage For Non-Infant Pediatric

Massage and Job Stress

Massage and Labor Pain

Massage and Leukemia

Massage and Migraine

Massage and Multiple Sclerosis

Massage and Musculoskeletal Complaints

Massage and Neck Pain

Massage and Pain

Massage for Post-Traumatic Stress Disorder and Acute Stress Disorder

Massage for Pregnancy and Post-Partum Issues

Massage and Paralysis and Spinal Cord Injury

Massage and PMS

Massage and Stress

Massage and Stroke Rehabilitation

Massage and TMJ (Temporo-Mandibular Joint Dysfunction)

Massage and Surgery

Massage and Transplant Patients

Massage and Vagal Activity

Massage and Voice Disorders

Massage and Vertigo

If you are aware of a massage study that is not on our list, you may enter it here.

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Studies on the Effects of Massage on Agression

Diego, M.A., Field, T., Hernandez-Reif, M., Shaw, J.A., Rothe, E.M., Castellanos, D. & Mesner, L. (2002). Aggressive adolescents benefit from massage therapy. Adolescence, 37, 597-607.

EXPERIMENT DESIGN: Seventeen aggressive adolescents were randomly assigned to a massage therapy group or a relaxation therapy group to receive 20-minute therapy sessions, twice a week for five weeks.

RESULTS/CONCLUSIONS: The massaged adolescents had lower anxiety after the first and last sessions. By the end of the study, they also reported feeling less hostile and they were perceived by their parents as being less aggressive. Significant differences were not found for the adolescents who were assigned to the relaxation group.



Studies of the Effects of Massage Therapy on Alzheimer's Patients

Rowe, M. & Alfred, D. (1999). The effectiveness of slow-stroke massage in diffusing agitated behaviors in individuals with Alzheimer’s disease. Journal of Gerontology and Nursing, 25, 22-34.

EXPERIMENT DESIGN: Agitated behaviors of individuals with Alzheimer’s disease (AD), often endured or unsuccessfully treated with chemical or physical restraints, markedly increase the stress levels of family caregivers. The Theoretical Model for Aggression in the Cognitively Impaired guided the examination of caregiver-provided slow-stroke massage on the diffusion of actual and potential agitation for community-dwelling individuals with AD. Characteristics and frequency of agitation were quantified by two highly correlated instruments, the Agitated Behavior Rating Scale Scoring Guide and the Brief Behavior Symptom Rating Scale.

RESULTS/CONCLUSIONS: Expressions of agitation of patients with AD increased in a linear pattern from dawn to dusk. Verbal displays of agitation, the most frequently cited form of agitation in community-dwelling individuals with AD, were not diffused by slow-stroke massage. However, more physical expressions of agitation such as pacing, wandering, and resisting were decreased when slow-stroke massage was applied.


Suzuki M, Tatsumi A, Otsuka T, Kikuchi K, Mizuta A, Makino K, Kimoto A, Fujiwara K, Abe T, Nakagomi T, Hayashi T, Saruhara T. Physical and psychological effects of 6-week tactile massage on elderly patients with severe dementia. Am J Alzheimers Dis Other Demen. 2010 Dec;25(8):680-6.

EXPERIMENT DESIGN: Tactile massage is a soft massage that improves physical relaxation and psychological well-being. The purpose of this study was to clarify the effects of a 6-week tactile massage on changes in physical and mental function, symptoms of behavioral and psychological symptoms of dementia (BPSD) among elderly patients with dementia. In addition, chromogranin A (CgA) levels as an index of stress examined the effects of tactile massage intervention. A tactile massage group consisting of elderly patients with dementia received tactile massage therapy a total of 30 times each for about 20 minutes between 16:00 and 17:00 hours.

RESULTS/CONCLUSIONS: In the control group, the mean scores for ''intellectual'' and ''emotional function'' score decreased significantly after 6 weeks ; however, no change was observed in the tactile massage group. Both the ''aggressiveness'' score and CgA levels decreased significantly after 6 weeks in the tactile massage group. These results suggest that tactile massage reduces aggressiveness and stress level in patients with dementia.



Studies on the Effects of Massage Therapy on Anorexia

Hart, S., Field, T. & Hernandez-Reif, M., Nearing, G., Shaw, S., Schanberg, S., & Kuhn, C. (2001). Anorexia nervosa symptoms are reduced by massage therapy. Eating Disorders, 9, 289-299.

EXPERIMENT DESIGN: Women diagnosed with anorexia nervosa were given a massage twice per week for five weeks or standard treatment.

RESULTS/CONCLUSIONS: The massaged women reported lower stress and anxiety levels and showed lower cortisol levels immediately following the massage. Over the five-week treatment period, they also reported decreased body dissatisfaction on the Eating Disorder Inventory and showed increased dopamine and norepinephrine levels.



Studies on the Effects of Massage on Anxiety

Bauer, B.A., Cutshall, S.M., Wentworth, L.J., Engen, D., Messner, P.K., Wood, C.M., Brekke, K.M., Kelly, R.F. & Sundt III, T.M. (2010). Effects of massage therapy on pain, anxiety, and tension after cardiac surgery: a randomized study. Complementary Therapies in Clinical Practice, 16, 70-75.

EXPERIMENT DESIGN: Cardiac surgery patients were randomized to receive a massage or to have quiet relaxation time on postoperative day 2 (the day after surgery) and day 4.

RESULTS/CONCLUSIONS: Patients receiving massage therapy had decreased pain, anxiety, and tension. Massage therapy may be an important component of the healing experience for patients after cardiovascular surgery.


Cutshall, S.M., Wentworth, L.J., Engen, D., Sundt, T.M., Kelly, R.F. & Bauer, B.A. (2010). Effects of massage therapy on pain, anxiety, and tension in cardiac surgical patients: a pilot study. Complementary Therapies in Clinical Practice, 16, 92-95.

EXPERIMENT DESIGN: A randomized controlled trial comparing outcomes before and after intervention in and across groups. Patients undergoing cardiovascular surgical procedures (coronary artery bypass grafting and/or valvular repair or replacement) were selected for this study and randomly assigned to an intervention or standard care group. Patients in the intervention group received a 20-minute session of massage therapy intervention between postoperative days 2 and 5. Patients in the control group received standard care and a 20-minute quiet time between postoperative days 2 and 5.

RESULTS/CONCLUSIONS: Statistically and clinically significant decreases in pain, anxiety, and tension scores were observed for patients who received a 20-minute massage compared with those who received standard care. Patient feedback was markedly positive.Statistically and clinically significant decreases in pain, anxiety, and tension scores were observed for patients who received a 20-minute massage compared with those who received standard care. Patient feedback was markedly positive. This pilot study showed that massage can be successfully incorporated into a busy cardiac surgical practice. These results suggest that massage may be an important therapy to consider for inclusion in the management of postoperative recovery of cardiovascular surgical patients.


Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C. & Schanberg, S. (1992). Massage reduces anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 125-131.

EXPERIMENT DESIGN: A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents.

RESULTS/CONCLUSIONS: Compared with a control group who viewed relaxing videotapes, the massage subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.


Shulman, K.R. & Jones, G.E. (1996). The effectiveness of massage therapy intervention on reducing anxiety in the work place. Journal of Applied Behavioral Science, 32, 160-173.

EXPERIMENT DESIGN: This study evaluated the effectiveness of an on-site chair massage therapy program in reducing anxiety levels of employees. A quasi-experimental pretest/posttest control group design was used to determine changes in anxiety levels due to the massage therapy intervention. Eighteen subjects participated in the chair massage therapy program for 6 weeks. Fifteen control group subjects participated in break therapy. For 15 minutes weekly, subjects either received a massage or were allowed a break, depending on their assignment to either the treatment or control condition. Participants' stress levels were measured with the State-Trait Anxiety Inventory Self-Assessment Questionnaire. This measure was administered twice during pretest, posttest, and delayed posttest to achieve stable measures.

RESULTS/CONCLUSIONS: Significant reductions in anxiety levels were found for the massage group. Future research and implications for management are discussed.


Field T, Ironson G, Scafidi F, Nawrocki T, Goncalves A, Burman I, Pickens J, Fox N, Schanberg S, Kuhn C.(1996) Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations. Int J Neurosci. 1996 Sep;86(3-4):197-205

EXPERIMENT DESIGN: Twenty-six adults were given a chair massage and 24 control group adults were asked to relax in the massage chair for 15 minutes, two times per week for five weeks. On the first and last days of the study they were monitored for EEG, before, during and after the sessions. In addition, before and after the sessions they performed math computations, they completed POMS Depression and State Anxiety Scales and they provided a saliva sample for cortisol. At the beginning of the sessions they completed Life Events, Job Stress and Chronic POMS Depression Scales.

RESULTS/ CONCLUSIONS: Group by repeated measures and post hoc analyses revealed the following: 1) frontal delta power increased for both groups, suggesting relaxation; 2) the massage group showed decreased frontal alpha and beta power (suggesting enhanced alertness); while the control group showed increased alpha and beta power; 3) the massage group showed increased speed and accuracy on math computations while the control group did not change; 4) anxiety levels were lower following the massage but not the control sessions, although mood state was less depressed following both the massage and control sessions; 5) salivary cortisol levels were lower following the massage but not the control sessions but only on the first day; and 6) at the end of the 5 week period depression scores were lower for both groups but job stress score were lower only for the massage group.


Garner B, Phillips LJ, Schmidt HM, Markulev C, O'Connor J, Wood SJ, Berger GE, Burnett P, McGorry PD. (2008) Pilot study evaluating the effect of massage therapy on stress, anxiety and aggression in a young adult psychiatric inpatient unit. Aust N Z J Psychiatry. 2008 May;42(5):414-22.

EXPERIMENT DESIGN: The aim of the present pilot study was to examine the effectiveness of a relaxation massage therapy programme in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit. This was a prospective, non-randomized intervention study comparing treatment as usual (TAU) with TAU plus massage therapy intervention (MT) over consecutive 7 week blocks (May-August 2006). MT consisted of a 20 min massage therapy session offered daily to patients during their period of hospitalization. The Kennedy Nurses' Observational Scale for Inpatient Evaluation (NOSIE), the Symptom Checklist-90-Revised (SCL-90-R), the State-Trait Anxiety Inventory (STAI) and stress hormone (saliva cortisol) levels were used to measure patient outcomes at admission and discharge from the unit. The Staff Observation Aggression Scale-Revised (SOAS-R) was used to monitor the frequency and severity of aggressive incidents on the unit.

RESULTS/ CONCLUSIONS: There was a significant reduction in self-reported anxiety, resting heart rate and cortisol levels immediately following the initial and final massage therapy sessions. Significant improvements in hostility and depression scores on the SCL-90-R were observed in both treatment groups. There was no group x time interaction on any of the measures. Poor reliability of staff-reported incidents on the SOAS-R limited the validity of results in this domain. Massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients. Study limitations preclude any definite conclusions on the effect of massage therapy on aggressive incidents in an acute psychiatric setting. Randomized controlled trials are warranted.




Studies on the Effects of Massage on Arthritis

Field, T., Hernandez-Reif, M., Seligman, S., Krasnegor, J. & Sunshine, W. (1997). Juvenile rheumatoid arthritis: Benefits from massage therapy. Journal of Pediatric Psychology, 22, 607-617.

EXPERIMENT DESIGN: Children with mild to moderate juvenile rheumatoid arthritis were massaged by their parents 15 minutes a day for 30 days (and a control group engaged in relaxation therapy).

RESULTS/CONCLUSIONS: The children’s anxiety and stress hormone (cortisol) levels were immediately decreased by the massage, and over the 30-day period their pain decreased on self-reports, parent reports, and their physician’s assessment of pain (both the incidence and severity) and pain-limiting activities.



Yurtkuran, M. & Kocagil, T. (1999). TENS, electropuncture and ice massage: Comparison of treatment for osteoarthritis of the knee. American Journal of Acupuncture, 27, 133-140.

EXPERIMENT DESIGN: The purpose of this study was to compare the effectiveness of transcutaneous electrical nerve stimulation (TENS), electroacupuncture (EA), and ice massage with placebo treatment for the treatment of pain. Subjects (n = 100) diagnosed with osteoarthritis (OA) of the knee were treated with these modalities. The parameters for evaluating the effectiveness of treatment included pain at rest, stiffness, 50 foot walking time, quadriceps muscle strength, and knee flexion degree.

RESULTS/CONCLUSIONS: The results showed (a) that all three methods could be effective in decreasing not only pain but also the objective parameters in a short period of time; and (b) that the treatment results in TENS, EA and ice massage were superior to placebo.



Perlman, A.I., Sabina, A., Williams, A.L., Njike, V.Y., & Katz, D.L. (2006). Massage therapy for osteoarthritis of the knee: a randomized controlled trial. Archives of Internal Medicine, 166, 2533-2538.

EXPERIMENT DESIGN: Sixty-eight adults with radiographically confirmed Osteoarthritis of the knee were assigned either to treatment (twice-weekly sessions of standard Swedish massage in weeks 1-4 and once-weekly sessions in weeks 5-8) or to control (delayed intervention). Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and functional scores and the visual analog scale of pain assessment.

RESULTS/CONCLUSIONS: The group receiving massage therapy demonstrated significant improvements in the mean (SD) WOMAC global scores, pain scores, stiffness scores, and physical function domains, and in the visual analog scale of pain assessment, range of motion in degrees, and time to walk 50 ft (15 m) in seconds. Findings were unchanged in multivariable models controlling for demographic factors. Massage therapy seems to be efficacious in the treatment of OA of the knee. Further study of cost effectiveness and duration of treatment effect is clearly warranted.



Field, T., Diego, M., Hernandez-Reif, M., Shea, J. (2007). Hand arthritis pain reduced by massage therapy. Journal of Bodywork and Movement Therapies, 2, 21-24.

EXPERIMENT DESIGN: Twenty-two adults with wrist/hand arthritis were randomly assigned to a massage therapy or a standard treatment control group. The massage therapy group was massaged on the affected wrist/hand once a week for a 4-week period and were also taught self-massage on the wrist/hand that was to be done daily at home.

RESULTS/CONCLUSIONS: The massage therapy group versus the control group had lower anxiety and depressed mood scores after the first and last sessions, and that group reported less pain and greater grip strength after their sessions. The massage therapy group showed greater improvement than the control group on all of these measures across the study period.




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Studies on the Effects of Massage Therapy on Asthma

Field, T., Henteleff, T., Hernandez-Reif, M., Martinez, E., Mavunda, K., Kuhn, C. & Schanberg, S. (1998). Children with asthma have improved pulmonary functions after massage therapy. Journal of Pediatrics, 132, 854-858.

EXPERIMENT DESIGN: Thirty-two children with asthma (16 4- to 8-year-olds and 16 9- to 14-year-olds) were randomly assigned to receive either massage therapy or relaxation therapy. The children’s parents were taught to provide one therapy or the other for 20 minutes before bedtime each night for 30 days.

RESULTS/CONCLUSIONS: The younger children who received massage therapy showed an immediate decrease in behavioral anxiety and cortisol levels after massage. Also, their attitude toward asthma and their peak air flow and other pulmonary functions improved over the course of the study. The older children who received massage therapy reported lower anxiety after the massage. Their attitude toward asthma also improved over the study, but only one measure of pulmonary function (forced expiratory flow 25% to 75%) improved. The reason for the smaller therapeutic benefit in the older children is unknown; however, it appears that daily massage improves airway caliber and control of asthma.



Studies on the Effectiveness of Massage on Attention Deficit Hyperactivity Disorder (ADHD)

Field, T., Quintino, O., Hernandez-Reif, M. & Koslovsky, G. (1998). Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence, 33, 103-108.

EXPERIMENT DESIGN: Twenty-eight adolescents with attention deficit hyperactivity disorder were provided either massage therapy or relaxation therapy for 10 consecutive school days.

RESULTS/CONCLUSIONS: The massage therapy group, but not the relaxation therapy group, rated themselves as happier and observers rated them as fidgeting less following the sessions. After the 2-week period, their teachers reported more time on task and assigned them lower hyperactivity scores based on classroom behavior.



Khilnani, S., Field, T., Hernandez-Reif, M., & Schanberg, S. (2003). Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder. Adolescence, 38, 623-638.

EXPERIMENT DESIGN: The present study involved 30 children and adolescents between the ages of 7 and 18 (M = 13) diagnosed with attention-deficit/hyperactivity disorder (ADHD). The children were randomly assigned to a wait-list control and a massage group. The latter group received massage therapy for 20 minutes twice per week over the course of one month.

RESULTS/CONCLUSIONS: Mood state improved for the massage but not the control group based on smiley face and thermometer scales. The massage group also improved in classroom behavior in the areas of the Conners Teacher Rating Scales on anxiety, daydreaming and hyperactivity. The wait-list control group did not show these gains. In sum, the results revealed that massage therapy benefited children and adolescents with ADHD by improving short-term mood state and longer-term classroom behavior.



Studies of the Effectiveness of Massage on Autism

Field, T., Lasko, D., Mundy, P., Henteleff, T., Talpins, S., & Dowling, M. (1986). Autistic children's attentiveness and responsitivity improved after touch therapy. Journal of Autism and Developmental Disorders, 27, 329-334.

EXPERIMENT DESIGN: This study investigated the effects of touch therapy on three problems commonly associated with autism including inattentiveness (off-task behavior), touch aversion, and withdrawal.

RESULTS/CONCLUSIONS: Results showed that touch aversion decreased in both the touch therapy and the touch control group, off task behavior decreased in both groups, orienting to irrelevant sounds decreased in both groups, but significantly more in the touch therapy group, and stereotypic behaviors decreased in both groups but significantly more in the touch therapy group.



Escalona, A., Field, T., Singer-Strunk, R., Cullen, C., & Hartshorn, K. (2001). Improvements in the behavior of children with autism. Journal of Autism and Developmental Disorders, 31, 513-516.

EXPERIMENT DESIGN: Twenty children with autism ranging in age from 3 to 6 years were randomly assigned to massage therapy and reading attention control groups. Parents in the massage therapy group were trained by a massage therapist to massage their children for 15 minutes prior to bedtime every night for one month while the parents of the attention control group read Dr. Seuss stories to their children on the same time schedule. Conners Teacher and Parent scales, classroom and playground observations and sleep diaries were used to assess the effects of therapy on various behaviors including hyperactivity, stereotypical and off-task behavior, as well as sleep problems.

RESULTS/CONCLUSIONS: Results suggested that the children in the massage group exhibited less stereotypic behavior and showed more on-task and social relatedness behavior during play observations at school, and they experienced fewer sleep problems at home.



Piravej, K., Tangtrongchitr, P., Chandarasiri, P., Paothong, L. & Sukprasong, S. (2009). Effects of Thai traditional massage on autistic children's behavior. Journal of Alternative and Complementary Medicine, 15, 1355-1361.

EXPERIMENT DESIGN: A total of 60 autistic children between the ages of 3 and 10 completed this study. Interventions: Standard sensory integration therapy (SI) was compared to the SI with TTM treatments. Outcome measures: Parents and teachers assessed major behavior disturbances using the Conners' Rating Scales at 0 and 8 weeks. Sleep Diary (SD), recorded by the parents, assessed the patient's sleeping patterns every week.

RESULTS/CONCLUSIONS: No statistical differences were seen in the demographic and baseline data among both groups. From both the Conners' Teacher Questionnaire and SD, statistical improvement was detected for conduct problem, hyperactivity, inattention-passivity, hyperactivity index, and sleeping behavior. However, results from the Conners' Parent Questionnaire revealed an improvement only for anxiety (p = 0.04) in the massage group, whereas when both groups were compared, a significant improvement in conduct problem (p = 0.03) and anxiety (p = 0.01) was found. Results indicated that TTM may have a positive effect in improving stereotypical behaviors in autistic children. Over a period of 8 weeks, our findings suggested that TTM could be used as a complementary therapy for autistic children in Thailand.



Studies on the Effects of Massage Therapy on Back Pain and Chronic Pain

Pope, M. H., Phillips, R. B., Haugh, L. D., Hsieh, C. Y., MacDonald, L., and Haldeman, S. (1994). A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain. Spine, 19, 2571-2577.

EXPERIMENT DESIGN: A randomized prospective trial of manipulation, massage, corset and transcutaneous muscle stimulation (TMS) was conducted in patients with subacute low back pain. The authors determined the relative efficacy of chiropractic treatment to massage, corset, and TMS. Although all of these treatments are used for subacute low back pain treatment, there have been few comparative trials using objective outcome criteria. Patients were enrolled for a period of 3 weeks. They were evaluated once a week by questionnaires, visual analog scale, range of motion, maximum voluntary extension effort, straight leg raising and Biering-Sorensen fatigue test. The dropout rate was highest in the muscle stimulation and corset groups and lowest in the manipulation group. Rates of full compliance did not differ significantly across treatments. A measure of patient confidence was greatest in the manipulation group.

RESULTS/CONCLUSIONS: After 3 weeks, the manipulation group scored the greatest improvements in flexion and pain while the massage group had the best extension effort and fatigue time, and the muscle stimulation group the best extension.



Degan, M., Fabris, F., Vanin, F., Bevilacqua, M., Genova, V., Mazzucco, M. & Negrisolo, A. (2000). The effectiveness of foot reflexotherapy on chronic pain associated with a herniated disk. Professioni Infermieristiche, 53, 80-87.

EXPERIMENT DESIGN: A group of 40 persons suffering almost exclusively from a lumbar-sacral disc hernia received three treatments of reflexology massage for a week.

RESULTS/CONCLUSIONS: The results found that 25 persons (62.5%) reported a reduction in pain, (rating at 0.75 on a scale of 0-4).



Preyde, M. (2000). Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial. CMAJ, 162, 1815-1820.

EXPERIMENT DESIGN: The effectiveness of massage therapy for low-back pain has not been documented. This randomized controlled trial compared comprehensive massage therapy (soft-tissue manipulation, remedial exercise and posture education), 2 components of massage therapy and placebo in the treatment of subacute (between 1 week and 8 months) low-back pain. Subjects with subacute low-back pain were randomly assigned to 1 of 4 groups: comprehensive massage therapy, soft-tissue manipulation only, remedial exercise with posture education only, or a placebo of sham laser therapy. Each subject received 6 treatments within approximately 1 month. Outcome measures obtained at baseline, after treatment and at 1-month follow-up consisted of the Roland Disability Questionnaire (RDQ), the McGill Pain Questionnaire (PPI and PRI), the State Anxiety Index and the Modified Schober test (lumbar range of motion).

RESULTS/CONCLUSIONS: Of the 107 subjects who passed screening, 98 (92%) completed post-treatment tests and 91 (85%) completed follow-up tests. Statistically significant differences were noted after treatment and at follow-up. The comprehensive massage therapy group had improved function, less intense pain, and a decrease in the quality of pain compared with the other 3 groups. Clinical significance was evident for the comprehensive massage therapy group and the soft-tissue manipulation group on the measure of function. At 1-month follow-up 63% of subjects in the comprehensive massage therapy group reported no pain as compared with 27% of the soft-tissue manipulation group, 14% of the remedial exercise group and 0% of the sham laser therapy group. Patients with subacute low-back pain were shown to benefit from massage therapy, as regulated by the College of Massage Therapists of Ontario and delivered by experienced massage therapists.



Cherkin, D.C., Eisenberg, D., Sherman, K.J., Barlow, W.,,Kaptchuk, T.J., Street, J. & Deyo, R.A. (2001). Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Archives of Internal Medicine, 161, 1081-1088.

EXPERIMENT DESIGN: This study randomized 262 patients aged 20 to 70 years who had persistent back pain to receive Traditional Chinese Medical acupuncture, therapeutic massage, or self-care educational materials. Up to 10 massage or acupuncture visits were permitted over 10 weeks. Symptoms (0-10 scale) and dysfunction (0-23 scale) were assessed by telephone interviewers masked to treatment group. Follow-up was available for 95% of patients after 4, 10, and 52 weeks, and none withdrew for adverse effects.

RESULTS/CONCLUSIONS:Treatment groups were compared after adjustment for prerandomization covariates using an intent-to-treat analysis. At 10 weeks, massage was superior to self-care on the symptom scale and the disability scale. Massage was also superior to acupuncture on the disability scale. After 1 year, massage was not better than self-care but was better than acupuncture. The massage group used the least medications and had the lowest costs of subsequent care. Therapeutic massage was effective for persistent low back pain, apparently providing long-lasting benefits. Traditional Chinese Medical acupuncture was relatively ineffective. Massage might be an effective alternative to conventional medical care for persistent back pain.



Hernandez-Reif, M., Field, T., Krasnegor, J., & Theakston, H. (2001). Lower back pain is reduced and range of motion increased after massage therapy. International Journal of Neuroscience, 106, 131-145.

METHODS: A randomized between-groups design evaluated massage therapy versus relaxation for chronic low back pain. Treatment effects were evaluated for reducing pain, depression, anxiety and stress hormones, and sleeplessness and for improving trunk range of motion associated with chronic low back pain.

RESULTS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and improved sleep. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher.



Hsieh, L.L., Kuo, C.H., Yen, M.F., & Chen, T.H. (2004). A randomized controlled clinical trial for low back pain treated by acupressure and physical therapy. Preventive Medicine, 39, 168-176.

METHODS: The aim of this study was to compare the efficacy of acupressure with that of physical therapy in reducing low back pain. 146 participants with chronic low back pain were randomly assigned to the acupressure group or the physical therapy group, each with a different treatment technique.

RESULTS: The mean posttreatment pain score after a 4-week treatment in the acupressure group was lower than that in the physical therapy group. At the 6-month follow-up assessment, the mean pain score in the acupressure group was still lower than that of the physical therapy group.



Sherman, K.J., Cherkin, D.C., Connelly, M.T., Erro, J., Savetsky, J.B., Davis, R.B. & Eisenberg, D.M. (2004). Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try? BMC Complementary and Alternative Medicine, 19, 4-9.

METHODS: Patients with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle were interviewed.

RESULTS: Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5-16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option.



Yip, Y.B., & Tse, S.H. (2004). The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: A randomized controlled trial. Complementary Therapy Medicine, 12, 28-37.

METHODS: This study assessed the effect of acupoint stimulation with electrodes combined with acupressure using an aromatic essential oil (lavender) as an add-on-treatment on pain relief and enhancing the physical functional activities among adults with sub-acute or chronic non-specific low back pain. The intervention was an 8-session relaxation acupoint stimulation followed by acupressure with lavender oil over a 3-week period. The control group received usual care only.

RESULTS: One week after the end of treatment, the intervention group had a 39% greater reduction in VAS pain intensity than the control group, improved walking time and greater lateral spine flexion range.



Hernandez-Reif, M., Field, T., Diego, M., & Fraser, M (2007). Lower Back Pain And Sleep Disturbances Are Reduced Following Massage Therapy. Journal of Bodyworks and Movement Therapies, 11, 141-145.

METHODS: Twenty- four adults with lower back pain were randomly assigned to a massage therapy or a progressive muscle relaxation group. Sessions were 30 minutes long twice a week for five weeks. On the first and last day of the 5-week study, participants completed questionnaires, provided a urine sample and were assessed for range of motion.

RESULTS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression and anxiety, and improved sleep. They also showed improvement trunk flexion, and their serotonin and dopamine levels were higher.



Wang, S., DeZinno, P., Fermo, L., William, K., Caldwell-Andrews, A., Bravemen, F. & Kain, Z. (2005). Complementary and alternative medicine for low-back pain in pregnancy: A cross-sectional survey. Journal of Alternative and Complementary Medicine, 11, 459-464.

METHODS: A survey was given to pregnant women and providers of prenatal health care (nurse educators, nurse midwives, and obstetricians).

RESULTS: The majority of pregnant women who participated in our survey (61.7%) reported that they would accept complementary and alternative medicine (CAM) therapy as treatment for low back pain (LBP) during pregnancy. Similarly, 61% of providers of prenatal health care reported that they would consider using CAM as treatment for LBP during pregnancy. Massage (61.4%), acupuncture (44.6%), relaxation (42.6%), yoga (40.6%), and chiropractic (36.6%) were the most common CAM therapies recommended for LBP in pregnancy by the providers of prenatal health care in our sample.




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Studies on the Effectiveness of Massage Therapy for Behavioral Problems

Escalona, A., Field, T., Cullen, C., Hartshorn, K., & Cruz, C. (2001). Behavior problem preschool children benefit from massage therapy. Early Child Development and Care, 161, 1-5.

METHODS: Twenty preschool children with behavior problems were randomly assigned to a massage group or a story reading attention control group. The sessions occurred for 15-minutes twice a week for a month. Pre and post session ratings were made on the first and last days of the study by teachers who were blind to the child’s group assignment.

RESULTS: These revealed that the children in the massage therapy group: 1) were more drowsy, less active, less talkative and had lower anxiety levels after the sessions; and 2) were less anxious and more cooperative by the end of the study.



Studies on the Effects of Massage Therapy on Blood Flow

Mori, H., Ohsawa, H., Tanaka, T.H., Taniwaki, E., Leisman, G. & Nishijo, K. (2004). Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Medical Science Monitor, 10, 173-178.

METHODS: Subjects participated in two experimental sessions (massage and rest conditions). Subjects lay prone on the table and were instructed to extend their trunks until the inferior portion of their rib cage no longer rested on the table. Subjects held this position for 90 seconds (Load I). Subjects then received massage on the lumbar region or rested for 5 minutes, then repeated the same load (Load II). Skin blood flow (SBF), muscle blood volume (MBV), skin temperature (ST), and subjects' subjective feelings of fatigue were evaluated using Visual Analogue Scale (VAS).

RESULTS: An increase of MBV between pre- and post-load II periods was higher after massage than after rest. An increase of SBF at pre- and post-load II was observed only under massage condition. An increase of SBF between post-load I and pre-load II periods was higher after massage than after rest. An increase of ST between post-load I and post-load II periods was greater after massage than after rest. The VAS score was lower with massage than with rest in the post-treatment period.



