ArticlePDF Available

Massage Therapy Reduces Anxiety and Enhances Eeg Pattern of Alertness and Math Computations

Authors:

Abstract and Figures

Twenty-six adults were given a chair massage and 24 control group adults were asked to relax in the massage chair for 15 minutes, two times per week for five weeks. On the first and last days of the study they were monitored for EEG, before, during and after the sessions. In addition, before and after the sessions they performed math computations, they completed POMS Depression and State Anxiety Scales and they provided a saliva sample for Cortisol. At the beginning of the sessions they completed Life Events, Job Stress and Chronic POMS Depression Scales. Group by repeated measures and post hoc analyses revealed the following: 1) frontal delta power increased for both groups, suggesting relaxation; 2) the massage group showed decreased frontal alpha and beta power (suggesting enhanced alertness); while the control group showed increased alpha and beta power; 3) the massage group showed increased speed and accuracy on math computations while the control group did not change; 4) anxiety levels were lower following the massage but not the control sessions, although mood state was less depressed following both the massage and control sessions; 5) salivary Cortisol levels were lower following the massage but not the control sessions but only on the first day; and 6) at the end of the 5 week period depression scores were lower for both groups but job stress scores were lower only for the massage group.
Content may be subject to copyright.
Intern. J. Neuroscience. 1996. Vol. 86. pp. 197-205 1996 OPA (Overseas Publishers Association)
Reprints available directly from the publisher Amsterdam B.V. Published under license by
Photocopying permitted by license only. Cordon and Breach Science Publishers SA
Printed in Malaysia
MASSAGE THERAPY REDUCES ANXIETY AND
ENHANCES EEG PATTERN OF ALERTNESS AND
MATH COMPUTATIONS
*
TIFFANY FIELD, GAIL ROBINSON, FRANK SCAFIDI, TOM NAWROCKI,
and ALEX GONCALVES
Touch Research Institute, University of Miami School of Medicine
JEFF PICKENS
James Madison University
NATHAN FOX
University of Maryland
SAUL SCHANBERG and CYNTHIA KUHN
Duke University Medical School
(Received March 3, 1996)
Twenty-six adults were given a chair massage and 24 control group adults were asked to relax in the massage chair
for 15 minutes, two times per week for five weeks. On the first and last days of the study' they were monitored for
EEG, before, during and after the sessions. In addition, before and after the sessions they Performed math
computations, they completed POMS Depression and State Anxiety Scales and they provided a saliva sample for
cortisol. At the beginning of the sessions they completed Life Events, Job Stress and Chronic POMS Depression
Scales. Group by repeated measures and Post hoc analyses revealed the following: 1)~frontal delta power increased
for both groups, suggesting relaxation; 2) the massage group showed decreased frontal alpha and beta power
(suggesting enhanced alertness); while the control group showed increased alpha and beta power; 3) the massage
group showed increased speed and accuracy on math computations while the control group did not change; 4)
anxiety levels were lower following the massage but not the control sessions, although mood State was less
depressed following both the massage and control sessions; 5) salivary cortisol levels were lower following the
massage but not the control sessions but only on the first day; and at the end of the 5 week period depression scores
were lower for both groups but job stress scores were lower only for the massage group.
Keywords: Massage. alertness
Despite the increasing popularity of stress-management programs (Ivancevitch, Matteson, Freedman &
Phillips, 1990) very little evaluation research has been done. Most evaluations are based on "professional
opinions" and survey studies rather than empirical studies. A recent study on stress in HIV positive men
suggested that those who were most stressed gained most from a massage therapy intervention (Ironson, Field,
Kumar, Price, Kumar, Hansen & Burman, 1995). Longterm (one month) effects indicated immunological
benefits including increased natural killer cell number and natural killer cell cytotoxicity. Massage therapy has
also been noted to decrease anxiety and depression as well as cortisol and norepinephrine levels and improve
sleep patterns in adolescents with psychiatric problems (Field, Morrow, Valdeon, Larson, Kuhn & Schanberg,
1992). Thus, massage is noted to decrease anxiety and depression based on self-report, behavior observations,
salivary cortisol and urinary norepinephrine levels and to enhance immune function.
