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Clinical Studies about Therapeutic Massage

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Massage therapy reduces blood pressure. January 2015.

According to the US Centers for Disease Control and Prevention (CDC), one in three American adults has hypertension (commonly known as high blood pressure), yet only about half of affected people have their condition under control.1 This is concerning because hypertension can lead to dangerous health conditions including chronic heart failure, heart attack, kidney disease, and stroke. In fact, high blood pressure and its associated conditions lead to approximately 1,000 deaths each day in the United States.
Massage combined with antihypertensive medication was significantly more effective at reducing both systolic and diastolic blood pressure than medication alone. In other words, people who take antihypertensive medication have better results if they also receive massage therapy.
The overall decrease in systolic and diastolic blood pressure due to massage therapy was approximately 6.9 and 3.6 millimeters of mercury (mmHg) respectively. To put this in context, the CDC reports that a 12–13 mmHg reduction in average systolic blood pressure over four years can reduce heart disease risk by 21 percent, stroke risk by 37 percent, and total risk of cardiovascular-related death by 25 percent.
Massage was shown to be significantly safer than antihypertensive medications based on the number of side effects reported. No serious adverse events occurred in either group, but there were significantly fewer minor adverse events with massage therapy than with medication.

Massage Therapy Eases Fibromyalgia. March 2015.

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by anxiety, depression, sleep disturbances, fatigue, and memory issues. According to the Mayo Clinic, fibromyalgia amplifies painful sensations by affecting the way the brain processes pain signals.1 Approximately 2–5 percent of the population is affected by fibromyalgia, leading to reduced activities in daily living and work capability.2
Fibromyalgia can be difficult to diagnose and treat. Pain and fatigue are often misdiagnosed as other conditions, such as chronic fatigue syndrome, hypothyroidism, and malingering. In some individuals, the diagnosis is not made for years due to overlapping symptoms. Once diagnosed, patients typically see several health-care providers in order to determine the best treatment for their condition. Traditionally, those with fibromyalgia try various medications, undergo physical therapy, and attend pain clinics. Because of the lack of success with conventional treatment, approximately 90 percent of those with fibromyalgia seek relief through at least one form of complementary and alternative treatment such as acupuncture, chiropractic, herbal supplements, and massage therapy.3
At least five weeks of massage therapy is likely needed to demonstrate pain reduction in fibromyalgia patients.
Fibromyalgia patients may also experience improvement in anxiety and depression after five weeks of massage therapy.
Massage therapy is expected to be safe for patients with fibromyalgia, as evidenced by no adverse reactions in any of the studies reviewed.

Massage Therapy Effective for Musculoskeletal Disorders. March 2016.

According to the 2010 Global Burden of Disease Study, musculoskeletal disorders are the fourth largest health problem worldwide, affecting 20–50 percent of the population at any given time.1 The most commonly affected areas include the low back, neck, shoulders, and knees. In fact, of all injuries presenting to emergency departments in the United States, 36 percent are sprains and/or strains of the lower extremity and 16 percent are sprains and/or strains of the upper extremity.2 Many treatments are utilized for these conditions, including massage therapy.
In this article, massage was defined as “systematic manual manipulation of the soft tissues of the body with rhythmical pressure and stroking.”
Massage techniques included Swedish massage (5 articles), Thai massage (4), self-massage (1), or a combination of massage techniques (12).
The results of the review included a total of 2,565 participants within the 26 studies. For reduction in pain in the short term, the data demonstrated evidence in favor of massage compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low-back pain or neck pain. For improvement in function in the short term, the data also showed evidence in favor of massage compared to no treatment in people with low-back pain, knee arthritis, or shoulder pain.
In this review, musculoskeletal disorders and injuries were based on the US Centers for Disease Control and Prevention definition and defined as “grade I–II sprains or strains; nonspecific shoulder, elbow, wrist, hip, knee, ankle, and/or foot pain; tendonitis; tendinopathy; tendinosis; and other musculoskeletal disorders and injuries (including nerve injuries/neuropathies).”
The results demonstrated that myofascial release therapy was beneficial for lateral epicondylitis and plantar fasciitis. Movement reeducation was also beneficial for lateral epicondylitis. Localized relaxation massage combined with other forms of care provided short-term benefit for carpal tunnel syndrome.

