Massage significantly lowered the intensity of soreness experienced in delayed onset muscle soreness, according to recent research.

“The effects of massage on delayed onset muscle soreness” was conducted by J.E. Hilbert, G.A. Sforzo and T. Swensen of the Center for Health Sciences Department of Exercise and Sport Sciences in Ithaca, New York.

Eighteen volunteers with an average age of 20 were randomly assigned to either massage or a control group.

The Profile of Mood States was used to establish baseline levels of tension-anxiety, depression-dejection, anger-hostility, vigor-activity, fatigue-inertia and confusion-bewilderment.

Baseline range-of-motion measurements were recorded as an average of three straight-leg raises. Subjects then completed eight submaximal and two maximal eccentric contractions with the right hamstrings at a slow velocity as a warm-up, rested two minutes, and completed five maximal eccentric contractions with the right hamstrings. The highest value recorded during these lifts served as baseline value for peak torque.

Participants also completed the Differential Descriptor Scale, an assessment of pain that measures both the sensory and emotional aspects of pain, and gave a blood sample to record the baseline percentage of neutrophils, an indication of muscle damage, in their blood.
On a different day, the treatment for each subject began at 8 a.m. with the previously described warm-up, followed by 10 maximal eccentric contractions with the right hamstring to cause muscle damage. After one minute of rest, subjects performed five more maximal eccentric contractions, from which peak torque was recorded and labeled as zero hours post exercise.

Participants returned two hours later and repeated the previous exercise. Afterward, they received either 20 minutes of massage or control treatment, which consisted of 20 minutes of rest.

The massage included five minutes of effleurage, one minute of tapotement, 12 minutes of petrissage and two more minutes of effleurage.

After the massage or control session, subjects completed a Profile of Mood States questionnaire. At six and 24 hours post exercise, they returned to the lab for evaluation of mood state, range of motion, peak torque, soreness, and neutrophil levels. Again at 48 hours they returned to the lab for assessment of the above factors, except neutrophil levels.

Both the massage and control groups had significantly higher intensities of soreness at six, 24 and 48 hours post exercise. However, the massage group’s intensity of soreness was significantly lower than the control group’s at 48 hours post exercise.

There were no significant differences between the massage and control group for the other factors.

“Although massage rendered after muscle injury did not alter any physiological variables, it did lower the intensity of soreness after 48 hours,” state the study’s authors.

“There is a growing body of evidence showing that massage lowers intensity of soreness during [delayed onset muscle soreness],” they concluded.

- Source: Center for Health Sciences. Authors: J.E. Hilbert, G.A. Sforzo and T. Swensen. Originally published in the British Journal of Sports Medicine, 2003, Issue 37, pp. 72-75.

After six weeks of reflexology sessions, children with chronic constipation and encopresis, or fecal incontinence, experienced a significant decrease in soiling and a significant increase in bowel movements, according to a recent study.

“Reflexology in the management of encopresis and chronic constipation” was conducted by Eileen Bishop, Evelyn McKinnon, Evelyn Weir and Denise Brown of Ayrshire and Arran Acute Hospitals Trust in the United Kingdom.

Fifty children between the ages of 3 and 14 with a diagnosis of encopresis/chronic constipation participated in the study. They were given 30 minutes of reflexology to their feet once a week for six weeks.

With the help of their parents, the children completed questionnaires on bowel movements and soiling patterns before, during and after the six sessions of reflexology. The questionnaires were designed to record the number of bowel movements and the incidents of soiling in each seven-day period before, during and after the reflexology treatment.

Before the start of reflexology, 78 percent of the participants reported soiling at least daily. Sixteen percent reported soiling one-to-three times a week, and six percent reported no soiling in seven days.

After the reflexology sessions, 20 percent of the group reported soiling at least once a day, 30 percent reported soiling one-to-three times a week, and 48 percent reported no soiling in seven days.
“The results show that soiling episodes reduced significantly,” state the study’s authors. “This may result in more socially acceptable behavior.”

As for bowel movements, the group, before starting reflexology, reported 36 percent with no bowel movement in a period of seven days, 46 percent with one-to-four bowel movements per week, and 18 percent having daily bowel movements.