Studies on the Effects of Massage Therapy on Blood Pressure

Kurosawa, M., Lundeberg, T., Agren, G., Lund, I., & Uvnas-Moberg, K. (1995). Massage-like stroking of the abdomen lowers blood pressure in anesthetized rats: influence of oxytocin. Journal of the Autonomic Nervous System, 56, 26-30.

METHODS: The ventral and/or lateral sides of the abdomen were stroked in pentobarbital anesthetized, artificially ventilated rats. Arterial blood pressure was recorded with a pressure transducer via catheter in the carotid artery.

RESULTS: Stroking of the ventral or both ventral and lateral sides of the abdomen for 1 minute caused a marked decrease in arterial blood pressure (approx. 50 mmHg). After cessation of the stimulation blood pressure returned to the control level within 1 min. Stroking only the lateral sides of the abdomen elicited a significantly smaller decrease in blood pressure (approx. 30 mmHg decrease) than stroking the ventral side.



Hernandez-Reif, M., Field, T., Krasnegor, J. & Theakston, H. (2000). High blood pressure and associated symptoms were reduced by massage therapy. Journal of Bodywork and Movement Therapies, 4, 31-38.

METHODS: Thirty adults with controlled hypertension (for at least the last six months) were randomly assigned to either a massage therapy group or a progressive relaxation group. Those in the massage group were given twice-weekly 30-minute massage sessions for five weeks. Participants in the progressive muscle relaxation group received instructions on completing self-administered, twice-weekly 30-minute exercises for five weeks.

RESULTS: Results showed that while both group had lower anxiety levels (STAI) and lower levels of depression (CES-D), only the massage therapy group showed decreases in sitting diastolic and systolic blood pressure; decreases in salivary and urinary cortisol stress-hormone levels; and lower scores for depression, anxiety and hostility.



McNamara, M.E., Burnham, D.C., Smith, C., & Carroll, D.L. (2003). The effects of back massage before diagnostic cardiac catheterization. Alternative Therapies, 9, 50-57.

METHODS: The purpose of this study was to measure the effects of a 20-minute back massage on the physiological and psychological human responses of patients admitted for a diagnostic cardiac catheterization. Data were compared in a repeated measures design before massage, immediately following the back massage or standard care, and 10 minutes later.

RESULTS: There was a reduction in systolic blood pressure in the treatment group. In addition, main effects were noted for time for diastolic blood pressure, respiration, total Profile of Mood States score and pain perception in both groups.



Olney, C.M. (2005).The effect of therapeutic back massage in hypertensive persons: a preliminary study. Biological Research for Nursing, 7, 98-105.

METHODS: This study tested the effects of a regularly applied back massage on the BP of patients with clinically diagnosed hypertension. A 10-min back massage was given to the experimental group, three times a week for 10 sessions. The control group relaxed in the same environment for 10 min, three times a week for 10 sessions.

RESULTS: Systolic BP decreased over time, as did the diastolic BP.



Studies on the Effects of Massage on Breast Cancer Patients

Hernandez-Reif, M., Ironson, G., Field, T., Katz, G., Diego, M., Weiss, S., Fletcher, M., Schanberg, S. & Kuhn, C. (2003). Breast cancer patients have improved immune functions following massage therapy. Journal of Psychosomatic Research, 57, 45-52.

METHODS: Women diagnosed with Stage I or II breast cancer were randomly assigned post surgery to a massage therapy group (to receive 30-minute massages three times per week for 5 weeks) or a standard treatment control group. On the first and last day of the study, the women were assessed on 1) immediate effects measures of anxiety, depressed mood, and vigor, and 2) longer term effects on depression, anxiety and hostility, functioning, body image and avoidant versus intrusive coping style, in addition, to urinary catecholamines (norepinephrine, epinephrine, and dopamine), and serotonin levels. A subset of 27 women (n= 15 massage) had blood drawn to assay immune measures.

RESULTS: The immediate massage therapy effects included reduced anxiety, depressed mood, and anger. The longer-term massage effects included reduced depression and hostility, increased urinary dopamine, serotonin values, natural killer cell number and lymphocytes. Avoidance coping was associated with greater NK cell number and intrusive coping with lower dopamine levels.



Hernandez-Reif, M., Field, T., Ironson, G., Beutler, J., Vera, Y., Hurley, J., Fletcher, M., Schanberg, S., Kuhn, C., & Fraser, M. (2005). Natural killer cells and lymphocytes increase in women with breast cancer following massage therapy. International Journal of Neuroscience, 115, 495-510

METHODS: Women diagnosed with breast cancer received massage therapy or practiced progressive muscle relaxation (PMR) for 30-minute sessions three times a week for 5-weeks or received standard treatment. The massage therapy and relaxation groups reported less depressed mood, anxiety and pain immediately after their first and last sessions. By the end of the study, however, only the massage therapy group reported being less depressed and less angry and having more vigor. Dopamine levels, Natural Killer cells and lymphocytes also increased from the first to the last day of the study for the massage therapy group.



Hernandez-Reif M, Ironson G, Field T, Hurley J, Katz G, Diego M, Weiss S, Fletcher MA, Schanberg S, Kuhn C, Burman I. Breast cancer patients have improved immune and neuroendocrine functions following massage therapy. J Psychosom Res. 2004 Jul;57(1):45-52.

METHODS: Women with breast cancer are at risk for elevated depression, anxiety, and decreased natural killer (NK) cell number. Stress has been linked to increased tumor development by decreasing NK cell activity. The objectives of this study included examining massage therapy for women with breast cancer for (1) improving mood and biological measures associated with mood enhancement (serotonin, dopamine), (2) reducing stress and stress hormone levels, and (3) boosting immune measures. Thirty-four women (M age=53) diagnosed with Stage 1 or 2 breast cancer were randomly assigned postsurgery to a massage therapy group (to receive 30-min massages three times per week for 5 weeks) or a control group. The massage consisted of stroking, squeezing, and stretching techniques to the head, arms, legs/feet, and back. On the first and last day of the study, the women were assessed on (1) immediate effects measures of anxiety, depressed mood, and vigor and (2) longer term effects on depression, anxiety and hostility, functioning, body image, and avoidant versus intrusive coping style, in addition to urinary catecholamines (norepinephrine, epinephrine, and dopamine) and serotonin levels. A subset of 27 women (n=15 massage) had blood drawn to assay immune measures.

RESULTS/ CONCLUSIONS: The immediate massage therapy effects included reduced anxiety, depressed mood, and anger. The longer term massage effects included reduced depression and hostility and increased urinary dopamine, serotonin values, NK cell number, and lymphocytes. Women with Stage 1 and 2 breast cancer may benefit from thrice-weekly massage therapy for reducing depressed mood, anxiety, and anger and for enhancing dopamine, serotonin, and NK cell number and lymphocytes.

Listing, M., Krohn, M., Liezmann, C., Kim, I, Reisshauer, A., Peters, E., Lapp, B.F. & Rauchfuss, M. (2010). The efficacy of classical massage on stress perception and cortisol following primary treatment of breast cancer.

METHODS: Women diagnosed with breast cancer were randomized into an intervention or control group. For 5 weeks the intervention group received biweekly 30-min classical massages and the control group received no additional treatment to their routine healthcare.

RESULTS: Compared with the control group, women in the intervention group reported lower mood disturbances and perceived stress levels were reduced after massage therapy.



Sturgeon, M., Wetta-Hall, R., Hart, T., Good, M., & Dakhil, S. (2009). Effects of therapeutic massage on the quality of life among patients with breast cancer during treatment. Journal of Complementary Medicine, 15, 373-380.

METHODS: Breast cancer patients received a massage for 3 consecutive weeks.

RESULTS: Participants reported lower state anxiety, and improved sleep quality, and quality of life/ function.



Studies on the Effects of Massage Therapy on Bulimia Patients

Field, T., Schanberg, S., Kuhn, C., Field, T., Fierro, K., Henteleff, T., Mueller, C., Yando, R., Shaw, S. & Burman, I. (1998). Bulimic adolescents benefit from massage therapy. Adolescence, 33, 555-563.

METHODS: Twenty-four female adolescent bulimic inpatients were randomly assigned to a massage therapy or a standard treatment (control) group.

RESULTS: The massaged patients showed immediate reductions in anxiety and depression (both self-report and behavior observation). In addition, by the last day of the therapy, they had lower depression scores, lower cortisol (stress) levels, higher dopamine levels, and they showed improvement on several other psychological and behavioral measures.



Studies on the Effect of Massage Therapy in Burn Treatment

Field, T., Peck, M., Krugman, S., Tuchel, T., Schanberg, S., Kuhn, C., & Burman, I. (1998). Burn injuries benefit from massage therapy. Journal of Burn Care and Rehabilitation, 19, 241-244.

METHODS: Twenty-eight adult patients with burns were randomly assigned before debridement to either a massage therapy group or a standard treatment control group.

RESULTS: State anxiety and cortisol levels decreased, and behavior ratings of state, activity, vocalizations, and anxiety improved after the massage therapy sessions on the first and last days of treatment. Longer-term effects were also significantly greater for the massage therapy group including decreases in depression and anger, and decreased pain on the McGill Pain Questionnaire, Present Pain Intensity Scale, and Visual Analogue Scale. Although the underlying mechanisms are not known, these data suggest that debridement sessions were less painful after the massage therapy sessions due to a reduction in anxiety, and that the clinical course was probably enhanced as a result of a reduction in pain, anger, and depression.



Field, T., Peck, M., Hernandez-Reif, M., Krugman, S., Burman, I., & Ozment-Schenck, L. (2000). Postburn itching, pain, and psychological symptoms are reduced with massage therapy. Journal of Burn Care & Rehabilitation, 21, 189-193.

METHODS: Twenty patients with burn injuries were randomly assigned to a massage therapy or a standard treatment control group during the remodeling phase of wound healing. The massage therapy group received a 30-minute massage with cocoa butter to a closed, moderate-sized scar tissue area twice a week for 5 weeks.

RESULTS: The massage therapy group reported reduced itching, pain, and anxiety and improved mood immediately after the first and last therapy sessions, and their ratings on these measures improved from the first day to the last day of the study.



Hernandez-Reif, M., Field, T., Largie, S., Hart, S., Redzepi, M., Nierenberg, B., & Peck, M. (2001). Childrens’ distress during burn treatment is reduced by massage therapy. Journal of Burn Care and Rehabilitation, 22, 191-195.

METHODS: Before dressing changes, 24 young children (mean age = 2.5 years) hospitalized for severe burns received standard dressing care or massage therapy in addition to standard dressing care. The massage therapy was conducted to body parts that were not burned.

RESULTS: During the dressing change, the children who received massage therapy showed minimal distress behaviors and no increase in movement other than torso movement. In contrast, the children who did not receive massage therapy responded to the dressing change procedure with increased facial grimacing, torso movement, crying, leg movement and reaching out. Nurses also reported greater ease in completing the dressing change procedure for the children in the massage therapy group. These findings suggest that massage therapy attenuates young children's distress responses to aversive medical procedures and facilitates dressing changes.



Parlak Gürol, A., Polat, S. & Akçay, M.N. (2010). Itching, pain, and anxiety levels are reduced with massage therapy in burned adolescents. Journal of Burn Care and Research, 31, 429-432.

METHODS: Adolescents were massaged after admission to a burn unit.

RESULTS: After 5 weeks, massage therapy reduced pain, itching and state anxiety.



Studies on the Effects of Massage Therapy in Cancer Treatment

Grealish, L., Lomasney, A., & Whiteman, B. (2000). Foot massage. A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nursing, 23, 237-243.

METHODS: This article describes the findings of an empirical study on the use of foot massage as a nursing intervention in patients hospitalized with cancer.

RESULTS: In a sample of 87 subjects, a 10-minute foot massage (5 minutes per foot) was found to reduce perceptions of pain, nausea, and relaxation when measured with a visual analog scale.



Stephenson, N.L., Weinrich, S.P., & Tavakoli, A.S. (2000). The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer. Oncology Nursing Forum, 27, 67-72.

METHODS: To test the effects of foot reflexology on anxiety and pain in patients with breast and lung cancer.

RESULTS: Following the foot reflexology intervention, patients with breast and lung cancer experienced a significant decrease in anxiety. One of three pain measures showed that patients with breast cancer experienced a significant decrease in pain.



Wilkie, D.J., Kampbell, J., Cutshall, S., Halabisky, H., Harmon, H., Johnson, L.P., Weinacht, L., & Rake-Marona, M. (2000). Effects of massage on pain intensity, analgesics and quality of life in patients with cancer pain: A pilot study of a randomized clinical trial conducted within hospice care delivery. Hospice Journal, 15, 31-53.

METHODS: This randomized controlled clinical trial examined the effects of massage on perceived pain intensity, prescribed morphine, hospital admissions, and quality of life. Massage interventions consisted of 4, twice-weekly massages. Baseline and outcome measurements were obtained before the 1st and after the 4th massages.

RESULTS: Pain intensity, pulse rate, and respiratory rate were significantly reduced immediately after the massages. At study entry, the massage group reported higher pain intensity which decreased by 42% compared to a 25% reduction in the control group.



Rexilius, S.J., Mundt, C., Erickson Megel, M., & Agrawal, S. (2002). Therapeutic effects of massage therapy and handling touch on caregivers of patients undergoing autologous hematopoietic stem cell transplant. Oncology Nursing Forum, 29, 35-44.

METHODS: This study examined the effects of massage therapy and Healing Touch on anxiety, depression, subjective caregiver burden, and fatigue experienced by caregivers of patients undergoing autologous hematopoietic stem cell transplant.

RESULTS: Results showed significant declines in anxiety scores, depression, general fatigue, reduced motivation fatigue, and emotional fatigue for individuals in the massage therapy group only.



Smith, M.C., Kemp, J., Hemphill, L., & Vojir, C.P. (2002). Outcomes of therapeutic massage for hospitalized cancer patients. Journal of Nursing Scholarship, 34, 257-262.

METHODS: To examine the effects of therapeutic massage on perception of pain, subjective sleep quality, symptom distress, and anxiety in patients hospitalized for treatment of cancer, twenty participants received therapeutic massage and 21 received the control therapy, nurse interaction.

RESULTS: Mean scores for pain, sleep quality, symptom distress, and anxiety improved from baseline for the subjects who received therapeutic massage; only anxiety improved from baseline for participants in the comparison group. Sleep improved only slightly for the participants receiving massage, but it deteriorated significantly for those in the control group.



Forchuk, C., Baruth, P., Prendergast, M., Holliday, R., Bareham, R., Brimner, S., Schulz, V., Chan, Y.C., Yammine, N. (2004). Postoperative arm massage: A support for women with lymph node dissection. Cancer Nursing, 27, 25-33.

METHODS: To evaluate the usefulness of arm massage from a significant other following lymph node dissection surgery, subjects' significant others in the intervention group were first taught, then performed arm massage as a postoperative support measure.

RESULTS: Participants reported a reduction in pain in the immediate postoperative period and better shoulder function. Arm massage decreased pain and discomfort related to surgery, and promoted a sense of closeness and support between subjects and their significant other.



Shin, Y.H., Kim, T.I., Shin, M.S., & Juon, H.S. (2004). Effect of acupressure on nausea and vomiting during chemotherapy cycle for Korean postoperative stomach cancer patients. Cancer Nursing, 27, 267-274.

METHODS: Despite the development of effective antiemetic drugs, nausea and vomiting remain the main side effects associated with cancer chemotherapy. The purpose of this study was to examine the effect of acupressure on emesis control in postoperative gastric cancer patients undergoing chemotherapy. Forty postoperative gastric cancer patients receiving the first cycle of chemotherapy were divided into control and intervention groups. Both groups received regular antiemesis medication; however, the intervention group received acupressure training and was instructed to perform the finger acupressure maneuver for 5 minutes on the point located at 3-finger widths up from the first palmar crease, at least 3 times a day before chemotherapy and mealtimes or based on their needs. Both groups received equally frequent nursing visits and consultations, and reported nausea and vomiting.

RESULTS: Significant differences were noted between intervention and control groups in the severity of nausea and vomiting, the duration of nausea, and frequency of vomiting. This study suggests that acupressure appears to be an effective adjunct maneuver in the course of emesis control.



Billhult, A., Lindholm, C., Gunnarsson, R., Stener-Victorin, E. (2009). The effect of massage on immune function and stress in women with breast cancer--a randomized controlled trial. Autonomic Neuroscience, 150, 111-115.

METHODS: Women, with breast cancer were assigned to a massage or an attention control group.

RESULTS: Massage decreased the deterioration of NK cell activity occurring during radiation therapy and lowered heart rate and systolic blood pressure.



Listing, M., Reisshauer, A., Krohn, M., Voigt, B., Tjahono, G., Becker, J., Klapp, B.F., & Rauchfuss. M. (2009). Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer. Psycononcology, 18, 1290-1299.

METHODS: Women with breast cancer were randomized into a massage or a control group. For 5 weeks, bi-weekly 30-min massages were given in the back, head, and neck.

RESULTS: A greater decrease in physical discomfort and group fatigue was noted in the massage group as well as mood disturbance. The effect of massage on mood disturbances was greater when treated continuously by the same therapist.



Post-White, J., Fitzgerald, M., Savik, K., Hooke, M.C., Hannahan, A.B., Sencer, S.F.(2009). Massage therapy for children with cancer. Journal of Pediatric Oncology Nursing, 26, 16-28.

METHODS: Children with cancer received 4 weekly massages alternated with 4 weekly quiet-time control sessions.

RESULTS: Massage was more effective than quiet time at reducing heart rate and anxiety in children as well as parent anxiety.


Yang JH(2009). The effects of foot reflexology on nausea, vomiting and fatigue of breast cancer patients undergoing chemotherapy. Taehan Kanho Hakhoe Chi. 2005 Feb;35(1):177-85.Taehan Kanho Hakhoe Chi. 2005 Feb;35(1):177-85.

METHODS: The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program.

RESULTS: There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times.


Billhult A, Lindholm C, Gunnarsson R, Stener-Victorin E (2009). The effect of massage on immune function and stress in women with breast cancer--a randomized controlled trial. Auton Neurosci. 2009 Oct 5;150(1-2):111-5. Epub 2009 Apr 18.

METHODS: Thirty women, aged 50 to 75 years (mean 61 sd=7.2) with breast cancer undergoing radiation therapy in a hospital in southwestern Sweden were enrolled in the study. They were allocated to either receive massage in the form of a full-body light pressure effleurage treatment, or a control visit where they were given an equal amount of attention. Blood samples, saliva, notation of heart rate and blood pressure were collected before and after massage/control visit. Differences in change over time between groups were analyzed by Student's t-test.

RESULTS: Light pressure effleurage massage decreased the deterioration of NK cell activity occurring during radiation therapy. Furthermore it lowered heart rate and systolic blood pressure. No effects were demonstrated on cortisol and diastolic pressure.


Hernandez-Reif M, Ironson G, Field T, Hurley J, Katz G, Diego M, Weiss S, Fletcher MA, Schanberg S, Kuhn C, Burman I(2004). Breast cancer patients have improved immune and neuroendocrine functions following massage therapy. J Psychosom Res. 2004 Jul;57(1):45-52.

METHODS: Thirty-four women (M age=53) diagnosed with Stage 1 or 2 breast cancer were randomly assigned postsurgery to a massage therapy group (to receive 30-min massages three times per week for 5 weeks) or a control group. The massage consisted of stroking, squeezing, and stretching techniques to the head, arms, legs/feet, and back. On the first and last day of the study, the women were assessed on (1) immediate effects measures of anxiety, depressed mood, and vigor and (2) longer term effects on depression, anxiety and hostility, functioning, body image, and avoidant versus intrusive coping style, in addition to urinary catecholamines (norepinephrine, epinephrine, and dopamine) and serotonin levels. A subset of 27 women (n=15 massage) had blood drawn to assay immune measures.

RESULTS: The immediate massage therapy effects included reduced anxiety, depressed mood, and anger. The longer term massage effects included reduced depression and hostility and increased urinary dopamine, serotonin values, NK cell number, and lymphocytes.


Sturgeon M, Wetta-Hall R, Hart T, Good M, Dakhil S (2009). Effects of therapeutic massage on the quality of life among patients with breast cancer during treatment. Journal of Alternative Complementary Medicine. 2009 Apr;15(4):373-80.

METHODS: Using a pre/post intervention assessment design, this prospective, convenience sample pilot study measured anxiety, pain, nausea, sleep quality, and quality of life. Treatment consisted of one 30-minute treatment per week for 3 consecutive weeks.

RESULTS: Participants experienced a reduction in several quality of life symptom concerns after only 3 weeks of massage therapy. Respondents' cumulative pre- and post-massage mean for state anxiety, sleep quality, and quality of life/functioning showed significant improvement. Among study participants, there was variability in reported episodes of nausea, vomiting, and retching; although participants reported decreased pain and distress, changes were non-significant.



Studies on the Effects of Massage Therapy on Cardiovascular Health

Lewis, P., Nichols, E., Mackey, G., Fadol, A., Sloane, L., Villagomez, E., & Liehr, P. (1997). The effect of turning and backrub on mixed venous oxygen saturation in critically ill patients. American Journal of Critical Care, 6, 132-140.

METHODS: A repeated-measures design was used to study 57 critically ill men. Mixed venous oxygen saturation was recorded at 1-minute intervals for 5 minutes in each of three periods: baseline, after turning, and after backrub. Subjects were randomly assigned to body position and timing of backrub. Subjects in the immediate-backrub group were turned and given a 1-minute backrub. Mixed venous oxygen saturation was measured at 1-minute intervals for 5 minutes at two points: after the backrub and then with the patient lying on his side. For subjects in the delayed-backrub group, saturation was measured at 1-minute intervals for 5 minutes at two different points: after the subject was turned to his side and after the backrub.

RESULTS: Both position and timing of backrub had significant effects on mixed venous oxygen saturation across conditions over time. Subjects positioned on their left side had a significantly greater decrease in saturation when the backrub was started. At the end of the backrub, saturation was significantly lower in subjects lying on their left side than in subjects lying on their right side. The pattern of change differed according to the timing of the backrub, and return to baseline levels of saturation after intervention differed according to body position. Two consecutive interventions (change in body position and backrub) caused a greater decrease in mixed venous oxygen saturation than the two interventions separated by a 5-minute equilibration period. Turning to the left side decreased oxygen saturation more than turning to the ride side did. Oxygen saturation returned to clinically acceptable ranges within 5 minutes of the intervention.



Delaney, J.P., Leong, K.S., Watkins, A., & Brodie, D. (2002). The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects. Journal of Advanced Nursing, 37, 364-371.

METHODS: An experimental study in which subjects were initially placed in age- and sex-matched groups and then randomized to treatment or control by alternate allocation. The study involved 30 healthy subjects (16 female and 14 male in their thirties). A 5-minute cardiac interbeat interval recording, systolic and diastolic blood pressure and subjective self-evaluations of muscle tension and emotional state were taken before and after intervention. Autonomic function was measured using time and frequency domain analysis of heart rate variability.

RESULTS: Following myofascial trigger-point massage therapy there was a significant decrease in heart rate, systolic blood pressure and diastolic blood pressure. Analysis of heart rate variability revealed a significant increase in parasympathetic activity following myofascial trigger-point massage therapy. Additionally both muscle tension and emotional state showed significant improvement.



McNamara, M.E., Burnham, D.C., Smith, C., & Carroll, D.L. (2003). The effects of back massage before diagnostic cardiac catheterization. Alternative Therapies in Health Medicine, 9, 50-57.

METHODS: The purpose of this study was to measure the effects of a 20-minute back massage on the physiological and psychological human responses of patients admitted for a diagnostic cardiac catheterization.

RESULTS: There was a significant reduction in systolic blood pressure in the treatment group. In addition, main effects were noted for time for diastolic blood pressure, respiration, total Profile of Mood States score and pain perception in both groups.



Wentworth, L.J., Briese, L.J., Timimi, F.K., Sanvick, C.L., Bartel, D.C., Cutshall, S.M., Tilbury, R.T., Lennon, R., & Bauer, B.A. (2009). Massage therapy reduces tension, anxiety, and pain in patients awaiting invasive cardiovascular procedures. Progress in Cardiovascular Nursing, 24, 155-161.

METHODS: Patients awaiting invasive cardiovascular procedures received 20 minutes massage at least 30 minutes before the procedure.

RESULTS: Differences in the scores for pain, anxiety, and tension were identified for the massage group more than for the control group receiving standard care. An increase in satisfaction was also noted for the massage therapy group.



Studies on the Effects of Massage Therapy on Carpal Tunnel Syndrome

Field, T., Diego, M., Cullen, C., Hartshorn, K., Gruskin, A., Hernandez-Reif, M., & Sunshine, W. (2004). Carpal tunnel syndrome symptoms are lessened following massage therapy. Journal of Bodywork and Movement Therapies, 8, 9-14.

METHODS: The objective of this study was to determine the effectiveness of massage therapy for relieving the symptoms of Carpal Tunnel Syndrome (CTS). Sixteen adults with CTS symptoms were randomized to a 4-week massage therapy or control group. Participants in the massage therapy group were taught a self-massage routine that was done daily at home. They were also massaged once a week by a therapist. The participants’ diagnosis was based on a nerve conduction velocity test, the Phalen test, and the Tinel sign test performed by a physician. The participants were also given the State Trait Anxiety Inventory (STAI), the Profile of Mood States (POMS), a visual analog scale for pain and a test of grip strength.

RESULTS: Participants in the massage therapy group improved on median peak latency and grip strength. They also experienced lower levels of perceived pain, anxiety, and depressed mood. The results suggest that symptoms of CTS can be relieved by a daily regimen of massage therapy



Studies on the Effect of Massage Therapy in Cerebral Palsy

Hernandez-Reif, M., Field, T., Largie, S., Diego, M., Manigat, N., Seonanes, J., Bornstein, J. & Waldman, R. (2005). Cerebral Palsy symptoms in children decreased following massage therapy. Journal of Early Child Development and Care, 175, 445-456.

METHODS: Twenty young children (M age = 32 months) with Cerebral Palsy (CP) recruited from early intervention programs received 30-minutes of massage or reading twice weekly for 12 weeks.

RESULTS: The children receiving massage therapy showed fewer physical symptoms including reduced spasticity, less rigid muscle tone overall and in the arms and improved fine and gross motor functioning. In addition, the massage group had improved cognition, social and dressing scores on the Developmental Profile and they showed more positive facial expressions and less limb activity during face-to-face play interactions.



Studies on the Effects of Chair Massage Therapy on Workers and Others

Deborah J Engen, Dietlind L Wahner-Roedler*, Anita M Nadolny, Colleen M Persinger, Jae K Oh, Peter C Spittell, Laura L Loehrer, Stephen S Cha and Brent A Bauer. (2010) The effect of chair massage on muscular discomfort in cardiac sonographers: a pilot study. BMC Complementary and Alternative Medicine 2010, 10:50

METHODS: Cardiac sonographers frequently have work-related muscular discomfort. We aimed to assess the feasibility of having sonographers receive massages during working hours in an area adjacent to an echocardiography laboratory and to assess relief of discomfort with use of the massages with or without stretching exercises. A group of 45 full-time sonographers was randomly assigned to receive weekly 30-minute massage sessions, massages plus stretching exercises to be performed twice a day, or no intervention. Outcome measures were scores of the QuickDASH instrument and its associated work module at baseline and at 10 weeks of intervention. Data were analyzed with standard descriptive statistics and the separation test for early-phase comparative trials.

RESULTS: Forty-four participants completed the study: 15 in the control group, 14 in the massage group, and 15 in the massage plus stretches group. Some improvement was seen in work-related discomfort by the QuickDASH scores and work module scores in the 2 intervention groups. The separation test showed separation in favor of the 2 interventions. On the basis of the results of this pilot study, larger trials are warranted to evaluate the effect of massages with or without stretching on work-related discomfort in cardiac sonographers. .


Mary Kay Brennan, MS, RN, LMBT, Rita D. DeBate, PhD, MPH, CHES. The effect of chair massage on stress perception of hospital bedside nurses. Journal of Bodywork and Movement Therapies Volume 10, Issue 4 , Pages 335-342, October 2006

METHODS: To evaluate the effectiveness of a 10min chair massage on the stress perception of hospital nurses in comparison to a routine “coffee break” during a working shift. Eighty-two bedside nurses, mean age of, within a small, suburban hospital, participated in this study to determine the effect a 10-min on-site chair massage had on their stress perception in comparison to a 10-min “coffee break”. The feasibility of incorporating a massage into their workload during a shift was also considered. Using the Perceived Stress Scale (PSS), stress perception was assessed in an experimental pre-test–post-test design and analyzed using t-tests for dependent samples.

RESULTS:Stress perception was significantly lower in the massage group and was not significantly changed in the control group. Also, 86% of the nurses scheduled to participate in the study were able to do so within their normal workday. Incorporating chair massage into a nurse's hospital shift is feasible and a 10min session reduces the stress perception of the nurse more so than the standard “coffee break”. This study focused on a one-time intervention for the 82 nurses enrolled. Further study on the longer term feasibility and effects of chair massage on this population and others in high stress professions is warranted.


Peter Mackerethemail, Paola Sylt, Ashley Weinberg, Gwynneth Campbell. Chair massage for carers in an acute cancer hospital European Journal of Oncology Nursing Volume 9, Issue 2, Pages 167–179, June 2005

METHODS: The Chair Massage service considered in this evaluation study was provided to carers, visiting in-patients at a major cancer hospital in the UK. The two-stage evaluation comprised: firstly, a retrospective review of treatment records for the previous 12 months (Math Eq), and secondly, a prospective study, gathering data by interview and a ‘next-day’ questionnaire from carers (Math Eq), during 1 week of service delivery. The study at both stages sought to identify who used the service, post-treatment comments and changes in scores using a Feeling Good Thermometer (Field, T., 2000. Touch Therapy. Churchill Livingstone, London). During the second stage the carers were also asked about their concerns and worries, and to report changes in physical and emotional states using visual scales

RESULTS: Findings included significant improvements in physical and psychological scores; these were retained through to the next day. The next-day questionnaire also reported improved sleep for the majority of carers. A number of concerns and worries were raised at interview, notably anxieties about the patient and uncertainty about the future, family and financial worries. Overall, the service was well evaluated with parents and in particular female carers appearing to gain the most from the intervention.


