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PubMed2002

Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group.

BACKGROUND: Low back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability and speed return-to-normal function. OBJECTIVES: To assess the effects of massage therapy for nonspecific LBP. SEARCH STRATEGY: We searched MEDLINE, Embase, Cochrane Controlled Trials Register, HealthSTAR, CINAHL, and dissertation abstracts through May 2001 with no language restrictions. References in the included studies and in reviews of the literature were screened. Contact with content experts and massage associations was also made. SELECTION CRITERIA: The studies had to be randomized or quasirandomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for nonspecific LBP. DATA COLLECTION AND ANALYSIS: Two reviewers blinded to authors, journals, and institutions selected the studies, assessed the methodologic quality using the criteria recommended by the Cochrane Collaboration Back Review Group, and extracted the data using standardized forms. The studies were analyzed in a qualitative way because of heterogeneity of population, massage technique, comparison groups, timing, and type of outcome measured. RESULTS: Nine publications reporting on eight randomized trials were included. Three had low and five had high methodologic quality scores. One study was published in German, and the rest, in English. Massage was compared with an inert treatment (sham laser) in one study that showed that massage was superior, especially if given in combination with exercises and education. In the other seven studies, massage was compared with different active treatments. They showed that massage was inferior to manipulation and transcutaneous electrical nerve stimulation; massage was equal to corsets and exercises; and massage was superior to relaxation therapy, acupuncture, and self-care education. The beneficial effects of massage in patients with chronic LBP lasted at least 1 year after the end of the treatment. One study comparing two different techniques of massage concluded in favor of acupuncture massage over classic (Swedish) massage. CONCLUSIONS: Massage might be beneficial for patients with subacute and chronic nonspecific LBP, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this needs confirmation. More studies are needed to confirm these conclusions, to assess the effect of massage on return-to-work, and to measure longer term effects to determine cost-effectiveness of massage as an intervention for LBP.

Controlled Clinical Trials as Topic↗
PubMed2005

The mechanisms of massage and effects on performance, muscle recovery and injury prevention.

Many coaches, athletes and sports medicine personnel hold the belief, based on observations and experiences, that massage can provide several benefits to the body such as increased blood flow, reduced muscle tension and neurological excitability, and an increased sense of well-being. Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms). Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing. Depending on the massage technique, mechanical pressure on the muscle is expected to increase or decrease neural excitability as measured by the Hoffman reflex (neurological mechanisms). Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response (physiological mechanisms). A reduction in anxiety and an improvement in mood state also cause relaxation (psychological mechanisms) after massage. Therefore, these benefits of massage are expected to help athletes by enhancing performance and reducing injury risk. However, limited research has investigated the effects of pre-exercise massage on performance and injury prevention. Massage between events is widely investigated because it is believed that massage might help to enhance recovery and prepare athletes for the next event. Unfortunately, very little scientific data has supported this claim. The majority of research on psychological effects of massage has concluded that massage produces positive effects on recovery (psychological mechanisms). Post-exercise massage has been shown to reduce the severity of muscle soreness but massage has no effects on muscle functional loss. Notwithstanding the belief that massage has benefits for athletes, the effects of different types of massage (e.g. petrissage, effleurage, friction) or the appropriate timing of massage (pre-exercise vs post-exercise) on performance, recovery from injury, or as an injury prevention method are not clear. Explanations are lacking, as the mechanisms of each massage technique have not been widely investigated. Therefore, this article discusses the possible mechanisms of massage and provides a discussion of the limited evidence of massage on performance, recovery and muscle injury prevention. The limitations of previous research are described and further research is recommended.

Athletic Injuries↗
PubMed2004

Use of oxytocin and cloprostenol to facilitate semen collection by electroejaculation or transrectal massage in bulls.