MS: Easing Symptoms with Informed Massage. November 2012.

Right now, more than 350,000 Americans experience symptoms associated with multiple sclerosis (MS), including weakness, spasm, loss of coordination, and impaired cognition. As a massage therapist, you can be sure that someone with MS will walk through your door and be desperate for help.

 What is MS?

MS is an inflammatory disease of the central nervous system (CNS) in which the myelin sheath deteriorates, resulting in the destruction of nerve fibers. The origin is unknown, but we do know:

• There are multiple autoimmune, environmental, and genetic factors that can trigger MS.

• A person with a history of serious viral or bacterial infection is more prone to be affected.

• Usual onset is between 20 and 40 years of age.

• It occurs twice as often in young women than in young men, but after 30, both genders are equally affected.

• Every year, 25,000 new cases are diagnosed in the United States.

How Are MS patients Treated Medically?

…the primary treatment for the condition is largely pharmaceutical.

While steroids can quiet flares, drugs that limit the immune system’s response to inflammation, reduce flares, and prolong periods of remission are now most commonly used to treat MS. Interferon betas allow many patients to live almost symptom-free. These drugs, which are immunomodulators, help manage relapsing MS and reduce the development of brain lesions (injury to nerves in the brain caused by demyelination). Chemotherapeutic agents, also called antineoplastics, quiet the immune system but are reserved to treat the most severe cases of MS. Drug cocktails (combinations of two or more medications) can address a variety of symptoms, yet all of these medications have serious, long-term, adverse side effects.

How Can Massage Therapy Help?

The careful administration of massage therapy techniques can help relieve muscle cramping, spasm, spasticity, and hand and foot paresthesias. Secondary limb and joint compensatory stiffness, contractures, and localized edema can be addressed with effective soft-tissue and range of motion (ROM) techniques. Depression can be reduced and an altered self-image can be improved by compassionate bodywork.

Because of the mercurial symptomatic picture presented by most clients with MS, therapeutic goals will shift frequently. Given both the musculoskeletal involvement of MS and the understandable accompanying stress, the following three general goals can be combined with the client’s specific concerns: 1) relieving musculoskeletal pain, spasm, and stiffness on the affected and compensating sides of the body; 2) reducing stress; and 3) helping maintain thoracic capacity and efficient breathing patterns.

The Benefits of Massage Therapy for Parkinson's. July 2016.

For those with Parkinson’s disease, the brain slowly degenerates because the neurotransmitter dopamine stops being produced. As dopamine production slows, the patient has a significant reduction in control over his or her movements. As rigidity sets in, so does pain. According to the Parkinson’s Disease Foundation (www.pdf.org), more than half of all patients with Parkinson’s disease have associated pain, with some pain expression overshadowing the symptoms of the disease itself.
Many people with Parkinson’s disease seek complementary and alternative care in addition to conventional medicine. Massage therapy is commonly sought, with some neurologists advocating this form of care for alleviation of muscle rigidity, joint contractures, and associated pain.
A 30-minute traditional Japanese massage was provided to each subject by the same licensed massage therapist who had 20 years of experience. For each subject, the massage was conducted through the clothes and mostly included kneading to the neck, back, and associated limbs, starting on the less severe side and then moving to the severe side. Each subject received an individualized massage based on his or her areas of complaint.
A 20-meter walk test (10-meter walk and return) was administered before and after the massage to the four patients with gait disturbance who were able to walk unassisted. The 20-meter walk times improved for all patients, including one patient whose time was 95.0 seconds before the massage and 21.5 seconds after the massage. Also, one wheelchair-bound patient who only ambulated with the aid of her daughter before the massage was able to walk unassisted 10 meters to her wheelchair after the massage.
Changes in shoulder range of motion were also measured before and after massage for the three patients with frozen shoulder, demonstrating improvements from 10 to 25 degrees in flexion and from 5 to 35 degrees in abduction. After the massage, all of the previously frozen shoulders demonstrated nearly full range of motion.
Other changes in symptoms before and after the massage included individual improvements in the heaviness of lower and upper extremities, lassitude of the whole body, fatigue, shoulder stiffness, and muscle pain.
Overall, this case series demonstrated multiple subjects’ improvements in walking, speaking, and shoulder movement. Interestingly, the treatment was only a one-time, 30-minute traditional Japanese massage, rather than a weekly 60-minute Swedish massage over five weeks like the previous study.