After the reflexology sessions, two percent had no bowel movement in one week, 72 percent had one-to-four bowel movements per week, and 24 percent reported daily bowel movements.

“The frequency of bowel motions has also significantly increased, with 72 percent now passing motions regularly,” state the study’s authors.

It was noted that none of the children required an enema during the study, and many parents said their child’s appetite increased and sleep pattern improved.

“Administering reflexology to the children has been achieved with ease and there have been no adverse reactions observed or reported,” state the study’s authors. “Reflexology for childhood encopresis and chronic constipation is now an established service with five pediatricians and two staff grade doctors referring children of all ages for treatment.”

- Source: Ayrshire and Arran Acute Hospitals Trust, United Kingdom. Authors: Eileen Bishop, Evelyn McKinnon, Evelyn Weir and Denise Brown. Originally published in Paediatric Nursing, April 2003, Vol. 15, pp. 20-21.

Postoperative pain and distress may be eased by massage, according to recent research.

“Effects of Adjunctive Swedish Massage and Vibration Therapy on Short-Term Postoperative Outcomes: A Randomized, Controlled Trial” studied the effects of massage on 105 women, age 18 and older, who underwent an abdominal laparotomy for removal of suspected cancerous lesions, generally ovarian masses.

The women were randomly assigned to one of three groups: usual postoperative care, usual care along with massage therapy, or usual care plus vibration therapy.

Subjects in the massage group received a 45-minute massage, consisting of Swedish techniques, after surgery and at the same time on the next two postoperative days.

Patients in the vibration group received 20 minutes of standardized physiotones therapy on the evening after surgery and at the same time on the two postoperative days. Physiotones therapy involves vibration as inaudible, pure tonal, low-frequency sound waves that resonate through a mattress into both superficial and deep tissues.

The study’s primary outcome measures were sensory pain, affective pain and distress. Both sensory and affective pain were rated on a scale of 0-10. According to the study’s authors, sensory pain “imparts information on the location, time, and intensity of noxious stimuli, while affective pain, or unpleasantness/suffering, reflects the aversive qualities of the pain experience.”

Distress was measured on an 11-point rating scale.
On the day of the surgery, massage was significantly more effective than usual care for affective and sensory pain. Massage was also found to be significantly more effective than vibration for affective pain.

On the second day after surgery, massage was significantly more effective than usual care for distress. It was significantly better than vibration for sensory pain.

Vibration was found to be significantly more effective than usual care for sensory pain and distress.

After controlling for multiple comparisons and outcomes, no significant differences were found between the three groups; however, the authors stated, “Although effects were small and not significant in multivariate analyses, we observed a trend in favor of massage therapy, such that massage was more effective than [usual care] and physiotone therapy.

“In summary, adjunctive gentle Swedish massage therapy may have minor effects on postoperative sensory pain, affective pain, and distress among women undergoing an abdominal laparotomy for removal of suspected malignant lesions, as suggested by a trend in favor of the group that received massage therapy.”

- Source: University of Virginia Health System’s Center for the Study of Complementary and Alternative Therapies, Cancer Center, Department of Obstetrics and Gynecology, and Department of Health Evaluation Sciences. Authors: Ann Gill Taylor, R.N.; Daniel L. Galper, Ph.D.; Peyton Taylor, M.D.; Laurel W. Rice, M.D.; Willie Andersen, M.D.; William Irvin, M.D.; Xin-Qun Wang; and Frank E. Harrell, Jr., Ph.D. Originally published in The Journal of Alternative and Complementary Medicine, 2003, Vol. 9, No. 1, pp. 77-89.

Pressure on the extra 1 acupuncture point increases sedation and decreases stress, according to recent research.

In the study, “Pressure Applied on the Extra 1 Acupuncture Point Reduces Bispectral Index Values and Stress in Volunteers,” 25 subjects received acupressure on the extra 1 acupuncture point, located midway between the medial ends of the two eyebrows, at the root of the nose. On a different day, the subjects received acupressure on a control point two centimeters from the lateral end of the left eyebrow.

