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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.

METHOD: 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.

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Alzheimer’s

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.

METHOD: 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.

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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.

METHOD: 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.

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Anxiety

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

METHOD: 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.

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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.

METHOD: 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.

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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.

METHOD: 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.

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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.

METHOD: 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.

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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.

METHOD: 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.
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Attention Deficit Hyperactivity Disorder

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

METHOD: 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.

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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, 623-38.

METHOD: 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.

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Autism

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.

METHOD: 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.

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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.

METHOD: 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.

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Back Pain

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, 1081-8.

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.

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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, 80-7.

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.

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Ernst, E. (1999). Massage therapy for low back pain: a systematic revierw. Journal of Pain Symptom Management, 17, 65-69.

Massage therapy is frequently employed for low back pain. The aim of this sytematic review was to find the evidence for or against its efficacy in this indication. Four random clinical trials were located in which massage was tested as a monotherapy for low back pain. All were burdened with major methodological flaws. One of these studies suggests that massage is superior to no treatment. Two trials imply that it is equally effective as spinal manipulation or transcutaneous electrical stimulation. One study suggests that it is less effective than spinal manipulation. It is concluded that too few trials of massage therapy exist for a reliable evaluation of its efficacy. Massage seems to have some potential as a therapy for low back pain.

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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.

METHOD: 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.

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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.

METHOD: 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.

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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. Prev Med., 39, 168-76.

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.

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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, 1418-24.

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.

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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, 6,113-28.

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.

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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.

METHOD: 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.

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Preyde, M. (2000). Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial. CMAJ, 162, 1815-20.

METHOD: 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.

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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 Complement Altern Med, 19,4-9.

METHOD: 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.

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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. Complement Ther Med, 12, 28-37.

METHOD: 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.

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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, 459-64.

METHOD: 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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Behavior 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.

METHOD: 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.

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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. Med Sci Monit, 10, 173-8.


METHOD: 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.

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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, 610-14.

METHOD: 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.

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Blood Pressure

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.

METHOD: 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. Researchers instructed subjects to only perform their session on assigned days to ensure compatibility with the massage group's schedule. Relaxation sessions began with participants breathing deeply for several minutes while in a supine position with the hands alongside the body. They then followed instructions to tighten and then relax different muscles, moving upward from the feet to the head. Muscle groups included were of the feet, calves, thighs, hands, arms, back and face. Pre- and post-treatment assessments included: a state anxiety inventory (STAI) to assess current emotions; a salivary sample to measure the levels of the stress hormone cortisol; systolic blood pressure and diastolic blood pressure measures; the Center for Epidemiological Studies Depression Scale (CES-D) questionnaire to rate depressive symptoms; Symptom Checklist-90-Revised (SCL-90-R) self-report symptom inventory of depression, anxiety and hostility; and urinary catecholamines (biologically active amines which affect the nervous and cardiovascular systems) and cortisol measurement. 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.

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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.

METHOD: The aim of this study was to determine how massage-like stroking of the abdomen in rats influences arterial blood pressure. The participation of oxytocinergic mechanisms in this effect was also investigated. 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. The maximum decrease in blood pressure was achieved at frequencies of 0.083 Hz or more. 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. The decrease in blood pressure caused by stroking was not altered by an oxytocin antagonist. In contrast, the administration of oxytocin diminished the effect, which was antagonized by a simultaneous injection of the oxytocin antagonist. These results indicate that the massage-like stroking of the abdomen decreases blood pressure in anesthetized rats. This effect does not involve intrinsic oxytocinergic transmission. However, since exogenously applied oxytocin was found to diminish the effect of stroking, oxytocin may exert an inhibitory modulatory effect on this reflex arc.

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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.

METHOD: 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. A randomized clinical trial design was used. Data were compared in a repeated measures design before massage, immediately following the back massage or standard care, and 10 minutes later. Forty-six subjects admitted from home for a diagnostic cardiac catheterization were included in the study. Heart rate, heart rate variability, blood pressure, respiration, peripheral skin temperature, pain perception, and psychological state were the main outcome measures. 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.

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Olney, C.M. (2005).The effect of therapeutic back massage in hypertensive persons: a preliminary study. Biol Res Nurs, 7, 98-105.

METHOD: 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.

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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.

METHOD: Thirty-four 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.

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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

METHOD: 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.

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Breast Massage

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 andGastroenterology Nutrition., 38, 484-7.

METHOD: 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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Jones, E., Dimmock, P.W., & Spencer, S.A. (2001). A randomised controlled trial to compare methods of milk expression after preterm delivery. Arch Dis Child Fetal Neonatal Ed. 85(2), F91-5.

