Paul Manley Clinic London Massage Research

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Specific research findings about the benefits of massage


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.

METHODS: 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: 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.


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.

METHODS: 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: 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.


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.

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

RESULTS: 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.


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.

METHODS: 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: Patients receiving massage therapy had decreased pain, anxiety, and tension.

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.

METHODS: 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: Patients receiving massage therapy had decreased pain, anxiety, and tension.

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.

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

RESULTS: 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.

METHODS: An on-site chair massage therapy program was provided to reduce anxiety levels of 18 employees in a downsizing organization. 15 control group Ss participated in break therapy. Subjects’ stress levels were measured with the State-Trait Anxiety Inventory, which was administered twice during pretest, post test, and delayed post test to achieve stable measures.

RESULTS: Significant reductions in anxiety levels were found for the massage group.


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.

METHODS: 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: 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.

METHODS: 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: 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.

METHODS: Adults with Osteoarthritis of the knee were assigned either to treatment (twice-weekly sessions of Swedish massage in weeks 1-4 and once-weekly sessions in weeks 5-8) or to control (delayed intervention).

RESULTS: The group receiving massage therapy improved pain, stiffness and physical function domains and in range of motion in degrees, and time to walk 50 ft.

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.

METHODS: 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: 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.


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.

METHODS: 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: 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.

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.

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

RESULTS: 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.

METHODS: 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: 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.


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.

METHODS: 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: 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.

METHODS: 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: 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.

METHODS: Autistic children received standard sensory integration therapy (SI) or SI with Thai Traditional Massage over a period of 8 weeks.

RESULTS: Fewer conduct problems and less anxiety were found in the massage group.

Ginsberg, F. and Famaey, J. P. (1987). A double-blind study of topical massage with Rado-Salil ointment in mechanical low-back pain. Journal of International Medical Research, 15, 148-153.

METHODS: Forty patients with acute mechanical low-back pain were treated in a double-blind manner with either Rado-Salil or placebo for 14 days.

RESULTS: Statistically significant improvements in spontaneous pain, muscular contracture and in both the patient's and physician's opinions occurred by day 3. These improvements persisted at day 14 and, in addition, there were statistically significant improvements in the finger-floor distance and the degree of lumbar extension. Treatment with Rado-Salil also allowed significant reduction in the use of oral analgesics. Only a few localized transient side-effects, requiring no specific treatment, were observed.

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.

METHODS: 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. 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 a fatigue test.

RESULTS: 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 reflexology on chronic pain associated with a herniated disk. Professioni Infermieristiche, 53, 80-87.

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

RESULTS: sixty-three percent of the group reported a reduction in pain.

Kolich, M., Taboun, S.M., & Mohamed, AI. (2000). Low back muscle activity in an automobile seat with a lumbar massage system. International Journal of Occupational Safety & Ergonomics, 6, 113-128.

METHODS: This investigation was conducted to determine the effects of a massaging lumbar support system on low back muscle activity. The apparatus was a luxury-level automobile seat massage. The dependent variable was the change in the EMG signal.

RESULTS: One minute of lumbar massage every five minutes was found to have a beneficial effect on low back muscle activity as compared to no massage.

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

METHODS: 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: 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. 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.

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.

METHODS: 262 patients who had persistent back pain received Traditional Chinese Medical acupuncture, therapeutic massage, or self-care educational materials for up to 10 massage or acupuncture visits over 10 weeks.

RESULTS: 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. The massage group used the least medications and had the lowest costs of subsequent care.

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.

Kalauokalani, D., Cherkin, D.C., Sherman, K.J., Koepsell, T.D., & Deyo, R.A. (2001). Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects. Spine, 26, 1418-1424.

METHODS: 135 patients with chronic low back pain who received acupuncture or massage were studied. Study participants were asked to describe their expectations regarding the helpfulness of each treatment on a scale of 0 to 10.

RESULTS: Improved function was observed for 86% of the participants with higher expectations for the treatment they received, as compared with 68% of those with lower expectations. Patients who expected greater benefit from massage than from acupuncture were more likely to experience better outcomes with massage than with acupuncture, and vice versa.

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.

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.

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.

Shoemaker, J. K., Tidus, P. M., & Mader, R. (1997). Failure of manual massage to alter limb blood flow: Measures by Doppler ultrasound. Medicine and Science in Sports and Exercise 1, 610-614.