In the above studies subjects anecdotally reported enhanced alertness instead of the expected soporific effect
following massage. The purpose of the present study was to investigate the effects of massage on alertness as
measured by accuracy of performance on math computations. The only massage study in the literature that
recorded EEG showed that facial massage was accompanied by decreased alpha and beta, a pattern that is
inconsistent with drowsiness (Jodo, Yamada, Hatayama, Abe & Maruyama, 1988). The EEG alpha was
expected similarly to decrease during the chair massage in this study and the behavioral measure of alertness,
namely math computation performance, was expected to improve following massages. In addition, anxiety,
depression and cortisol levels were expected to decrease as they did in the Field et al. (1995) study on
disturbed adolescents and the Ironson et al. (1995) study on HIV men.
METHOD
Subjects
The subjects were 50 medical faculty and staff members (80% females, M age = 26). The subjects were well-
educated (62% college graduate, 12% graduate school, 27% graduate degree). Income was $20,OOO for 58%,
$2~30,OOO for 35% and greater than $30,OOO for 8%. Forty-six percent of the sample exercised regularly,
with moderate numbers exercising once per week (31%), to several times per week (27%), to daily (15%). Of
the sample 50% had tried relaxation techniques, and 62% had received a massage prior to the study (62%
rarely, 31% occasionally and 8% weekly). The subjects were recruited using advertising fliers at the medical
school. They were randomly assigned to the massage and the relaxation control groups. Chi square analyses
comparing the two groups on sex, education, income, and lifestyle questions (i.e., exercise and previous use of
massage and relaxation) and a t test on age yielded no group differences (see Table 1).
TABLE 1
Means for Demographic Variables for Massage Therapy
and Relaxation Control Group Measures
Measures Massage Control p
Age 26.4 26.2 NS
Sex (% female) 79.5 80.2 NS
Graduate degree (%) 25.8 28.0 NS
[income> $30.000 (%) 7.8 9.1 NS
Regular exercise (%) 47.3 45.4 NS
Tried relaxation (%) 49.2 51.0 NS
Tried massage (%) 64.0 60.9 NS
Therapy Procedures
Massage therapy. The massage therapy was given by a professional massage therapist (different therapists
each day) for 15 minutes a day, 2 days a week for 5 weeks, and the sessions were scheduled at noon each day.
The subjects were seated fully clothed in a special massage chair, and a standard Swedish massage procedure
(kneading of muscles) was used. The procedure consisted of long broad strokes with moderate pressure on the
BACK: 1) compression to the back parallel to the spine from the shoulders to the base of the spine; 2)
compression to the entire back adding some gentle rocking; 3) trapezius squeeze: 4) finger pressure around
scapula and shoulder; 5) finger pressure along the length of the spine and back; and 6) circular strokes to the
hips below the iliac crest. ARMS: 1) drop arms to the side. Knead arms from shoulder to lower arm; and 2)
press down points of upper and lower arms. HANDS; 1) massage entire hands. Traction to the fingers; 2) press
the fleshy part of the palm between the thumb and index finger for 15 to 20 seconds; and 3) traction of the
arms both in lateral and superior directions (arm in line with the body). NECK: 1) kneading area of cervical
vertebrae; 2) finger pressure along base of skull and along side of neck; 3) scalp massage; and 4) press down
on trapezius, finger pressure and squeezing continuing down the arms.
Relaxation control group. The subjects were asked to relax by tightening and relaxing the same body parts as
those that were massaged for the massage therapy group (and in the same sequence). The subjects were briefly
shown by a research assistant how to tighten and release their muscles which they were told would help them
relax. This group was included as a control for focusing on the body and for standardizing activity level during
the assessment sessions (controlling movement artifact in the EEG measure).
Assessment Procedures
On the first and last day of the study the procedure was conducted in the following order:
1) the EEG cap was positioned on the subject's head; 2) a saliva sample was taken for cortisol; 3) the subjects
completed the 3 long-term measures including the Life Events, Job Stress and Chronic POMS Depression
Scales; 4) the subjects completed the session base-line measures including the POMS Depression, State
Anxiety and the math computations; and 5) immediately after the 15 minute massage/control sessions the
subjects completed another math computation, the POMS Depression and State Anxiety Scale, and about 20
minutes after the end of the massage/control sessions they provided another saliva sample for cortisol.