Studies on the Effects of Massage Therapy on Chronic Fatigue Syndrome

Field, T, Sunshine, W., Hernandez-Reif, M., Quintino, O., Schanberg, S., Kuhn, C., & Burman, I. (1997). Chronic fatigue syndrome: Massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome, 3, 43-51.

METHODS: Twenty chronic fatigue syndrome subjects were randomly assigned to a massage therapy or a SHAM TENS (transcutaneous electrical stimulation) control group.

RESULTS: Immediately following the massage therapy versus SHAM TENS on the first and last days of the study the massage therapy group had lower depression and anxiety scores and lower cortisol levels. Longer-term effects (last day versus first day) suggested that the massage therapy versus the SHAM TENS group had lower depression, emotional distress and somatic symptom scores, more hours of sleep and lower epinephrine and cortisol levels.



Studies on the Effects of Massage Therapy on Chronic Illness or Chronic Pain

Diane Kempson, MSW, PhD, Virginia Conley, PhD, FNP, University of Wyoming–Laramie, Family Caregiver Provided Massage for Rural-Dwelling Chronically Ill Persons. Home Health Care Management Practice OnlineFirst, published on November 5, 2008 as doi:10.1177/1084822308325782; Home Health Care Management Practice February 2009 vol. 21 no. 2 117-123

Method: The interventional pilot study used a triangulated design to elicit information regarding rural caregivers’ willingness to learn and use simple Swedish massage techniques for their chronically ill loved ones as well as to determine their perceptions of resultant burdens and benefits for the caregiver. Data consisted of descriptive data of participants from a demographic questionnaire, and phenomenological data obtained through semistructured face-to-face interviews with the participants postintervention. Institutional review board approval was obtained before initiating the study. Participants were recruited from a western frontier state through newspaper advertisements, word of mouth, and through the social services director at a long-term care (LTC) facility. One of the researchers, a licensed massage therapist, met with interested persons either individually or in small groups at their home or a mutually convenient location, such as a conference room at the LTC facility. During this initial meeting, the study was described and informed consent was obtained. Participants were briefly interviewed to determine their comfort level and any former experience providing massage; and they filled out a demographic data form. The gentle massage techniques of effleurage and petrissage were then demonstrated for the participants and a return demonstration was obtained. Any questions were answered. Participants were given a gift basket containing massage oil, a CD of relaxing music, chocolates, and a phone card so they could call the researchers for any problems or questions.

Results: Results from this study indicate that rural-dwelling caregivers are willing to learn basic massage techniques as a way to care for their loved ones. Moreover, as evidenced by the statements of a majority of the participants, the ability to administer massage to a loved one often results in benefits for the caregiver in terms of being able to offer something special to the loved one, thereby strengthening perceived self-efficacy; and of promoting a time for relaxation for the caregiver.



Marcia M Piotrowski, RN, MS, Cynthia Paterson, RN, MSA, Allison Mitchinson, MPH, Hyungjin Myra Kim, ScD, Marvin Kirsh, MD, FACS, Daniel B Hinshaw, MD, FACS. Massage as Adjuvant Therapy in the Management of Acute Postoperative Pain: A Preliminary Study in Men. Journal of the American College of Surgeons Volume 197, Issue 6 , Pages 1037-1046, December 2003

Method: This prospective randomized clinical trial compared pain relief after major operations in 202 patients who received one of three nursing interventions: massage, focused attention, or routine care. Interventions were performed twice daily starting 24 hours after the operation through postoperative day 7. Perceived pain was measured each morning.

Results:The rate of decline in the unpleasantness of postoperative pain was accelerated by massage. Massage also accelerated the rate of decline in the intensity of postoperative pain but this effect was not statistically significant. Use of opioid analgesics was not altered significantly by the interventions. CONCLUSIONS: Massage may be a useful adjuvant therapy for the management of acute postoperative pain. Its greatest effect appears to be on the affective component (ie, unpleasantness) of the pain. ( J Am Coll Surg 2003;197:1037–1046. © 2003 by the American College of Surgeons)



Studies on the Effects of Massage Therapy on Cocaine Exposed Individuals

Wheeden, A., Scafidi, F.A., Field, T., Ironson, G., Valdeon, C. & Bandstra, E. (1993). Massage effects on cocaine-exposed preterm neonates. Journal of Developmental and Behavioral Pediatrics, 14, 318-322.

METHODS: Thirty cocaine-exposed preterm neonates (mean gestational age 30 weeks, mean birth weight = 1212 g, mean intensive care unit duration = 18 days) were randomly assigned to a massage therapy or a control group as soon as they were considered medically stable. Group assignment was based on a random stratification of gestational age, birth weight, intensive care unit duration, and entry weight into the study. The treatment group (N=15) received massages for three 15-minute periods over 3 consecutive hours for a 10-day period.

RESULTS: Findings suggested that the massaged infants (1) averaged 28% greater weight gain per day (33 vs 26 g) although the groups did not differ on intake (calories or volume), (2) showed significantly fewer postnatal complications and stress behaviors than the control infants, and (3) demonstrated more mature motor behaviors on the Brazelton examination at the end of the 10-day study period.



Studies on the Effect of Massage Therapy on Learning and Cognition

Cigales, M., Field, T., Lundy, B., Cuadra, A., Hart, S. (1997). Massage enhances recovery from habituation in normal infants. Infant Behavior and Development, 20, 29-34.

METHODS: Four-month-old infants were given either 8 minutes of massage, play, or no stimulation prior to an audiovisual habituation task.

RESULTS: Infants who received massage showed response recovery from habituation during test trials, whereas those in the other two conditions did not.



Hart, S., Field, T., Hernandez-Reif, M., & Lundy, B. (1998). Preschoolers’cognitive performance improves following massage. Early Child Development & Care, 143, 59-64.

METHODS: Preschoolers (M age = 4 years, 4 months) were given WPPSI subtests, including Block Design, Animal Pegs and Mazes, before and after receiving a 15-minute massage or spending 15-minutes reading stories with an experimenter.

RESULTS: Performance on the Block Design improved following massage and accuracy was greater on the Animal Pegs in the massage group.



Studies on the Effects of Massage Therapy on Constipation

Bishop, E., McKinnon, E., Weir, E., & Brown, D.W. (2003). Reflexology in the management of encopresis and chronic constipation. Paediatric Nursing., 15, 20-21.

METHODS: This study investigated the efficacy of treating patients with encopresis and chronic constipation with reflexology. An observational study was carried out of 50 children between three and 14 years of age who had a diagnosis of encopresis/chronic constipation. The children received six sessions of 30-minutes of reflexology to their feet. With the help of their parents they completed questionnaires on bowel movements and soiling patterns before, during and after the treatment. A further questionnaire was completed by parents pre and post treatment on their attitude towards reflexology. Forty-eight of the children completed the sessions.

RESULTS: The number of bowel movements increased and the incidence of soiling decreased. Parents were keen to try the reflexology and were satisfied with the effect of reflexology on their child's condition. It appears that reflexology has been an effective method of treating encopresis and constipation over a six-week period in this cohort of patients.



Lämås, K., Lindholm, L., Stenlund, H., Engström, B., & Jacobsson, C. (2009). Effects of abdominal massage in management of constipation: A randomized controlled trial. International Journal of Nursing Students, 46, 759-797.

METHODS: A sample of 60 people with constipation were randomized to an interventional abdominal massage group in addition to an earlier prescribed laxative, while the control group received only laxatives according to prior prescriptions.

RESULTS: Abdominal massage significantly decreased severity of gastrointestinal symptoms, constipation syndrome and abdominal pain syndrome. The massage group also had increased bowel movements compared to the control group.



Lämås K, Graneheim UH, Jacobsson C.(2012) Experiences of abdominal massage for constipation. J Clin Nurs. 2012 Mar;21(5-6):757-65. doi: 10.1111/j.1365-2702.2011.03946.x. Epub 2011 Nov 21.

METHODS: This study aims to illuminate participants' experiences of receiving abdominal massage for constipation. Abdominal massage has been found to decrease the severity of constipation and abdominal pain, but little is known about how patients experience receiving abdominal massage. The present study is a qualitative descriptive study, based on individual interviews. Nine adults receiving abdominal massage for constipation were invited to participate. Semi-structured interviews were conducted in Sweden between 2005-2007. The interviews were transcribed and subjected to qualitative content analysis.

RESULTS:Four themes were formulated: 'being on one's guard', 'becoming embraced by safe hands', 'being touched physically and emotionally' and 'feeling vulnerable'. The participants reported that they were on guard, i.e. they were sceptical about whether or not abdominal massage was effective and suitable. However, as the massage sessions continued, they found the massage pleasant and began to feel embraced and in safe hands. They described how the abdominal massage made them feel as 'being touched physically and emotionally' and their bowel habits were improved. Along with the improvements, their agony was gone and they felt relieved. However, they considered their new condition fragile and they felt vulnerable to relapse. Abdominal massage was experienced as pleasurable, and after treatment, the participants felt more comfortable with their bowel function. Participants described abdominal massage as affecting the whole person. Abdominal massage has been shown to be an effective intervention for constipation. A crucial aspect is that nurses need to be sensitive and respect the intimacy associated with the abdomen.



Lämås, K., Lindholm, L., Stenlund, H., Engström, B., & Jacobsson, C. (2009). Effects of abdominal massage in management of constipation: A randomized controlled trial. International Journal of Nursing Students, 46, 759-797.

METHODS: A sample of 60 people with constipation were randomized to an interventional abdominal massage group in addition to an earlier prescribed laxative, while the control group received only laxatives according to prior prescriptions.

RESULTS: Abdominal massage significantly decreased severity of gastrointestinal symptoms, constipation syndrome and abdominal pain syndrome. The massage group also had increased bowel movements compared to the control group.



Studies on the Effects of Massage on Cystic Fibrosis

Hernandez-Reif, M., Field, T., Krasnegor, J., Martinez, E., Schwartzman, M. & Mavunda, K. (1999). Children with cystic fibrosis benefit from massage therapy. Journal of Pediatric Psychology, 24, 175-181.

METHODS: Twenty children (5-12 years old) with cystic fibrosis and their parents were randomly assigned to a massage therapy or a reading control group. Parents in the treatment group were instructed and asked to conduct a 20-minute child massage every night at bedtime for one month. Parents in the reading control group were instructed to read for 20 minutes a night with their child for one month. On days 1 and 30, parents and children answered questions relating to present anxiety levels and children answered questions relating to mood, and their peak air flow was measured.

RESULTS: Following the first and last massage session, the children and parents reported reduced anxiety. Mood and peak air flow readings also improved for the children in the massage therapy group. These findings suggest that parents may reduce anxiety levels by massaging their children with cystic fibrosis and their children may benefit from receiving massage by having less anxiety and improved mood, which in turn may facilitate breathing.



Studies on the Effects of CranioSacral Therapy on Various Conditions

Arnadottir TS, Sigurdardottir AK. Is craniosacral therapy effective for migraine? Tested with HIT-6 Questionnaire. Complement Ther Clin Pract. 2013 Feb;19(1):11-4. doi: 10.1016/j.ctcp.2012.09.003.

METHODS: A cross-over experimental design was used with twenty participants, aged between 20 and 50 years, who suffered from at least two migraine attacks per month. Participants were randomly assigned to two equal-sized groups, A and B. All received six craniosacral treatments over four weeks and the groups answered the "HIT-6" Questionnaire four times; every four weeks (Times 1, 2, 3 and 4). Group A, received treatment after answering the questionnaire the first time, but Group B, answered the questionnaire twice before receiving treatment.

RESULTS: Immediately after treatments and one month afterwards there was significant lowering in HIT-6 scorings compared with prior to treatment. There was also significant difference in HIT-6 scorings between Times 1 and 4 (p = 0.004). The effect size was 0.43-0.55. The results indicate that craniosacral treatment can alleviate migraine symptoms. Further research is suggested.


Curtis P, Gaylord SA, Park J, Faurot KR, Coble R, Suchindran C, Coeytaux RR, Wilkinson L, Mann JD. Credibility of low-strength static magnet therapy as an attention control intervention for a randomized controlled study of CranioSacral therapy for migraine headaches. J Altern Complement Med. 2011 Aug;17(8):711-21. doi: 10.1089/acm.2010.0277.

METHODS: Developing valid control groups that generate similar perceptions and expectations to experimental complementary and alternative (CAM) treatments can be challenging. The perceived credibility of treatment and outcome expectancy often contributes to positive clinical responses to CAM therapies, thereby confounding efficacy data. As part of a clinical feasibility study, credibility and expectancy data were obtained from subjects suffering from migraine who received either CranioSacral therapy (CST) or an attention-control, sham, and low-strength magnet (LSSM) intervention. The objective of this study was to evaluate whether the LSSM intervention generated similar levels of subject credibility and expectancy compared to CST. This was a two-arm randomized controlled trial. Sixty-five (65) adults with moderate to severe migraine were the subjects of this study. After an 8-week baseline, subjects were randomized to eight weekly treatments of either CST (n=36) or LSSM (n=29). The latter involved the use of a magnet-treatment protocol using inactive and low-strength static magnets designed to mimic the CST protocol in terms of setting, visit timing, body positioning, and therapist-subject interaction. A four-item, self-administered credibility/expectancy questionnaire, based on a validated instrument, was completed after the first visit.

RESULTS: Using a 0-9 rating scale, the mean score for perceived logicality of treatment was significantly less for LSSM (5.03, standard deviation [SD] 2.34) compared to CST (6.64, SD 2.19). Subject confidence that migraine would improve was greater for CST (5.94, SD 2.01) than for LSSM (4.9, SD 2.21), a difference that was not statistically significant. Significantly more subjects receiving CST (6.08, SD 2.27) would confidently recommend treatment to a friend than those receiving LSSM (4.69, SD 2.49). Although LSSM did not achieve a comparable level of credibility and expectancy to the CST, several design and implementation factors may have contributed to the disparity. Based on analysis of these factors, the design and implementation of a future study may be improved.


Matarán-Peñarrocha GA, Castro-Sánchez AM, García GC, Moreno-Lorenzo C, Carreño TP, Zafra MD. Influence of craniosacral therapy on anxiety, depression and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011;2011:178769.

METHODS: Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The causes of pathologic mechanism underlying fibromyalgia are unknown, but fibromyalgia may lead to reduced quality of life. The objective of this study was to analyze the repercussions of craniosacral therapy on depression, anxiety and quality of life in fibromyalgia patients with painful symptoms. An experimental, double-blind longitudinal clinical trial design was undertaken. Eighty-four patients diagnosed with fibromyalgia were randomly assigned to an intervention group (craniosacral therapy) or placebo group (simulated treatment with disconnected ultrasound). The treatment period was 25 weeks. Anxiety, pain, sleep quality, depression and quality of life were determined at baseline and at 10 minutes, 6 months and 1-year post-treatment.

RESULTS: State anxiety and trait anxiety, pain, quality of life and Pittsburgh sleep quality index were significantly higher in the intervention versus placebo group after the treatment period and at the 6-month follow-up. However, at the 1-year follow-up, the groups only differed in the Pittsburgh sleep quality index. Approaching fibromyalgia by means of craniosacral therapy contributes to improving anxiety and quality of life levels in these patients.

Karen Voigt, Jan Liebnitzky, Ute Burmeister, Henna Sihvonen-Riemenschneider, Matthias Beck, Roger Voigt, and Antje Bergmann. The Journal of Alternative and Complementary Medicine. March 2011, 17(3): 225-230. doi:10.1089/acm.2009.0673. Volume: 17 Issue 3: March 20, 2011

METHODS: Migraine is one of the most prevalent neurological disorders in Europe, severely affecting ability to work and quality of life. Medical therapies are considered to be the “gold standard” of treatment. This study addresses osteopathic treatment for acute therapy or prophylactic therapy as an alternative to traditional therapies. Forty-two (42) female patients with migraine were randomized into an intervention group (n?=?21) and a control group (n?=?21). Outcomes were evaluated with three questionnaires before the treatment (t1) and 6 months later (t2). The intervention group received five 50-minute osteopathic manipulative treatments (OMT) over a 10-week period. The control group did not receive OMT, sham treatment, or physical therapy. Patients of this group only filled the questionnaires. Both groups continued with previously prescribed medication.

RESULTS: Three (3) of the eight HRQoL domains of the SF-36 form in the intervention group showed significant improvement (from t1 to t2), with a general betterment exhibited in the other domains. The total MIDAS score, pain intensity, and disturbance in occupation due to migraine as well as number of days of disablements were also significantly reduced. The control group showed insignificant differences in these areas.This study affirms the effects of OMT on migraine headache in regard to decreased pain intensity and the reduction of number of days with migraine as well as working disability, and partly on improvement of HRQoL. Future studies with a larger sample size should reproduce the results with a control group receiving placebo treatment in a long-term follow-up.

Ian Drysdale, Vinood Patel, Ioma Bramati Castellarin. Evaluation of behavioural and gastrointestinal symptoms in autistic children after visceral osteopathic treatment. International Journal of Osteopathic Medicine Volume 16, Issue 1 , Pages e13-e14, March 2013

METHODS: Autism or Autistic Spectrum Disorder (ASD) is a Pervasive Developmental Disorder (PDD) with abnormal or impaired development in reciprocal social interaction, abnormal or impaired social communication and social imagination. Recent theories focused on the possibility of autism being linked with gastrointestinal (GI) abnormalities. Moreover, the problem behaviour typical of autism might be linked to the underlying medical symptoms such as abdominal pain, diarrhoea, and bloating typical of GI dysfunction. The study utilised VOT on 49 autistic children aged 3–8 yrs to investigate possible effects of the techniques. The children in the study were suffering from gastrointestinal symptoms and presented with impaired social relationship and communication, but were otherwise healthy. VOT was applied to the abdomen (duodenum, ileo-caecal valve, sigmoid and pancreas areas) and gastrointestinal and behavioural changes were measured after 6 osteopathic treatment sessions, once a week for six weeks. Each intervention session was for thirty minutes. The evaluation of the study was accessed via 8 questionnaires given to the parents who were asked to grade the child's response following the VOT intervention e.g. frequency of bowel movement, appetite eye contact and other parameters. Four questionnaires were given to the parents before initiation of the osteopathic treatment and the other four were given during the treatment phase of the research. Ethics approval was granted by The British College of Osteopathic Medicine and by University of Westminster Ethics Committee – London UK.

RESULTS: Wilcoxon Signed-Rank Test has been used to compare the “pre treatment” data and the “during treatment” data. Statistical analysis indicated improvement in the gastrointestinal symptom of vomiting (p = 0.00029) and in the parameter of poor appetite (p = 0.039) after application of VOT. The subjects also had a significant improvement in eye contact (p = 0.035) one of the most characteristic social behavioural symptoms of autistic patients. The experimental hypothesis has been supported indicating a positive effect of VOT on the measured symptoms and behavioural patterns of Autistic children. This data indicates that the use of VOT on GI function may be of benefit to autistic children.

Mehl-Madrona L, Kligler B, Silverman S, Lynton H, Merrell W. The impact of acupuncture and craniosacral therapy interventions on clinical outcomes in adults with asthma. Explore (NY). 2007 Jan-Feb;3(1):28-36.

METHODS: Synergy has been proposed between modalities operating at different levels of action. Acupuncture and craniosacral therapy are two very different modalities for which synergy has been proposed. This study sought to test for such synergy and to determine if complementary therapies would improve pulmonary function and quality of life for people suffering from asthma, as well as reducing anxiety, depression, and medication usage. Subjects were randomly assignment to one of five groups: acupuncture, craniosacral therapy, acupuncture and craniosacral, attention control, and waiting list control. Subjects received 12 sessions of equal length with pretreatment and posttreatment assessment of pulmonary function, asthma quality of life, depression, and anxiety. Medication use was also assessed.

RESULTS: Synergy was not demonstrated. When treatment was compared with the control group, statistically treatment was significantly better than the control group in improving asthma quality of life, whereas reducing medication use with pulmonary function test results remained the same. However, the combination of acupuncture and craniosacral treatment was not superior to each therapy alone. In fact, although all active patients received 12 treatment sessions, those who received all treatments from one practitioner had statistically significant reductions in anxiety when compared with those receiving the same number of treatments from multiple practitioners. No effects on depression were found. Acupuncture and/or craniosacral therapy are potentially useful adjuncts to the conventional care of adults with asthma, but the combination of the two does not provide additional benefit over each therapy alone.


Studies on the Effects of Massage on Depression

Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., & Schanberg, S.(1992). Massage reduces depression and anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 125-131.

METHODS: A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. A control group viewed relaxing videotapes.

RESULTS: Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.


Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996). Massage and relaxation therapies' effects on depressed adolescent mothers. Adolescence, 31, 903-911.

METHODS: Thirty-two depressed adolescent mothers received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group.

RESULTS: Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group.


Onozawa, K., Glover, V., Adams, D., Modi, N., & Kumar, R.C. (2001). Infant massage improves mother-infant interaction for mothers with postnatal depression. Journal of Affective Disorders, 63, 1-3.

METHODS: Thirty-four primiparous depressed mothers, median 9 weeks postpartum, identified as being depressed following completion of the Edinburgh Postnatal Depression Scale (EPDS) at 4 weeks postpartum, were randomly allocated either to an infant massage class and a support group (massage group) or to a support group (control group). Each group attended for five weekly sessions. Changes in maternal depression and mother-infant interaction were assessed at the beginning and the end of the study by comparing EPDS scores and ratings of videotaped mother-infant interaction.

RESULTS: The EPDS scores fell in both groups. Significant improvement of mother-infant interaction was seen only in the massage group. This study suggests that learning the practice of infant massage by mothers is an effective treatment for facilitating mother-infant interaction in mothers with postnatal depression.


Field, T., Deeds, O., Diego, M., Gualer, A., Sullivan, S., Wilson, D. & Nearing, G. (2009). Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women. Journal of Bodywork and Movement Therapies, 13, 297-303.

METHODS: One hundred and twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy. The group Interpersonal Psychotherapy (1h sessions) and massage therapy (20 min sessions) were held once per week for 6 weeks.

RESULTS: The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater percentage of that group completed the 6-week program. The group who received both therapies also showed a greater decrease in depression, depressed affect and somatic-vegetative symptom scores on the Center for Epidemiological Studies-Depression Scale (CES-D), a greater decrease in anxiety scale (STAI) scores and a greater decrease in cortisol levels. The group therapy process appeared to be effective for both groups as suggested by the increased expression of both positive and negative affect and relatedness during the group therapy sessions. Thus, the data highlight the effectiveness of group Interpersonal Psychotherapy and particularly when combined with massage therapy for reducing prenatal depression.


Field, T., Diego, M., Hernandez-Reif, M., Deeds, O. & Figueiredo, B. (2009). Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behavior and Development, 32, 454-460.

METHODS: Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group.

RESULTS: The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.


Müller-Oerlinghausen B, Berg C, Droll W.(2007) The efficacy of Slow Stroke Massage in depression. Psychiatr Prax. 2007 Sep;34 Suppl 3:S305-8.

EXPERIMENT DESIGN: Depression afflicts the whole organism, body as well as experience and behaviour. Therefore, therapeutic touch, i.e. a direct body-to-body approach might be helpful in depression, as it has been known and practiced in medicine centuries ago. We investigated the antidepressive effects of an one hour lasting, relaxing, very sensitive soft treatment (Slow Stroke Massage) in a double controlled study comparing massage with a control condition and also comparing effects in depressed patients vs. healthy subjects. The treatment was repeated 5 times within intervals of 2-3 days. Data of 32 acutely depressed in-patients was analyzed. The pre-post-differences in various dimensions were significantly greater during massage than during the control condition. They were also more marked in patients as compared to healthy subjects.

RESULTS/ CONCLUSIONS: Slow Stroke Massage can be used effectively and safely as a complimentary therapeutic strategy in depressed patients.


Müller-Oerlinghausen B, Berg C, Scherer P, Mackert A, Moestl HP, Wolf J. (2004) Effects of slow-stroke massage as complementary treatment of depressed hospitalized patients. Dtsch Med Wochenschr. 2004 Jun 11;129(24):1363-8.

EXPERIMENT DESIGN: 32 depressed patients (24 women, 8 men; average 48 years - coveringthe entire spectrum of affective disorders listed in the ICD but without comorbidity in axis 2) with a minimum BRMS score of 16,7 - were included in the study. The randomized cross-over trial involved three massage sessions at set times (M) and sessions in two control groups (C) (relaxation and perception) lasting for 60 min 2-3 days apart. Under the control conditions there was no touching. The effects of depression-specific variables (e.g. mood, drive, abnormal cognition, as well as typical progress variables of the slow-stroke massage (bodily awareness, general state of health, etc.) were measured by both the patients' own assessment and that of an independent observer.

RESULTS/ CONCLUSIONS: Under condition of both M and C, comparison of before and after effects, there was not only the primarily postulated mood-enhancing effect, but also some very marked changes in almost all dimension, the mean improvement ratio under M often being stronger than under C. After Bonferroni correction for multiple tests, the statistical significance there remained the stronger effect of M in four dimensions (global tenseness, restlessness, depressed mood, neck/shoulder tension). The intensive effect of M compared with C was confirmed by both female and male patients regarding the answers to various open questions. Slow-stroke massage is suitable for adjuvant acute treatment of patients with depression. It is very readily accepted also by very ill patients. In relation to the skin as an organ that aids identity, non-hedonic depressed patients are able to recognize the sensory quality of therapeutic touching as a positive stimulus. In view of the latent period of many weeks and the only moderate efficacy of antidepressants, the described complementary method, which does not require physiotherapeutic training, should be more often applied in both a hospital and general practice setting.



Studies on the Effects of Massage on Dermatitis

Schachner, L., Field, T., Hernandez-Reif, M., Duarte, A. & Krasnegor, J. (1998). Atopic dermatitis symptoms decreased in children following massage therapy. Pediatric Dermatology, 15, 390-395.

METHODS: Young children with atopic dermatitis were treated with standard topical care and massaged by their parents for 20 minutes daily for a 1 month period. A control group received standard topical care only.

RESULTS: The children's affect and activity level significantly improved, and their parent's anxiety decreased immediately after the massage therapy sessions. Over the 1 month period, parents of massaged children reported lower anxiety levels in their children, and the children improved significantly on all clinical measures including redness, scaling, lichenification, excoriation, and pruritus. The control group only improved significantly on the scaling measure. These data suggest that massage therapy may be a cost-effective adjunct treatment for atopic dermatitis.



Studies on the Effects of Massage on Diarrhea

Jump, V.K. Fargo, J.D. & Akers, J. (2006). Impact of massage therapy on health outcomes among orphaned infants in Ecuador: Results of a randomized clinical trial. Family Community Health, 29, 314-319.

METHODS: Diarrhea is the second leading cause of death among infants and young children in the developing world. This project investigated whether therapeutic infant massage could reduce diarrheal episodes and decrease overall illness of infants. Infants living in 2 orphanages in Quito, Ecuador, were matched by age and randomly assigned to an experimental or a control condition. The experimental group received an intervention, daily infant massage therapy by orphanage staff or volunteers, which lasted an average of 53 days, and symptoms of illness data were documented daily by volunteers in the orphanages.

RESULTS: Results indicated that control group infants had a 50% greater risk of having diarrhea than experimental infants. Control group infants were also 11% more likely than experimental infants to experience illness of any kind. The implications for the use of therapeutic infant massage, a remarkably inexpensive intervention, are discussed, and the need for further research is highlighted.



Studies of the Effects of Massage on Down Syndrome

Hernandez-Reif, Maria; Field, Tiffany; Largie, Shay; Mora, Dana; Bornstein, Joan; Waldman, Ronnie (2006) Children with Down Syndrome Improved in Motor Functioning and Muscle Tone Following Massage Therapy. Early Child Development and Care, v176 n3-4 p395-410 May 2006

METHODS: Twenty-one moderate to high functioning young children (mean age, two years) with Down syndrome receiving early intervention (physical therapy, occupational therapy and speech therapy) were randomly assigned to additionally receive two 0.5-hour massage therapy or reading sessions (control group) per week for two months. On the first and last day of the study, the childrens functioning levels were assessed using the Developmental Programming for Infants and Young Children scale, and muscle tone was assessed using a new preliminary scale (the Arms, Legs and Trunk Muscle Tone Score).

RESULTS:Children in the massage therapy group revealed greater gains in fine and gross motor functioning and less severe limb hypotonicity when compared with the children in the reading/control group. These findings suggest that the addition of massage therapy to an early intervention program may enhance motor functioning and increase muscle tone for children with Down syndrome.



Studies on the Effects of Massage on Drug Addiction

Black S, Jacques K, Webber A, Spurr K, Carey E, Hebb A, Gilbert R. (2010) Chair massage for treating anxiety in patients withdrawing from psychoactive drugs. Journal of Alternative and Complementary Medicine. 2010 Sep;16(9):979-87.

METHODS: Therapeutic massage has been proven to be an effective, nonpharmacologic, alternative for managing state and trait anxiety in a variety of clinical situations. However, no controlled study has investigated this effect in an addiction treatment setting. The design was a randomized, controlled clinical trial conducted from June 2008 to January 2009. Subjects, Eighty-two (82) adult patients who received inpatient treatment for psychoactive drug withdrawal (alcohol, cocaine, and opiates), were randomly assigned to receive chair massage (n?=?40) or a relaxation control condition (n?=?42). Treatments were offered for 3 consecutive days. Standard counseling and pharmacologic management were also offered concurrently to patients in all conditions. The primary outcome measure was anxiety assessed using the Spielberger State-Trait Anxiety Inventory (STAI). State and trait anxiety scores were determined immediately prior to and following each treatment intervention.

RESULTS:Analysis of STAI scores showed a significant reduction in state and trait anxiety for both interventions. The magnitude in the reduction in state and trait anxiety was significantly greater in the chair massage group where the effect on state anxiety was sustained, at least in part for 24 hours. Within the clinical context of this study, chair massage was more effective that relaxation control in reducing anxiety. Further investigation of chair massage as a potential nonpharmacologic adjunct in the management of withdrawal related anxiety is warranted.