Pressure on the extra 1 point lasted for 10 minutes, while pressure on the control point lasted for five minutes, due to subjects’ discomfort with pressure on this point.

Effects of the acupressure were measured using the bispectral index and verbal stress scales. The bispectral index uses electroencephalography (EEG), the recording and analysis of electrical activity in the brain, to measure the depth of hypnosis and sedation in subjects. The verbal stress scales measure stress and tension on a scale of 0 to 10.

Bispectral index values were recorded, using a ZipprepTM electrode attached to the subject’s forehead, before the acupressure took place, every 30 seconds during acupressure, and after pressure was released. Subjects completed the verbal stress scale before and after the acupressure occurred.

Bispectral index values were significantly reduced at 2.5, 5, 7.5 and 10 minutes into acupressure on the extra 1 point, indicating an increase in sedation. After the pressure was released, the bispectral index values returned to baseline.
Pressure on the control point also decreased bispectral index values, but the values were significantly higher than those obtained during pressure on the extra 1 point.

Verbal stress scores were reduced by 50 percent after acupressure on the extra 1 point and by 14 percent after acupressure on the control point.

“Our results demonstrate a 50 percent reduction in [bispectral index] values when pressure was applied on the extra 1 point and a 50 percent reduction in anxiety and stress by pressing this point for 10 minutes,” state the study’s authors.

“The method may prove to be effective in attenuating anxiety and stress in everyday life as well,” they continued, “and may replace tranquilizers and hypnotics, at least in part, for thousands of people under stress.”

- Source: Department of Anesthesiology at Aretaieion Hospital and St. Savas Hospital, Athens, Greece. Authors: Argyro Fassoulaki, M.D., Ph.D.; Adia Paraskeva, M.D.; Konstantinos Patris, M.D.; Theodora Pourgiezi, M.D.; and Georgia Kostopanagiotou, M.D. Originally published in Anesthesia Analgesia, 2003, Vol. 96, pp. 885-889.

Soft-tissue massage improved range of motion, reduced pain and improved function in people with shoulder pain, according to a research study.

“A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain” was conducted by staff at Auburn Hospital and Concord Repatriation General Hospital in Sydney, Australia.

Twenty-nine subjects who had been referred to the Concord hospital for management of shoulder pain participated in the study. Their medical diagnoses varied, but impingement, rotator-cuff tear and unspecified shoulder pain were the most common diagnoses.

Fourteen of the participants were randomly assigned to the control group, where they were placed on a waiting list for massage and received no treatment for two weeks.

Fifteen of the participants were randomly assigned to the massage group, where they received six sessions of soft-tissue massage around the shoulder for two weeks. The massage included the lateral border of the scapula, in full shoulder flexion; posterior deltoid, at end-of-range horizontal flexion; anterior deltoid, at end-of-range hand-behind-back; and pectoralis major, in the stretch position. Each session lasted 15-20 minutes.
Active range of motion was evaluated for flexion, abduction and hand-behind-back movements before and after the study. Pain was assessed on the Short Form McGill Pain Questionnaire, and functional ability was assessed with the Patient Specific Functional Disability Measure, both before and after the study period.

Subjects in the control group showed no significant improvements from the beginning to the end of the two-week period. Subjects in the massage group showed significant improvements in all measures, with a mean improvement of 22.6 degrees in flexion; 42.2 degrees in abduction; and the ability to reach a mean of 11 centimeters further up the back. Subjects in the massage group also reported decreased pain and improved function.

“This randomized, controlled trial has shown that soft tissue massage around the shoulder in subjects with shoulder pain of local mechanical origin produces significantly greater improvements in pain, function and range of motion than does no treatment over a two-week period,” state the study’s authors.

“The fact that these patients improved with such a wide range of diagnoses points to the potential generalisability of the effects of this massage in patients with shoulder pain of local mechanical origin.”

- Source: Auburn Hospital and Concord Repatriation General Hospital in Sydney, Australia. Authors: Paul A. van den Dolder and David L. Roberts. Originally published in the Australian Journal of Physiotherapy 2003, Vol. 49, pp. 183-188.