Pre-post therapy session measures on first and last day. The following measures were used to assess the
immediate effects of the massage on the first and last days of the study.
a) The Profile of Mood States (POMS; McNair, Lorr & Droppleman, 1971). The POMS Scale is a 5-point
adjective Likert rating scale asking the subject to describe how well an adjective describes his/her current
feelings. The 14 items that comprise the depression factor were used. The scale has adequate internal
consistency (r = .95; McNair & Lorr, 1964) and is an adequate measure of intervention effectiveness
(Pugtach, Haskell & McNair, 1969). A summary score is obtained by adding the weight of each item. This
scale was used because positive mood state would be expected to affect alertness and performance on math
computations and because massage therapy have been noted to improve mood state in stressed adolescents
(Field et al., 1992).
b) The State Anxiety 1nventory (STAI; Spielberger, Gorsuch & Lushene, 1970). This is a 20 item scale
which measures the transitory anxiety level in terms of severity (not at all to very much so). Characteristic
items include "I feel tense," "I feel nervous" and 'I feel relaxed." The STAI has adequate concurrent validity
(Spielberger, 1972) and internal consistency (r - .83; Spielberger et al., 1970). In addition, the STAI state
scores an increase in response to situational stress and a decline under relaxing conditions (Spielberger et
al., 1970). A summary score is obtained by adding the weight of each item. This measure was included
because state anxiety is known to affect alertness and performance on cognitive tasks negatively and
because state anxiety typically decreases following massage therapy (Field et al, 1992; Ironson et al.,
1995).
c) Salivary cortisol. Saliva samples were collected and assayed for cortisol as a measure of stress that
might be expected to affect alertness and performance on math computations. In addition, salivary cortisol
levels decreased in at least two previous massage therapy studies (Field et al., 1992; Ironson et al, 1995).
The samples were collected at the beginning of the therapy sessions and 20 minutes after the end of the
sessions 0fl the assessment days. Due to the 20 minute lag in cortisol change, saliva samples reflect
responses to events occurring 20 minutes prior to collection. Salivary cortisol samples were obtained by
having subjects place a cotton dental swab dipped in sugar-free lemonade crystals along their gumline for
30 seconds. The swab was placed in a syringe, and the saliva was squeezed into a microcentrifuge tube.
d) Math computations. Before the massage sessions a series of 7 numbers was given and after the massage a
different series was given, and the subject was asked to add them. The time to complete the series and the
correct/incorrect answer were recorded. This measure was used to determine the immediate effects of
massage 0fl a task that might be expected to be enhanced by alertness.
e) EEG procedure. EEG was considered the primary dependent variable in this study as the physiological
measure of alertness. Although subjects have anecdotally reported heightened alertness in previous studies,
no direct measures have been made of alertness. Although EEG alpha and beta were noted to decrease
(suggesting heightened alertness) in a previous study (Jodo et al., 1988), face massage was used and no
self report or performance measures were included. EEG was recorded in the present study for 3 minute
periods prior to, during and after the therapy sessions with the subjects' eyes closed. The EEG was recorded
using a Lycra stretchable cap (manufactured by Electro-Cap, Inc.) that was positioned on the subject using
the standard 1~20 system. Electrode gel was injected into the following sites: F3, F4, P3, P4 and Cz.
Impedances were brought below 5 K ohms, and the impedances of adjacent sites were brought within 500
ohms of each other. The EEG signals were amplified using a Grass Model 12 Neurodata Acquisition
System with amplifiers set as follows: Low frequency filter: 1 Hz; High frequency filter: 100 Hz;
Amplification: 20,000. The line frequency filter was on for all channels. The output from the amplifiers
was directed to a Dell 325D PC fitted with an Analog Devices RTI-815 A/D board. The signal was
sampled at a rate of 512 Hz and streamed to hard disk using data acquisition software (Snapstream HEM
Data Corp.). Additional electrodes were positioned on the external canthus and the supraorbital position of
one eye to record the subject's EOG, which was used to facilitate artifact scoring.
The first step involved the elimination of data which were unusable due to artifact from eye movements,
muscle activity or technical difficulty. The artifact-free data were spectrally analyzed using a discrete Fourier
transform with a Hanning window to yield power data for the following frequency bands: 1-4 Hz (Delta), 5-7
Hz (Theta), 8-12 Hz (Alpha), 13-20 Hz (Beta-low), 21-30 Hz (Beta-high). The EEG data were analyzed using
an EEG analysis software package developed by James Long Company.
First Day/Last Day Measures
a) Life Events Questionnaire. The Life Events Questionnaire comprises a list of 9 stressful events (e.g.,
death of mate or lover, major financial difficulties). The subject is asked to check which events have
occurred in the last four weeks. The subject is then asked to rate how each event has affected his/her life
from not at all to very stressful on a 4 point scale. This measure was included to ensure that the results
of this study were not negatively affected by significant life events. The Cronbach's alpha (.71) for
internal consistency was reasonable as was the test-retest reliability (.89).
b) Job Stress Yesterday Questionnaire. This questionnaire measures job stress experienced yesterday and
consists of 31 words or phrases requiring two responses each. The first response is a word or phrase
describing the job (e.g., hectic, hassled, comfortable, too little time to think or plan). Possible answers
are YES, NO or ? (cannot decide). If the phrase does describe the job yesterday, the subject is then
asked to rate on a four point scale how much it bothers him/her. This questionnaire was included as a
self-report measure on job stress. Cronbach's alpha (.73) for internal consistency was reasonable as was
the test-retest reliability (.87).