METHODS: The ability of manual massage to alter muscle blood flow through three types of massage treatments in a small (forearm) and a large (quadriceps) muscle mass was tested in 10 healthy individuals. A certified massage therapist administered effleurage, petrissage, and tapotement treatments to the forearm flexors (small muscle mass) and quadriceps (large muscle mass) muscle groups in a counterbalanced manner. Limb blood flow was determined from mean blood velocity (MBV) (pulsed Doppler) and vessel diameter (echo Doppler). MBV values were obtained from the continuous data sets prior to treatment, and at 5, 10, and 20 s and 5 min following the onset of massage, Arterial diameters were measured immediately prior to and following the massage treatments; these values were not different and were averaged for the blood flow calculations.

RESULTS: The MBV and blood flows for brachial and femoral arteries, respectively, were not altered by any of the massage treatments in either the forearm or quadriceps muscle groups. Mild voluntary handgrip and knee extension contractions resulted in peak blood velocities and blood flow for brachial and femoral arteries, respectively, which were significantly elevated from rest. The results indicated that manual massage did not elevate muscle blood flow irrespective of massage type or the muscle mass receiving the treatment.

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.

Blood Pressure

Albert, N.M., Gillinov, A.M., Lytle, B.W., Feng, J., Cwynar, R. & Blackstone, E.H. (2009). A randomized trial of massage therapy after heart surgery. Heart and Lung: The Journal of Critical Care, 38, 480-490.

METHODS: Cardiac surgery patients were randomized to usual postoperative care or usual care plus two massages.

RESULTS: Postoperative blood pressure was lower after massage.

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.

Breast Cancer

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.

RESULTS: 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.

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.

Breast Massage

Yokoyama, Y., Ueda, T., Irahara, M., & Aono, T. (1994). Releases of oxytocin and prolactin during breast massage and suckling in puerperal women. European Journal of Obstetrics, Gynecology & Reproductive Biology, 53, 17-20.

METHODS: The responses of prolactin and oxytocin to suckling and breast massage were examined in lactating women.

RESULTS: The suckling group showed an increase in frequency of pulsatile release of oxytocin and an increase in the plasma prolactin level. In contrast, the breast massage group showed a significant, but not a pulsatile increase in the plasma oxytocin level and no increase in the plasma prolactin level. These findings suggest that suckling causes both milk production and milk ejection, while breast massage causes only ejection of milk already stored, and that prolactin release is not related to an increase of the oxytocin level itself, but to its pulsatile release.

Jones, E., Dimmock, P.W., & Spencer, S.A. (2001). A randomised controlled trial to compare methods of milk expression after preterm delivery. Archives of Disease in Childhood Fetal and Neonatal Edition, 85, 91-95.

METHODS: Women were randomly assigned to use either simultaneous (both breasts simultaneously) or sequential (one breast then the other) milk expression. Stratification was used to ensure that the groups were balanced for parity and gestation. A crossover design was used for massage, with patients acting as their own controls. Women were randomly assigned to receive either massage or non-massage first.

RESULTS: Milk yield per expression was: sequential pumping with no massage, 51 g; sequential pumping with massage, 79 g; simultaneous pumping with no massage, 88 g; simultaneous pumping with massage, 125 g. The fat concentration in the milk was not affected by the increase in volume achieved by the interventions. Thus, simultaneous pumping was more effective at producing milk than sequential pumping and breast massage had an additive effect, improving milk production in both groups.

Foda, M.I., Kawashima, T., Nakamura, S., Kobayashi, M., & Oku, T. (2004). Composition of milk obtained from unmassaged versus massaged breasts of lactating mothers. Journal of Pediatrics and Gastroenterology Nutrition, 38, 484-487. METHODS: Milk samples were obtained immediately before and after massage from healthy, exclusively breast-feeding Japanese mothers at two different periods of lactation one <3 months the other >3 months after parturition. Lipids, whey protein, casein, lactose, ash, and total solids were measured in milk samples. The gross energy content of milk was estimated.

RESULTS: Breast massage significantly increased lipids in the late lactating period but not in the early lactating period. In the early lactating period casein was increased by breast massage but was not significantly affected in the late lactating period. Breast massage caused a significant increase in total solids from the first day to 11 months postpartum. The gross energy in the late lactating period was significantly increased by breast massage but not in the early lactating period.

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