Massage therapy as a nonpharmacologic treatment for individuals suffering from migraines. August 2006.

BACKGROUND:

Migraine is a distressing disorder that is often triggered by stress and poor sleep.

RESULTS:

Compared to control participants, massage participants exhibited greater improvements in migraine frequency and sleep quality during the intervention weeks and the 3 follow-up weeks. Trends for beneficial effects of massage therapy on perceived stress and coping efficacy were observed. During sessions, massage induced decreases in state anxiety, heart rate, and cortisol.

Massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients. May 2008.

OBJECTIVE:

The aim of the present pilot study was to examine the effectiveness of a relaxation massage therapy programme in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit.

RESULTS:

There was a significant reduction in self-reported anxiety (p < 0.001), resting heart rate (p < 0.05) and cortisol levels (p < 0.05) immediately following the initial and final massage therapy sessions. Significant improvements in hostility (p = 0.007) and depression scores (p < 0.001) on the SCL-90-R were observed in both treatment groups.

A meditation-based stress management program can be effective in relieving anxiety symptoms in patients with anxiety disorder. February 2007.

OBJECTIVE:

The objective of this study was to examine the effectiveness of a meditation-based stress management program in patients with anxiety disorder.

METHODS:

Patients with anxiety disorder were randomly assigned to an 8-week clinical trial of either a meditation-based stress management program or an anxiety disorder education program.

RESULTS:

Compared to the education group, the meditation-based stress management group showed significant improvement in scores on all anxiety scales.

Light pressure massage for patients with severe anxiety. February 2007.

Abstract

Generalised anxiety disorder (GAD) is common in the western world with a lifetime prevalence of 4.3 to 5.9% and is twice as common in women as in men. GAD can have a decisive impact on a patient’s everyday life as it is surrounded by unfocused worries and the severe anxiety may interfere with normal social functions. The treatments include cognitive behavioural therapy and/or psychopharmacological drugs. In previous studies the positive effects of massage on anxiety have been shown. The present study described the experience of receiving massage for eight patients with GAD. Findings revealed that the patients were able to rediscover their own capacity during the massage period. This was illuminated by the experience of being relaxed in body and mind, the experience of unconditional attention, the experience of decreased anxiety and the experience of increased self-confidence.

Massage & Meditation for Breast Cancer Patients - November 2012

Besides skin cancer breast cancer is the most common malignancy among women. Most women with breast cancer will undergo some kind of breast cancer surgery. For women undergoing a mastectomy, breast reconstruction offers significant quality of life benefits and is a vital option to enhance breast cancer recovery. There are two general types of reconstructive options:

  1. Prosthetic devices (saline implants, silicone implants, tissue expanders)
  2. Autologous tissue reconstructions with tissue flaps that are transferred from adjoining or distant donor sites to the anterior chest wall.

When reconstruction of the breast mound is accomplished using the patient’s own tissues, the result is typically more natural in both appearance and feel than with expander/implant reconstruction. However the disadvantages of autologous reconstruction include longer surgical procedures and prolonged recovery time as compared to prosthetic reconstruction. Postoperative pain, anxiety, fatigue are among the challenges facing patients undergoing breast cancer surgery and especially patients who decided to undergo these complicated plastic surgical procedures. Massage therapy has been used successfully to target common postoperative symptoms such as pain, anxiety, tension and fatigue in breast cancer patients.

Meditation has been shown to be helpful in achieving healing and relaxation through purposeful contemplation and reflection.

A randomized, controlled trial of massage therapy as a treatment for migraine. August 2006.

BACKGROUND:

Migraine is a distressing disorder that is often triggered by stress and poor sleep.