METHOD: 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.

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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.

METHOD: 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.

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Bulimia

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.

METHOD: 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.

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Burn

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.

METHOD: 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.

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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, 189-93.

METHOD: 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.

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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.

METHOD: 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.

Hernandez-Reif, M., Field, T., Diego, M., & Fraser, M (2006). Lower Back Pain And Sleep Disturbances Are Reduced Following Massage Therapy. Journal of Bodyworks and Movement Therapies, In Press.

METHOD: 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.

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Cancer

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 Nurs., 27, 25-33.

METHOD: 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.

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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, 237-43.

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.

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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, E35-44.

METHOD: 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.

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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 Nurs., 27, 267-74.

METHOD: 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.

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Smith, M.C., Kemp, J., Hemphill, L., & Vojir, C.P. (2002). Outcomes of therapeutic massage for hospitalized cancer patients. J Nurs Scholarsh. 34, 257-62.

METHOD: 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.

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Soden, K., Vincent, K., Craske, S., Lucas, C., & Ashley, S. (2004). A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med., 18, 87-92.

METHOD: Research suggests that patients with cancer,particularly in the palliative care setting, are increasingly using aromatherapy and massage. There is good evidence that these therapies may be helpful for anxiety reduction for short periods, but few studies have looked at the longer term effects. This study was designed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer. Forty-two patients were randomly assigned to receive weekly massages with lavender essential oil (aromatherapy group), an inert carrier oil only (massage group) or no intervention. RESULTS: We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control, anxiety or quality of life. Sleep scores improved significantly in both the massage and the combined massage (aromatherapy and massage) groups. There were also statistically significant reductions in depression scores in the massage group.

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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.

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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.

METHOD: 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.

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Cardiovascular

Boone, T. & Cooper, R. (1995). The effect of massage on oxygen consumption at rest. American Journal of Chinese Medicine, 23, 37-41.

METHOD: This study determined the effect of massage on oxygen consumption at rest. Ten healthy, adult males volunteered to serve as subjects. During the Control Session, each subject was placed in the supine position on a massage table to remain motionless for 30 minutes. During the Treatment Session, each subject received a 30-minute sports massage of the lower extremities. Oxygen consumption was measured. RESULTS: The subjects' oxygen consumption did not change with the massage. Also, there were no significant differences in heart rate, stroke volume, cardiac output, and arteriovenous oxygen difference during the massage. These findings indicate that massaging the lower extremities results in neither an increase nor a decrease in the subjects' expenditure of energy at rest.

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Boone, T., Tanner, M., & Radosevich, A. (2001). Effects of a 10-minute back rub on cardiovascular responses in healthy subjects. American Journal of Chinese Medicine. 29, 47-52

METHODS: This study determined the cardiovascular responses to a 10-minute back rub. Twelve healthy, college-age males and females volunteered to participate as subjects. The subjects were assessed for 10 minutes on a massage table lying on one side. During the treatment period, a back rub was administered. Oxygen consumption and cardiac output were measured. RESULTS: The central and peripheral components of oxygen consumption were changed and cardiac output decreased. These results indicate that the back rub was effective in inducing relaxation.

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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, 364-71.

METHOD: This study investigated the effects of myofascial trigger-point massage therapy to the head, neck and shoulder areas on cardiac autonomic tone. 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. 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.

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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.

METHOD: A repeated-measures design was used to examine the effect of a change in body position (right or left lateral) and timing of backrub (immediate or delayed) on mixed venous oxygen saturation in 57 surgical ICU patients. 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.

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McNamara, M.E., Burnham, D.C., Smith, C., & Carroll, D.L. (2003). The effects of back massage before diagnostic cardiac catheterization. Altern Ther Health Med., 9, 50-7.

METHOD: 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.

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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.

METHOD: 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.

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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.

METHOD: 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.

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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.

METHOD: 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.

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Cocaine Exposure

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.

METHOD: 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.

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Cognition (Learning)

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.

METHOD: 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.

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

METHOD: 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.

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Constipation

Bishop, E., McKinnon, E., Weir, E., & Brown, D.W. (2003). Reflexology in the management of encopresis and chronic constipation. Paediatr Nrs., 15, 20-1.

METHOD: 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.

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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.

METHOD: Parents massaged their children with cystic fibrosis to reduce anxiety and their children’s anxiety 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, the parents and children answered questions relating to present anxiety levels and the 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.

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Dancers

Leivadi, S., Hernandez-Reif, M., Field, T., O'Rourke, M., D'Arienzo, S., Lewis, D., del Pino, N., Schanberg, S., Kuhn, C. (1999). Massage Therapy and Relaxation Effects on University Dance Students. Journal of Dance Medicine & Science, 3, 108-112.