RESULTS
Self-Report Data
Analyses of baseline measures yielded no group differences except that the control group had less job stress at
baseline higher scores are optimal). Data were subjected to repeated measures by group (massage/control)
ANOVAS with session (presession/postsession) and phase (pretreatment/posttreatment) as the repeated
measures. Post hoc Bonferroni corrected t tests were performed to assess the group by repeated measures
interaction effects. A priori nonorthogonal contrasts were made because based on previous anecdotal reports by
subjects and the facial massage EEG data (Jodo et al., 1988) we expected that the analyses would reveal
enhanced alertness and performance. We also expected reduced anxiety, depression and cortisol levels
following massage therapy based on previous massage therapy studies (Field et al., 1992; Ironson et al.,
1995). The analyses revealed the following (see Table 2): 1) a repeated measures effect revealed that the
massage and relaxation control groups had significantly lower POMS depressed mood state scores following
the first and last day sessions; 2) a repeated measures by group interaction effect revealed that the massage
therapy group had significantly lower state anxiety scores after the first and the last day sessions than the
relaxation control group; 3) No group differences or time changes were noted for the Life Events Scale; 4) for
the Job Stress Scale, a significant repeated measures by group interaction effect was noted, suggesting a
decrease in job stress (higher scores are optimal) but only for the massage therapy group; and 5) a repeated
measures effect suggested both groups showed a decrease in chronic depressed mood state.
Saliva Cortisol Data
A repeated measures by group interaction effect revealed a decrease in salivary cortisol levels on the first day
for the massage group and an increase on the last day for the relaxation control group.
Math Computations
Massage also facilitated performance on math computation tasks (see Table 2). Group by repeated measures
interaction effects suggested that the massage therapy group performed better following the sessions on both
the first and last days. The decreased time required to complete the math computation task was significantly
greater for the massage therapy group, and the decrease in the number of errors was significantly greater for the
massage therapy versus the relaxation control group.
EEG Data
Repeated measures ANOVAs with group as the between subjects factor and pre-, during and postsession
values as the repeated measures were conducted on the frontal alpha, beta, delta and theta values recorded
before, during and after the massage/control sessions. These group (massage/control) by trial (0efore, during,
after massage/control session) repeated measures ANOVAS revealed the following (see Table 3 for repeated
measures and repeated measures by group interaction effects and their F values): 1) a repeated measures effect
revealed that delta increased for both groups from pre- to during the session, suggesting enhanced relaxation
(see Table 3); 2) theta did not change for either group; 3) group by repeated measures interaction effects
suggested that: a) alpha significantly decreased from pre- to during the massage and from pre- to postmassage
while alpha significantly increased for the relaxation group from pre- to postmassage and; b) beta significantly
decreased for the massage group from pre- to during and from pre- to postmassage, and the control group
significantly increased from pre- to postmassage.
Relations between EEG and Math Computation Measures
Correlation analyses were performed for each of the groups to determine whether there was a relationship
between the alpha and beta EEG measures and the math computation (speed and accuracy) variables. For the
massage therapy group the number of problems correctly solved was correlated with the decrease in the natural
log of alpha from the period pre to during the massage (r,-, .43,p <.05), and the amount of time required to
complete the computations was inversely related to the decrease in the natural log of beta from pre- to
postmassage (r = -.59, p < .001).