RESULTS:

Compared to control participants, massage participants exhibited greater improvements in migraine frequency and sleep quality during the intervention weeks and the 3 follow-up weeks. Trends for beneficial effects of massage therapy on perceived stress and coping efficacy were observed. During sessions, massage induced decreases in state anxiety, heart rate, and cortisol.

CONCLUSIONS:

The findings provide preliminary support for the utility of massage therapy as a nonpharmacologic treatment for individuals suffering from migraines.

Effects of Swedish massage therapy on blood pressure, heart rate, and inflammatory markers in hypertensive women. August 2013.

Abstract

Swedish Massage Therapy (SMT) is known for its therapeutic relaxation effects. Hypertension is associated with stress and elevated endothelial inflammatory markers. This randomized control trial measured the effects of whole body SMT (massage group) or resting (control group) an hour weekly for four weeks on hypertensive women. Blood pressure (BP) and heart rate (HR) were measured before and after each intervention and endothelial inflammatory markers: vascular endothelial adhesion molecules 1 (VCAM-1) and intracellular adhesion molecules 1 (ICAM-1) were measured at baseline and after the last intervention.
Heart rate of the massage group was reduced significantly after each session, and the changes were significant between groups after sessions one, three, and four. Even though the duration of the massage session is different from other studies, these results are consistent with studies that measure the effects of massage on normal individuals [22], breast cancer patients [32], hospice patients [33], migraine patients [34], and critical care patients [35].
The reduction in BP and HR could be explained through the comfortable feeling and relaxation, as well as the increase in parasympathetic activities……..massage applied at medium pressure for 15 minutes caused increase in the high-frequency component of HR variability which reflected an increase in vagal activities. In addition, there was a decrease in the ratio of low-frequency component to high-frequency component of HR variability which indicates a change from sympathetic activities to parasympathetic activities.

Conclusion

This study has shown that Swedish Massage Therapy or resting an hour weekly significantly reduced BP, HR, and VCAM-1 through the effects that have been discussed. However, the effect of rest on BP does not extend to four weeks as compared to SMT. In addition, massage also reduces resting HR in hypertensive women.

The effect of back massage on blood pressure in the patients with primary hypertension in 2012-2013: a randomized clinical trial. October 2014.

BACKGROUND:

Tension and stress are among the factors that lead to hypertension. In most individuals, behavioral strategies, such as relaxation and massage, are effective in controlling the individuals’ response to stress, thus reducing hypertension.

RESULTS:

In the intervention group, systolic and diastolic blood pressure decreased to 6.44 and 4.77 mmHg, respectively after back massage (P<0.001).

CONCLUSION:

The obtained results were indicative of the effectiveness of back massage in reducing blood pressure in the study participants. Using stress control methods, such as massage, is a simple, acceptable, and teachable method for families to control blood pressure. After conducting more studies on this issue, back massage can be recommended as a non-pharmacological method to control blood pressure.

The effect of massage therapy on blood pressure of women with pre-hypertension. Winter 2011.

BACKGROUND:

Prehypertension is considered as a cardiovascular disease predicator. Management of prehypertension is an appropriate objective for clinicians in a wide range of medical centers. Treatment of prehypertension is primarily non-pharmacological, one of which is massage therapy that is used to control the blood pressure. This study aimed to evaluate the effect of Swedish massage (face, neck, shoulders and chest) on blood pressure (BP) of the women with prehypertension.

RESULTS:

The results indicated that mean systolic and diastolic blood pressure in the massage group was significantly lower in comparison with the control group (p < 0.001).

CONCLUSIONS:

Findings of the study indicated that massage therapy was a safe, effective, applicable and cost-effective intervention in controlling BP of the prehypertension women and it can be used in the health care centers and even at home.

Massage therapy: understanding the mechanisms of action on blood pressure. A scoping review. October 2015.
  • Massage therapy (MT) has shown promise as an adjunctive treatment for prehypertension and hypertension.
  • MT stimulates several central and peripheral mechanisms across physiological and psychological domains.
    This review included the thematic analysis of 27 publications that considered the influence of MT on BP. Based on this analysis, six potential BP mediating pathways were identified Current theories suggest that MT exerts sympatholytic effects through physiologic and psychological mechanisms, improves hypothalamus–pituitary–adrenocortical axis function, and increases in blood flow, which, in turn, may improve endothelial function.
The effect of a scalp massage on stress hormone, blood pressure, and heart rate of healthy female. October 2016.