Women with breast cancer who received massage therapy showed a significant increase in both beneficial natural-killer cells and dopamine levels, and a significant decrease in long-term anxiety, as compared to women who received relaxation therapy, according to a recent study.

“Breast Cancer Women Experience Increased Natural Killer Cells Following Massage Therapy” was conducted by staff at the Touch Research Institutes.

Fifty-eight women diagnosed within the last three years with early-stage breast cancer, at least three months post-surgery and finished with radiation and chemotherapy, were randomly assigned to either a massage-therapy group, a relaxation-therapy group or a standard-treatment control group.

Relaxation therapy was used to discover whether massage benefits women with breast cancer simply because it’s relaxing, or if it is the massage itself that produces positive effects.

Women assigned to the massage-therapy group received three 30-minute massages per week for five weeks. Women in the relaxation group self-administered three 30-minute progressive-muscle-relaxation sessions per week for five weeks. Women in the control group received standard breast-cancer treatment.

On the first and last days of the study, the women were evaluated for both immediate and long-term effects of the sessions on depression, anger, anxiety, vigor and pain. The Profile of Mood States, the Symptom Checklist 90 Revised (SCL-90R) Depression Subscale and the State Anxiety Inventory were used to assess these items. Pain was evaluated with the Short-form McGill Pain Questionnaire.

Urine and blood samples were taken at the beginning and end of the study to measure dopamine and natural-killer-cell levels. Natural-killer cells are known to be effective against virus-infected cells and various types of tumor cells.
Results of the study showed that both the massage and relaxation groups had lower levels of depression, anxiety and pain immediately after the sessions, as compared to the standard-treatment control group. However, it was only women in the massage group who experienced a long-term reduction in anxiety.

It was also the massage-therapy group alone that showed a significant increase in dopamine and natural-killer-cell levels from the first to last day of the study.

“The pivotal finding in this study was the increase in natural-killer cell numbers for the women with breast cancer who received massage therapy,” state the study’s authors. “Their clinical condition would be expected to improve inasmuch as natural-killer cells are noted to destroy tumor cells.”
Source: The Touch Research Institutes, with support from BIOTONE and the U.S. Department of Defense. Authors: Maria Hernandez-Reif, Ph.D.; Tiffany Field, Ph.D.; Gail Ironson, M.D.; Julia Beutler; Yanexy Vera; Judith Hurley, M.D.; Mary Ann Fletcher, Ph.D.; Saul Schanberg, M.D., Ph.D.; and Cynthia Kuhn, Ph.D.

Reflexology significantly improved paresthesia, urinary symptoms and spasticity in people with multiple sclerosis, according to recent research.

“Reflexology treatment relieves symptoms of multiple sclerosis: a randomized controlled study” was conducted by staff at the Department of Orthopedic Rehabilitation, Complementary Medicine Clinic and the Multiple Sclerosis Center at Sheba Medical Center in Tel-Hashomer, Israel; and the Gertner Institute for Epidemiology and Health Policy Research.

Seventy-one people with multiple sclerosis were randomly assigned to receive either reflexology or control treatment for 45 minutes once a week, for 11 weeks. Fifty-three of the subjects completed the study. Thirty-six reflexologists participated in the study, each treating one reflexology and one control subject.

The reflexology sessions consisted of manual pressure on specific points of the feet and massage of the calf area. The control sessions consisted of nonspecific massage of the calf area, a sham treatment to control for the effects of touch and relaxation.

Outcome measures were the mean intensity of paresthesias (sensory deficits), evaluated by the Visual Analogue Scale; urinary symptoms, evaluated by the American Urological Association symptom score; sum muscle strength of the iliopsoas, quadriceps, hamstrings and adductor muscles, each evaluated by the British Medical Research Council scale; and spasticity, evaluated by the Ashworth scale.
A masked assessment was performed before the study period; at the start of the study period; six weeks into the study; at the end of 11 weeks; and three months after the study period ended.

The reflexology group showed significant improvements at the end of the study period for scores of paresthesias, urinary symptoms and spasticity. Muscle strength scores for the reflexology group showed borderline improvement. The improvement in the intensity of paresthesia remained significant at the three-month follow-up.