Two experiments were conducted with 24 bulls in which semen collection was attempted by transrectal massage (RM) and electroejaculation (EE). In experiment 1, bulls received the following treatments on successive semen collection days: saline 10 min prior to electroejaculation (control); saline 10 min prior to 2 min of transrectal massage followed by electroejaculation; cloprostenol (CLO) 10 min prior to 2 min of transrectal massage followed by electroejaculation; oxytocin (OXY) 10 min prior to 2 min of transrectal massage followed by electroejaculation. Transrectal massage consisted of general, back and forth motion over the ampullae, prostate and urethra with a flattened hand. In experiment 2, bulls received saline (control), oxytocin, or cloprostenol 10 min before attempting semen collection by transrectal massage. Massage was applied specifically to the ampullae for a maximum of 5 min or until a semen sample was obtained. Electroejaculation was attempted in all bulls following transrectal massage. In experiment 1, semen was obtained in <1% of bulls by transrectal massage. However, by using an improved massage technique in experiment 2, semen was obtained in 97.2% of attempts. Semen was obtained in 96.9 and 98.9% of attempts by electroejaculation in experiments 1 and 2, respectively. Oxytocin treatment increased the time to penile protrusion during electroejaculation in experiment 1 and during massage in experiment 2. In experiment 1, oxytocin decreased the time to semen emission and tended to decrease the number of electroejaculation stimuli to semen emission. Cloprostenol treatment, in experiment 1, resulted in an increased number of electroejaculation stimuli to penile protrusion, but did not affect the number of stimuli required for semen emission. Massage of the ampullae prior to electroejaculation reduced both the time to semen emission and the number of electroejaculation stimuli required for semen emission. Transrectal massage of the ampullae was very effective in this experiment for producing semen emission, but quantity of semen samples was less than for electroejaculation. The usefulness of transrectal massage for semen collection in breeding soundness evaluations needs to be investigated further under field conditions.

Animals↗
PubMed2004

Massage provision by physiotherapists at major athletics events between 1987 and 1998.

BACKGROUND: The equivocal findings in the literature on efficacy of massage makes it difficult to assess the requirement for, or justify the use of, specialist massage personnel at major athletics events. However, the use of massage by athletes during training and competition remains popular. OBJECTIVES: To quantify the amount of their time that physiotherapists devote to massage treatment at major athletics events in an attempt to determine the importance of this treatment modality, and to examine whether the use of massage at athletics events is changing over time. METHODS: Data recorded by the head team physiotherapist from 12 major athletics events (national and international events) between 1987 and 1998 were examined. For each event, the data included: total number of treatments administered by the physiotherapist, the treatment modalities used, and the number of attendances for treatment. The amount of massage provided was expressed as a percentage of the total number of treatments for each athletic event, and the pattern of change in use of massage treatment over time was evaluated. RESULTS: The percentage of time spent providing massage treatment ranged from 24.0% to 52.2% of the total number of treatments made. The overall median percentage of total treatments in the form of massage was 45.2%. No significant increase or decrease in the use of massage as a treatment modality was observed between 1987 and 1998 in the athletics events examined (p = 0.95). CONCLUSIONS: A significant proportion of physiotherapists' time is devoted to the delivery of massage treatment at athletics events. The demand for massage treatment has been steady over the time period, in the events for which data are available, indicating a consistent use of this treatment modality. Given the popularity of massage among athletes, consideration should be given to the use of specialist sports massage staff at major athletics events. Furthermore, it would seem prudent to further investigate the efficacy of the treatment.

Athletic Injuries↗
PubMed1999

An evaluation of aromatherapy massage in palliative care.