[Purpose] A scalp massage was conducted on female office workers divided into a 15 minute group and 25 minute group and its effect on stress hormone, blood pressure and heart rate was analyzed in order to provide a theoretical rationale to apply scalp massage as stress therapy. [Subjects and Methods] A scalp massage was applied to 34 female office workers twice a week for a total of 10 weeks; the subjects were classified into 15 min., 25 min. and control groups, and their stress hormone levels, blood pressure and heart rate were evaluated. [Results] Significant differences in norepinephrine, cortisol and blood pressure (SBP & DBP) were found in terms of interaction by time interval and between groups. [Conclusion] As a result of applying scalp massage to female office workers for 15 and 25 minutes, positive effects were observed on stress hormone, blood pressure and heart rate. Therefore, scalp massage can be used for stress control with no spatial or time limit.

Durability of effect of massage therapy on blood pressure. May 2013.

BACKGROUND:

Pre-hypertension is considered as a cardiovascular disease predicator. Management of pre-hypertension is an appropriate objective for clinicians in a wide range of medical centers. Treatment of pre-hypertension is primarily non-pharmacological, one of which is massage therapy that is used to control the BP. This study aimed to evaluate the survival effect of Swedish massage (face, neck, shoulders, and chest) on BP of the women with pre-hypertension.

RESULTS:

The results indicated that mean systolic and diastolic BP in the massage group was significantly lower in comparison with the control group (P < 0.001). Evaluation of durability of the massage effects on BP also indicated that 72 h after finishing the study, still there was a significant difference between the test and control groups in systolic and diastolic BP (P < 0.001).

CONCLUSIONS:

Findings of the study indicated that massage therapy was a safe, effective, applicable and cost-effective intervention in controlling BP of the pre-hypertension women and it can be used in the health care centers and even at home.

Does touch massage facilitate recovery after stroke? A study protocol of a randomized controlled trial. February 2016.

BACKGROUND:

Despite high quality stroke care, decreased sensorimotor function, anxiety and pain often remain one year after stroke which can lead to impaired health and dependence, as well as higher healthcare costs. Touch massage (TM) has been proven to decrease anxiety and pain, and improve quality of health in other conditions of reduced health, where reduced anxiety seems to be the most pronounced benefit. Thus there are reasons to believe that TM may also reduce anxiety and pain, and improve quality of life after stroke. Further, several studies indicate that somatosensory stimulation can increase sensorimotor function, and it seems feasible to believe that TM could increase independence after stroke. In this study we will evaluate effects of TM after stroke compared to sham treatment.

DISCUSSION:

TM seems to decrease anxiety and pain, increase health-related quality of life, and improve sensorimotor functions after stroke, but the field is largely unexplored. Considering the documented pleasant effects of massage in general, absence of reported adverse effects, and potential effects in relation to stroke, it is essential to evaluate effects of TM during the sub-acute phase after stroke. The results of this project will hopefully provide important knowledge for evidence-based care.

Five-week outcomes from a dosing trial of therapeutic massage for chronic neck pain. March 2014.

PURPOSE:

This trial was designed to evaluate the optimal dose of massage for individuals with chronic neck pain.

METHODS:

We recruited 228 individuals with chronic nonspecific neck pain from an integrated health care system and the general population, and randomized them to 5 groups receiving various doses of massage (a 4-week course consisting of 30-minute visits 2 or 3 times weekly or 60-minute visits 1, 2, or 3 times weekly) or to a single control group (a 4-week period on a wait list). We assessed neck-related dysfunction with the Neck Disability Index (range, 0-50 points) and pain intensity with a numerical rating scale (range, 0-10 points) at baseline and 5 weeks

CONCLUSIONS:

After 4 weeks of treatment, we found multiple 60-minute massages per week more effective than fewer or shorter sessions for individuals with chronic neck pain. Clinicians recommending massage and researchers studying this therapy should ensure that patients receive a likely effective dose of treatment.

Whole body massage for reducing anxiety and stabilizing vital signs of patients in cardiac care unit. June 2014.