Subjects in the control group showed no significant improvements on any of the outcome measures.

“It is of interest to note such positive effects of single intervention on a broad range of symptoms,” state the study’s authors. “Further clinical and laboratory studies are needed to validate these results and to understand the mechanisms by which reflexology improves symptoms secondary to [multiple sclerosis].”

- Source: Department of Orthopedic Rehabilitation, Complementary Medicine Clinic, Multiple Sclerosis Center at Sheba Medical Center in Tel-Hashomer, Israel; and Gertner Institute for Epidemiology and Health Policy Research. Authors: I. Siev-Ner; D. Gamus; L. Lerner-Geva; and A. Achiron. Originally published in Multiple Sclerosis, 2003, Vol. 9, pp. 356-361.

A program that trained parents to massage their disabled children resulted in reduced parental anxiety and increased parental perceptions of self-efficacy.

“A Training and Support Programme for caregivers of children with disabilities” was conducted by staff of the Interdisciplinary Research Centre in Health, Coventry University, West Midlands, England.

Eighty-two children and their caregivers, the majority of whom were mothers, participated in the study. The children ranged in age from newborn to 16 and had a wide variety of disabilities, from mild colic to cerebral palsy, autism spectrum disorder, epilepsy and chromosomal disorders.

The training and support program involved parents learning a simple massage routine they could give their kids at home. Parents received one hour of massage instruction per week for eight weeks. One massage therapist worked with each child-caregiver pair throughout the eight-week program. The parents were also provided with a training pack that included a list of contraindications, instructions on techniques, diagrams and photographs.

“The aim is not about treating children, but giving parents something practical and useful to do in the care of their children,” state the study’s authors.
“It’s about parents and children connecting, bonding, having quality time together, doing something that is pleasurable for both giver and receiver,” they continue. “It is about using the important sense of touch for these things and, of course, touch for communication.”

Questionnaires assessing parents’ levels of anxiety, depression and self-efficacy were distributed immediately before and after the program, and again 16 weeks later. Qualitative data evaluating parents’ perceptions of their children’s well-being and changes in symptoms were collected from home record sheets completed by parents and monitoring forms completed by therapists.

Self-reports from parents showed that their own anxiety levels were significantly lower. The caregivers perceived that their children were eating and sleeping better, were more mobile, had increased bowel movements and body awareness, were more calm and relaxed, and that they found the massage enjoyable.

Qualitative data collected throughout the program reflected that the children were in fact sleeping and eating better, and were more calm and relaxed.

“Comparisons of study variables over time showed significant improvements in parental self-efficacy for giving children massage and self-efficacy for managing children’s psychosocial well-being,” state the study’s authors. “Regardless of the nature of children’s disabilities, relaxation emerged as a salient outcome for both giver and recipient.”

- Source: Interdisciplinary Research Centre in Health, Coventry University, West Midlands, England. Authors: Lesley Cullen, Ph.D., and Julie Barlow, Ph.D.

Stable preterm infants gained more weight and slept less after five days of massage therapy than infants who did not receive massage, according to a recent study.

“Stable Preterm Infants Gain More Weight and Sleep Less after Five Days of Massage Therapy” was conducted by staff at the Touch Research Institutes, University of Miami School of Medicine; and the Center for Prenatal Assessment and Human Development, Emory University.

Infants were randomly assigned to either the massage-therapy group or the control group. Sixteen infants, approximately three weeks old, were in each group.

Massage therapy started the day after group assignment and continued for five consecutive days. Each day, the first 15-minute massage happened about one hour after the morning feeding; the second happened about one half-hour after the midday feeding; and the third happened approximately 45 minutes after the second massage.

The massage sessions comprised five minutes of tactile stimulation, five minutes of kinesthetic stimulation and then another five minutes of tactile stimulation.

Data on weight gain, formula intake, kilocalories, bowel movements and sleep/wake behavior of the infants in the massage-therapy group were taken from daily nursing notes and compared with the control group.