TABLE 2
Means for Massage Therapy and Relaxation Control Group Measures (S.D.s under means)
Massage Control
Day 1 Day 10 Day 1 Day 10
Measures Pre Post Pre Post Pre Post Pre Post
Effects
*
POMS depression
1.55
.6
b
3
1.4
a
.5
b
3
2.11
.9
b
3
1.7
a
.8
b
2
S
.4 .2 .4 .3 .6 .3 .5 .3
State anxiety
37.0
a
30.0
b
4
38.5
a
31.3
b
4
38.0
a
37.0
a
37.0
a
5.2
a SxG
11.3 9.6 12.7 10.5 13.2 12.9 13.9 11.4
Computation accuracy
69.2
a
39.2
b
2
83.1
b
96.2
c
2
600
a
68.2
a
70.8
a
72.3
a SxG
20.9 28.3 29.7 31.0 24.0 20.7 26.3 25.9
Computation time
250.0
a
234.0
b
2
232.5
b
210.9
c
1
249.0
a
241.0
a
231.1
b
226.2
b SxG
85.1 72.3 75.9 64.0 82.6 71.8 65.0 62.3
Salivary cortisol (ng)
2.1
a
1.6
b
2
1.8
a
2.0
a
2.2
a
2.0
a
1.6
b
2.1
a
3
SxG
.5 .5 .4 .5 .7 .6 .4 .6
Day 1 Day 10 Day 1 Day 10 Effects
Life events
8.0
a
7.4
a
1
9.5a 8.9a
Job stress1
38.0
44.0
b 47.0b 46.0b PxG
Chronic POMS depression
4.5
a
3.8
b
1
5.1a 3.6b1 p
1
p<.05,
2
p<.01,
3
p<.005,
4
p<.
001
*G = group (massage/control)
S = session (pre-session/post-session)
P = Phase (pre-treatment/post-treatment)
**higher score is optimal
TABLE 3
Natura1 Log of Raw Power for Delta, Theta, Alpha. and Beta
Delta (1~4 Hz)
Massage Control
Pre Dur Post Pre Dur Post
Mean 4.29 4.55 4.16 3.93 4.66 3.99
SD .93 1.14 .81 .96 1.34 1.22
Pre v. Dur v. Post: Tria1 F = 6.32 p = .004
Pre v. Dur: Trial F = 8.07 p = .009
Theta (5-7 Hz)
Massage Control
Pre Post Pre Dur Post
Mean 3.02 2.71 3.02 2.92 3.25 3.00
SD 1.38 1.20 1.32 158 1.26 1.45
Alpha (8-l2 Hz)
Massage Control
Pre Dur Post Pre Dur Post
Mean 5.50 4.64 5.20 4.99 4.87 5.61
SD 158 1.30 1.67 1.01 1.41 1.32
Pre v. Dur: Trial F = 6.51 p = .003
Group by Trial F = 3.40 p = .04
Pre v. Dur: Trial F = 6.86 p = .02
Pre v. Post: Group by Trial F = 6.36 p = .02
Beta (1~30 Hz)
Massage Control
Pre Dur Post Pre Dur Post
Mean 1.71 1.45 1.41 2.03 3.04 2.84
SD 1.81 2.14 1.95 150 1.44 1.49
Pre v. Dur v. Post: TriaI F = 8.23 p = .001
Group by Trial F = 12.37 p = .000
Pre v. Dur: Trial F = 7.32 p = .0l
Group by Trial F = 21.29 p = .000
Pre v. Post: Trial F = 13.68 p = .001
Group by Trial F = 5.20 p = .03
DISCUSSION
These data, like those of other studies on massage therapy showed decreases in anxiety and stress hormones
(cortisol) immediately after the sessions (Field et al., 1992; Ironson et al., 1995). And, both the massage
therapy and relaxation therapy groups showed increased delta activity, suggesting that both therapies had a
relaxation effect and temporary and more chronic shifts in mood State which may have related to their
relaxation. The decrease in self-reported depression is consistent with other massage studies (Field et al, 1992;
Ironson et al., 1995) as well as other relaxation studies (Platania-Solazzo, Field, Blank, Seligman, Kuhn,
Schanberg & Saab, 1992).
Heightened alertness and enhanced performance on math computations occurred in the massage therapy
group. The massage sessions were characterized by an EEG pattern of alertness. Although delta increased for
both groups of subjects, suggesting relaxation, the pattern of enhanced alertness (decreased alpha and decreased
beta) occurred in the massage therapy group while a pattern of drowsiness (increased alpha and increased beta)
occurred in the relaxation control group. The decreased alpha and decreased beta were not surprising since at
least one other study documented EEG alpha decreases associated with facial massage (Jodo Yamada,
Hatayama, Abe & Maruyama, 1988). The correlation analysis further suggested that the accuracy of the math
computations and the decrease in pre- to during massage EEG alpha were related. Although the alpha decrease
occurred during the massages it could have affected the state of alertness for enhancing accuracy after the
massage. Further, the speed of performing the calculations and the decrease in EEG beta pre- to postmassage
were related. This more contemporaneous relationship suggests that performance speed may have been related
to decreased beta.
The superior performance of the massage therapy group might relate to the tactile and pressure stimulation.