Studies on the Effects of Massage Therapy on the Elderly

Field, T., Hernandez-Reif, M., Quintino, O., Schanberg, S. & Kuhn, C. (1998). Elder retired volunteers benefit from giving massage therapy to infants. Journal of Applied Gerontology, 17, 229-239.

METHODS: This exploratory within-subjects study compared the effects of elder retired volunteers giving massage to infants with receiving massage themselves. Three times a week for 3 weeks, 10 elder volunteers (8 females, mean age = 70 years) received Swedish massage sessions. For another 3 weeks, three times per week, the same elderly volunteers massaged infants at a nursery school. Receiving massage first versus giving massage first was counterbalanced across subjects.

RESULTS: Immediately after the first- and last-day sessions of giving massages, the elder retired volunteers had less anxiety and depression and lower stress hormones (salivary cortisol) levels. Over the 3-week period, depression and catecholamines (norepinephrine and epinephrine) decreased and lifestyle and health improved. These effects were not as strong for the 3-week period when they received massage, possibly because the elder retired volunteers initially felt awkward about being massaged and because they derived more satisfaction massaging the infants.


Hartshorn, K., Delage, J., Field, T., & Olds, L. (2001). Senior citizens benefit from movement therapy. Journal of Bodywork and Movement Therapies, 5, 1-5.

METHODS: Sixteen senior citizens participated in four, 50-min movement therapy sessions over a 2-week period and were compared to 16 senior citizens who belonged to a wait list control group who received the movement sessions only after the end of the study.

RESULTS: The movement therapy participants improved in their functional motion on the Tinetti scale, and specifically on the gait scale, their leg strength increased, and their leg pain significantly decreased.



Studies on the Effects of Massage Therapy on Enuresis or Bedwetting

Yuksek, M.S., Erdem, A.F., Atalay, C., & Demirel, A. (2003). Acupressure versus oxybutinin in the treatment of enuresis. The Journal of International Medical Research, 31, 552-556.

METHODS: We aimed to assess the efficacy of acupressure for treating nocturnal enuresis, compared with oxybutinin. Acupressure was administered to 12 patients by their parents, who had been taught the technique. Pressure was applied at acupuncture points Gv4, Gv15, Gv20, B23, B28, B32, H7, H9, St36, Sp4, Sp6, Sp12, Ren2, Ren3, Ren6, K3 and K5. Twelve control patients received 0.4 mg/kg oxybutinin. Parents were asked to record incidences of bed-wetting and patients and/or parents completed a questionnaire 15 days and 1, 3 and 6 months after the start of treatment.

RESULTS: Complete and partial responses after 6 months of treatment were seen in 83.3% and 16.7%, respectively, of patients treated with acupressure, and in 58.3% and 33.3%, respectively, of children who received oxybutinin. In conclusion, nocturnal enuresis can be partially treated by oxybutinin but acupressure could be an alternative non-drug therapy. Acupressure has the advantages of being non-invasive, painless and cost-effective.



Studies on the Effects of Massage Therapy on Exercise

Rodenburg, J. B., Steenbeek, D., Schiereck, P., & Bar, P. R. (1994). Warm-up, stretching and massage diminish harmful effects of eccentric exercise. International Journal of Sports Medicine. 15, 414-419.Rodenburg, J. B., Steenbeek, D., Schiereck, P., & Bar, P. R. (1994). Warm-up, stretching and massage diminish harmful effects of eccentric exercise. International Journal of Sports Medicine. 15, 414-419.

METHODS: The effect of a combination of a warm-up, stretching exercises and massage on subjective scores for delayed onset muscle soreness (DOMS) and objective functional and biochemical measures was studied. Fifty people, randomly divided in a treatment and a control group, performed eccentric exercise with the forearm flexors for 30 min. The treatment group additionally performed a warm-up and underwent a stretching protocol before the eccentric exercise and massage afterwards. Functional and biochemical measures were obtained before, and 1, 24, 48, 72 and 96h after exercise.

RESULTS: The median values at the five post-exercise time points differed significantly for DOMS measured when the arm was extended. Significant main effects for treatment were found on the maximal force, the flexion angle of the elbow and the creatine kinase activity in blood.


Smith, L. L., Keating, M. N., Holbert, D., Spratt, D. J., McCammon, M. R., Smith, S. S., and Israel, R. G. (1994). The effects of athletic massage on delayed onset muscle soreness, creatine kinase, and neutrophil count: A preliminary report. Journal of Orthopaedic & Sports Physical Therapy, 19, 93-99.

METHODS: It was hypothesized that athletic massage administered 2 hours after eccentric exercise would disrupt an initial crucial event in acute inflammation, the accumulation of neutrophils. This would result in a diminished inflammatory response and a concomitant reduction in delayed onset muscle soreness (DOMS) and serum creatine kinase (CK). Untrained males were randomly assigned to a massage or control group. All performed five sets of isokinetic eccentric exercise of the elbow flexors and extensors. Two hours after exercise, massage subjects received a 30-minute athletic massage; control subjects rested. Delayed onset muscle soreness and CK were assessed before exercise and at 8, 24, 48, 72, 96, and 120 hours after exercise. Circulating neutrophils were assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; cortisol was assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; cortisol was assessed at similar times.

RESULTS: A trend analysis revealed a significant treatment by time interaction effect for 1) DOMS, with the massage group reporting reduced levels; 2) CK, with the massage group displaying reduced levels; 3) neutrophils, with the massage group displaying a prolonged elevation; and 4) cortisol, with the massage group showing a diminished diurnal reduction. The results of this study suggest that sports massage will reduce DOMS and CK when administered 2 hours after the termination of eccentric exercise. This may be due to a reduced emigration of neutrophils and/or higher levels of serum cortisol.


Rinder, A.N. & Sutherland, C.J. (1995). An investigation of the effects of massage on quadriceps performance after exercise fatigue. Complement Ther Nurs Midwifery, 1, 99-102.

METHODS: Thirteen males and 7 females completed their maximum number of leg extensions against a half maximum load. In a randomised, crossover study they were exercised to fatigue using an ergonometer, ski-squats and leg extensions followed either by a 6 min massage or rest after which they again completed their maximum number of leg extensions against half maximum load. The process was repeated a few days later with the alternative condition (rest or massage).

RESULTS: The results showed that massage after exercise fatigue significantly improved quadriceps performance compared to rest. The data was further analysed in relation to age and gender.


Viitasalo, J. T., Niemela, K., Kaappola, R., Korjus, T., Levola, M., Mononen, H. V., Rusko, H. K., and Takala, T. E. (1995). Warm underwater water-jet massage improves recovery from intense physical exercise. European Journal of Applied Physiology & Occupational Physiology, 71, 431-438.

METHODS: The effects of warm underwater water-jet massage on neuromuscular functioning, selected biochemical parameters (serum creatine kinase, lactic dehydrogenase, serum carbonic anhydrase, myoglobin, urine urea and creatinine) and muscle soreness were studied among 14 junior track and field athletes. Each subject spent, in a randomized order, two identical training weeks engaged in five strength/power training sessions lasting 3 days. The training weeks differed from each other only in respect of underwater water-jet massage treatments. These were used three times (20 min each) during the treatment week and not used during the control week.

RESULTS: During the treatment week continuous jumping power decreased and ground contact time increased significantly less and serum myoglobin increased more than during the control week. It is suggested that underwater water-jet massage in connection with intense strength/power training increases the release of proteins from muscle tissue into the blood and enhances the maintenance of neuro-muscular performance capacity.


Mori, H., Ohsawa, H., Tanaka, T.H., Taniwaki, E., Leisman, G. & Nishijo, K. (2004). Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise. Med Sci Monit, 10, 173-8.

METHODS: Twenty-nine healthy male subjects participated in two experimental sessions (massage and rest conditions). Subjects lay prone on the table and were instructed to extend their trunks until the inferior portion of their rib cage no longer rested on the table. Subjects held this position for 90 seconds (Load I). Subjects then either received massage on the lumbar region or rested for 5 minutes, then repeated the same load (Load II). Skin blood flow (SBF), muscle blood volume (MBV), skin temperature (ST), and subjects' subjective feelings of fatigue were evaluated using Visual Analogue Scale (VAS).

RESULTS: An increase of MBV between pre- and post-load II periods was higher after massage than after rest. An increase of SBF at pre- and post-load II was observed only under massage condition. An increase of SBF between post-load I and pre-load II periods was higher after massage than after rest. An increase of ST between post-load I and post-load II periods was greater after massage than after rest. The VAS score was lower with massage than with rest in the post-treatment period. A significant difference was observed between massage and rest condition on VAS for muscle fatigue. Lumbar massage administration also appeared to have some effect on increasing skin temperature and enhancement of blood flow in local regions.


Brooks, C.P., Woodruff, L.D., Wright, L.L. & Donatelli, R. (2005). The immediate effects of manual massage on power-grip performance after maximal exercise in healthy adults. Journal of Alternative and Complementary Medicine, 11, 1093-101.

METHODS: Fifty-two (52) volunteer massage-school clients, staff, faculty, and students participated. Interventions: Subjects randomly received either a 5-minute forearm/hand massage of effleurage and friction (to either the dominant hand or nondominant hand side), 5 minutes of passive shoulder and elbow range of motion, or 5 minutes of nonintervention rest. Power-grip measurements (baseline, postexercise, and postintervention) were performed on both hands using a commercial hand dynamometer. These measurements preceded and followed 3 minutes of maximal exercise using a commercial isometric hand exerciser that produced fatigue to 60% of baseline strength.

RESULTS: After 3 minutes of isometric exercise, power grip was consistently fatigued to at least 60% of baseline, with recovery occurring over the next 5 minutes. Statistical analyses involving single-factor repeated-measures analyses of variance with Bonferroni a priori tests demonstrated that massage had a greater effect than no massage or than placebo on grip performance after fatigue, especially in the nondominant-hand group. Manual massage to the forearm and hand after maximal exercise was associated with greater effects than nonmassage on postexercise grip performance. The present data do support the use of a 5-minute manual massage to assist immediate grip performance after fatigue in healthy subjects.


Zainuddin, Z., Newton, M., Sacco, P. & Nosaka, K. (2005). Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train, 40, 174-80.

METHODS: To test the hypothesis that massage applied after eccentric exercise would effectively alleviate DOMS without affecting muscle function. We used an arm-to-arm comparison model with 2 independent variables (control and massage) and 6 dependent variables (maximal isometric and isokinetic voluntary strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness). A 2-way repeated-measures analysis of variance and paired t tests were used to examine differences in changes of the dependent variable over time (before, immediately and 30 minutes after exercise, and 1, 2, 3, 4, 7, 10, and 14 days postexercise) between control and massage conditions. Subjects were ten healthy subjects (5 men and 5 women) with no history of upper arm injury and no experience in resistance training. Subjects performed 10 sets of 6 maximal isokinetic (90 degrees x s(-1)) eccentric actions of the elbow flexors with each arm on a dynamometer, separated by 2 weeks. One arm received 10 minutes of massage 3 hours after eccentric exercise; the contralateral arm received no treatment. Outcome measures were maximal voluntary isometric and isokinetic elbow flexor strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness.

RESULTS: Delayed-onset muscle soreness was significantly less for the massage condition for peak soreness in extending the elbow joint and palpating the brachioradialis muscle. Soreness while flexing the elbow joint and palpating the brachialis muscle was also less with massage. Massage treatment had significant effects on plasma creatine kinase activity, with a significantly lower peak value at 4 days postexercise, and upper arm circumference, with a significantly smaller increase than the control at 3 and 4 days postexercise. Massage was effective in alleviating DOMS by approximately 30% and reducing swelling.



Studies on the Effects of Massage Therapy on Fibromyalgia

Sunshine, W., Field, T., Schanberg, S., Quintino, O., Kilmer, T., Fierro, K., Burman, I., Hashimoto, M., McBride, C., & Henteleff, T. (1996). Massage therapy and transcutaneous electrical stimulation effects on fibromyalgia. Journal of Clinical Rheumatology, 2, 18-22.

METHODS: Thirty adult fibromyalgia syndrome subjects were randomly assigned to a massage therapy, a transcutaneous electrical stimulation (TENS), or a transcutaneous electrical stimulation no-current group (Sham TENS) for 30-minute treatment sessions two times per week for 5 weeks.

RESULTS: The massage therapy subjects reported lower anxiety and depression, and their cortisol levels were lower immediately after the therapy sessions on the first and last days of the study. The TENS group showed similar changes, but only after therapy on the last day of the study. The massage therapy group improved on the dolorimeter measure of pain. They also reported less pain the last week, less stiffness and fatigue, and fewer nights of difficult sleeping. Thus, massage therapy was the most effective therapy with these fibromyalgia patients.


Morhenn VB. Firm stroking of human skin leads to vasodilatation possibly due to the release of substance P. J Dermatol Sci. 2000 Feb;22(2):138-44.

METHODS: Many animal species invest a large amount of time in grooming behavior without deriving any apparent benefit. In order for this behavior to have survived, however, it must confer some survival advantage. In seven of eight humans tested, an elevation in the skin's temperature was documented after massaging of the cheeks of the face. The elevation of the skin's temperature reached a plateau after about 40 min of massaging and was correlated to visible erythema. This effect could be inhibited by repeated pretreatment of the skin with topical capsaicin, a chemical that results in the release of substance P from peripheral nerve endings.

RESULTS: Thus, it appears that the temperature elevation induced by stroking of human skin is controlled, at least in part, by release of the neurotransmitter, substance P. In conclusion, it appears that the release of neurotransmitter(s) may be the survival advantage that grooming confers to animals. Substance P is defined on arthritis.about.com as the following: Nerve cells communicate with one another through neurotransmitters. Substance P is one such neurotransmitter. It is a protein found in the brain and spinal cord, and is associated with some inflammatory processes in the joints. Its function is to cause pain. Substance P has been implicated in pain syndromes such as: low back pain fibromyalgia arthritis


Field, T., Diego, M., Cullen, C., Hernandez-Reif, M., & Sunshine, W. (2002). Fibromyalgia pain and substance P decreases and sleep improves following massage therapy. Journal of Clinical Rheumatology, 8, 72-76.

METHODS: Massage therapy has been observed to be helpful in some patients with fibromyalgia. This study was designed to examine the effects of massage therapy versus relaxation therapy on sleep, substance P, and pain in fibromyalgia patients. Twenty-four adult fibromyalgia patients were assigned randomly to a massage therapy or relaxation therapy group. They received 30-minute treatments twice weekly for 5 weeks.

RESULTS:Both groups showed a decrease in anxiety and depressed mood immediately after the first and last therapy sessions. However, across the course of the study, only the massage therapy group reported an increase in the number of sleep hours and a decrease in their sleep movements. In addition, substance P levels decreased, and the patients' physicians assigned lower disease and pain ratings and rated fewer tender points in the massage therapy group.


Castro-Sánchez AM, Matarán-Peñarrocha GA, Sánchez-Labraca N, Quesada-Rubio JM, Granero-Molina J, Moreno-Lorenzo C. (2011) A randomized controlled trial investigating the effects of craniosacral therapy on pain and heart rate variability in fibromyalgia patients. Clinical Rehabilitation. 2011 Jan;25(1):25-35

METHODS: Fibromyalgia is a prevalent musculoskeletal disorder associated with widespread mechanical tenderness, fatigue, non-refreshing sleep, depressed mood and pervasive dysfunction of the autonomic nervous system: tachycardia, postural intolerance, Raynaud's phenomenon and diarrhoea. To determine the effects of craniosacral therapy on sensitive tender points and heart rate variability in patients with fibromyalgia. Ninety-two patients with fibromyalgia were randomly assigned to an intervention group or placebo group. Patients received treatments for 20 weeks. The intervention group underwent a craniosacral therapy protocol and the placebo group received sham treatment with disconnected magnetotherapy equipment. Pain intensity levels were determined by evaluating tender points, and heart rate variability was recorded by 24-hour Holter monitoring.

RESULTS:After 20 weeks of treatment, the intervention group showed significant reduction in pain at 13 of the 18 tender points. Significant differences in temporal standard deviation of RR segments, root mean square deviation of temporal standard deviation of RR segments and clinical global impression of improvement versus baseline values were observed in the intervention group but not in the placebo group. At two months and one year post therapy, the intervention group showed significant differences versus baseline in tender points at left occiput, left-side lower cervical, left epicondyle and left greater trochanter and significant differences in temporal standard deviation of RR segments, root mean square deviation of temporal standard deviation of RR segments and clinical global impression of improvement. Craniosacral therapy improved medium-term pain symptoms in patients with fibromyalgia.



Studies on the Effects of Massage Therapy on Gastrointestinal Motility

Chen, L.L., Hsu, S.F., Wang, M.H., Chen, C.L., Lin, Y.D., & Lai, J.S. (2003). Use of acupressure to improve gastrointestinal motility in women after trans-abdominal hysterectomy. The American Journal of Chinese Medicine, 31, 781-790.

METHODS: The purpose of this study was to evaluate the effectiveness of acupressure on gastrointestinal (GI) motility in women after trans-abdominal hysterectomy (TAH). Patients were randomly assigned into two groups of 21 and 20 patients each. The experimental group received acupressure for 3 minutes at each of three meridian points: Neiguan (PC-6), Zusanli (ST-36) and Sanyinjiao (SP-6). The control group received 3 minutes of acupressure on sham points. Acupressure was performed twice a day. A questionnaire was used to determine patients' satisfaction prior to and after afternoon acupressure. GI contractions were measured with a multifunctional stethoscope before and after acupressure.

RESULTS: Acupressure of these three meridian points significantly increased GI motility in the experimental group, but there was little change in the control group. Our conclusions are that non-invasive acupressure of these meridian points can significantly improve GI motility and can be incorporated into the technical curriculum and clinical education program of nursing schools. Patients and their family members can be taught to continue this procedure at home to enhance GI motility in patients who have undergone TAH.


Diego MA, Field T, Hernandez-Reif M. (2005).Vagal activity, gastric motility, and weight gain in massaged preterm neonates. Journal of Pediatrics, 147, 50-55

METHODS: Multiple studies have documented an increase in weight gain after 5 to 10 days of massage therapy for preterm neonates. The massaged preterm neonates did not consume more calories than the control neonates. One potential mechanism for these effects might involve massage-induced increases in vagal activity, which in turn may lead to increased gastric motility and thereby weight gain. The present randomized study explored this potential underlying mechanism by assessing gastric motility and sympathetic and parasympathetic nervous system activity in response to massage therapy (moderate pressure) versus sham massage (light pressure) and control conditions in a group of preterm neonates.

RESULTS: Compared with preterm neonates receiving sham massage, preterm neonates receiving massage therapy exhibited greater weight gain and increased vagal tone and gastric motility during and immediately after treatment. Gastric motility and vagal tone during massage therapy were significantly related to weight gain. The weight gain experienced by preterm neonates receiving moderate-pressure massage therapy may be mediated by increased vagal activity and gastric motility.



Studies on the Effects of Massage Therapy on General and Overall Health

Tiffany Field, Miguel Diego, and Maria Hernandez-Reif (2010) Moderate Pressure is Essential for Massage Therapy Effects. International Journal of Neurosciene May 2010, Vol. 120, No. 5 , Pages 381-385

EXPERIMENT DESIGN: This study compared a number of other studies utilizing light pressure or moderate pressure to determine whether the benefits of massage therapy require moderate pressure

RESULTS/ CONCLUSIONS: Moderate pressure appears to be necessary for massage therapy effects. Studies comparing moderate and light pressure massage are reviewed and they suggest that growth and development are enhanced in infants and stress is reduced in adults, but only by moderate pressure massage. The stimulation of pressure receptors leads to increased vagal activity which, in turn, seems to mediate the diverse benefits noted for massage therapy.



Studies on the Effects of Massage Therapy on Headaches

Li XZ, Liu XG, Song WZ, Tang Y, Zeng F, Liang FR.(2008) Effect of acupuncture at acupoints of the Shaoyang Meridian on cerebral glucose metabolism in the patient of chronic migraine. Zhongguo Zhen Jiu. 2008 Nov;28(11):854-9.

EXPERIMENT DESIGN: The objective of this study was to observe response characteristics of human brain to acupuncture of corresponding channel point selection and probe into the central nervous mechanism of acupuncture at the points selected along channel. Six cases of chronic migraine were treated with acupuncture at Fengchi (GB 20), Waiguan (TE 5), Yang-lingquan (GB 34) on the Shaoyang Channel. Positron emission computerized tomography (PET-CT) was used for scanning and statistic parameter map (SPM 2) software was used to analyze the data and compare with healthy human brain function imaging and investigate the changes of metabolism of glucose in the brain of the patient of migraine before and after acupuncture.

RESULTS/ CONCLUSIONS: After acupuncture, excitation areas of the pain brain regions such as the brain stem, insula, etc. obviously reduced, and the brain function-reducing area turned from the right temporal lobe as main to bilateral temporal lobes with symmetry. The pons, insula, anterior frontal gyrus, etc. possibly are the target points of analgesic effect of acupuncture at the Shaoyang Channel on chronic migraine, and the change of metabolism reduction on bilateral temporal lobes induced by acupuncture possibly is one of the mechanisms for acu-puncture at points on the Shaoyang Channel for treatment of migraine. Acupuncture achieves whole and beneficial therapeutic effect possibly through coordination and redistribution of energy metabolism in the brain.


Maria Hernandez-reif, John Dieter, Tiffany Field, Bernard Swerdlow and Miguel Diego (1998) Migraine Headaches are Reduced by Massage Therapy. International Journal of Neuroscience 1998, Vol. 96, No. 1-2 , Pages 1-11

EXPERIMENT DESIGN: Twenty-six adults with migraine headaches were randomly assigned to a wait-list control group or to a massage therapy group, who received two 30-minute massages per week for five consecutive weeks.

RESULTS/ CONCLUSIONS: The massage therapy subjects reported fewer distress symptoms, less pain, more headache free days, fewer sleep disturbances and they showed an increase in serotonin levels.


Moraska A, Chandler C.(2009) Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study. Journal of Manual and Manipulative Therapy. 2009;17(2):86-94.

EXPERIMENT DESIGN: Investigations into complementary and alternative medicine (CAM) approaches to address stress, depression, and anxiety of those experiencing chronic pain are rare. The objective of this pilot study was to assess the value of a structured massage therapy program, with a focus on myofascial trigger points, on psychological measures associated with tension-type headache. Participants were enrolled in an open-label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week periods) and a follow-up phase. Eighteen subjects with episodic or chronic tension-type headache were enrolled and evaluated at 3-week intervals using the State-Trait Anxiety Inventory, Beck Depression Inventory, and the Perceived Stress Scale. The Daily Stress Inventory was administered over 7-day periods during baseline and the final week of massage. Twice weekly, 45-minute massage therapy sessions commenced following the baseline phase and continued for 6 weeks.

RESULTS: A significant improvement in all psychological measures was detected over the timeframe of the study. Post hoc evaluation indicated improvement over baseline for depression and trait anxiety following 6 weeks of massage, but not 3 weeks. A reduction in the number of events deemed stressful as well as their respective impact was detected. This pilot study provides evidence for reduction of affective distress in a chronic pain population, suggesting the need for more rigorously controlled studies using massage therapy to address psychological measures associated with TTH.


Quinn C, Chandler C, Moraska A.(2002) Massage therapy and frequency of chronic tension headaches. American Journal of Public Health 2002 Oct;92(10):1657-61.

EXPERIMENT DESIGN: The effect of massage therapy on chronic nonmigraine headache was investigated. Chronic tension headache sufferers received structured massage therapy treatment directed toward neck and shoulder muscles. Headache frequency, duration, and intensity were recorded and compared with baseline measures.

RESULTS/ CONCLUSIONS: Compared with baseline values, headache frequency was significantly reduced within the first week of the massage protocol. The reduction of headache frequency continued for the remainder of the study (P =.009). The duration of headaches tended to decrease during the massage treatment period (P =.058). Headache intensity was unaffected by massage (P =.19). The muscle-specific massage therapy technique used in this study has the potential to be a functional, nonpharmacological intervention for reducing the incidence of chronic tension headache.


Foster KA, Liskin J, Cen S, Abbott A, Armisen V, Globe D, Knox L, Mitchell M, Shtir C, Azen S. (2004) The Trager approach in the treatment of chronic headache: a pilot study. Alternative Therapies in Health Medicine 2004 Sep-Oct;10(5):40-6.

EXPERIMENT DESIGN: Although the traditional treatment of headache has been pharmacological, there have been many attempts to treat headaches with other methods with mixed levels of success. To obtain preliminary data on the efficacy of the Trager approach in the treatment of chronic headache. Small-scale randomized controlled clinical trial in a University-based clinic. Thirty-three volunteers with a self-reported history of chronic headache with at least one headache per week for at least 6 months. Interventions included medication only control group, medication and attention control group, and medication and Trager treatment group. Self-reported frequency, duration, and intensity of headache, medication usage and headache quality of life (HQOL) obtained at baseline and after a 6-week treatment period.

RESULTS/ CONCLUSIONS: Analyses of variance demonstrated significant improvement in HQOL for the Trager and attention control groups, and reduction in medication usage for the Trager group. Within-group analyses revealed that participants randomized to Trager demonstrated a significant decrease in the frequency of headaches, improvement in HQOL, and a 44% decrease in medication usage. Participants randomized to the attention control group demonstrated a significant improvement in HQOL and a 19% decrease in medication usage (P = 0.15). Participants randomized to the no-treatment control group revealed a significant increase in headache duration and intensity, and a declination in HQOL. The Trager approach decreased headache frequency and medication usage. Trager and physician attention improved HQOL. A larger, multi-site study is recommended.



Studies on the Effects of Massage Therapy on Hospice Care Patients

Meek SS. (1993) Effects of slow stroke back massage on relaxation in hospice clients. Journal of Nursing Scholarship. 1993 Spring;25(1):17-21.

EXPERIMENT DESIGN: This study was done to investigate a nonpharmacological means of relaxation with 30 hospice clients. The purpose was to examine the effects of slow stroke back massage (SSBM) on systolic and diastolic blood pressure, heart rate and skin temperature.This study was done to investigate a nonpharmacological means of relaxation with 30 hospice clients. The purpose was to examine the effects of slow stroke back massage (SSBM) on systolic and diastolic blood pressure, heart rate and skin temperature.

RESULTS/ CONCLUSIONS: SSBM was associated with decreases in systolic BP, diastolic BP, and heart rate and with an increase in skin temperature. SSBM was shown to produce modest clinical, but statistically significant changes in vital signs which were indicative of relaxation. It is a cost-effective treatment which adds to the comfort of hospice clients.


Holland B, Pokorny ME. (2001) Slow stroke back massage: its effect on patients in a rehabilitation setting. Rehabilitative Nursing. 2001 Sep-Oct;26(5):182-6.

EXPERIMENT DESIGN: A quasi-experimental design was used to determine the effects of three consecutive days of slow stroke back massage (SSBM) on adult patients in a rehabilitation setting. This study used the Huckstadt Touch Instrument to assess physiological and psychological responses to touch, as well as the recipients' perceptions of touch. The convenience sample comprised 24 adult patients in a rehabilitation hospital in southeastern North Carolina. Subjects' ages ranged between 52 and 88 years with a mean of 71.8 years.

RESULTS/ CONCLUSIONS: There was a significant decrease in systolic and diastolic blood pressure after SSBM on all 3 days. There was a statistically significant decrease in mean heart rate and mean respiratory rate on Days 1 and 3. There was no psychological change in any of the patients. Perception scores, however, indicate a positive response to SSBM. Patients perceived it as being comfortable, good, pleasant, and warm. On all occasions, their responses indicated that the intervention made them feel cared for, happy, physically relaxed, less anxious, calm, restful, and gave them a feeling of closeness with the nurse.


Mok E, Woo CP. (2004) The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients. Complementary Therapies in Nursing and Midwifery. 2004 Nov;10(4):209-16.

EXPERIMENT DESIGN: This study explores the effect of slow-stroke back massages on anxiety and shoulder pain in hospitalized elderly patients with stroke. An experimental quantitative design was conducted, comparing the scores for self-reported pain, anxiety, blood pressure, heart rate and pain of two groups of patients before and immediately after, and three days after the intervention. The intervention consisted of ten minutes of slow-stroke back massage (SSBM) for seven consecutive evenings. One hundred and two patients participated in the entire study and were randomly assigned to a massage group or a control group.

RESULTS/ CONCLUSIONS: The results revealed that the massage intervention significantly reduced the patients' levels of pain perception and anxiety. In addition to the subjective measures, all physiological measures (systolic and diastolic blood pressures and heart rate) changed positively, indicating relaxation. The prolonged effect of SSBM was also evident, as reflected by the maintenance of the psycho-physiological parameters three days after the massage. The patients' perceptions of SSBM, determined from a questionnaire, revealed positive support for SSBM for elderly stroke patients. The authors suggest that SSBM is an effective nursing intervention for reducing shoulder pain and anxiety in elderly patients with stroke. From a nursing perspective, this nursing practice provides a challenge and an opportunity for nurses and family caregivers to blend alternative therapies with technology to provide more individualized and holistic patient care.



Studies on the Effects of HIV/ AIDS Patients

Diego MA, Field T, Hernandez-Reif M, Shaw K, Friedman L, Ironson G.(2001) HIV adolescents show improved immune function following massage therapy. Int J Neurosci. 2001 Jan;106(1-2):35-45.

EXPERIMENT DESIGN: HIV+adolescents (M CD4=466 mm3) recruited from a large urban university hospital's outpatient clinic were randomly assigned to receive massage therapy (n=12) or progressive muscle relaxation (n=12) two-times per week for 12 weeks. To assess treatment effects, participants were assessed for depression, anxiety and immune changes before and after treatment the 12 weeks treatment period.