The use of complementary therapies, such as massage and aromatherapy massage, is rising in popularity among patients and healthcare professionals. They are increasingly being used to improve the quality of life of patients, but there is little evidence of their efficacy. This study assessed the effects of massage and aromatherapy massage on cancer patients in a palliative care setting. We studied 103 patients, who were randomly allocated to receive massage using a carrier oil (massage) or massage using a carrier oil plus the Roman chamomile essential oil (aromatherapy massage). Outcome measurements included the Rotterdam Symptom Checklist (RSCL), the State-Trait Anxiety Inventory (STAI) and a semi-structured questionnaire, administered 2 weeks postmassage, to explore patients' perceptions of massage. There was a statistically significant reduction in anxiety after each massage on the STAI (P < 0.001), and improved scores on the RSCL: psychological (P < 0.001), quality of life (P < 0.01), severe physical (P < 0.05), and severe psychological (P < 0.05) subscales for the combined aromatherapy and massage group. The aromatherapy group's scores improved on all RSCL subscales at the 1% level of significance or better, except for severely restricted activities. The massage group's scores improved on four RSCL subscales but these improvements did not reach statistical significance. Massage with or without essential oils appears to reduce levels of anxiety. The addition of an essential oil seems to enhance the effect of massage and to improve physical and psychological symptoms, as well as overall quality of life.

Adult↗
PubMed2004

[The history of massage in the ways of life and healing in India].

The use of massage in India can be accounted for back to the time of the first indo-aryan settlements; its is however, likely that massage was already in use during the preceding era of the Indus valley culture.The important cultural function of the ancient practice of home massage can be seen in that massage was often linked to social, religious or ritual customs. Massage was considered to be beneficial to health. The classic Ayurveda texts mention massage in this sense and recommend it as an almost indispensible healing factor. To this day, massage is regularly used in India for the promotion of general health and fitness as well as in treating minor health problems. Ayurvedic doctors also employ massage as a complete therapy to be applied systematically in the treatment of serious illness. Massage is most commonly applied to the entire body or individual body parts with the aid of ample amounts of warmed oils and, at times, other substances which are specific to the patient's constitution. The usual massage method is similar in some ways to the western method. The Ayurveda system, moreover, has a wide range of special massage methods which are used to treat particular illnesses. While today the efficacy and effect of western massage is, in large part, accounted for scientifically, in India, common, traditional massage is usually employed based on ancient experience. The general social conditions in southern Asia will likely ensure that these types of massage will continue to be a respected and frequently practised aspect of Indian culture in the future.

History, 15th Century↗
PubMed2001

Women's views on the practice of prenatal perineal massage.

OBJECTIVE: To determine how women who practised perineal massage during pregnancy assessed the technique. DESIGN: Observational study within one arm of a randomised controlled trial. SETTING: Five secondary and tertiary care hospitals in the Province of Quebec, Canada. PARTICIPANTS: Among 763 women randomised to the massage arm of a clinical trial of perineal massage during pregnancy, 684 (90%) who completed a questionnaire after delivery. MAIN OUTCOME MEASURES: A 20-item questionnaire completed a few days after birth. The first 18 questions elicited opinions using a 6-point Likert scale. Based on a factor analysis, 17 of these questions were classified into four categories: acceptability of perineal massage (8 items); preparation for birth (4 items); relationship with the partner (2 items); and effect of massage on delivery (3 items). Scores of each scale varied between 1 (highly negative assessment) to 6 (highly positive assessment). The last two questions asked whether women would perform the massage in their next pregnancy and whether they would recommend perineal massage to another pregnant woman. In addition, 262 also provided comments about their experience in the daily diary provided to record compliance during the trial. RESULTS: On average, perineal massage was felt to be quite acceptable [mean (standard deviation) 4.09 (0.93)]. Pain and technical problems reported during the first week or two of massage tended to disappear after a few weeks. Women's assessment of the effect of massage on preparation for birth [4.34 (1.08)] and on delivery [4.18 (1.37)] was positive. Women's views about the effect on their relationship with their partner were either positive or negative [3.54 (1.74)] and were proportional to the partner's participation with the massage. Most women said they would massage again if they were to have another pregnancy (79%; 95% CI, 76%-82%) and would recommend it to another pregnant woman (87%; 95% CI 84%-90%). CONCLUSION: Overall, women's assessment of prenatal perineal massage is positive.

Adult↗