Tactile and pressure stimulation, in addition to enhancing the EEG patterns of alertness and math
computations in this study, have been noted to enhance parasympathetic activity (elevated vagal tone) which is
characteristic of a more relaxed, alert state during which cognitive performance improves (Field et al., 1992).
Future research might add other measures such as vagal activity and catecholamines further to understand the
underlying mechanism for the massage therapy-enhanced alertness relationship.
In addition, a longer term follow-up would be important to assess the persistence of the effects.
Presumably, like exercise, a steady dose of massage may be required. Larger doses may also be more effective
and result in more clinically meaningful changes in mood state and cortisol than occurred in this study.
Finally, the cost effectiveness of massage therapy would need to be documented for more widespread
acceptance and adoption of the treatment.
REFERENCES
Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C. & Schanberg, S. (1992). Massage therapy reduces
anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child and
Adolescent Psychiatry, 31. 12~131.
Ironson. G., Field, T., Kumar, A., Price, A., Kumar, M.. Hansen, K. & Burman, I. (In Press). Relaxation
through massage is associated with decreased distress and increased serotonin levels. International
Journal of Neuroscience.
Ivancevitch, J. M., Matteson, M. T., Freedman, S. M. & Phillips, J. S. (1990). Worksite stress management
interventions. American Psychologist, 45, 252-261.
Jodo, Yamada, Hatayama, Abe & Maruyama (1988). Effects of facial massage on the spontaneous EEG.
Tohoku Psycologica Folia, 47, 8-15.
McNair. D. M. & Lorr. M. (1964). An analysis of mood in neurotics. Journal of Abnormal Social
Psychology,
69. 620-627.
McNair. D. M. Lorr. M. & Droppleman, L. F. (1971). Profile of Mood States. San Diego: Educational and
Industrial Testing Service.
Platania-Solazzo, A., Field, T., Blank, J., Seligman, F., Kuhn, C., Schanberg, S. & Saab. P. (1992).
Relaxation therapy reduces anxiety in child/adolescent psychiatry patients. Acta Paedopsychiatrica, 55,
115-120.
Pugtac, D., Haskell, D. & McNair, D. M. (1969). Predictors and patterns of change associated with the course
of time-limited psychotherapy. Mimeo Report.
Spielberger. C. D., Gorsuch, R. L. & Lushene, R. E. (1970). The State Trait Anxiety Inventory. Palo Alto,
CA:
Consulting Psychologists Press.
Spielberger, C. D. (1972>. Anxiety as an emotional State. In C. D. Spielberger (Ed.), Anxiety: Current trends
(n theory and research. New York, NY: Academic Press.
... While some have reported strong relation between meditation practices and decreased stress level (Moseley et al., 2004;Oman et al., 2008), others have failed to find the effect, at least empirically (Goyal et al., 2014). Meditation techniques is one of the most validated modalities that activates parasympathetic nervous system activity that results in stress reduction (Field et al., 1996). Researchers in the present study postulates that one plausible explanation for reporting of feeble relationship between the two variables could be the omission of intervening variables through which the mechanism can be explained emphatically. ...
... Researchers have examined impact of meditation on stress reduction and found that regular practice of meditation activates parasympathetic nervous system activity that results in stress reduction (Field et al., 1996;Moseley et al., 2004;Oman et al., 2008). Meditation helps the distressed body to return to healing mode by lowering the stress hormone (cortisol) that boost blood flow to the front of the brain (Olpin and Bracken, 2014). ...
... Meditation act as therapeutic aid to mind. Researchers have examined suggested impact of meditation on stress reduction and found that regular practice of meditation activates parasympathetic nervous system activity that results in stress reduction (Field et al., 1996;Moseley et al., 2004;Oman et al., 2008). It relaxes and calm down the mental chaos caused by many unwanted waste thoughts that travel in to the mind. ...
Article
Full-text available
Stress has become inevitable in today's contemporary life. Mild to acute, it is prevailing to every walk of life from which people are unable to escape. Researchers has defined stress in many ways but in general any feeling that is unpleasant and remains for a longer period in mind, is stress. A clutter of disturbing or negative thoughts that mind cannot manage. For this, mind has to be strong enough to handle such hard feelings so as to keep itself at peace. Mental abilities or emotional intelligence can be built with the help of meditation techniques, which act as therapeutic aid to the mind. Consequently, our research starts with meditation as the main component in the hypothesised model, followed by EI as intervening variables to explain PSR. The research has followed the post positivist approach in explaining how regular practice of meditation can influence PSR among women. The present study assumes that EI mediates between meditation and PSR believing that reasoning with emotions that is fostered through regular meditation practice play prime psychological instrument in establishing relationship between meditation and PSR.