RESULTS/ CONCLUSIONS: Adolescents who received massage therapy versus those who experienced relaxation therapy reported feeling less anxious and they were less depressed, and showed enhanced immune function by the end of the 12 week study. Immune changes included increased Natural Killer cell number (CD56) and CD56+CD3-. In addition, the HIV disease progression markers CD4/CD8 ratio and CD4 number showed an increase for the massage therapy group only.


Scafidi, F. & Field, T. (1996). Massage therapy improves behavior in neonates born to HIV positive mothers. Journal of Pediatric Psychology, 21, 889-898.

EXPERIMENT DESIGN: Assigned randomly 28 neonates born to HIV-positive mothers to a massage therapy or control group. The treatment infants were given three 15-minute massages daily for 10 days.

RESULTS/ CONCLUSIONS: The massaged group showed superior performance on almost every Brazelton newborn cluster score and had a greater daily weight gain at the end of the treatment period unlike the control group who showed declining performance.


Ironson, G., Field, T., Scafidi, F., Hashimoto, M., Kumar, M., Kumar, A., Price, A., Goncalves, A., Burman, I., Tetenman, C., Patarca, R., & Fletcher, M. A. (1996). Massage therapy is associated with enhancement of the immune system's cytotoxic capacity. International Journal of Neuroscience, 84, 205-217.

EXPERIMENT DESIGN: Twenty-nine gay men (20 HIV+, 9 HIV-) received daily massages for one month. A subset of 11 of the HIV+ subjects served as a within subject control group (one month with and without massages).

RESULTS/ CONCLUSIONS: Major immune findings for the effects of the month of massage included a significant increase in Natural Killer Cell number, Natural Killer Cell Cytotoxicity, soluble CD8, and the cytotoxic subset of CD8 cells. There were no changes in HIV disease progression markers (CD4, CD4/CD8 ratio, Beta-2 microglobulin, neopterin). Major neuroendocrine findings, measured via 24 hour urines included a significant decrease in cortisol, and nonsignificant trends toward decrease of catecholamines. There were also significant decreases in anxiety and increases in relaxation which were significantly correlated with increases in NK cell number. Thus, there appears to be an increase in cytotoxic capacity associated with massage. Implications for HIV+ men as those with other illnesses, particularly cancer, are discussed.



Studies on the Effects of Massage Therapy on High Blood Pressure

Hernandez-Reif, M., Field, T., Krasnegor, J., Theakston, H., Hossain, Z., & Burman, I. (2000). High blood pressure and associated symptoms were reduced by massage therapy. Journal of Bodywork and Movement Therapies, 4, 31-38.

EXPERIMENT DESIGN:High blood pressure is associated with elevated anxiety, stress and stress hormones, hostility, depression and catecholamines. Massage therapy and progressive muscle relaxation were evaluated as treatments for reducing blood pressure and these associated symptoms. Adults who had been diagnosed as hypertensive received ten 30 min massage sessions over five weeks or they were given progressive muscle relaxation instructions (control group).

RESULTS/ CONCLUSIONS: Sitting diastolic blood pressure decreased after the first and last massage therapy sessions and reclining diastolic blood pressure decreased from the first to the last day of the study. Although both groups reported less anxiety, only the massage therapy group reported less depression and hostility and showed decreased urinary and salivary stress hormone levels (cortisol). Massage therapy may be effective in reducing diastolic blood pressure and symptoms associated with hypertension.



Studies on the Effects of Massage Therapy on Immunity

Mark Hyman Rapaport, Pamela Schettler, and Catherine Bresee. A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic–Pituitary–Adrenal and Immune Function in Normal Individuals The Journal of Alternative and Complementary Medicine. October 2010, 16(10): 1079-1088. doi:10.1089/acm.2009.0634.

EXPERIMENT DESIGN:Massage therapy is a multi–billion dollar industry in the United States with 8.7% of adults receiving at least one massage within the last year; yet, little is known about the physiologic effects of a single session of massage in healthy individuals. The purpose of this study was to determine effects of a single session of Swedish massage on neuroendocrine and immune function. It was hypothesized that Swedish Massage Therapy would increase oxytocin (OT) levels, which would lead to a decrease in hypothalamic–pituitary–adrenal (HPA) activity and enhanced immune function. The study design was a head-to-head, single-session comparison of Swedish Massage Therapy with a light touch control condition. Serial measurements were performed to determine OT, arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocytes markers, and mitogen-stimulated cytokine production. This research was conducted in an outpatient research unit in an academic medical center. Medically and psychiatrically healthy adults, 18–45 years old, participated in this study. The intervention tested was 45 minutes of Swedish Massage Therapy versus a light touch control condition, using highly specified and identical protocols. The standardized mean difference was calculated between Swedish Massage Therapy versus light touch on pre- to postintervention change in levels of OT, AVP, ACTH, CORT, lymphocyte markers, and cytokine levels.

RESULTS/ CONCLUSIONS: Compared to light touch, Swedish Massage Therapy caused a large effect size decrease in AVP, and a small effect size decrease in CORT, but these findings were not mediated by OT. Massage increased the number of circulating lymphocytes, CD 25+ lymphocytes, CD 56+ lymphocytes, CD4?+?lymphocytes, and CD8+ lymphocytes (effect sizes from 0.14 to 0.43). Mitogen-stimulated levels of interleukin (IL)–1ß, IL-2, IL-4, IL-5, IL-6, IL-10, IL-13, and IFN-? decreased for subjects receiving Swedish Massage Therapy versus light touch (effect sizes from -0.22 to -0.63). Swedish Massage Therapy decreased IL-4, IL-5, IL-10, and IL-13 levels relative to baseline measures.Preliminary data suggest that a single session of Swedish Massage Therapy produces measurable biologic effects. If replicated, these findings may have implications for managing inflammatory and autoimmune conditions.



Studies on the Effects of Massage Therapy on Infants and Children

Chen H, Miller S, Shaw J, Moyer-Mileur L. Massage therapy during early postnatal life promotes greater lean mass and bone growth, mineralization, and strength in juvenile and young adult rats. J Musculoskelet Neuronal Interact. 2009 Oct-Dec;9(4):278-87.

EXPERIMENT DESIGN:The objects of this study were to investigate the effects of massage therapy during early life on postnatal growth, body composition, and skeletal development in juvenile and young adult rats. Massage therapy was performed for 10 minutes daily from D6 to D10 of postnatal life in rat pups (MT, n=24). Body composition, bone area, mineral content, and bone mineral density were measured by dual energy X-ray absorptiometry (DXA); bone strength and intrinsic stiffness on femur shaft were tested by three-point bending; cortical and cancellous bone histomorphometric measurements were performed at D21 and D60

RESULTS/ CONCLUSIONS: Results were compared to age- and gender-matched controls (C, n=24). D21 body weight, body length, lean mass, and bone area were significantly greater in the MT cohort. Greater bone mineral content was found in male MT rats; bone strength and intrinsic stiffness were greater in D60 MT groups. At D60 MT treatment promoted bone mineralization by increasing trabecular mineral apposition rate in male and endosteal mineral surface in females, and also improved micro-architecture by greater trabeculae width in males and decreasing trabecular separation in females. In summary, massage therapy during early life elicited immediate and prolonged anabolic effects on postnatal growth, lean mass and skeletal developmental in a gender-specific manner in juvenile and young adult rats.


Field, T., Grizzle, N., Scafidi, F., Abrams, S., & Richardson, S. (1996). Massage therapy for infants of depressed mothers. Infant Behavior and Development 19, 109-114.

EXPERIMENT DESIGN:Forty full-term 1- to 3-month-old infants born to depressed adolescent mothers who were low socioeconomic status (SES) and single parents were givn 15 min of either massage or rocking for 2 days per week for a 6-week period.

RESULTS/ CONCLUSIONS: The infants who experienced massagetherapy compared to infants in the rocking control group spent more time in active alert and active awake states, cried less, and had lower salivary cotisol levels, suggesting lower stree. After the massage versus the rocking sessions, the infants spent less time in an active awake state, suggesting that massage may be more effective than rocking for inducing sleep. Over the 6-week period, the massage-therapy infants gained more weight, showed greater improvement on emotionality, sociability, amd soothability temperament dimensions and had greater decreases in urinary stress catecholamines/hormones (norepinephrine, epinephrine, cortisol).


Cullen, C., Field, T., Escalona, A. & Hartshorn, K. (2000). Father-infant interactions are enhanced by massage therapy. Early Child Development and Care, 164, 41-47.

EXPERIMENT DESIGN:Infants were given massages by their fathers for 15 minutes prior to their daily bedtime for one month.

RESULTS/ CONCLUSIONS: By the end of the study, the fathers who massaged their infants were more expressive and showed more enjoyment and more warmth during floor-play interactions with their infants.


Field, T. & Hernandez-Reif, M. (2001). Sleep problems in infants decrease following massage therapy. Early Child Development and Care, 168, 95-104.

EXPERIMENT DESIGN:Infants and toddlers (M age = 1.5 years) with sleep onset problems were given daily massages by their parents for 15 minutes prior to bedtime for one month.

RESULTS/ CONCLUSIONS: Based on parent diaries the massaged versus the control children (who were read bedtime stories) showed fewer sleep delay behaviors and had a shorter latency to sleep onset by the end of the study. Forty-five minute behavior observations by an independent observer also revealed more time awake, alert and active and more positive affect in the massaged children by the end of the study.


Ferber, S.G., Laudon, M., Kuint, J., Weller, A., & Zisapel, N. (2002). Massage therapy by mothers enhances the adjustment of circadian rhythms to the nocturnal period in full-term infants. Journal of Developmental and Behavioral Pediatrics, 23, 410-415.

EXPERIMENT DESIGN:The objective of this study was to investigate the effect of massage therapy on phase adjustment of rest-activity and melatonin secretion rhythms to the nocturnal period in full-term infants. Rest-activity cycles of infants were measured by actigraphy before and after 14 days of massage therapy (starting at age 10 and subsequently at 6 and 8 weeks of age). 6-Sulphatoxymelatonin excretion was assessed in urine samples at 6, 8, and 12 weeks of age .

RESULTS/ CONCLUSIONS: At 8 weeks the controls revealed one peak of activity at approximately 12 midnight (11 p.m.-3 a.m.) and another one at approximately 12 noon (11 a.m.-3 p.m.), whereas in the treated group, a major peak was early in the morning (3 a.m.-7 a.m.) and a secondary peak in the late afternoon (3 p.m.-7 p.m.). At 12 weeks, nocturnal 6-sulphatoxymelatonin excretions were significantly higher in the treated infants (1346.38 +/- 209.40 microg/night vs 823.25 +/- 121.25 microg/night, respectively;. It is concluded that massage therapy by mothers in the perinatal period serves as a strong time cue, enhancing coordination of the developing circadian system with environmental cues.


Kim, T.I., Shin, Y.H., & White-Traut, R.C. (2003). Multisensory intervention improves physical growth and illness rates in Korean orphaned newborn infants. Res Nurs Health, 26, 424-433.

EXPERIMENT DESIGN:The purpose of this study was to evaluate the effectiveness of a multisensory intervention on the physical growth and health of Korean orphaned infants. Fifty-eight full-term infants were randomly assigned to a control (n = 28) or an experimental (n = 30) group within 14 days postbirth. In addition to receiving the routine orphanage care, infants in the experimental group received 15 min of auditory (female voice), tactile (massage), and visual (eye-to-eye contact) stimulation twice a day, 5 days a week, for 4 weeks.

RESULTS/ CONCLUSIONS: Compared to the control group, the experimental group had gained significantly more weight and had larger increases in length and head circumference after the 4-week intervention period and at 6 months of age. In addition, the experimental group had significantly fewer illnesses and clinic visits. These data demonstrate that multisensory intervention in conjunction with human/social contact may be effective in facilitating growth for newborn infants placed in orphanages.



Tiffany Fields, Tracy Kilmera, Maria Hernandez-Reifa & Iris Burmana. Preschool Children's Sleep and Wake Behavior: Effects of Massage Therapy. Early Child Development and Care Volume 120, Issue 1, 1996, pages 39-44

EXPERIMENT DESIGN:Preschool children received 20-minute massages twice a week for five weeks.

RESULTS/ CONCLUSIONS: The massaged children as compared to children in the wait-list control group had better behavior ratings on state, vocalization, activity and cooperation after the massage sessions on the first and last days of the study. Their behavior was also rated more optimally by their teachers by the end of the study. Also, at the end of the 5 week period parents of the massaged children rated their children as having less touch aversion and being more extraverted. Finally, the massaged children had a shorter latency to naptime sleep by the end of the study.


Sybil Harta, Tiffany Field†a, Maria Hernandez-Reifa & Brenda Lundya . Preschoolers' Cognitive Performance Improves Following Massage. Early Child Development and Care Volume 143, Issue 1, 1998 pages 59-64

EXPERIMENT DESIGN:Preschoolers (Mage = 4 years, 4 months) were given WPPSI subtests, including Block Design, Animal Pegs and Mazes, before and after receiving a 15-minute massage or spending 15 minutes reading stories with an experimenter.

RESULTS/ CONCLUSIONS: Results revealed that performance on Block Design improved following massage and accuracy was greater on Animal Pegs in the massage group, particularly in more temperamental children.


Çetinkaya B, Basbakkal Z. The effectiveness of aromatherapy massage using lavender oil as a treatment for infantile colic. International Journal of Nursing Practice. 2012 Apr;18(2):164-9.

EXPERIMENT DESIGN:The aim of this paper was to investigate the effect of aromatherapy massage using lavender oil as a possible treatment for this condition. This research was carried out on a group of 40 infants between 2 and 6 weeks of age with a gestational age of 38-42 weeks and normal development and growth. All the infants weighed between 2500 and 4000 g at birth and all exhibited the signs of colic. Infants in the treatment group received abdominal massage by their mothers using lavender oil, while those in the control group were not subject to an intervention.

RESULTS/ CONCLUSIONS:The infants in both control and treatment groups were monitored once a week by the researchers, in total five times. The effect of the massage was measured in terms of changes in the length of time the infants cried per week. The use of aromatherapy massage using lavender oil was found to be effective in reducing the symptoms of colic.


Underdown A, Barlow J, Chung V, Stewart-Brown S. Massage intervention for promoting mental and physical health in infants aged under six months. Cochrane Database OF Systematic Reviews. 2006 Oct 18;(4)

EXPERIMENT DESIGN:Infant massage is increasingly being used in the community for low-risk babies and their primary care givers. Anecdotal claims suggest benefits for sleep, respiration, elimination and the reduction of colic and wind. Infant massage is also thought to reduce infant stress and promote positive parent-infant interaction. The aim of this review was to assess the effectiveness of infant massage in promoting infant physical and mental health in population samples. Searches were undertaken of CENTRAL 2005 (Issue 3), MEDLINE (1970 to 2005), PsycINFO (1970 to 2005), CINAHL (1982 to 2005), EMBASE (1980 to 2005), and a number of other Western and Chinese databases. Studies in which babies under the age of six months were randomised to an infant massage or a no-treatment control group, and utilising a standardised outcome measuring infant mental or physical development. Weighted and standardised mean differences and 95% confidence intervals are presented. Where appropriate the results have been combined in a meta-analysis using a random effects model.

RESULTS/ CONCLUSIONS:Twenty-three studies were included in the review. One was a follow-up study and thirteen were included in a separate analysis due to concerns about the uniformly significant results and the lack of dropout. The results of nine studies providing primary data suggest that infant massage has no effect on growth, but provides some evidence suggestive of improved mother-infant interaction, sleep and relaxation, reduced crying and a beneficial impact on a number of hormones controlling stress. Results showing a significant impact on number of illnesses and clinic visits were limited to a study of Korean orphanage infants. There was no evidence of effects on cognitive and behavioural outcomes, infant attachment or temperament. The data from the 13 studies regarded to be at high risk of bias show uniformly significant benefits on growth, sleep, crying and bilirubin levels. The only evidence of a significant impact of massage on growth was obtained from a group of studies regarded to be at high risk of bias. There was, however, some evidence of benefits on mother-infant interaction, sleeping and crying, and on hormones influencing stress levels. In the absence of evidence of harm, these findings may be sufficient to support the use of infant massage in the community, particularly in contexts where infant stimulation is poor. Further research is needed, however, before it will be possible to recommend universal provision.


Bennedbaek O, Viktor J, Carlsen KS, Roed H, Vinding H, Lundbye-Christensen S. [Infants with colic. A heterogenous group possible to cure? Treatment by pediatric consultation followed by a study of the effect of zone therapy on incurable colic]. Ugeskrift for Laeger (Danish publication). 2001 Jul 2;163(27):3773-8.

EXPERIMENT DESIGN:The aim of the study was to investigate and treat infants with colic by conventional medicine followed by an investigation of the effect of reflexological treatment. The investigation was prospective, followed by a randomised, single-blind, double-controlled, prospective study of reflexological treatment with an interview and diary. Sixty-three infants aged 1-3 months referred by general practitioners with crying for > 90 minutes a day were given a paediatric examination and intervention. The cause of crying was discovered in 33 infants: Vitamin D (5), elimination of cow's milk protein (3), and anal stenosis (3); counselling on feeding, sleep, reduction of stimulation, and avoidance of passive smoking (22). Thirty infants without the benefit of paediatric consultation were randomised to three groups for a duration of two weeks: A: Presumed non-effective reflexological treatment vs B: Presumed effective reflexological treatment vs C: No treatment--only observation. The most important parameter was the number of crying hours over 24 hours. Cure was defined as crying for less than or equal to 30 minutes.

RESULTS/ CONCLUSIONS:Examination by the paediatrician: Thirty-three of 63 infants benefited with a reduction in crying of less than 90 minutes and 13 of these infants were cured. The randomised study: In group C (control), none of the patients was cured. In groups A and B (presumed non-effective reflexological treatment and presumed effective treatment), half the patients were cured, which was significantly better than in group C. There was no significant difference between groups A and B, but B seemed better than group A. B was significantly better than C. Infantile colic had a significant cure rate at paediatric consultation and the children who did not benefit from this intervention had a significantly better outcome after reflexological treatment than had the observation group. Further investigations in reflexological treatment in infants are recommended.



Studies on the Effects of Massage Therapy on Non-Infant Pediatric Patients

Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996). Massage and relaxation therapies' effects on depressed adolescent mothers. Adolescence, 31, 903-911

EXPERIMENT DESIGN:Thirty-two depressed adolescent mothers received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group.

RESULTS/ CONCLUSIONS: Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group.


Children with cancer and blood diseases experience positive physical and psychological effects from massage therapy. Haun JN, Graham-Pole J, Shortley B. Int J Ther Massage Bodywork. 2009 Jun 29;2(2):7-14.

EXPERIMENT DESIGN:This randomized, non-blinded prospective study used measures of physical health and mental wellbeing that were completed before, during, and after four MT sessions were implemented. Descriptive statistics, one-way between-subjects analysis of variance, and an independent-samples t-test were used to analyze the data. The treatment group received 20-minute sessions of Swedish MT once daily for approximately 4 days (inpatients), or once weekly for approximately 4 weeks (outpatients); the control group received no MT.

RESULTS/ CONCLUSIONS: Between-groups analyses indicated significant psychological improvements for the MT group on state anxiety, trait anxiety, and emotional state. Between-groups analyses indicated significant physical improvements for the MT group on muscle soreness, discomfort, respiratory rate, and overall progress. No significant differences were found between groups on parent-completed ratings of their child's physical or psychological health, pulse rate, or blood pressure. In children with cancer and blood diseases, MT can reduce psychological and physical distress and can have a positive effect on quality of life.


Dominican Children with HIV not Receiving Antiretrovirals: Massage Therapy Influences their Behavior and Development. Hernandez-Reif M, Shor-Posner G, Baez J, Soto S, Mendoza R, Castillo R, Quintero N, Perez E, Zhang G. Evid Based Complement Alternat Med. 2008 Sep;5(3):345-354.

EXPERIMENT DESIGN: Forty-eight children (M age = 4.8 years) infected with HIV/AIDS and living in the Dominican Republic were randomly assigned to a massage therapy or a play session control group. The children in the massage therapy group received two weekly 20-min massages for 12 weeks; the children in the control group participated in a play session (coloring, playing with blocks) for the same duration and length as the massage therapy group.

RESULTS/ CONCLUSIONS: Overall, the children in the massage therapy group improved in self-help abilities and communication, suggesting that massage therapy may enhance daily functioning for children with HIV/AIDS. Moreover, the HIV infected children who were six or older also showed a decrease in internalizing behaviors; specifically depressive/anxious behaviors and negative thoughts were reduced. Additionally, baseline assessments revealed IQ equivalence below normal functioning for 70% of the HIV infected children and very high incidences of mood problems (depression, withdrawn) for 40% of the children and anxiety problems for 20% of the children, suggesting the need for better monitoring and alternative interventions in countries with limited resources to improve cognition and the mental health status of children infected with HIV/AIDS.


Massage therapy as a supportive care intervention for children with cancer. Hughes D, Ladas E, Rooney D, Kelly K. Oncol Nurs Forum. 2008 May;35(3):431-42. Review.Massage therapy as a supportive care intervention for children with cancer. Hughes D, Ladas E, Rooney D, Kelly K. Oncol Nurs Forum. 2008 May;35(3):431-42. Review.

EXPERIMENT DESIGN: To review relevant literature about massage therapy to assess the feasibility of integrating the body-based complementary and alternative medicine (CAM) practice as a supportive care intervention for children with cancer. PubMed, online references, published government reports, and the bibliographies of retrieved articles, reviews, and books on massage and massage and cancer. More than 70 citations were reviewed.

RESULTS/ CONCLUSIONS: Massage therapy may help mitigate pain, anxiety, depression, constipation, and high blood pressure and may be beneficial during periods of profound immune suppression. Massage techniques light to medium in pressure are appropriate in the pediatric oncology setting. Massage is an applicable, noninvasive, therapeutic modality that can be integrated safely as an adjunct intervention for managing side effects and psychological conditions associated with anticancer treatment in children. Massage may support immune function during periods of immunosuppression.


Pediatric massage therapy: an overview for clinicians. Beider S, Mahrer NE, Gold JI. Pediatr Clin North Am. 2007 Dec;54(6):1025-41; xii-xiii. Review.

EXPERIMENT DESIGN: Pediatric massage therapy (MT), similar to its younger counterpart infant massage, has a limited number of rigorous studies supporting its clinical application and associated effects. However, clinicians and researchers have been intrigued by the potential benefits of pediatric MT for improving psychological and physiologic states in children who have various health conditions. This article provides a broad overview of pediatric MT, including proven and promising effects of MT across disease-specific clinical applications, contraindications, safety, context and availability of services, and future directions. Computerized databases were searched for relevant studies, including prior reviews, primary case studies, and randomized controlled trials of infant and pediatric MT.

RESULTS/ CONCLUSIONS: Current findings provide varying levels of evidence for the benefits of pediatric MT in children who have diverse medical conditions; however, anxiety reduction has shown the strongest effect. Future studies should use rigorous study design and methodology, with long-term follow-up, for examining the longitudinal effects of pediatric MT.


Itching, pain, and anxiety levels are reduced with massage therapy in burned adolescents. Parlak Gürol A, Polat S, Akçay MN. J Burn Care Res. 2010 May-Jun;31 (3):429-32.

EXPERIMENT DESIGN: Burn can be among the most severe physical and psychologic traumas a person may face. Patients with burns commonly have severe itching and pain. Severe itching has also been associated with anxiety, sleep disturbance, and disruption of daily living activities. The addition of complementary treatments to standard care may lead to improved pain management and may offer a safer approach for reducing pain and procedural anxiety for patients with burns. The authors conducted an experimental study to examine whether the effects of massage therapy reduced burned adolescents' pain, itching, and anxiety levels. Sixty-three adolescents were enrolled in this study shortly after admission (mean days = 3 +/- 0.48) at a burn unit in a large university hospital from February 2008 to June 2009. The measures including the pain, itching, and state anxiety were collected on the first and last days of the 5-week study period. The participants had an average age of 14.07 +/- 1.78 years and came usually from the lower socioeconomic strata.

RESULTS/ CONCLUSIONS: The authors observed that massage therapy reduced all these measures from the first to the last day of this study. In most cultures, massage treatments are used to alleviate a wide range of symptoms. Although health professionals agree on the use of nonpharmacologic method for patients with burns, these applications are not yet common.


Myofascial trigger points in children with tension-type headache: a new diagnostic and therapeutic option. von Stülpnagel C, Reilich P, Straube A, Schäfer J, Blaschek A, Lee SH, Müller-Felber W, Henschel V, Mansmann U, Heinen F. J Child Neurol. 2009 Apr;24 (4):406-9.

EXPERIMENT DESIGN: The goal of this pilot study was to evaluate the effect of a trigger point-specific physiotherapy on headache frequency, intensity, and duration in children with episodic or chronic tension-type headache. Patients were recruited from the special headache outpatient clinic. A total of 9 girls (mean age 13.1 years; range, 5-15 years) with the diagnosis of tension-type headache participated in the pilot study from May to September 2006 and received trigger point-specific physiotherapy twice a week by a trained physiotherapist.

RESULTS/ CONCLUSIONS: After an average number of 6.5 therapeutic sessions, the headache frequency had been reduced by 67.7%, intensity by 74.3%, and duration by 77.3%. No side effects were noted during the treatment. These preliminary findings suggest a role for active trigger points in children with tension-type headache. Trigger point-specific physiotherapy seems to be an effective therapy in these children. Further prospective and controlled studies in a larger cohort are warranted.


Procedural pain heart rate responses in massaged preterm infants. Diego MA, Field T, Hernandez-Reif M. Infant Behav Dev. 2009 Apr;32(2):226-9. Epub 2009 Jan 30.

EXPERIMENT DESIGN: Heart rate (HR) responses to the removal of a monitoring lead were assessed in 56 preterm infants who received moderate pressure, light pressure or no massage therapy. The infants who received moderate pressure massage therapy exhibited lower increases in HR suggesting an attenuated pain response.

RESULTS/ CONCLUSIONS: The heart rate of infants who received moderate pressure massage also returned to baseline faster than the heart rate of the other two groups, suggesting a faster recovery rate.


Children with cancer and blood diseases experience positive physical and psychological effects from massage therapy. Haun JN, Graham-Pole J, Shortley B. Int J Ther Massage Bodywork. 2009 Jun 29;2(2):7-14.

EXPERIMENT DESIGN: Previous research has shown positive effects from massage therapy (MT) for premature infants and for children with asthma, arthritis, and other illnesses. Although these effects have been demonstrated, MT research on children with cancer and blood disease is needed. PURPOSE AND SETTING: The present study, conducted at the Cancer Center, Shands Hospital, at the University of Florida, Gainesville, measured the physical and psychological effects of MT on pediatric oncology and hematology patients. The participants were 30 children with cancer or blood disease, ages 6 months to 17 years. This randomized, non-blinded prospective study used measures of physical health and mental wellbeing that were completed before, during, and after four MT sessions were implemented. Descriptive statistics, one-way between-subjects analysis of variance, and an independent-samples t-test were used to analyze the data. The treatment group received 20-minute sessions of Swedish MT once daily for approximately 4 days (inpatients), or once weekly for approximately 4 weeks (outpatients); the control group received no MT.

RESULTS/ CONCLUSIONS: Between-groups analyses indicated significant psychological improvements for the MT group on state anxiety, trait anxiety, and emotional state. Between-groups analyses indicated significant physical improvements for the MT group on muscle soreness, discomfort, respiratory rate, and overall progress. No significant differences were found between groups on parent-completed ratings of their child's physical or psychological health, pulse rate, or blood pressure.In children with cancer and blood diseases, MT can reduce psychological and physical distress and can have a positive effect on quality of life.


Complementary and alternative medicine for acute procedural pain in children. Evans S, Tsao JC, Zeltzer LK. Altern Ther Health Med. 2008 Sep-Oct;14(5):52-6. Review.

EXPERIMENT DESIGN: Pain may cause physical and emotional distress in children experiencing medical procedures. Complementary and alternative medical (CAM) therapies have become increasingly important in treating children's painful conditions, yet it is still unclear whether CAM has a place in acute pediatric pain analgesia. This review aims to present an overview of the available published evidence. Most research has examined the efficacy of hypnosis, which has emerged as useful in alleviating acute pain associated with a number of medical procedures. Music therapy also has gained some attention and for the most part shows promise in the pediatric acute pain setting. Acupuncture, laughter therapy, and massage also may prove beneficial.

RESULTS/ CONCLUSIONS: Despite the promise of many of these modalities, we conclude that further empirical research into safety and efficacy using well-designed studies and large samples is required before guidelines can be established. In addition, further work is needed in standardizing interventions, creating treatment manuals, and determining treatment efficacy as a function of the child's development, his or her individual characteristics, and the type of procedure the child is undergoing.


Growing pains: a noninflammatory pain syndrome of early childhood. Lowe RM, Hashkes PJ. Nat Clin Pract Rheumatol. 2008 Oct;4(10):542-9. Epub 2008 Sep 2. Review.

EXPERIMENT DESIGN: The term 'growing pains' has been used for almost 200 years to refer to the often severe, generally bilateral lower-extremity nocturnal pains experienced by up to one-third of all children at some time during early childhood. No clear mechanism has yet been identified that explains these pains, but there is an increasing body of evidence indicating that several factors, individually or in combination, might be responsible for this phenomenon. These include mechanical factors, such as joint hypermobility and flat feet, decreased pain thresholds, reduced bone strength, and emotional factors involving the patient's family and other social stressors. Correct diagnosis of growing pains requires a thorough patient history and physical examination. The diagnosis can be safely established without unnecessary laboratory investigations or imaging; however, identification of one or more clinical cautionary signs, such as unilateral pain, morning stiffness, joint swelling and systemic symptoms (e.g. fever, weight loss and malaise), should trigger an extended evaluation to exclude other more serious conditions that might also present with limb pain.

RESULTS/ CONCLUSIONS: Once the diagnosis has been established, conservative management, using symptomatic pain medications, massage and other supportive measures, should be employed until the syndrome self-resolves with time.