Infants’ sleep/wake behavior was recorded by observers for 30 minutes, at the same time, on the first and last days of the study. Observers coded the behavior according to whether it was non-REM sleep, active sleep without REM, REM sleep, drowsy, quiet alert, active alert or crying.
Results of the study showed that the massage-therapy group gained an average of 26 grams more per day than the control group, a 53-percent greater average daily weight gain than the control infants.

“Five days of massage therapy also led to a significant reduction in sleep states and an increase in drowsiness,” state the study’s authors. “Along with the statistically significant increase in drowsiness, trends shown by the massage therapy infants may reflect acceleration in the developmental course of sleep/wake patterns in preterm infants.”

Daily formula intake, kilocalories and number of bowel movements did not differ between the two groups.

“Healthy, low-risk preterm infants gained more weight and slept less with just five days of massage, in contrast to 10 days in previous studies,” state the authors. “That the promotion of weight gain was so rapid suggests that the dose-response ratio may be lower than previously thought.”

- Source: Touch Research Institute, University of Miami School of Medicine, and the Center for Prenatal Assessment and Human Development, Emory University, with support from Johnson and Johnson. Authors: John N.I. Dieter, Ph.D.; Tiffany Field, Ph.D.; Maria Hernandez-Reif, Ph.D.; Eugene K. Emory, Ph.D.; and Mercedes Redzepi, Psy.D. Originally Published in the Journal of Pediatric Psychology, 2003, Vol. 28, No. 6, pp. 403-411.

Massage therapy and healing touch reduced pain, mood disturbance (anger, anxiety, depression, confusion) and fatigue in cancer patients undergoing chemotherapy, according to a recent study.

“Therapeutic Massage and Healing Touch Improve Symptoms in Cancer” was conducted by staff at the University of Minnesota in Minneapolis, and United Hospital Department of Integrative Health in St. Paul, Minnesota.

Eighty-seven percent of the 164 subjects in the study were women. More than half of them had breast cancer; other types of cancers prevalent in the study were gynecological or genitourinary cancer, gastro-intestinal cancer and lung cancer, among others.

Subjects were randomly assigned to one of three groups: massage therapy, healing touch or caring presence. They received 45 minutes of the assigned intervention per week for four weeks. All participants also received four weeks of standard cancer care alone, which was the control condition.

In the massage group, a standard Swedish massage was given, with modifications for tumor or surgical sites, as well as individual tolerance.

In the healing-touch group, a protocol developed by Healing Touch International was used, involving both touch and non-touch techniques, such as centering, unruffling, magnetic unruffling, full-body connection and mind clearing.
Subjects in the caring-presence group laid on the massage table for 45 minutes and listened to the same relaxing music played during the massage and healing-touch sessions, while one of the massage or healing-touch therapists was present.

Immediate outcomes, measured before and after each intervention session, or once per control session, were heart rate, respiratory rate, blood pressure, and self-reports of pain and nausea.

Outcomes evaluated at the beginning and end of each four-week period were anxiety, mood, fatigue, pain, nausea, use of analgesics and antiemetics, and overall satisfaction with care.

Both massage therapy and healing touch reduced blood pressure, respiratory rate, heart rate, total mood disturbance and pain. Subjects in the healing-touch group also had lower fatigue, while subjects in the massage group had lower anxiety and used less nonsteroidal anti-inflammatory drugs (NSAIDs).

Caring presence was found to reduce respiratory rate and heart rate, but did not differ from standard care on any other outcomes.

“[Massage therapy] and [healing touch] were more effective than presence alone or standard care in inducing physical relaxation, reducing pain, improving mood states and fatigue,” state the study’s authors. “These results clearly suggest a benefit to both massage and [healing touch] that goes beyond the mere presence of a caring practitioner.”

- Source: University of Minnesota in Minneapolis and United Hospital Department of Integrative Health in St. Paul, Minnesota. Authors: Janice Post-White, R.N., Ph.D.; Mary Ellen Kinney, R.N.; Kay Savik; Joanna Bernsten Gau, R.N.; Carol Wilcox, R.N.; and Irving Lerner, M.D. Originally published in Integrative Cancer Therapies, 2003, Vol. 2, No. 4, pp. 332-344.