... In the first case, therapeutic massage is practiced as part of therapeutic interventions targeting the symptoms of a specific pathology/disease. MM appears to be an effective treatment for infants of depressed mothers, and in elderly patients with severe dementia (Field et al., 1996;Suzuki et al., 2010). Also, world-class athletes benefit from MM to improve their performance and facilitate recovery (Espí-López et al., 2020). ...
... To index cognitive performances, we used a mental calculation task. Performance in mental calculation paradigms was positively affected in past research by massage therapy, foam rolling, aromatherapy or Tai chi/ yoga interventions (Field et al., 1996;Diego et al., 1998;Field et al., 2005Field et al., , 2010 In press). The task consisted in iterated subtractions (-7) from a starting number randomly selected between 500 and 1 000. ...
... MM was associated with increased cardiac parasympathetic activity as well as improved relaxation measures indexes Smith et al., 2013). Also, these results confirmed the positive influence of MM on cognitive performance, well-being and stress (Field et al., 1996;Kerautret et al., In press). Regarding the classic RM, i.e., without remote control, previous data reported comparable well-being impact . ...
Thesis
L’objectif de ce travail doctoral est d’étendre les connaissances sur les massages manuels et autogènes, et d’évaluer les effets de solutions de massage robotiques autonomes et interactives. Dans un premier temps, les travaux expérimentaux ont permis de préciser les caractéristiques du massage autogène, notamment ses effets interférents avec les performances en force lors d’une pratique intégrée aux séances d’entraînement, et l’absence de bénéfices additionnels lorsque des mouvements de pression glissée étaient intégrés aux routines. Nous avons ensuite comparé sur la base d’indicateurs psychométriques, comportementaux et neurophysiologiques massage manuel et massage autogène. Les deux méthodes de massages ont induit des états de relaxation supérieurs à la condition contrôle. Toutefois, le massage manuel semblait induire un état de relaxation plus marqué que le massage autogène, tant sur la base d’indicateurs objectifs que subjectifs. Sur le plan du contrôle moteur, le massage manuel engage le sujet dans un mode de contrôle de l’action essentiellement rétroactif. À l’inverse, le massage autogène implique la production de mouvements volontaires et engage donc le sujet dans un mode de contrôle proactif. Nous avons cherché à situer le massage robotique au sein de ce continuum. Le massage robotique, en offrant la possibilité au sujet d’interagir en temps réel avec les mouvements du robot, permet l’alternance entre modes de contrôle proactif et rétroactif. Le massage robotique représente donc une expérience sensorimotrice distincte du massage manuel et autogène. Dans une dernière étude, nous avons comparé l’efficacité du massage robotique à celle d’un massage manuel réalisé par un professionnel expérimenté. Les deux interventions ont produit des effets sur les indicateurs de bien-être et de relaxation, mais ceux-ci demeuraient plus marqués à l’issue du massage manuel. Toutefois, l’effet des deux interventions sur les sensations perçues était comparable. Les dispositifs de massages robotisés n’ont pas vocation à remplacer les praticiens. Ils représentent une solution d’assistance pour des tâches répétitives et élémentaires. Le massage robotique pourrait permettre, par exemple, de pallier la fatigue induite par la répétition des massages qui fut enregistrée au cours de l’étude. Les effets du massage robotique sur les indicateurs objectifs et subjectifs de bien-être laissent envisager des possibilités de démocratisation.
... To index cognitive performances, we used a mental calculation task. Performance in mental calculation paradigms was positively affected in past research by massage therapy, aromatherapy, or Tai chi/yoga interventions [19,42,43]. The task consisted of iterated subtractions (−7) from a starting number randomly selected between 500 and 1000. ...
... However, their effects remain difficult to dissociate from those resulting from a cognitively oriented relaxation routine that did not involve pressures on soft tissues. Although FR and MM groups exhibited distinct patterns profiles of resting-state activity, both interventions promoted brain states of relaxation, characterized by alpha and beta synchronizations in the frontal and parietal region, respectively [19,28,[87][88][89]. Conversely, a desynchronization was observed after autogenic training. ...