Massage therapy as a supportive care intervention for children with cancer. Hughes D, Ladas E, Rooney D, Kelly K. Oncol Nurs Forum. 2008 May;35(3):431-42. Review.

EXPERIMENT DESIGN: To review relevant literature about massage therapy to assess the feasibility of integrating the body-based complementary and alternative medicine (CAM) practice as a supportive care intervention for children with cancer. DATA SOURCES: PubMed, online references, published government reports, and the bibliographies of retrieved articles, reviews, and books on massage and massage and cancer. More than 70 citations were reviewed. DATA SYNTHESIS: Massage therapy may help mitigate pain, anxiety, depression, constipation, and high blood pressure and may be beneficial during periods of profound immune suppression. Massage techniques light to medium in pressure are appropriate in the pediatric oncology setting.

RESULTS/ CONCLUSIONS: Massage is an applicable, noninvasive, therapeutic modality that can be integrated safely as an adjunct intervention for managing side effects and psychological conditions associated with anticancer treatment in children. Massage may support immune function during periods of immunosuppression. Pediatric oncology nurses are vital in helping patients safely integrate CAM into conventional treatment. Pediatric oncology nurses can help maximize patient outcomes by assessing, advocating, and coordinating massage therapy services as a supportive care intervention.


Complementary and alternative medicine therapies to promote healthy moods. Kemper KJ, Shannon S. Pediatr Clin North Am. 2007 Dec;54(6):901-26; x. Review.

EXPERIMENT DESIGN: Pediatric mood disorders (unipolar depression and bipolar disorder) are serious, common, persistent, and recurrent medical conditions. Depression is the second leading cause of illness and disability among young people worldwide. A healthy lifestyle and healthy environment are the cornerstones for promoting positive moods. In addition, several complementary therapies, including nutritional supplements, herbs, mind-body therapies, massage, and acupuncture can be helpful.

RESULTS/ CONCLUSIONS: The focus of this article is the fundamental lifestyle approaches and complementary therapies that enhance mental health in young people. Various resources are available to clinicians to help patients and families promote mental health.


Brief report: use of complementary and alternative medicine and psychological functioning in Latino children with juvenile idiopathic arthritis or arthralgia. Zebracki K, Holzman K, Bitter KJ, Feehan K, Miller ML. J Pediatr Psychol. 2007 Sep;32(8):1006-10. Epub 2007 Jul 11.

EXPERIMENT DESIGN: To describe the use of complementary and alternative medicine (CAM) and its relationship to symptoms of anxiety, depression, and dysthymia in Latino children with juvenile idiopathic arthritis (JIA) or arthralgia. Parents of 36 children between the ages of 6 and 16 years with either JIA (n = 17) or arthralgia (n = 19) completed questionnaires during routine pediatric rheumatology clinic visits assessing use of CAM and psychological functioning.

RESULTS/ CONCLUSIONS: CAM was used by the majority of children primarily to treat pain episodes. The most common modalities were prayer and massage therapy. CAM use was associated with decreased symptoms of anxiety and dysthymia in children with arthralgia, but not in children with JIA. Preliminary findings suggest that CAM use is associated with improved psychological functioning in children with arthralgia. Healthcare providers are encouraged to routinely screen for CAM usage and to educate families about the potential benefits and limitations of CAM.


Diego, M.A., Hernandez-Reif, M., Field, T., Friedman, L. & Shaw, K. (2001). HIV adolescents show improved immune function following massage therapy. International Journal of Neuroscience, 106, 35-45.

EXPERIMENT DESIGN: HIV+adolescents (M CD4=466 mm3) recruited from a large urban university hospital's outpatient clinic were randomly assigned to receive massage therapy (n=12) or progressive muscle relaxation (n=12) two-times per week for 12 weeks. To assess treatment effects, participants were assessed for depression, anxiety and immune changes before and after treatment the 12 weeks treatment period.

RESULTS/ CONCLUSIONS: . Adolescents who received massage therapy versus those who experienced relaxation therapy reported feeling less anxious and they were less depressed, and showed enhanced immune function by the end of the 12 week study. Immune changes included increased Natural Killer cell number (CD56) and CD56+CD3-. In addition, the HIV disease progression markers CD4/CD8 ratio and CD4 number showed an increase for the massage therapy group only.


Pediatric massage therapy: an overview for clinicians. Beider S, Mahrer NE, Gold JI. Pediatr Clin North Am. 2007 Dec;54(6):1025-41; xii-xiii. Review.

EXPERIMENT DESIGN: Pediatric massage therapy (MT), similar to its younger counterpart infant massage, has a limited number of rigorous studies supporting its clinical application and associated effects. However, clinicians and researchers have been intrigued by the potential benefits of pediatric MT for improving psychological and physiologic states in children who have various health conditions. This article provides a broad overview of pediatric MT, including proven and promising effects of MT across disease-specific clinical applications, contraindications, safety, context and availability of services, and future directions. Computerized databases were searched for relevant studies, including prior reviews, primary case studies, and randomized controlled trials of infant and pediatric MT.

RESULTS/ CONCLUSIONS: Current findings provide varying levels of evidence for the benefits of pediatric MT in children who have diverse medical conditions; however, anxiety reduction has shown the strongest effect. Future studies should use rigorous study design and methodology, with long-term follow-up, for examining the longitudinal effects of pediatric MT.


Field, T., Cullen, C., Diego, M., Hernandez-Reif, M., Sprinz, P., Beebe, K., Kissel, B. & Bango-Sanchez, V. (2001). Leukemia immune changes following massage therapy. Journal of Bodywork and Movement Therapies, 3, 1-5.

EXPERIMENT DESIGN: Twenty children with leukemia were provided with daily massage therapy by their parents and were compared to a standard treatment control group.

RESULTS/ CONCLUSIONS: Following a month of massage therapy, depressed mood decreased in the children's parents, and the children's white blood cell and neutrophil counts increased.


Severe pediatric rumination syndrome: successful interdisciplinary inpatient management. Green AD, Alioto A, Mousa H, Di Lorenzo C. J Pediatr Gastroenterol Nutr. 2011 Apr;52(4):414-8.

EXPERIMENT DESIGN: Rumination syndrome is a condition that occurs when people constantly regurgitate and expel or reswallow food soon after they eat. The most severe cases of rumination syndrome can be debilitating, requiring total parenteral nutrition or enteral tube feedings. We report our experience with the treatment of children with severe rumination syndrome. Five patients with severe rumination syndrome received a novel inpatient interdisciplinary approach, which involved pediatric psychology, pediatric gastroenterology, clinical nutrition, child life, therapeutic recreation, and massage therapy.

RESULTS/ CONCLUSIONS: Inpatient hospitalization lasted between 9 and 13 days. The treatment was successful in all 5 of the patients. They left with complete caloric intake orally. This treatment protocol could benefit pediatric gastroenterologists, pediatricians, and child psychologists in managing both standard and severe cases of rumination syndrome.


Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., & Schanberg, S. (1992). Massage therapy reduces anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 125-130.

EXPERIMENT DESIGN: A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents.

RESULTS/ CONCLUSIONS: Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.


Escalona, A., Field, T., Singer-Strunck, R., Cullen, C., & Hartshorn, K. (2001). Brief report: improvements in the behavior of children with autism following massage therapy. Journal of Autism & Developmental Disorders, 31, 513-516.

EXPERIMENT DESIGN: Twenty children with autism, ages 3 to 6 years, were randomly assigned to massage therapy and reading attention control groups. Parents in the massage therapy group were trained by a massage therapist to massage their children for 15 minutes prior to bedtime every night for 1 month and the parents of the attention control group read Dr. Seuss stories to their children on the same time schedule. Conners Teacher and Parent scales, classroom and playground observations, and sleep diaries were used to assess the effects of therapy on various behaviors, including hyperactivity, stereotypical and off-task behavior, and sleep problems.

RESULTS/ CONCLUSIONS: Results suggested that the children in the massage group exhibited less stereotypic behavior and showed more on-task and social relatedness behavior during play observations at school, and they experienced fewer sleep problems at home.


Hernandez-Reif M, Field T, Krasnegor J, Martinez E, Schwartzman M, Mavunda K. (1999) Children with cystic fibrosis benefit from massage therapy. J Pediatr Psychol. 1999 Apr;24(2):175-81.

EXPERIMENT DESIGN: To measure the effects of parents giving massage therapy to their children with cystic fibrosis to reduce anxiety in parents and their children and to improve the children's mood and peak air flow readings. Twenty children (5-12 years old) with cystic fibrosis and their parents were randomly assigned to a massage therapy or a reading control group. Parents in the treatment group were instructed and asked to conduct a 20-minute child massage every night at bedtime for one month. Parents in the reading control group were instructed to read for 20 minutes a night with their child for one month. On days 1 and 30, parents and children answered questions relating to present anxiety levels and children answered questions relating to mood, and their peak air flow was measured.

RESULTS/ CONCLUSIONS: Following the first and last massage session, children and parents reported reduced anxiety. Mood and peak air flow readings also improved for children in the massage therapy group. These findings suggest that parents may reduce anxiety levels by massaging their children with cystic fibrosis and their children may benefit from receiving massage by having less anxiety and improved mood, which in turn may facilitate breathing.


Studies on the Effects of Massage Therapy on Job Stress

Cady, S. H., & Jones, G. E. (1997). Massage therapy as a workplace intervention for reduction of stress. Perceptual & Motor Skills, 84, 157-158.

EXPERIMENT DESIGN: This study evaluated the effectiveness of a 15-min. on-site massage while seated in a chair on reducing stress as indicated by blood pressure. 52 employed participants' blood pressures were measured before and after a 15-min. massage at work.

RESULTS/ CONCLUSIONS: Analysis showed a significant reduction in participants' systolic and diastolic blood pressure after receiving the massage although there was no control group.


Katz, J., Wowk, A., Culp, D., & Wakeling, H. (1999). Pain and tension are reduced among hospital nurses after on-site massage treatments: a pilot study. Journal of Perianesthesia Nursing, 14, 128-133.

EXPERIMENT DESIGN: Tension and pain are common occupational hazards of modern-day nursing, especially given recent changes to the health care system. The aims of the pilot study were (1) to evaluate the feasibility of carrying out a series of eight 15-minute workplace-based massage treatments, and (2) to determine whether massage therapy reduced pain and stress experienced by nursing staff at a large teaching hospital. Twelve hospital staff (10 registered nurses and 2 nonmedical ward staff) working in a large tertiary care center volunteered to participate. Participants received up to eight, workplace-based, 15-minute Swedish massage treatments provided by registered massage therapists. Pain, tension, relaxation, and the Profile of Mood States were measured before and after each massage session.

RESULTS/ CONCLUSIONS: Pain intensity and tension levels were significantly lower after massage. In addition, relaxation levels and overall mood state improved significantly after treatments. The results of this pilot study support the feasibility of an eight-session, workplace-based, massage therapy program for pain and tension experienced by nurses working in a large teaching hospital. Further research is warranted to study the efficacy of workplace massage in reducing stress and improving overall mood.



Studies on the Effects of Massage Therapy on Labor Pain

Field, T., Hernandez-Reif, M., Taylor, S., Quintino, O., & Burman, I. (1997). Labor pain is reduced by massage therapy. Journal of Psychosomatic Obstetrics and Gynecology, 18, 286-291.

EXPERIMENT DESIGN: Twenty-eight women were recruited from prenatal classes and randomly assigned to receive massage in addition to coaching in breathing from their partners during labor, or to receive coaching in breathing alone (a technique learned during prenatal classes).

RESULTS/ CONCLUSIONS: The massaged mothers reported a decrease in depressed mood, anxiety and pain, and showed less agitated activity and anxiety and more positive affect following the first massage during labor. In addition, the massaged mothers had significantly shorter labors, a shorter hospital stay and less postpartum depression.


Chang, M.Y., Wang, S.Y., & Chen, C.H. (2002). Effects of massage on pain and anxiety during labor: a randomized controlled trial in Taiwan. Journal of Advanced Nursing, 38, 68-73.

EXPERIMENT DESIGN: A randomized controlled study was conducted between September 1999 and January 2000. Sixty primiparous women expected to have a normal childbirth at a regional hospital in southern Taiwan were randomly assigned to either the experimental (n=30) or the control (n=30) group. The experimental group received massage intervention whereas the control group did not. The nurse-rated present behavioural intensity (PBI) was used as a measure of labour pain. Anxiety was measured with the visual analogue scale for anxiety (VASA). The intensity of pain and anxiety between the two groups was compared in the latent phase (cervix dilated 3-4 cm), active phase (5-7 cm) and transitional phase (8-10 cm).

RESULTS/ CONCLUSIONS: In both groups, there was a relatively steady increase in pain intensity and anxiety level as labour progressed. A t-test demonstrated that the experimental group had significantly lower pain reactions in the latent, active and transitional phases. Anxiety levels were only significantly different between the two groups in the latent phase. Twenty-six of the 30 (87%) experimental group subjects reported that massage was helpful, providing pain relief and psychological support during labour. Findings suggest that massage is a cost-effective nursing intervention that can decrease pain and anxiety during labour, and partners' participation in massage can positively influence the quality of women's birth experiences.


Chung, U.L., Hung, L.C., Kuo, S.C., & Huang, C.L. (2003). Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. The Journal of Nursing Research, 11, 251-260.

EXPERIMENT DESIGN: Acupressure is said to promote the circulation of blood and qi, the harmony of yin and yang, and the secretion of neurotransmitters, thus maintaining the normal functions of the human body and providing comfort. However, there has been little research-based evidence to support the positive effects of acupressure in the area of obstetric nursing. The purpose of this study is to determine the effect of LI4 and BL67 acupressure on labor pain and uterine contractions during the first stage of labor. An experimental study with a pretest and posttest control group design was utilized. A total of 127 parturient women were randomly assigned to three groups. Each group received only one of the following treatments, LI4 and BL67 acupressure, light skin stroking, or no treatment/conversation only. Data collected from the VAS and external fetal monitoring strips were used for analysis.

RESULTS/ CONCLUSIONS: Findings indicated that there was a significant difference in decreased labor pain during the active phase of the first stage of labor among the three groups. There was no significant difference in effectiveness of uterine contractions during the first stage of labor among the three groups. Results of the study confirmed the effect of LI4 and BL67 acupressure in lessening labor pain during the active phase of the first stage of labor. There were no verified effects on uterine contractions.



Studies on the Effects of Massage Therapy on Leukemia

Field, T., Cullen, C., Diego, M., Hernandez-Reif, M., Sprinz, P., Beebe, K., Kissel, B., & Bango-Sanchez, V. (2001). Leukemia immune changes following massage therapy. Journal of Bodywork and Movement Therapies, 5, 271-274.

EXPERIMENT DESIGN: Twenty children with leukemia were provided with daily massagetherapy by their parents and were compared to a standard treatment control group.

RESULTS/ CONCLUSIONS: Following a month of massagetherapy, depressed mood decreased in the children's parents, and the children's white blood cell and neutrophil counts increased.



Studies of the Effects of Massage Therapy on Migraine Sufferers

Lawler, S. & Cameron, L. (2006). A randomized, controlled trial of massage therapy as a treatment for migraine. Annual Behavior and Medicine, 32, 50-59.

EXPERIMENT DESIGN:Migraine sufferers (N = 47) who were randomly assigned to massage or control conditions completed daily assessments of migraine experiences and sleep patterns for 13 weeks. Massage participants attended weekly massage sessions during Weeks 5 to 10. State anxiety, heart rates, and salivary cortisol were assessed before and after the sessions. Perceived stress and coping efficacy were assessed at Weeks 4, 10, and 13.

RESULTS/ CONCLUSIONS: Compared to control participants, massage participants exhibited greater improvements in migraine frequency and sleep quality during the intervention weeks and the 3 follow-up weeks. Trends for beneficial effects of massage therapy on perceived stress and coping efficacy were observed. During sessions, massage induced decreases in state anxiety, heart rate, and cortisol. The findings provide preliminary support for the utility of massage therapy as a nonpharmacologic treatment for individuals suffering from migraines.


Chaibi A, Tuchin PJ, Russell MB. Manual therapies for migraine: a systematic review. J Headache Pain. 2011 Apr;12(2):127-33. Epub 2011 Feb 5.

EXPERIMENT DESIGN:Migraine occurs in about 15% of the general population. Migraine is usually managed by medication, but some patients do not tolerate migraine medication due to side effects or prefer to avoid medication for other reasons. Non-pharmacological management is an alternative treatment option. We systematically reviewed randomized clinical trials (RCTs) on manual therapies for migraine.

RESULTS/ CONCLUSIONS:The RCTs suggest that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine. However, the evaluated RCTs had many methodological shortcomings. Therefore, any firm conclusion will require future, well-conducted RCTs on manual therapies for migraine.


Arnadottir TS, Sigurdardottir AK. Is craniosacral therapy effective for migraine? Tested with HIT-6 Questionnaire. Complementary Therapies Clinical Practice. 2013 Feb;19(1)

EXPERIMENT DESIGN:To determine whether or not craniosacral therapy alleviates migraine symptoms. A cross-over experimental design was used with twenty participants, aged between 20 and 50 years, who suffered from at least two migraine attacks per month. Participants were randomly assigned to two equal-sized groups, A and B. All received six craniosacral treatments over four weeks and the groups answered the "HIT-6" Questionnaire four times; every four weeks (Times 1, 2, 3 and 4). Group A, received treatment after answering the questionnaire the first time, but Group B, answered the questionnaire twice before receiving treatment.

RESULTS/ CONCLUSIONS:Immediately after treatments and one month afterwards there was significant lowering in HIT-6 scorings compared with prior to treatment. There was also significant difference in HIT-6 scorings between Times 1 and 4 (p = 0.004). The effect size was 0.43-0.55. The results indicate that craniosacral treatment can alleviate migraine symptoms. Further research is suggested.



Studies of the Effects of Massage Therapy on Mulptiple Sclerosis

Lawler, S. & Cameron, L. (2006). A randomized, controlled trial of massage therapy as a treatment for migraine. Annual Behavior and Medicine, 32, 50-59.

EXPERIMENT DESIGN:Migraine sufferers (N = 47) who were randomly assigned to massage or control conditions completed daily assessments of migraine experiences and sleep patterns for 13 weeks. Massage participants attended weekly massage sessions during Weeks 5 to 10. State anxiety, heart rates, and salivary cortisol were assessed before and after the sessions. Perceived stress and coping efficacy were assessed at Weeks 4, 10, and 13.

RESULTS/ CONCLUSIONS: Compared to control participants, massage participants exhibited greater improvements in migraine frequency and sleep quality during the intervention weeks and the 3 follow-up weeks. Trends for beneficial effects of massage therapy on perceived stress and coping efficacy were observed. During sessions, massage induced decreases in state anxiety, heart rate, and cortisol. The findings provide preliminary support for the utility of massage therapy as a nonpharmacologic treatment for individuals suffering from migraines.



Studies on the Effects of Massage Therapy on Musculoskeletal Complaints


Buttagat V, Eungpinichpong W, Chatchawan U, Arayawichanon P. Therapeutic effects of traditional Thai massage on pain, muscle tension and anxiety in patients with scapulocostal syndrome: a randomized single-blinded pilot study. J Bodyw Mov Ther. 2012 Jan;16(1):57-63. Epub 2011 Jun 22.

EXPERIMENT DESIGN: The purpose of this study was to investigate the therapeutic effects of traditional Thai massage (TTM) on pain intensity, pressure pain threshold (PPT), muscle tension and anxiety associated with scapulocostal syndrome (SCS). Twenty patients were randomly allocated to receive a 30-min session of either TTM or physical therapy modalities (PT: ultrasound therapy and hot pack) for 9 sessions over a period of 3 weeks. Pain intensity, PPT, muscle tension and anxiety were measured before and immediately after the first treatment session, 1 day after the last treatment session and 2 weeks after the last treatment session

RESULTS/ CONCLUSIONS: Results indicated that the TTM group showed a significant improvement in all parameters after the first treatment session and at 1 day and 2 weeks after the last treatment session. For all outcomes, similar changes were observed in the PT group except for PPT. The adjusted post-test mean values of each assessment time point for pain intensity and muscle tension were significantly lower in the TTM group than those of the PT group. In addition, the values for PPT were significantly higher in the TTM group. We therefore suggest that TTM could be an alternative treatment for the patient with SCS.


Field T, Diego M, Delgado J, Garcia D, Funk CG. Hand pain is reduced by massage therapy. Complement Ther Clin Pract. 2011 Nov;17(4):226-9. doi: 10.1016/j.ctcp.2011.02.006. Epub 2011 Mar 15.

EXPERIMENT DESIGN: Forty-six adults with hand pain were randomly assigned to a massage therapy or a standard treatment control group. Those assigned to the massage therapy group were massaged by a therapist on the affected hand once a week for a 4-week period and were also taught self-massage on the hand that was to be done by the individual participant once daily.

RESULTS/ CONCLUSIONS: The massage therapy group versus the control group had less pain and greater grip strength after the first and last sessions, and their anxiety and depressed mood scores decreased more than the control group. Over the four-week period the massage group had a greater decrease in pain and a greater increase in grip strength as well as lower scores on anxiety, depressed mood and sleep disturbance scales.


Siško PK, Videmšek M, Karpljuk D. The effect of a corporate chair massage program on musculoskeletal discomfort and joint range of motion in office workers. J Altern Complement Med. 2011 Jul;17(7):617-22. Epub 2011 Jun 20.

EXPERIMENT DESIGN: The aim of this study was to determine the effects of workplace manual technique interventions for female participants on the degree of joint range of motion and on the level of musculoskeletal ache, pain, or discomfort experienced when performing workplace responsibilities. Nineteen (19) female volunteers were given chair massages on-site twice per week for 1 month. Subjects completed a series of self-report questionnaires that asked for information concerning musculoskeletal discomfort for the neck, upper back, and lower back in the form of a body diagram. A range-of-motion test (to compare the change in joint angles) was performed with a goniometer to assess cervical lateral flexion, cervical flexion, cervical extension, lumbar flexion, and lumbar extension.

RESULTS/ CONCLUSIONS: Between the first and the last measurements, a significant difference was found in increased range of motion for cervical lateral flexion. Wilcoxon signed rank test showed a significant increase in range of motion for cervical lateral flexion, cervical extension (63.2±12.4 to 67.2±12.3), and a significant decrease in the Cornell Musculoskeletal Discomfort Questionnaire values for the neck and the upper back from the phase 2 to 3. Significant reductions were also shown in the Cornell Musculoskeletal Discomfort Questionnaire values for the neck and the upper back from the phase 1 to 3.


Sefton JM, Yarar C, Carpenter DM, Berry JW. Physiological and clinical changes after therapeutic massage of the neck and shoulders. Man Ther. 2011 Oct;16(5):487-94. Epub 2011 May 12.

EXPERIMENT DESIGN: Little is known regarding the physiological and clinical effects of therapeutic massage (TM) even though it is often prescribed for musculoskeletal complaints such as chronic neck pain. This study investigated the influence of a standardized clinical neck/shoulder TM intervention on physiological measures assessing a-motoneurone pool excitability, muscle activity; and the clinical measure of range of motion (ROM) compared to a light touch and control intervention. Flexor carpi radialis (FCR) a-motoneurone pool excitability (Hoffmann reflex), electromyography (EMG) signal amplitude of the upper trapezius during maximal muscle activity, and cervical ROM were used to assess possible physiological changes and clinical effects of TM. Sixteen healthy adults participated in three, 20 min interventions: control (C), light touch (LT) and therapeutic massage (TM).

RESULTS/ CONCLUSIONS: Analysis of Covariance indicated a decrease in FCR a-motoneurone pool excitability after TM, compared to both the LT or C interventions. EMG signal amplitude decreased after TM by 13%, when compared to the control, and 12% as compared to LT intervention. The TM intervention produced increases in cervical ROM in all directions assessed: flexion, lateral flexion, extension, and rotation. TM of the neck/shoulders reduced the a-motoneurone pool excitability of the flexor carpi radialis after TM, but not after the LT or C interventions. Moreover, decreases in the normalized EMG amplitude during MVIC of the upper trapezius muscle; and increases in cervical ROM in all directions assessed occurred after TM, but not after the LT or C interventions.


Blasche G, Leibetseder V, Marktl W. Association of spa therapy with improvement of psychological symptoms of occupational burnout: a pilot study. Forsch Komplementmed. 2010;17(3):132-6. Epub 2010 Jun 16.

EXPERIMENT DESIGN: The aim of the present study was to investigate effects of a 3-week resort-based spa therapy (a combination of balneotherapy, massages, exercise etc., including a respite from work) on psychological symptoms associated with occupational burnout. In a longitudinal design, a group of 65 actively working individuals (45 women, 20 men, mean age 50.4 +/- 6.7 years) of various occupations selected on the basis of their level of burnout and undergoing spa therapy primarily for musculoskeletal pain were studied in regard to the change in fatigue, distress, reduced motivation, and quality of sleep. Variables were assessed at the beginning and at the end of spa therapy as well as 4 weeks and 3 months after treatment. Two levels of burnout were distinguished: individuals with mild burnout (i.e. increased emotional exhaustion) and individuals with a full burnout syndrome (i.e. increased exhaustion plus social detachment and/or performance dissatisfaction).

RESULTS/ CONCLUSIONS: At the end of the treatment, all four symptoms of burnout showed a significant improvement in both groups compared to their pre-treatment level. This improvement was sustained up to 3 months post-treatment for both burnout groups. Spa therapy may be a helpful measure for treating the symptoms of occupational burnout.


Montenegro ML, Mateus-Vasconcelos EC, Candido dos Reis FJ, Rosa e Silva JC, Nogueira AA, Poli Neto OB. Thiele massage as a therapeutic option for women with chronic pelvic pain caused by tenderness of pelvic floor muscles. J Eval Clin Pract. 2010 Oct;16(5):981-2. doi: 10.1111/j.1365-2753.2009.01202.x.

EXPERIMENT DESIGN: Musculoskeletal system has been found to be involved in genesis and perpetuation of chronic pelvic pain (CPP) and has strong evidences that up to 80% of women with CPP present dysfunction of the musculoskeletal system. In this study, we report a series of women with CPP caused by tenderness of pelvic floor muscles successfully treated with Thiele massage. Were included in this study six women with CPP caused by tenderness of the levator ani muscle that underwent transvaginal massage using the Thiele technique, over a period of 5 minutes repeated once a week for 4 weeks. After 1 month, the women returned for follow-up.

RESULTS/ CONCLUSIONS: The median tenderness score for the six women evaluated was 3 at the first evaluation and 0 after 1 month of follow-up. The mean Visual Analogue Scale and McGill Pain Index scores were 8.1 and 34, respectively, at the first evaluation, and 1.5 and 16.6 at follow-up. Thiele massage appears to be very helpful for women with CPP caused by tenderness of the levator ani muscle. However, these results are preliminary and a larger number of women are necessary to obtain more conclusive results.


Bergman GJ, Winters JC, Groenier KH, Meyboom-de Jong B, Postema K, van der Heijden GJ. Manipulative therapy in addition to usual care for patients with shoulder complaints: results of physical examination outcomes in a randomized controlled trial. J Manipulative Physiol Ther. 2010 Feb;33(2):96-101.

EXPERIMENT DESIGN: The purpose of this study was to examine the effect of manipulative therapy on the shoulder girdle, in addition to usual care provided by the general practitioner, on the outcomes of physical examination tests for the treatment of shoulder complaints. This was a randomized controlled trial in a primary care setting in the Netherlands. A total of 150 participants were recruited from December 2000 until December 2002. All patients received usual care by the general practitioner. Usual care included one or more of the following depending on the needs of the patient: information/advice, oral analgesics or nonsteroidal antiinflammatory drugs, corticosteroid injections, exercises, and massage. In addition to usual care, the intervention group received manipulative therapy, up to 6 treatment sessions in a 12-week period. Twenty-four physical examination tests were done at baseline and after 6, 12, and 26 weeks. Factor analysis was done to reduce the number of outcome measures.

RESULTS/ CONCLUSIONS: The factor analysis resulted in 4 factors: "shoulder pain," "neck pain," "shoulder mobility," and "neck mobility." At 12 weeks, the mean changes of all 4 factors favored the intervention group; the factors "shoulder pain" and "neck pain" reached statistical significance (95% confidence interval [CI], 0.1-2.1). At 26 weeks, differences in the factors "shoulder pain" (95% CI, 0.0-2.6), "shoulder mobility" (95% CI, 0.2-1.7), and "mobility neck" (95% CI, 0.2-1.3) statistically favored the intervention group. In this pragmatic study, manipulative therapy, in addition to usual care by the general practitioner, diminished severity of shoulder pain and neck pain and improved shoulder and neck mobility.



Studies of the Effects of Massage Therapy on Neck Pain

Sherman KJ, Cherkin DC, Hawkes RJ, et al. Randomized trial of therapeutic massage for chronic neck pain. Clinical Journal of Pain. 2009; 25(3):233–238.

EXPERIMENT DESIGN:Sixty-four patients with chronic pain were randomized to receive up to 10 massages over 10 weeks or a self-care book. Follow-up telephone interviews after 4, 10, and 26 weeks assessed outcomes including dysfunction and symptoms. Log-binomial regression was used to assess whether there were differences in the percentages of participants with clinically meaningful improvements in dysfunction and symptoms (ie, >5-point improvement on the Neck Disability Index; >30% improvement from baseline on the symptom bothersomeness scale) at each time point.

RESULTS/ CONCLUSIONS: At 10 weeks, more participants randomized to massage experienced clinically significant improvement on the Neck Disability Index [39% vs. 14% of book group; relative risk (RR)=2.7; 95% confidence interval (CI), 0.99-7.5] and on the symptom bothersomeness scale (55% vs. 25% of book group; RR=2.2; 95% CI, 1.04-4.2). After 26 weeks, massage group members tended to be more likely to report improved function (RR=1.8; 95% CI, 0.97-3.5), but not symptom bothersomeness (RR=1.1; 95% CI, 0.6-2.0). Mean differences between groups were strongest at 4 weeks and not evident by 26 weeks. No serious adverse experiences were reported. This study suggests that massage is safe and may have clinical benefits for treating chronic neck pain at least in the short term. A larger trial is warranted to confirm these results.