METHOD: Thirty female university dancers were randomly assigned to a massage therapy or relaxation therapy group. The therapies consisted of 30-minute sessions twice a week for five weeks. RESULTS: Both groups reported less depressed mood and lowered anxiety levels. However, saliva cortisol (stress hormones) decreased only for the massage therapy group. Both groups reported less neck, shoulder, and back pain after the treatment sessions and reduced back pain across the study. However, only the massage therapy group showed increased range of motion across the study, including neck extension and shoulder abduction.

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Dental Pain

Ottoson, D., Ekblom, A., & Hansson, P. (1981). Vibratory stimulation for the relief of pain of dental origin. Pain ,10, 37-45.

METHOD: Vibratory stimulation was used for dental pain in 36 patients. The patients were from a clinic for dental surgery and all had suffered pain from pulpal inflammation, apoical periodontitis or postoperative pain following extraction of an impacted wisdom tooth for more than 2 days. Vibration at 100 Hz was applied to various points in the facial region or the skull. RESULTS: All patients except three experienced an effective reduction in pain intensity. In the patients who experienced pain reduction there was usually a best point at which vibration had a greater pain alleviating effect than at other points. At some points the stimulation added to the pain. In 16 patients the stimulation caused a reduction in pain intensity of 75-100%; out of these, 12 patients reported a complete relief of pain.

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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.

METHOD: 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 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.

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

METHOD: 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.

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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).

METHOD: Thirty-four primiparous depressed mothers at 4 weeks postpartum were randomly assigned either to an infant massage class and a support group (massage group) or to a support group (control group). Each group attended five weekly sessions. RESULTS: The depression scores fell in both groups. However, improvement of mother-infant interactions was seen only in the massage group.

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Dermatitis

Anderson, C., Lis-Balchin, M., & Kirk-Smith, M. (2000). Evaluation of massage with essential oils on childhood atopic eczema. Phytotherapy Research, 14, 452-6.

METHODS: Eight children, born to professional working mothers were studied to test the hypothesis that massage with essential oils (aromatherapy) used as a complementary therapy in conjunction with normal medical treatment, would help alleviate the symptoms of childhood atopic eczema. The children were randomly assigned to a massage and a massage with essential oils group. They received massage once a week by a therapist and every day by the mother over a period of 8 weeks. The preferred essential oils, chosen by the mothers for their child, from 36 commonly used aromatherapy oils, were: sweet marjoram, frankinsence, German chamomile, myrrh, thyme, benzoin, spike lavender and Litsea cubeba. The treatments were evaluated by means of daily day time irritation scores and night time disturbance scores, determined by the mother before and during the treatment, both over an 8 week period. RESULTS: The results showed a significant improvement in the eczema in the two groups of children following therapy, but there was no significant difference in improvement shown between the aromatherapy massage and massage only group. Further studies on the essential oil massage group showed a deterioration in the eczematous condition after two further 8 week periods of therapy, following a period of rest after the initial period of contact. This may have been due to a decline in the novelty of the treatment, or, it strongly suggests possible allergic contact dermatitis provoked by the essential oils themselves.

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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.

METHOD: Young children with atopic dermatitis were treated with standard topical care and massage 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 parents' anxiety decreased immediately after the massage therapy sessions. Over the 1 month period, the parents of the 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.

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Diabetes

Field, T., Hernandez-Reif, M., LaGreca A., Shaw, K., Schanberg, S., & Kuhn, C. (1997). Massage therapy lowers blood glucose levels in children with Diabetes Mellitus. Diabetes Spectrum ,10, 237-239.

METHOD: Twenty diabetic children were randomly assigned to a touch therapy or relaxation therapy group. The children's parents were taught one or the other therapy and were asked to provide them for 20 minutes before bedtime each night for 30 days. RESULTS: The immediate effects of the touch therapy were reduced parent anxiety and depressed mood and reduced child anxiety, fidgetiness and depressed affect. Over the 30 day period compliance on insulin and food regulation improved and blood glucose levels decreased from 159 to within the normal range (121).

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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, 314-9.

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. METHOD: Infants living in 2 orphanages in Quito, Ecuador, were matched by age and randomly assigned to a massage therapy or a control group. Daily infant massage therapy was provided 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: the 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.

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Down Syndrome

Hernandez-Reif, M., Field, T., Bornstein, J. & Fewell, R. (2006). Children with Down Syndrome improved in motor function and muscle tone following massage therapy. Journal of Early Child Development and Care, 176, 395-410..