Background: Patients admitted in coronary care units face various stressors. Ambiguity of future life conditions and unawareness of caring methods intensifies the patients’ anxiety and stress. This study was conducted to assess the effects of whole body massage on anxiety and vital signs of patients with acute coronary disorders.

Methods: A randomized controlled trial was conducted on 120 patients. Patients were randomly allocated into two groups. The intervention group received a session of whole body massage and the control group received routine care.
Conclusion: The results suggest that whole body massage was effective in reducing anxiety and stabilizing vital signs of patients with acute coronary disorders.

A critical review of manual therapy use for headache disorders: prevalence, profiles, motivations, communication and self-reported effectiveness. March 2017.

Background

Despite the expansion of conventional medical treatments for headache, many sufferers of common recurrent headache disorders seek help outside of medical settings. The aim of this paper is to evaluate research studies on the prevalence of patient use of manual therapies for the treatment of headache and the key factors associated with this patient population.
Despite the strong need for more high quality research to assess the efficacy of MT as a treatment for headache, the substantial use of MT brings attention to the need for more public health and health services research within this area of headache management. The need for this type of research was identified in a recent global report on the use of headache-related healthcare resources [18]. Furthering this information can lead to improvements in healthcare policy and the delivery of healthcare services.
Primary healthcare providers should be mindful of the use of this highly popular approach to headache management in order to help facilitate safe, effective and coordinated care.

 

A randomized, controlled trial of massage therapy as a treatment for migraine. August 2006.
Longer massage times or “Booster” doses for those initially receiving 60 minutes of massage should be incorporated into future trials of massage for chronic neck pain. 2015.

Background context

This is the first study to systematically evaluate the value of a longer treatment period for massage. We provide a framework of how to conceptualize an optimal dose in this challenging setting of nonpharmacologic treatments.

Purpose

The aim was to determine the optimal dose of massage for neck pain.

Study design/setting

Two-phase randomized trial for persons with chronic nonspecific neck pain. Primary randomization to one of five groups receiving 4 weeks of massage (30 minutes 2x/or 3x/wk or 60 minutes 1x, 2x, or 3x/wk). Booster randomization of participants to receive an additional six massages, 60 minutes 1x/wk, or no additional massage.

Conclusions

“Booster” doses for those initially receiving 60 minutes of massage should be incorporated into future trials of massage for chronic neck pain.

Adults Demonstrate Modified Immune Response After Receiving Massage, Cedars-Sinai Researchers Show. October 2010.

Researchers in Cedars-Sinai’s Department of Psychiatry and Behavioral Neurosciences have reported people who undergo massage experience measureable changes in their body’s immune and endocrine response.

Although there have been previous, smaller studies about the health benefits of massage, the Cedars-Sinai study is widely believed to be the first systematic study of a larger group of healthy adults.

The study is published online at http://www.liebertonline.com/loi/acm.  It also will be published in the October printed edition of the Journal of Alternative and Complementary Medicine.  

“Massage is popular in America, with almost 9 percent of adults receiving at least one massage within the past year,” said Mark Rapaport, MD, chairman of the Department of Psychiatry and Behavioral Neurosciences.  “People often seek out massage as part of a healthy lifestyle but there hasn’t been much physiological proof of the body’s heightened immune response following massage until now.”

In the study, 29 subjects received 45 minutes of Swedish massage and 24 received 45 minutes of light touch massage.  Each participant underwent informed consent, a physical and mental evaluation and was deemed to be physically healthy and free of any mental disorder.  Massage therapists were trained in how to deliver both Swedish and light touch using specific and identical protocols.

Among the study’s results:

  • People in the Swedish massage group experienced significant changes in lymphocytes ,(lymphocyte numbers and percentages white blood cells that play a large role in defending the body from disease.
  • Swedish massage caused a large decrease (effect size -.74) in Arginine Vasopressin (AVP) a hormone believed to play a role in aggressive behavior and linked to helping cause increases in the stress hormone cortisol.
  • Swedish massage caused a decrease in levels of the stress hormone cortisol.
  • Swedish massage caused a notable decrease in most cytokines produced by stimulated white blood cells.