Studies of the Effects of Massage Therapy on Pain

Cutshall SM, Wentworth LJ, Engen D, Sundt TM, Kelly RF, Bauer BA. Effect of massage therapy on pain, anxiety, and tension in cardiac surgical patients: a pilot study. Complement Ther Clin Pract. 2010 May;16(2):92-5. Epub 2009 Nov 14.

EXPERIMENT DESIGN: Objective: To assess the role of massage therapy in the cardiac surgery postoperative period. Specific aims included determining the difference in pain, anxiety, tension, and satisfaction scores of patients before and after massage compared with patients who received standard care. The design was a randomized controlled trial comparing outcomes before and after intervention in and across groups. Subjects were randomized controlled trial comparing outcomes before and after intervention in and across groups. Interventions were Patients in the intervention group received a 20-minute session of massage therapy intervention between postoperative days 2 and 5. Patients in the control group received standard care and a 20-minute quiet time between postoperative days 2 and 5. Outcome measures were the Linear Analogue Self-assessment scores for pain, anxiety, tension, and satisfaction.

RESULTS/ CONCLUSIONS: Statistically and clinically significant decreases in pain, anxiety, and tension scores were observed for patients who received a 20-minute massage compared with those who received standard care. Patient feedback was markedly positive. This pilot study showed that massage can be successfully incorporated into a busy cardiac surgical practice. These results suggest that massage may be an important therapy to consider for inclusion in the management of postoperative recovery of cardiovascular surgical patients.


Tiffany Field, Maria Hernandez-Reif, Miguel Diego, Monica Fraser. Lower back pain and sleep disturbance are reduced following massage therapy. Journal of Bodywork and Movement Therapies Volume 11, Issue 2 , Pages 141-145, April 2007

EXPERIMENT DESIGN: A randomized between-groups design was used to evaluate massage therapy versus relaxation therapy effects on chronic low back pain. Treatment effects were evaluated for reducing pain, depression, anxiety and sleep disturbances, for improving trunk range of motion (ROM) and for reducing job absenteeism and increasing job productivity. Thirty adults (M age=41 years) with low back pain with a duration of at least 6 months participated in the study. The groups did not differ on age, socioeconomic status, ethnicity or gender. Sessions were 30min long twice a week for 5 weeks. On the first and last day of the 5-week study participants completed questionnaires and were assessed for ROM.

RESULTS/ CONCLUSIONS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and sleep disturbance. They also showed improved trunk and pain flexion performance.


Field T, Figueiredo B, Hernandez-Reif M, Diego M, Deeds O, Ascencio A. Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships. J Bodyw Mov Ther. 2008 Apr;12(2):146-50. Epub 2007 Oct 2.

EXPERIMENT DESIGN: Prenatally depressed women (N=47) were randomly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group.

RESULTS/ CONCLUSIONS: Self-reported leg pain, back pain, depression, anxiety and anger decreased more for the massaged pregnant women than for the control group women. In addition, the partners who massaged the pregnant women versus the control group partners reported less depressed mood, anxiety and anger across the course of the massage therapy period. Finally, scores on a relationship questionnaire improved more for both the women and the partners in the massage group. These data suggest that not only mood states but also relationships improve mutually when depressed pregnant women are massaged by their partners.


Lemanek KL, Ranalli M, Lukens C. A randomized controlled trial of massage therapy in children with sickle cell disease. J Pediatr Psychol. 2009 Nov-Dec;34(10):1091-6. Epub 2009 Mar 12.

EXPERIMENT DESIGN: This randomized controlled trial investigated the short-term effects of massage therapy on youth with SCD and their parents. Thirty-four children and adolescents, and their parents were assigned to a massage therapy or an attention control group. Parents were trained in massage in their homes once a week for 4 weeks, with instructions to provide nightly massages. Families in the control group were visited weekly by a research assistant. Participants completed measures of depression and anxiety, functional status, pain intensity, medication use, and service utilization.

RESULTS/ CONCLUSIONS: Youth in this group showed higher levels of functional status, and lower levels of depression, anxiety, and pain. Health service utilization rates were unchanged from pre- to post-intervention. These results offer preliminary support for parent-delivered massage therapy as an intervention for SCD pain.


Dion L, Rodgers N, Cutshall SM, Cordes ME, Bauer B, Cassivi SD, Cha S. Effect of massage on pain management for thoracic surgery patients. Int J Ther Massage Bodywork. 2011;4(2):2-6. Epub 2011 Jun 29

EXPERIMENT DESIGN: Integrative therapies such as massage have gained support as interventions that improve the overall patient experience during hospitalization. Thoracic surgery patients undergo long procedures and commonly have postoperative back, neck, and shoulder pain. Given the promising effects of massage therapy for alleviation of pain, we studied the effectiveness and feasibility of massage therapy delivered in the postoperative thoracic surgery setting.Patients who received massage in the postoperative setting had pain scores evaluated pre and post massage on a rating scale of 0 to 10 (0 = no pain, 10 = worst possible pain).

RESULTS/ CONCLUSIONS: In total, 160 patients completed the pilot study and received massage therapy that was individualized. Patients receiving massage therapy had significantly decreased pain scores after massage (p = .001), and patients' comments were very favorable. Patients and staff were highly satisfied with having massage therapy available, and no major barriers to implementing massage therapy were identified. Massage therapy may be an important additional pain management component of the healing experience for patients after thoracic surgery.



Studies of the Effects of Massage Therapy on Pregnant and Post-Partum Women

Timur Tashan S1, Kafkasli A. The effect of bitter almond oil and massaging on striae gravidarum (stretch marks) in primiparaous women. J Clin Nurs. 2012 Jun;21(11-12):1570-6. doi: 10.1111/j.1365-2702.2012.04087.x.

EXPERIMENT DESIGN: This study aims to identify the effect of applying bitter almond oil with and without massage on preventing striae gravidarum during pregnancy. Striae gravidarum is a dermatological problem bringing about cosmetic concerns in about 90% of pregnant women. On the onset, striae gravidarum appears as a pink-purple atrophic strip. Striae appear pale atrophic in the postnatal period, but they never disappear completely. In view of the physiology of striae gravidarum formation, this study employs a posttest-only quasi-experimental design with a control group. The participants of this study were the primiparous women who visited the pregnancy unit of a medical centre in the eastern region of Turkey between February 1st, 2010 and April 15th, 2011. The participants were divided into three groups: the primiparous women who applied bitter almond oil with massage (n = 47), who merely applied bitter almond oil (n = 48) and who were in the control group (n = 46).

RESULTS/ CONCLUSIONS: The frequency of striae gravidarum was 20% among the women who applied bitter almond oil with massage, 38·8% among those who merely applied almond oil and 41·2% in the control group. A statistically significant difference was observed in the frequency of striae gravidarum between the groups, and it was the group who applied almond oil with massage that accounted for the difference. The frequency of striae gravidarum was also found to be lower in the group who applied almond oil with massage compared to the others. It was found that a 15-minute massage applied with almond oil during pregnancy reduced the development of striae gravidarum, but using bitter almond oil had no effect on this in itself. It is recommended that pregnant women be informed about the positive effects of massaging applied with almond oil early during their pregnancy. Nurses and midwives can use the findings of this study in preventing the development of striae gravidarum during pregnancy.


Cheryl N. Larden,M. Lynne Palmer and Patricia Janssen. Efficacy of Therapeutic Touch in Treating Pregnant Inpatients Who Have a Chemical Dependency. J Holist Nurs December 2004 vol. 22 no. 4 320-332

EXPERIMENT DESIGN: Chemical dependency is known to complicate about 3.8% of pregnancies in Vancouver, British Columbia, Canada. In this study, 54 English-speaking, hospitalized women were randomly assigned to receive either (a) daily Therapeutic Touch over a 7-day period for 20 minutes each day, (b) shared activity with a registered nurse for 20 minutes over a 7-day period, or (c) standard ward care. Anxiety was measured using Spielberger’s State-Trait Anxiety Inventory. Withdrawal symptoms were measured using a standardized Symptom Checklist.

RESULTS/ CONCLUSIONS: Anxiety scores were significantly less on Days 1, 2, and 3 for the group receiving Therapeutic Touch. Therapeutic Touch may be of value as an adjunctive measure in the treatment of chemical dependency among pregnant women.


Hall HG, McKenna LG, Griffiths DL. Midwives' support for Complementary and Alternative Medicine: a literature review. Women Birth. 2012 Mar;25(1):4-12. doi: 10.1016/j.wombi.2010.12.005. Epub 2011 Jan 13.

EXPERIMENT DESIGN: There is evidence that the use of Complementary and Alternative Medicine by childbearing women is becoming increasingly popular in industrialised countries. The aim of this is paper is to review the research literature investigating the midwives' support for the use of these therapies. A search for relevant research published from 2000 to 2009 was undertaken using a range of databases and by examining relevant bibliographies. A total of thirteen studies were selected for inclusion in this review.

RESULTS/ CONCLUSIONS: The findings indicate that the use of Complementary and Alternative Medicine is widespread in midwifery practice. Common indications for use include; labour induction and augmentation, nausea and vomiting, relaxation, back pain, anaemia, mal-presentation, perineal discomfort, postnatal depression and lactation problems. The most popular therapies recommended by midwives are massage therapy, herbal medicines, relaxation techniques, nutritional supplements, aromatherapy, homeopathy and acupuncture. Midwives support the use Complementary and Alternative Medicine because they believe it is philosophically congruent; it provides safe alternatives to medical interventions; it supports the woman's autonomy, and; incorporating Complementary and Alternative Medicine can enhance their own professional autonomy. There is considerable support by midwives for the use of Complementary and Alternative Medicine by expectant women. Despite this enthusiasm, currently there are few educational opportunities and only limited research evidence regarding CAM use in midwifery practice. These shortfalls need to be addressed by the profession. Midwives are encouraged to have an open dialogue with childbearing women, to document use and to base any advice on the best available evidence.


O'Higgins M, St James Roberts I, Glover V. (2008) Postnatal depression and mother and infant outcomes after infant massage. J Affect Disord. 2008 Jul;109(1-2):189-92. Epub 2007 Dec 20.

EXPERIMENT DESIGN: Postnatal depression can be a long lasting condition which affects both the mother and her baby. A pilot study indicated that attending baby massage improved maternal depression and mother-infant interactions. The current study further investigates any benefits of baby massage for mothers with postnatal depression and their infants. Mothers scoring (3)13 on the Edinburgh Postnatal Depression Scale (EPDS) at 4 weeks postpartum were randomly assigned to attend baby massage classes (n=31) or a support group (n=31). They completed depression, anxiety and Infant Characteristics Questionnaires and were filmed interacting with their infants before and after 6 intervention sessions, and at one year. Thirty four non-depressed mothers also completed the study.

RESULTS/ CONCLUSIONS: More of the massage than support group mothers showed a clinical reduction in EPDS scores between four weeks and outcome. At one year, massage-group mothers had non-depressed levels of sensitivity of interaction with their babies, whereas the support group did not. There were no other differences in either mother or child between the two intervention groups. Depressed mothers did not achieve control depression or anxiety scores at one year. For ethical reasons, the study did not include a control group of depressed mothers who did not receive an intervention. Both intervention groups showed reductions in depression scores across the study period, but the massage group did better on some indices. They also had somewhat better interactions with their infants at one year, but these effects were limited.


Field T, Hernandez-Reif M, Hart S, Theakston H, Schanberg S, Kuhn C. (1999) Pregnant women benefit from massage therapy. J Psychosom Obstet Gynaecol. 1999 Mar;20(1):31-8.

EXPERIMENT DESIGN: Twenty-six pregnant women were assigned to a massage therapy or a relaxation therapy group for 5 weeks. The therapies consisted of 20-min sessions twice a week.

RESULTS/ CONCLUSIONS: Both groups reported feeling less anxious after the first session and less leg pain after the first and last session. Only the massage therapy group, however, reported reduced anxiety, improved mood, better sleep and less back pain by the last day of the study. In addition, urinary stress hormone levels (norepinephrine) decreased for the massage therapy group and the women had fewer complications during labor and their infants had fewer postnatal complications (e.g., less prematurity).


Field T, Diego MA, Hernandez-Reif M, Schanberg S, Kuhn C. (2004) Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol. 2004 Jun;25(2):115-22.

EXPERIMENT DESIGN: Eighty-four depressed pregnant women were recruited during the second trimester of pregnancy and randomly assigned to a massage therapy group, a progressive muscle relaxation group or a control group that received standard prenatal care alone. These groups were compared to each other and to a non-depressed group at the end of pregnancy. The massage therapy group participants received two 20 min therapy sessions by their significant others each week for 16 weeks of pregnancy, starting during the second trimester. The relaxation group provided themselves with progressive muscle relaxation sessions on the same time schedule.

RESULTS/ CONCLUSIONS: Immediately after the massage therapy sessions on the first and last days of the 16-week period the women reported lower levels of anxiety and depressed mood and less leg and back pain. By the end of the study the massage group had higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine. These changes may have contributed to the reduced fetal activity and the better neonatal outcome for the massage group (i.e. lesser incidence of prematurity and low birthweight), as well as their better performance on the Brazelton Neonatal Behavior Assessment. The data suggest that depressed pregnant women and their offspring can benefit from massage therapy.



Field T, Hernandez-Reif M, Hart S, Theakston H, Schanberg S, Kuhn C. (1999) Pregnant women benefit from massage therapy. J Psychosom Obstet Gynaecol. 1999 Mar;20(1):31-8.

EXPERIMENT DESIGN: Twenty-six pregnant women were assigned to a massage therapy or a relaxation therapy group for 5 weeks. The therapies consisted of 20-min sessions twice a week.

RESULTS/ CONCLUSIONS: Both groups reported feeling less anxious after the first session and less leg pain after the first and last session. Only the massage therapy group, however, reported reduced anxiety, improved mood, better sleep and less back pain by the last day of the study. In addition, urinary stress hormone levels (norepinephrine) decreased for the massage therapy group and the women had fewer complications during labor and their infants had fewer postnatal complications (e.g., less prematurity).


Field T, Diego MA, Hernandez-Reif M, Schanberg S, Kuhn C. (2004) Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol. 2004 Jun;25(2):115-22.

EXPERIMENT DESIGN: Eighty-four depressed pregnant women were recruited during the second trimester of pregnancy and randomly assigned to a massage therapy group, a progressive muscle relaxation group or a control group that received standard prenatal care alone. These groups were compared to each other and to a non-depressed group at the end of pregnancy. The massage therapy group participants received two 20 min therapy sessions by their significant others each week for 16 weeks of pregnancy, starting during the second trimester. The relaxation group provided themselves with progressive muscle relaxation sessions on the same time schedule.

RESULTS/ CONCLUSIONS: Immediately after the massage therapy sessions on the first and last days of the 16-week period the women reported lower levels of anxiety and depressed mood and less leg and back pain. By the end of the study the massage group had higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine. These changes may have contributed to the reduced fetal activity and the better neonatal outcome for the massage group (i.e. lesser incidence of prematurity and low birthweight), as well as their better performance on the Brazelton Neonatal Behavior Assessment. The data suggest that depressed pregnant women and their offspring can benefit from massage therapy.


Field T, Diego M, Hernandez-Reif M, Medina L, Delgado J, Hernandez A. Yoga and massage therapy reduce prenatal depression and prematurity. J Bodyw Mov Ther. 2012 Apr;16(2):204-9. doi: 10.1016/j.jbmt.2011.08.002. Epub 2011 Sep 23.

EXPERIMENT DESIGN: Eighty-four prenatally depressed women were randomly assigned to yoga, massage therapy or standard prenatal care control groups to determine the relative effects of yoga and massage therapy on prenatal depression and neonatal outcomes.

RESULTS/ CONCLUSIONS: Following 12 weeks of twice weekly yoga or massage therapy sessions (20 min each) both therapy groups versus the control group had a greater decrease on depression, anxiety and back and leg pain scales and a greater increase on a relationship scale. In addition, the yoga and massage therapy groups did not differ on neonatal outcomes including gestational age and birthweight, and those groups, in turn, had greater gestational age and birthweight than the control group.


Elden H, Ostgaard HC, Glantz A, Marciniak P, Linnér AC, Olsén MF. Effects of craniosacral therapy as adjunct to standard treatment for pelvic girdle pain in pregnant women: a multicenter, single blind, randomized controlled trial. Acta Obstetricia Gynecologica Scandinavia. 2013 Jul

EXPERIMENT DESIGN: Pelvic girdle pain (PGP) is a disabling condition affecting 30% of pregnant women. The aim of this study was to investigate the efficacy of craniosacral therapy as an adjunct to standard treatment compared with standard treatment alone for PGP during pregnancy. Randomized, multicenter, single blind, controlled trial. University hospital, a private clinic and 26 maternity care centers in Gothenburg, Sweden. A total of 123 pregnant women with PGP. Participants were randomly assigned to standard treatment (control group, n = 60) or standard treatment plus craniosacral therapy (intervention group, n = 63). Primary outcome measures: pain intensity (visual analog scale 0-100 mm) and sick leave. Secondary outcomes: function (Oswestry Disability Index), health-related quality of life (European Quality of Life measure), unpleasantness of pain (visual analog scale), and assessment of the severity of PGP by an independent examiner.

RESULTS/ CONCLUSIONS: Between-group differences for morning pain, symptom-free women and function in the last treatment week were in favor of the intervention group. Visual analog scale median was 27 mm (95% confidence interval 24.6-35.9) vs. 35 mm (95% confidence interval 33.5-45.7) (p = 0.017) and the function disability index was 40 (range 34-46) vs. 48 (range 40-56) (p = 0.016).Lower morning pain intensity and less deteriorated function was seen after craniosacral therapy in conjunction with standard treatment compared with standard treatment alone, but no effects regarding evening pain and sick-leave. Treatment effects were small and clinically questionable and conclusions should be drawn carefully. Further studies are warranted before recommending craniosacral therapy for PGP.


Latifses, V., Bendell Estroff, D., Field, T., & Bush, J. (2005). Father massaging and relaxing their pregnant wives lowered anxiety and facilitated marital adjustment. Journal of Bodywork and Movement Therapies, 9, 277-82.

EXPERIMENT DESIGN: This study examined the effects of fathers massaging their pregnant wives and practicing relaxation with them. Participants were married American fathers who completed the Dyadic Adjustment Scale (DAS), the State-Trait Anxiety Inventory (STAI), and the Paternal Fetal Attachment Scale. The fathers learned to massage their pregnant wives, learned relaxation techniques with their wives, or received no intervention

RESULTS/ CONCLUSIONS: Massage therapy lowered the fathers’ self-reported anxiety levels on the STAI and improved marital adjustment on the DAS..


Field, T., Deed, O., Diego, M., Gualer, A., Sullivan, S., Wilson, D. & Nearing, G. (2009). Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women. Journal of Bodywork and Movement Therapies, 13, 297-303.

EXPERIMENT DESIGN: One hundred and twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy.

RESULTS/ CONCLUSIONS: The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater percentage of that group completed the 6-week program. The group who received both therapies also showed a greater decrease in depression, depressed affect and somatic-vegetative symptom scores on the Center for Epidemiological Studies-Depression Scal , a greater decrease in anxiety scale scores and a greater decrease in cortisol levels. The group therapy process appeared to be effective for both groups as suggested by the increased expression of both positive and negative affect and relatedness during the group therapy sessions.


Field, T. (2010). Pregnancy and labor massage therapy. Expert Review of Obstetrics and Gynecology, 5, 177-181.

EXPERIMENT DESIGN: Massage therapy has been demonstrated to be effective during pregnancy

RESULTS/ CONCLUSIONS: Women who received massage therapy reported decreased depression, anxiety, and leg and back pain. Cortisol levels decreased and, in turn, excessive fetal activity decreased, and the rate of prematurity was lower in the massage group. In a study of labor pain, women who received massage therapy experienced significantly less pain, and their labors were on average 3 h shorter with less need for medication. An underlying mechanism we have been exploring is that these effects are mediated by increased vagal activity. This likely occurs by the stimulation of pressure receptors that are innervated by vagal afferent fibers, which ultimately project to the limbic system, including hypothalamic structures involved in autonomic nervous system regulation and cortisol secretion.


Chung, U.L., Hung, L.C., Kuo, S.C., & Huang, C.L. (2003). Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. The Journal of Nursing Research, 11, 251-260.

EXPERIMENT DESIGN:127 parturient [laboring] women were randomly assigned to three groups. Each group received one of the following treatments, LI4 and BL67 acupressure, light skin stroking, or no treatment/conversation only. Data collected from the VAS and external fetal monitoring strips were used for analysis.

RESULTS/ CONCLUSIONS: Results of the study confirmed the effect of LI4 and BL67 acupressure in lessening labor pain during the active phase of the first stage of labor. There were no verified effects on uterine contractions.


"The Effects of Reflexology on Labour Outcome," Dr. Gowri Motha and Dr. Jane McGrath, Forest Gate, London, England, Nursing Times, Oct. 11, 1989.

EXPERIMENT DESIGN:Thirty-seven of 64 pregnant women, who were offered free reflexology, completed the set course of ten treatments.

RESULTS/ CONCLUSIONS: . The effects of reflexology on labour outcomes were perceived as outstanding. Some had labour times of only 2 hours, some 3 hours. The 20 - 25 year olds had an average time of first stage labour of 5 or 6 hours. The 26 - 30 year olds seemed to have the longest labours. In total, the average first stage was 5 hours, second stage 16 minutes, and third stage 7 minutes. This is compared to textbook figures of 16 to 24 hours' first stage, and, 1 to 2 hour's second stage.


"Easier Births Using Reflexology." by Gabriella Bering Liisberg, "Tidsskrift for Jordemodre," No. 3, 1989.

EXPERIMENT DESIGN:Of 593 women who gave birth at Gentofte County Hospital (UK) in 1988, 103 chose reflexology as an alternative to both pain killing drugs and to labour stimulating and inducing drugs.

RESULTS/ CONCLUSIONS: . Of sixty-eight women who chose reflexology with no analgesic drugs, sixty one (89.71%) stated that reflexology had helped reduce pain, six (8.82%) felt no effect, and, one had increased pain in spite of reflexology treatment. Four of the sixty-one women who were helped by reflexology also required pain medication. Of forty-nine women who chose reflexology to stimulate labour, twenty-four gave birth without additional drug treatment. Fourteen women who were candidates for surgical delivery, received reflexology treatment between 30 and 60 minutes of birth. Eleven (78.57%) were then able to discharge the placenta. The other three had it surgically removed. All participants, except one, found the reflexology treatments extremely pleasant.


Country: Ireland Institution: large maternity hospital in Belfast Citation: McNeill, Jennifer A., Alderdice, Fiona A., and McMurray, Frances. "A Retrospective Cohort Study Exploring The Relationship Between Antenatal Reflexology And Intranatal Outcomes." 2006 Complementary Therapies in Clinical Practice, 12, pp.119-125.

EXPERIMENT DESIGN:: The integration of reflexology into midwifery care has become more common in recent years as a result of a developing interest in alternative and complementary therapies and also due to the integration of new skills into midwifery practice. The objective of this study was to investigate the association of antenatal reflexology with different outcomes in the intranatal period. The key variables of interest were onset of labour, duration of labour, analgesia used and mode of delivery. This study of 150 low risk (no medical or obstetric complications) women in their first pregnancy was divided into two groups. Fifty received reflexology, and the rest were in a control group that received no reflexology. The number of reflexology sessions differed from one to 4 or more, and the women had been referred for reflexology for backache, constipation, pelvic arthropy or were women who wished to avoid interventions during labor.

RESULTS/ CONCLUSIONS: The findings showed there was no significant difference in the onset of labour or duration of labour between the two groups. The group who had four or more reflexology treatments had a reduced length of labour but this was not statistically significant. There was a significant difference in the use of Entonox™ between the two groups with the reflexology group having a lower uptake. Fewer women in the reflexology group had a normal labour with a higher percentage of women having a forceps delivery. In conclusion the only statistically significant difference between groups was less use of Entonox™ in the reflexology group. Further research requires standardized treatment and outcome measurement using prospective randomized designs with large samples.There was no difference in the primary outcome of interest in the study—onset of labor—between the two groups. Further research is needed in this area in which reflexology is applied for more sessions and in a more uniform matter.


Labor pain is reduced by massage therapy J Psychosom Obstet Gynaecol. 1997 Dec;18(4):286-91 T. Field, M. Hemandez-Reif, S. Taylor1, O. Quintino1 and I. Burman

EXPERIMENT DESIGN:: Abstract Twenty-eight women were recruited from prenatal classes and randomly assigned to receive massage in addition to coaching in breathing from their partners during labor, or to receive coaching in breathing alone (a technique learned during prenatal classes).

RESULTS/ CONCLUSIONS: The massaged mothers reported a decrease in depressed mood, anxiety and pain, and showed less agitated activity and anxiety and more positive affect following the first massage during labor. In addition, the massaged mothers had significantly shorter labors, a shorter hospital stay and less postpartum depression.


Chang, M.Y., Wang, S.Y., & Chen, C.H. (2002). Effects of massage on pain and anxiety during labor: a randomized controlled trial in Taiwan. Journal of Advanced Nursing, 38, 68-73.

EXPERIMENT DESIGN:Sixty primiparous [first time pregnant] women expected to have a normal childbirth in Taiwan were randomly assigned to either the experimental or the control group. The experimental group received massage whereas the control group did not. The nurse-rated present behavioural intensity (PBI) was used as a measure of labour pain. Anxiety was measured with the visual analogue scale for anxiety (VASA). The intensity of pain and anxiety between the two groups was compared in the latent phase (cervix dilated 3-4 cm), active phase (5-7 cm) and transitional phase (8-10 cm).

RESULTS/ CONCLUSIONS: In both groups, there was a relatively steady increase in pain intensity and anxiety level as labour progressed. A t-test demonstrated that the experimental group had significantly lower pain reactions in the latent, active and transitional phases. Anxiety levels were only significantly different between the two groups in the latent phase. Twenty-six of the 30 (87%) experimental group subjects reported that massage was helpful, providing pain relief and psychological support during labour. Findings suggest that massage is a cost-effective nursing intervention that can decrease pain and anxiety during labour, and partners' participation in massage can positively influence the quality of women's birth experiences.



Studies on the Effects of Massage Therapy on Post-Traumatic Stress Disorder and Acute Stress Disorder

Longacre M, Silver-Highfield E, Lama P, Grodin M. (2012) Complementary and alternative medicine in the treatment of refugees and survivors of torture: a review and proposal for action. Torture. 2012;22(1):38-57

EXPERIMENT DESIGN: Survivors of torture and refugee trauma often have increased needs for mental and physical healthcare. This is due in part to the complex sequelae of trauma, including chronic pain, major depressive disorder, posttraumatic stress disorder (PTSD) and somatization. This article reviews the scientific medical literature for the efficacy and feasibility of some complementary and alternative medicine (CAM) modalities including meditation, Ayurveda, pranayama/yogic breathing, massage/body-work, dance/movement, spirituality, yoga, music, Traditional Chinese Medicine and acupuncture, qigong, t'ai chi, chiropractic, homeopathy, aromatherapy and Reiki specifically with respect to survivors of torture and refugee trauma.

RESULTS/ CONCLUSIONS: We report that preliminary research suggests that the certain CAM modalities may prove effective as part of an integrated treatment plan for survivors of torture and refugee trauma. Further research is warranted.


Price CJ, McBride B, Hyerle L, Kivlahan DR (2007) Mindful awareness in body-oriented therapy for female veterans with post-traumatic stress disorder taking prescription analgesics for chronic pain: a feasibility study. Alternative Therapies in Health and Medicine. 2007 Nov-Dec;13(6):32-40.

EXPERIMENT DESIGN: Preliminary studies of body therapy for women in trauma recovery suggest positive results but are not specific to women with post-traumatic stress disorder (PTSD) and chronic pain. Objective: To examine the feasibility and acceptability of body-oriented therapy for female veterans with PTSD and chronic pain taking prescription analgesics. A 2-group, randomized, repeated-measures design was employed. Female veterans (N=14) were recruited from a Veterans Affairs (VA) healthcare system in the Northwest United States (VA Puget Sound Health Care System, Seattle, Washington). Participants were assigned to either treatment as usual (TAU) or treatment as usual and 8 weekly individual body-oriented therapy sessions (mindful awareness in body-oriented therapy group). Written questionnaires and interviews were used to assess intervention acceptability; reliable and valid measures were administered at 3 time points to evaluate measurement acceptability and performance; and within-treatment process measures and a participant post-intervention questionnaire assessed treatment fidelity. Intervention used was a body-oriented therapy protocol, "Mindful Awareness in Body-oriented Therapy" (MABT) was used. This is a mind-body approach that incorporates massage, mindfulness, and the emotional processing of psychotherapy.

RESULTS/ CONCLUSIONS: Over 10 weeks of recruitment, 31 women expressed interest in study participation. The primary reason for exclusion was the lack of prescription analgesic use for chronic pain. Study participants adhered to study procedures, and 100% attended at least 7 of 8 sessions; all completed in-person post-treatment assessment. Written questionnaires about intervention experience suggest increased tools for pain relief/relaxation, increased body/mind connection, and increased trust/safety. Ten of 14 responded to mailed 3-month follow-up. The response-to-process measures indicated the feasibility of implementing the manualized protocol and point to the need for longer sessions and a longer intervention period with this population.


Collinge W, Kahn J, Soltysik R (2012) Promoting reintegration of National Guard veterans and their partners using a self-directed program of integrative therapies: a pilot study. Military Medicine. 2012 Dec;177(12):1477-85.