METHOD: Twenty-one moderate to high functioning young children (M age = 2 years) with Down syndrome receiving early intervention (PT, OT and speech therapy) were randomly assigned to also receive two ½-hour massage therapy or reading sessions (control group) per week for two months. On the first and last day of the study, the children were assessed on functioning using the Developmental Programming for Infants and Young Children Scale and muscle tone using a new Likert scale. RESULTS: Children in the massage therapy group experienced developmental gains in fine and gross motor functioning and showed less severe hypotonicity in their limbs. These findings suggest that the addition of massage therapy to an early intervention program may enhance motor and muscle functioning for children with Down syndrome.

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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.

METHOD: This exploratory within-subjects study compared the effects of elder volunteers giving massage to infants versus receiving massage themselves. Three times a week for 3 weeks, 10 elder volunteers received massage sessions. For another 3 weeks, three times per week, the same elderly volunteers massaged infants at a nursery school. RESULTS: Immediately after the first-and last-day sessions of giving massages, the elder retired volunteers had less anxiety and depression and lower stress hormone (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 from massaging the infants.

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

METHOD: Sixteen senior citizens participated in four, 50-minute 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.

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Endorphins

Day, J. A., Mason, R. R., & Chesrown, S. E. (1987). Effect of massage on serum level of beta-endorphin and beta-lipotropin in healthy adults. Physical Therapy ,67, 926-930.

METHOD: The effect of massage was evaluated on the levels of endogenous opiates in peripheral venous blood. The results were based on findings from 21 healthy, adult volunteers. The volunteers were assigned randomly to either the Control Group (n = 11) that rested but received no massage or the Experimental Group (n = 10) that received a 30-minute complete back massage. RESULTS: No significant pretreatment or posttreatment difference was found in blood beta-endorphin or beta-lipotropin levels between the groups. The results indicate that massage did not change the measured serum levels of beta-endorphin or beta-lipotropin in these healthy subjects without pain.

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Enuresis

Yuksek, M.S., Erdem, A.F., Atalay, C., & Demirel, A. (2003). Acupressure versus oxybutinin in the treatment of enuresis. J Int Med Res., 31, 552-6.

METHOD: The efficacy of acupressure for treating nocturnal enuresis was compared with oxybutinin. Acupressure was administered to 12 children by their parents, who had been taught the technique. Twelve control patients received 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% and 16%, respectively, of children treated with acupressure, and in 58% and 33%, respectively, of children who received oxybutinin.

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Exercise

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. J Altern Complement Med, 11, 1093-101.

METHOD: This study assessed the effects of using manual massage to improve power-grip performance immediately after maximal exercise in healthy adults. Fifty-two volunteer massage-school clients, staff, faculty, and students participated. 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. 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. Massage had a greater effect than no massage or than placebo on grip performance after fatigue, especially in the nondominant-hand group.

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Drust, B., Atkinson, G., Gregson, W., French, D. & Binningsley, D. (2003). The effects of massage on intra muscular temperature in the vastus lateralis in humans. Int J Sports Med, 24, 395-9.

METHOD: The aim of the current investigation was to evaluate the effect of different durations of massage, and ultrasound treatment, on the temperature of the vastus lateralis muscle in males. Deep effleurage massage of the vastus lateralis was performed on seven healthy males for 5, 10 and 15 min periods. A 5-min period of ultrasound at 45 KHz was also completed by all subjects. Intra muscular temperature (at 1.5, 2.5 and 3.5 cm) and thigh skin temperature were assessed pre and post treatment. Heart rate was monitored continuously throughout all conditions. RESULTS: Pre treatment intra muscular temperature increased as depth of measurement increased. Changes in muscle temperature at 1.5 and 2.5 cm were significantly greater following massage than ultrasound. No significant differences between massage treatments and ultrasound were noted when intra muscular temperature was measured at 3.5 cm. Massage also significantly increased both heart rate and thigh skin temperature compared to ultrasound. Increases in intra muscular temperature, heart rate and thigh skin temperature were the same irrespective of massage duration. These data suggest that massage and ultrasound have only limited effects on deep muscle temperature.

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Hemmings, B., Smith, M., Graydon, J. & Dyson, R. (2000). Effects of massage on physiological restoration, perceived recovery, and repeated sports performance. Br J Sports Med, 34, 109-14

METHODS: Eight amateur boxers completed two performances on a boxing ergometer on two occasions in a counterbalanced design. Boxers initially completed performance 1, after which they received a massage or passive rest intervention. Each boxer then gave perceived recovery ratings before completing a second performance, which was a repeated simulation of the first. Heart rates and blood lactate and glucose levels were also assessed before, during, and after all performances. RESULTS: A repeated measures analysis of variance showed no significant group differences for either performance, although a main effect was found showing a decrement in punching force from performance 1 to performance 2 . The massage intervention significantly increased perceptions of recovery compared with the passive rest intervention. Blood lactate concentration after the second performance was significantly higher following massage.

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Hilbert, J.E., Sforzo, G.A. & Swensen, T. (2003). The effects of massage on delayed onset muscle soreness. Br J Sports Med, 37, 72-5.

METHODS: Eighteen volunteers were randomly assigned to either a massage or control group. Delayed onset muscle soreness was induced with six sets of eight maximal eccentric contractions of the right hamstring, which were followed 2 h later by 20 min of massage or sham massage (control). Peak torque and mood were assessed at 2, 6, 24, and 48 h postexercise. Range of motion (ROM) and intensity and unpleasantness of soreness were assessed at 6, 24, and 48 h postexercise. Neutrophil count was assessed at 6 and 24 h postexercise. RESULTS: Intensity of soreness was significantly lower in the massage group relative to the control group at 48 h postexercise.

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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.

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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: Massage after exercise fatigue significantly improved quadriceps performance compared to rest.

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Robertson, A., Watt, J.M. & Galloway, S.D. (2004). Effects of leg massage on recovery from high intensity cycling exercise. Br J Sports Med, 4 ,173-6.

METHODS: Nine male games players participated. They attended the laboratory on two occasions one week apart and at the same time of day. Dietary intake and activity were replicated for the two preceding days on each occasion. After baseline measurement of heart rate and blood lactate concentration, subjects performed a standardised warm up on the cycle ergometer. This was followed by six standardised 30 second high intensity exercise bouts, interspersed with 30 seconds of active recovery. After five minutes of active recovery and either 20 minutes of leg massage or supine passive rest, subjects performed a second standardised warm up and a 30 second Wingate test. Capillary blood samples were drawn at intervals, and heart rate, peak power, mean power, and fatigue index were recorded. RESULTS: Significantly lower fatigue index was observed in the massage trial.

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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.

METHOD: The combination of a warm-up, stretching exercises and massage were assessed for their effects on subjective scores for delayed onset muscle soreness (DOMS) and functional and biochemical measures. Fifty people, randomly assigned to a treatment and a control group, exercised with the forearm flexors for 30 min. The treatment group also performed a warm-up and stretching protocol followed by forearm exercise and massage. RESULTS: The median values at the five post-exercise time points differed significantly for DOMS measured when the arm was extended. Significant effects for treatment were found on the maximal force, the flexion angle of the elbow and the creatine kinase activity in blood.

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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.

METHOD: 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; CK 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.

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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.

METHOD: 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. RESULTS: The training weeks differed from each other only in respect to underwater water-jet massage treatments. These were used three times (20 min each) during the treatment week and not used during the control week. During the treatment week continuous jumping power decreased and ground contact time increased significantly less (P < 0.05) 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.

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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.

METHOD: This study tested the hypothesis that massage applied after eccentric exercise would effectively alleviate delayed-onset muscle soreness (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 between control and massage conditions. Ten healthy subjects with no history of upper arm injury and no experience in resistance training, performed 10 sets of 6 maximal isokinetic 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. 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.

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Facial Massage

Yamada, Y., Hatayama, T., Hirata, T., Maruyama, K., et al.(1986). A psychological effect of facial estherapy. Tohoku Psychologica Folia, 45, 6-16.

METHOD: Changes in emotion, level of arousal, and facial skin state were assessed in 24 female undergraduates by the use of 3 types of checklists. RESULTS: Two adjective checklists indicated that on items of both general deactivation and deactivation-sleep factors, many subjective rating scores were heightened after the facial esthetic massage and most subjects in the experimental group showed that the subjective state of their faces was much improved.

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Fibromyalgia

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.

METHOD: To determine the effects of massage therapy versus relaxation therapy on sleep, substance P and pain in fibromyalgia patients, twenty four adult fibromyalgia patients were randomly assigned to a massage therapy or relaxation therapy group. They received 30-minute treatments twice a week for five 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 tenderpoints in the massage therapy group.

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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.

METHOD: 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.

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Gastrointestinal Motility

Diego MA, Field T, Hernandez-Reif M. (2005).Vagal activity, gastric motility, and weight gain in massaged preterm neonates. Journal of Pediatrics, 147, 50-5

METHOD: 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.

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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. Am J Chin Med., 31, 781-90.

METHOD: 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. The control group received 3 minutes of acupressure on sham points. Acupressure was performed twice a day. A questionnaire was used to determine patients'