EXPERIMENT DESIGN: This article reports pilot data from phase I of a project to develop and evaluate a self-directed program of integrative therapies for National Guard personnel and significant relationship partners to support reintegration and resilience after return from Iraq or Afghanistan. Data are reported on 43 dyads. Intervention was an integrated multimedia package of guided meditative, contemplative, and relaxation exercises (CD) and instruction in simple massage techniques (DVD) to promote stress reduction and interpersonal connectedness. A repeated measures design with standardized instruments was used to establish stability of baseline levels of relevant mental health domains (day 1, day 30), followed by the intervention and assessments 4 and 8 weeks later. Significant improvements in standardized measures for post-traumatic stress disorder, depression, and self-compassion were seen in both veterans and partners; and in stress for partners. Weekly online reporting tracked utilization of guided exercises and massage.

RESULTS/ CONCLUSIONS: Veterans reported significant reductions in ratings of physical pain, physical tension, irritability, anxiety/worry, and depression after massage, and longitudinal analysis suggested declining baseline levels of tension and irritability. Qualitative data from focus groups and implications for continued development and a phase II trial are discussed.


Collinge W, Wentworth R, Sabo S. (2005) Integrating complementary therapies into community mental health practice: an exploration. Journal of Alternative and Complementary Medicine. 2005 Jun;11(3):569-74.

EXPERIMENT DESIGN: To (1) describe the integration of massage and energy-based therapies with psychotherapy in a community mental health center, (2) to present qualitative feedback on the service, and (3) to present pilot data from a sample of long-term clients with persistent mental health concerns. A noncontrolled pilot study was conducted using interview data before and self-report instruments after completing a brief program of complementary therapy accompanying ongoing psychotherapy. The program took place at a comprehensive community mental health center in southern Maine and in the private offices of massage therapists and energy healing practitioners who contracted with the program. Subjects were 20 women and 5 men, with mean age of 42 years and a mean history of 7.4 years of mental health treatment. All had histories that included trauma, 10 of which involved sexual abuse. The Diagnostic and Statistical Manual of Mental Disorders IV Axis I diagnoses were PTSD (10), major depression (nine), anxiety disorder (three), and dual diagnosis (three). Clients receiving ongoing psychotherapy were assigned to one modality of complementary therapy based on clinical judgment, availability of practitioners, and client interest. Modalities used were massage, acupuncture, Reiki, and Healing Touch. The mean number of sessions was five. Clients completed an investigator-generated instrument with Likert-scaled ratings of satisfaction and perceived changes in four dimensions of trauma recovery: perceived interpersonal safety, interpersonal boundary setting, bodily sensation, and bodily shame.

RESULTS/ CONCLUSIONS: Clients reported high levels of satisfaction with the service and significant levels of perceived (self-rated) change on each outcome measure. Qualitative results included enhanced psychotherapeutic outcomes reported by mental health clinicians. The integration of complementary therapies into community mental health practice may hold promise of enhancing mental health outcomes and improving quality of life for long-term users of mental health services.


Price C. (2005) Body-oriented therapy in recovery from child sexual abuse: an efficacy study. Body-oriented therapy in recovery from child sexual abuse: an efficacy study. Alternative Therapies in Health Medicine. 2005 Sep-Oct;11(5):46-57.

EXPERIMENT DESIGN: There has been little research on body therapy for women in sexual abuse recovery. This study examines body-oriented therapy--an approach focused on body awareness and involving the combination of bodywork and the emotional processing of psychotherapy. To examine the efficacy and the perceived influence on abuse recovery of body-oriented therapy. Massage therapy served as a relative control condition to address the lack of touch-based comparisons in bodywork research. A 2-group, repeated measures design was employed, involving randomization to either body-oriented therapy or massage group, conducted in 8, hour-long sessions by 1 of 4 research clinicians. Statistical and qualitative analysis was employed to provide both empirical and experiential perspectives on the study process. Participants were seen in treatment rooms of a university in the northwestern United States and in clinician's private offices. Participants were twenty-four adult females in psychotherapy for child sexual abuse. Intervention: Body-oriented therapy protocol was delivered in three stages, involving massage, body awareness exercises, and inner-body focusing process. Massage therapy protocol was standardized. Both protocols were delivered over clothes. The outcomes reflected 3 key constructs--psychological well being, physical well-being, and body connection. Repeated measures included: Brief Symptom Inventory, Dissociative Experiences Scale, Crime-Related Post Traumatic Stress Disorder Scale, Medical Symptoms Checklist, Scale of Body Connection and Scale of Body Investment. Results were gathered at 6 time points: baseline, 2 times during intervention, post-intervention, and at 1 month and 3 months follow-up, To examine the experiential perspective of the study process, written questionnaires were administered before and after intervention and at 1 month and 3 months follow-up.

RESULTS/ CONCLUSIONS: Repeated measures analysis of variance (ANOVA) indicated significant improvement on all outcome measures for both intervention groups, providing support for the efficacy of body therapy in recovery from childhood sexual abuse. There were no statistically significant differences between groups; however, qualitative analysis of open-ended questions about participant intervention experience revealed that the groups differed on perceived experience of the intervention and its influence on therapeutic recovery.


John E Upledger, Barry S Kaplan, Russell A Bourne, Jr., Richard B Zonderman THE EFFECTS OF UPLEDGER CRANIOSACRAL THERAPY ON POST TRAUMATIC STRESS DISORDER SYMPTOMATOLOGY IN VIETNAM COMBAT VETERANS Subtle Energies and Energy Medicine, Vol 11 No 2

EXPERIMENT DESIGN: The Upledger Institute has provided rwo week intensive treatment for Vietnam veterans suffering from Post Traumatic Stress Disorder as diagnosed by the Veteran's Affairs (VA) medical division. These patients received psychological evaluation tests at the times of entry and exit into and out of the program. The intensive treatment was about six-seven hours per day for eight full days, with approximately three-four hours on the first and last days of the program. The therapy used was primarily CranioSacral Therapy and its progeny Energy Cyst Release, SomatoEmotional Release and Therapeutic Imagery and Dialogue.

RESULTS/ CONCLUSIONS: The results obtained strongly suggest that PTSD may be more successfully treated when the thetapy includes corrections of the craniosacral system, the release of foreign energies and conscious-nonconscious integration.



Studies on the Effects of Massage Therapy on Paralysis and Spinal Cord Injuries

Diego MA, Field T, Hernandez-Reif M, Hart S, Brucker B, Field T, Burman I. (2002) Spinal cord patients benefit from massage therapy. Int J Neurosci. 2002 Feb;112(2):133-42.

EXPERIMENT DESIGN: The present study assessed the effects of massage therapy on depression, functionality, upper body muscle strength and range of motion on spinal cord injury patients. Twenty C5 through C7 spinal cord injury individuals recruited from a University outpatient clinic were randomly assigned to a massage therapy group or an exercise group. Patients in the massage therapy group received two 40-min massage therapy sessions per week for 5 weeks. Patients in the control group practiced a range of motion exercise routine targeting the arms, neck, shoulders, and back 2 times per week for 5 weeks.

RESULTS/ CONCLUSIONS: Although both the massage and exercise group appeared to benefit from treatment, only the massage group showed lower anxiety and depression scores and significantly increased their muscle strength and wrist range of motion.



Studies on the Effects of Massage on Premenstrual Syndrome in Women

Hernandez-Reif M, Martinez A, Field T, Quintero O, Hart S, Burman I.(2000) Premenstrual symptoms are relieved by massage therapy. J Psychosom Obstet Gynaecol. 2000 Mar;21(1):9-15.

EXPERIMENT DESIGN: Twenty-four women meeting Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria for premenstrual dysphoric disorder (PDD) were randomly assigned to a massage therapy or a relaxation therapy group.

RESULTS/ CONCLUSIONS: The massage group showed decreases in anxiety, depressed mood and pain immediately after the first and last massage sessions. The longer term (5 week) effects of massage therapy included a reduction in pain and water retention and overall menstrual distress. However, no long-term changes were observed in the massaged group's activity level or mood. Future studies might examine the effects of a longer massage therapy program on these symptoms. Overall, the findings from this study suggest that massage therapy may be an effective adjunct therapy for treating severe premenstrual symptoms.


Studies on the Effects of Massage Therapy on Pre-term Infants


Field, T., Schanberg, S., Scafidi, F., Bauer, C., Vega-Lahr, N., Garcia, R., Nystrom, J., & Kuhn, C. (1986). Tactile/kinesthetic stimulation effects on preterm neonates. Pediatrics, 77, 654-658.

EXPERIMENT DESIGN: Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements of the limbs for three, 15-minute periods per day for a 10 days.

RESULTS/ CONCLUSIONS: The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g v 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic stimulation may be a cost effective way of facilitating growth and behavioral organization even in very small preterm neonates.



Studies on the Effects of Massage Therapy on Stress

Satou T, Chikama M, Chikama Y, Hachigo M, Urayama H, Murakami S, Hayashi S, Koikem K. Effect of Aromatherapy Massage on Elderly Patients Under Long-Term Hospitalization in Japan. J Altern Complement Med. 2012 Oct 12.

EXPERIMENT DESIGN: Objectives: To verify the effectiveness of aromatherapy massage on elderly patients under long-term hospitalization. Design: Aromatherapy massage was performed twice a week for a total of eight times. Setting: Nursing home. Subjects: Elderly women under long-term hospitalization. Interventions: Questionnaire and measurement of stress marker levels (salivary amylase activity) before and after the first, fifth, and eighth aromatherapy massages. Outcome measures: Questionnaire (Face scale, General Health Questionnaire-12 [GHQ-12]), measurement of salivary amylase activity.

RESULTS/ CONCLUSIONS: A decrease in stress after aromatherapy massage compared to before each massage was confirmed at all measurement times and with the stress marker. No marked reduction was observed in Face scale or saliva amylase activity as a whole over the long term, although decreasing tendencies were seen. Marked reductions in GHQ-12 were observed over the long term. Conclusions: Aroma massage appears likely to prove effective in reducing psychological stress among elderly patients under long-term hospitalization.


Engen DJ, Wahner-Roedler DL, Vincent A, Chon TY, Cha SS, Luedtke CA, Loehrer LL, Dion LJ, Rodgers NJ, Bauer BA. Feasibility and effect of chair massage offered to nurses during work hours on stress-related symptoms: A pilot study. Complement Ther Clin Pract. 2012 Nov;18(4):212-5. doi: 10.1016/j.ctcp.2012.06.002. Epub 2012 Jul 17.

EXPERIMENT DESIGN: This study assessed feasibility and effect of weekly, 15-min chair massages during work for 38 nurses. Mean Perceived Stress Scale-14 (PSS-14), Smith Anxiety Scale (SAS), linear analog self-assessment scale (LASA), and symptom visual analog scale (SX-VAS) scores were tracked at baseline, 5 weeks, and 10 weeks. Of 400 available massage appointments, 329 were used.

RESULTS/ CONCLUSIONS: At 10 weeks, mean PSS-14 score decreased from 17.85 to 14.92 (P = .002); mean SAS score, from 49.45 to 40.95. Mean LASA score increased from 42.39 to 44.84 (P = .006); mean SX-VAS score, from 65.03 to 74.47. Massages for nurses during work hours reduced stress-related symptoms.


Hodgson NA, Lafferty D. Reflexology versus Swedish Massage to Reduce Physiologic Stress and Pain and Improve Mood in Nursing Home Residents with Cancer: A Pilot Trial. Evid Based Complement Alternat Med. 2012;2012:456897. Epub 2012 Jul 24.

EXPERIMENT DESIGN: Objective. The purpose of this pilot study was to investigate and compare the effects of reflexology and Swedish massage therapy on physiologic stress, pain, and mood in older cancer survivors residing in nursing homes. Methods. An experimental, repeated-measures, crossover design study of 18 nursing home residents aged 75 or over and diagnosed with solid tumor in the past 5 years and following completion of cancer treatments. The intervention tested was 20 minutes of Swedish Massage Therapy to the lower extremities, versus 20 minute Reflexology, using highly specified protocols. Pre- and post-intervention levels of salivary cortisol, observed affect, and pain were compared in the Swedish Massage Therapy and Reflexology conditions.

RESULTS/ CONCLUSIONS: Results. Both Reflexology and Swedish Massage resulted in significant declines in salivary cortisol and pain and improvements in mood. Conclusions. Preliminary data suggest that studies of Swedish Massage Therapy and Reflexology are feasible in this population of cancer survivors typically excluded from trials. Both interventions were well tolerated and produced measurable improvements in outcomes. Further research is needed to explore the mechanisms underlying the potential benefits of these CAM modalities in this patient population.


Morhenn V, Beavin LE, Zak PJ.(2012) Massage increases oxytocin and reduces adrenocorticotropin hormone in humans. Altern Ther Health Med. 2012 Nov-Dec;18(6):11-8.

EXPERIMENT DESIGN: Human beings are highly social creatures who often touch each other during social interactions. Although the physiologic effects of touch are not understood fully, it appears to sustain social bonds and to increase cooperative behaviors. Oxytocin (OT) is a hormone known to facilitate social bonding, and touch may affect OT release. Previous studies seeking to relate massage and oxytocin in humans have been inconsistent in their findings. This study examined the effect of massage on oxytocin and also measured its effect on other physiologic factors, including adrenocorticotropin hormone (ACTH), nitric oxide (NO), and beta-endorphin (BE). The research team advertised that the trial would study relaxation and assigned participants randomly to the intervention or the control group. A lab administrator assigned a random numeric code to participants to mask their identities. The study took place at the University of California Los Angeles (UCLA), Los Angeles, CA. Ninety-five people from UCLA gave written informed consent for participation in the study, with the team paying them to participate. The intervention group included 65 participants and the control group 30 participants. For the intervention (massage) group, the research team drew participants' blood and followed the blood draw with 15 minutes of moderate-pressure massage of the upper back. The control (rest) group rested quietly for 15 minutes after the blood draw. A second blood draw followed for both groups.

RESULTS/ CONCLUSIONS: The research team assayed OT, ACTH, NO, and BE. The team used four survey instruments to examine the relationship between personality factors and the physiologic measures of interest. The team analyzed data using SPSS 15.0 for Windows. Massage was associated with an increase in OT and reductions in ACTH, NO, and BE. Comparing the effects of massage for the massage group with those for the rest group, the research team found significant differences between groups for changes in OT, ACTH, NO, and BE. This study is the first using a large sample of mixed gender that demonstrates that massage increases OT and decreases ACTH, NO, and BE. These findings may help explain the mechanisms through which social connections reduce morbidity and mortality.


Kim JO, Kim IS. J Korean Acad Nurs. 2012 Oct;42(5):709-18. doi: 10.4040/jkan.2012.42.5.709. [Effects of aroma self-foot reflexology massage on stress and immune responses and fatigue in middle-aged women in rural areas].

EXPERIMENT DESIGN: This study was done to examine the effects of aroma self-foot reflexology massage on stress and immune responses and fatigue in middle-aged women in rural areas.The study was a nonequivalent control group pre-post test design. The participants were 52 middle-aged women from rural areas of which 26 were assigned to the experimental group and 26 to the control group. Data were collected from July to September, 2011 and analyzed using SPSS Win 17.0 version program. The intervention was conducted 3 times a week for six weeks.

RESULTS/ CONCLUSIONS: There were significant differences in reported perceived stress, systolic blood pressure, diastolic blood pressure and fatigue between the two groups. However, the issue of salivary cortisol and immune response were not significant. Aroma self-foot reflexology massage can be utilized as an effective intervention for perceived stress, systolic blood pressure, diastolic blood pressure and fatigue in middle-aged woman in rural areas.


Hodgson NA, Lafferty D. (2012) Reflexology versus Swedish Massage to Reduce Physiologic Stress and Pain and Improve Mood in Nursing Home Residents with Cancer: A Pilot Trial. Evid Based Complement Alternat Med. 2012;2012:456897. doi: 10.1155/2012/456897. Epub 2012 Jul 24.

EXPERIMENT DESIGN: Objective. The purpose of this pilot study was to investigate and compare the effects of reflexology and Swedish massage therapy on physiologic stress, pain, and mood in older cancer survivors residing in nursing homes. Methods. An experimental, repeated-measures, crossover design study of 18 nursing home residents aged 75 or over and diagnosed with solid tumor in the past 5 years and following completion of cancer treatments. The intervention tested was 20 minutes of Swedish Massage Therapy to the lower extremities, versus 20 minute Reflexology, using highly specified protocols. Pre- and post-intervention levels of salivary cortisol, observed affect, and pain were compared in the Swedish Massage Therapy and Reflexology conditions.

RESULTS/ CONCLUSIONS: Results. Both Reflexology and Swedish Massage resulted in significant declines in salivary cortisol and pain and improvements in mood. Conclusions. Preliminary data suggest that studies of Swedish Massage Therapy and Reflexology are feasible in this population of cancer survivors typically excluded from trials. Both interventions were well tolerated and produced measurable improvements in outcomes. Further research is needed to explore the mechanisms underlying the potential benefits of these CAM modalities in this patient population.


Buttagat V, Eungpinichpong W, Kaber D, Chatchawan U, Arayawichanon P. (2012) Acute effects of traditional Thai massage on electroencephalogram in patients with scapulocostal syndrome. Complement Ther Med. 2012 Aug;20(4):167-74. doi: 10.1016/j.ctim.2012.02.002. Epub 2012 Mar 2.

EXPERIMENT DESIGN: To investigate acute effects of traditional Thai massage (TTM) on brain electrical activity (electroencephalogram (EEG) signals), anxiety and pain in patients with scapulocostal syndrome (SCS). A single-blind, randomized clinical trial. The School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.The School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand. Forty patients, who were diagnosed with SCS, were randomly allocated to receive a 30-min session of either TTM or physical therapy (PT) using ultrasound therapy and hot packs. Electroencephalogram (EEG), State Anxiety Inventory (STAI), and pain intensity rating.

RESULTS/ CONCLUSIONS: Results showed that both TTM and PT were associated with significant decreases in anxiety and pain intensity. However, there was a significantly greater reduction in anxiety and pain intensity for the TTM group when compared with the PT group. Analysis of EEG in the TTM group showed a significant increase in relaxation, manifested as an increase in delta activity and a decrease in theta, alpha and beta activity. Similar changes were not found in the PT group. The EEG measures were also significantly different when compared between the groups, except for delta activity, indicating lower states of arousal with the TTM treatment. It is suggested that TTM provides acute neural effects that increase relaxation and decrease anxiety and pain intensity in patients with SCS.



Studies on the Effects of Massage Therapy on Stroke Rehabilitation

Sibbritt D, van der Riet P, Dedkhard S, Srithong K. (2012) Rehabilitation of stroke patients using traditional Thai massage, herbal treatments and physical therapies. Zhong Xi Yi Jie He Xue Bao. 2012 Jul;10(7):743-50.

EXPERIMENT DESIGN: To determine quantitatively if a unique rehabilitation program using traditional Thai massage, herbal treatments and physical therapies could improve activities of daily living, mood and sleep patterns, and pain intensity of stroke patients over time. This was a prospective cohort study, conducted over a three-month period. Patients were recruited from a 42-bed rehabilitation centre in Northern Thailand, which admits mainly stroke, head injury and spinal patients for rehabilitation. There were 62 patients enrolled in the study, with 55% being male. The average age of patients was 59 years and 63% were married. The average time since the initial stroke was 15 months.

RESULTS/ CONCLUSIONS: At baseline, the average Barthel Index score was 50.7, and the average emotion, pain and sleep scores were 2.6, 3.1, and 3.2, respectively. After adjusting for age, gender and time since initial stroke in the longitudinal model, the Barthel Index significantly improved by 6.1 points after one month and by 14.2 points after three months; emotion significantly improved by 0.7 points after one month and by 0.9 points after three months; pain significantly improved by 0.5 points after one month and by 0.5 points after three months; sleep significantly improved by 0.5 points after one month and by 0.6 points after three months This unique stroke rehabilitation program has produced significant improvements in activities of daily living, mood, pain and sleep patterns of stroke patients. These findings warrant the need for further research to compare patients undergoing this program of rehabilitation with patients undergoing more conventional rehabilitation programs.



Studies on the Effects of Massage Therapy on TMJ (Temporo-mandibular Joint Dysfunction)

Pierson MJ. (2011) Changes in temporomandibular joint dysfunction symptoms following massage therapy: a case report. Int J Ther Massage Bodywork. 2011;4(4):37-47. Epub 2011 Dec 31.

EXPERIMENT DESIGN: The objective of this case report was to describe the effects that massage therapy had on a woman with temporomandibular joint dysfunction. The 26-year-old woman's primary symptoms were pain, decreased range of motion, clicking, and crepitus. These symptoms were reportedly associated with emotional stress and bruxism. Ten 45-minute massage therapy treatments were administered over a five-week period. The client's progress was monitored by an initial, midway, and final assessment, using range of motion testing, personal interview, an orthopedic test, and postural analysis. Progress was also evaluated by the use of a daily journal. The client participated in a home care routine consisting of stretches, self-massage, postural training, a proprioception exercise, and hydrotherapy.

RESULTS/ CONCLUSIONS: Results include an increase in maximal opening from 3.1 cm to 3.8 cm, an overall increase in neck range of motion, a decrease in muscle hypertonicity using the Wendy Nickel's Scale, a decrease in pain from 7/10 to 3/10 on a numerical pain scale, and a decline in stress. Although the client in this report experienced positive results, more extensive studies are needed to understand the effects of massage on TMD.



Studies on the Effects of Massage Therapy on Surgery Patients (Pre and Post Operative)

Kim MS, Cho KS, Woo H, Kim JH. (2001) Effects of hand massage on anxiety in cataract surgery using local anesthesia. Journal of Cataract and Refractive Surgery. 2001 Jun;27(6):884-90.

EXPERIMENT DESIGN: PURPOSE: To evaluate the effects of hand massage on patient anxiety during cataract surgery. Kangnam St. Mary's Hospital, Seoul, Korea. This study comprised 59 patients having cataract surgery from December 11, 1996, to February 12, 1997. The patients were divided into those having a hand massage 5 minutes before surgery (experimental group, n = 29) and those not receiving a hand massage (control group, n = 30). Patients' anxiety levels were measured using the Visual Analog Scale and by assessing the systolic blood pressure, diastolic blood pressure, and pulse rate before and after the hand massage and 5 minutes before the end of surgery. Epinephrine, norepinephrine, cortisol, blood sugar levels, neutrophil, and lymphocyte percentages in white blood cells were also measured.

RESULTS/ CONCLUSIONS: After the hand massage, the psychological anxiety levels, systolic and diastolic blood pressures, and pulse rate were significantly lower than before the massage. The hand massage significantly decreased epinephrine and norepinephrine levels in the experimental group. Epinephrine, norepinephrine, and cortisol levels increased in the control group. The differences between groups were significant. There were no significant between-group differences in blood sugar levels or neutrophil and lymphocyte percentages in white blood cells. The findings indicate that hand massage decreases the psychological and physiological anxiety levels in patients having cataract surgery under local anesthesia.


Antoniv VR. (2002) [Effect of neck massage therapy on the soft tissues after thyroid surgery]. Lik Sprava. 2002;(2):93-6. (Ukrainian publication)

EXPERIMENT DESIGN: Our objectives in this study were to establish validated methods of massotherapy of the neck, to determine its action on the neck structures, and to conduct a comparative evaluation of results of the control and study groups after performing massotherapy.

RESULTS/ CONCLUSIONS: It has been found out that in 80 (85%) patients the skin comes to be tinged with healthy pink, the cutaneous-and-muscle tone getting improved, which event makes the skin smooth and elastic following the above massage. Over the first ten days of the massoprocedures 44 (48%) subjects demonstrated resolution of the edema and swelling, with the thickened skin fold as a roller dissappearing by the end of the second month. Dispelling of hypothyrosis phenomena made for reduction of dosages of hormonal preparations. We consider it mandatory that massotherapy of the neck be instituted in all those patients who had undergone operation on the neck and thyroid.


Brand LR, Munroe DJ, Gavin J. (2013) The effect of hand massage on preoperative anxiety in ambulatory surgery patients. AORN Journal. 2013 Jun;97(6):708-17. doi: 10.1016/j.aorn.2013.04.003.

EXPERIMENT DESIGN: Anxiety in patients awaiting surgery and diagnostic procedures in an ambulatory department can affect the patient's physiological and psychological well-being and outcome. We conducted a quasi-experimental study at a midwestern US community hospital to determine the effects of hand massage on patient anxiety in the ambulatory surgery setting. We also investigated whether adding the hand massage procedure affected the timing and flow of procedures.

RESULTS/ CONCLUSIONS: The results indicated that hand massage reduces anxiety for patients awaiting ambulatory surgery and outpatient procedures. Participants who received hand massage experienced lower anxiety levels than those who received customary nursing care. In addition, the performance of hand massage did not affect the flow or timing of procedures. Hand massage is an easy procedure for nurses to learn and administer, and it is within the scope of perioperative nursing practice.



Studies on the Effects of Massage Therapy on Transplant Patients

Smith MC, Reeder F, Daniel L, Baramee J, Hagman J. (2003) Outcomes of touch therapies during bone marrow transplant. Alternative Therapies in Health and Medicine. 2003 Jan-Feb;9(1):40-9.

EXPERIMENT DESIGN: The integration of complementary modalities into mainstream healthcare is gaining increasing emphasis. It is important, therefore, to document the effects of these interventions on patient outcomes. To investigate the effects of Therapeutic Touch and massage therapy on the outcomes of engraftment time, complications, and perceived benefits of therapy during bone marrow transplant. Randomized clinical trial. Subjects were adult patients on the bone marrow transplant unit of a large urban tertiary care center. Subjects were randomly assigned to 1 of 3 treatment groups: Therapeutic Touch (TT), massage therapy (MT), and a control group called the friendly visit (FV). Subjects (N = 88) were stratified by type of transplant (allogeneic or autologous). Twenty-seven subjects received MT; 31 received TT; and 30 received FV. Nurses with expertise in the 2 touch therapies administered them. The interventions of MT, TT, and FV were administered according to standarized protocols every third day beginning the day chemotherapy began until discharge from the program. Time for engraftment, complications, and patient perceptions of benefits of therapy were the main outcome measures. Analysis of variance and analysis of covariance were used to determine significant differences among the 3 groups with respect to time of engraftment.

RESULTS/ CONCLUSIONS: A significantly lower score for central nervous system or neurological complications was noted for subjects who received MT comppared with the control group; however, no differences were found among the 3 groups with respect to the other 10 complication categories or in the total mean score for complications. Patients' perception of the benefits of therapy (total score) was significantly higher for those who received MT compared with the FV control group. The mean scores on the comfort subscale were significantly higher for patients receiving both MT and TT compared with the FV control group. Massage therapy may be effective in altering the psychological and neurological complications associated with chemotherapy during bone marrow transplant. Both massage and Therapeutic Touch provide comfort to patients undergoing this challenging process



Studies on the Effects of Massage Therapy on Vagal Activity

Hatayama T, Kitamura S, Tamura C, Nagano M, Ohnuki K. (2008) The facial massage reduced anxiety and negative mood status, and increased sympathetic nervous activity. Biomedical Research (Japan) 2008 Dec;29(6):317

EXPERIMENT DESIGN: The aim of this study was to clarify the effects of 45 min of facial massage on the activity of autonomic nervous system, anxiety and mood in 32 healthy women. Autonomic nervous activity was assessed by heart rate variability (HRV) with spectral analysis. In the spectral analysis of HRV, we evaluated the high-frequency components (HF) and the low- to high-frequency ratio (LF/HF ratio), reflecting parasympathetic nervous activity and sympathetic nervous activity, respectively. The State Trait Anxiety Inventory (STAI) and the Profile of Mood Status (POMS) were administered to evaluate psychological status.

RESULTS/ CONCLUSIONS: The score of STAI and negative scale of POMS were significantly reduced following the massage, and only the LF/HF ratio was significantly enhanced after the massage. It was concluded that the facial massage might refresh the subjects by reducing their psychological distress and activating the sympathetic nervous system.



Studies on the Effects of Massage Therapy on Voice Disorders

Ternström S, Andersson M, Bergman U. (2000) An effect of body massage on voice loudness and phonation frequency in reading. Logopedics, Phoniatrics, Vocology. 2000;25(4):146-50.

EXPERIMENT DESIGN: The effect of massage on voice fundamental frequency (F(0)) and sound pressure level (SPL) was investigated. Subjects were recorded while reading a 3-min passage of prose text. Then, a 30-min session of massage was administered by a trained naprapathy therapist. Sixteen subjects were given the massage, while 15 controls rested, lying down in silence for the same amount of time. The subjects were then recorded reading the same passage again.

RESULTS/ CONCLUSIONS: The F(0), and SPL averages across the whole passage were measured for the pre- and post-treatment recordings. In the post-massage recordings, subjects had lowered their F(0) by 1.1 semitones and their SPL by 1.0 dB, with very high statistical significance. The drop in F(0) was somewhat larger for the males than for the females. The control subjects showed no effect at all.



Studies on the Effects of Massage Therapy on Vertigo

Christine DC. (2009) Temporal bone misalignment and motion asymmetry as a cause of vertigo: the craniosacral model. Alternative Therapies in Health and Medicine. 2009 Nov-Dec;15(6):38-42.

EXPERIMENT DESIGN: To describe dysfunction of the craniosacral system, particularly temporal bone motion asymmetry, as a cause of vertigo and to suggest a new perspective on research, diagnosis, and treatment. A database search was conducted using MEDLINE, CINHAL; Health Sources: Nursing/Academic Edition; and the Internet. Keywords: vertigo diagnosis and treatment, craniosacral therapy, temporal bones, cranial bone mobility, Upledger, and temporomandibular disorders. Articles that most clearly described a relationship between cranial bone misalignment and vertigo were selected for review.

RESULTS/ CONCLUSIONS: Clinical experience suggests that craniosacral therapy is a powerful evaluative and treatment modality for vertigo patients who have not found relief from medical treatments. A narrative review of the literature describes and supports a theoretical link between dysfunction of the craniosacral system and vertigo. Dysfunction of the craniosacral system may include osseous, dural membrane, and fascial restrictions leading to asymmetric temporal bone movement and hence vertigo. Clinical trials are necessary not only to verify that craniosacral therapy is an effective treatment but also to determine the full range of symptoms and medical diagnoses for which craniosacral therapy is beneficial.



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