Article
Full-text available
The present double-blinded, randomized controlled study sought to compare the effects of a full-body manual massage (MM) and a foam rolling (FR) intervention on subjective and objective indexes of performance and well-being. A total of 65 healthy individuals were randomly allocated to an FR, MM, or a control group who received a cognitively oriented relaxation routine. Self-report ratings of perceived anxiety, muscle relaxation, and muscle pain were used to index changes in affect and physical sensations. The sit-and-reach and toe-touch tests, as well as a mental calculation task, were used to index motor and cognitive performances, respectively. We also conducted resting-state electroencephalography and continuous skin conductance recordings before and after the experimental intervention. Both FR and MM groups exhibited neural synchronization of alpha and beta oscillations during the posttest. Skin conductance increased from the pretest to the posttest in the relaxation group, but decreased in the FR group. All interventions improved range of motion, although only the MM group outperformed the relaxation group for the toe-touch performance. MM was associated with reduced muscle pain and increased muscle relaxation. Reduced perceived anxiety after the intervention was observed in the FR group only. Overall, MM and FR both improved objective and subjective indexes of performance and well-being. Differences between the two massage interventions are discussed in relation to the effects of pressure stimulation on autonomic regulations and the proactive vs. retroactive nature of FR, compared to MM.
... Electroencephalogram (EEG) is non-invasive, cheap and convenient. In the existing studies using EEG to evaluate the effect of MT [7]- [9], most analysis focus on EEG absolute spectral power of four rhythms, such as delta (0-4 Hz), theta (4)(5)(6)(7)(8), alpha (mu, [8][9][10][11][12][13] and beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Hz) activity [10]. In our previous work, we have used entropy-based method for the EEG evaluation during the quiet status [11]. ...
... Electroencephalogram (EEG) is non-invasive, cheap and convenient. In the existing studies using EEG to evaluate the effect of MT [7]- [9], most analysis focus on EEG absolute spectral power of four rhythms, such as delta (0-4 Hz), theta (4)(5)(6)(7)(8), alpha (mu, [8][9][10][11][12][13] and beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Hz) activity [10]. In our previous work, we have used entropy-based method for the EEG evaluation during the quiet status [11]. ...
Article
Full-text available
Objective: Most of effectiveness assessments of the widely-used Massage therapy were based on subjective routine clinical assessment tools, such as Visual Analogue Scale (VAS) score. However, few studies demonstrated the impact of massage on the Electroencephalograph (EEG) rhythm decoding of Motor imagery (MI) and motion execution (ME) with trunk left/right bending in patients with skeletal muscle pain. Method: We used the sample entropy (SampEn), permutation entropy (PermuEn), common spatial pattern (CSP) features, support vector machine (SVM) and logic regression (LR) classifiers. We also used the convolutional neural network (CNN) and attention-based bi-directional long short-term memory (BiLSTM) for classification. Results: The averaged SampEn and PermuEn values of alpha rhythm decreased in almost fourteen channels for five statuses (quiet, MI with left/right bending, ME with left/right bending). It indicated that massage alleviates the pain for the patients of skeletal pain. Furthermore, compared with the SVM and LR classifiers, the BiLSTM method achieved a better area under curve (AUC) of 0.89 for the classification of MI with trunk left/right bending before massage. The AUC became smaller after massage than that before massage for the classification of MI with trunk left/right bending using CNN and BiLSTM methods. The Permutation direct indicator (PDI) score showed the significant difference for patients in different statuses (before vs after massage, and MI vs ME). Conclusions: Massage not only affects the quiet status, but also affects the MI and ME. Clinical Impact: Massage therapy may affect a bit on the accuracy of MI with trunk left/right bending and it change the topography of MI and ME with trunk left/right bending for the patients with skeletal muscle pain.
... Next, the teacher asked the students to demonstrate the solution to the exercise on the blackboard. The results demonstrated that touching increased the rate of volunteering by the students (see also Field et al., 1996). Hornik and Ellis (1988) have also shown that individuals who have been touched are more likely to agree to participate in mall interviews. ...
... The present review does not deal with the extant research that addressed the effect of massage on people's emotional state and well-being. This topic has been extensively reviewed elsewhere (e.g., seeField, 1998;Field et al., 1996Field et al., , 2005.A. Gallace, C. Spence / Neuroscience and Biobehavioral Reviews 34 (2010) 246-259 ...
... As in previous studies, it has been revealed that the current intimate and childhood positive touch protects from depression (Cochrane, 1990). Massage therapy as positive touch has a therapeutic effect on reducing depression and anxiety (Field et al., 1996;2004). Severe mental health issues may influence the neglect of individuals' physical appearance and hygiene, reflecting self-care neglect (Corrigan, 2000;Häfner et al., 2003). ...
Article
Full-text available
Communication via the sense of touch has long been perceived as an important aspect of human development, social comfort, and well-being. Human somatosensory system has in fact two tactile sub-modalities, one providing the well-recognized discriminative touch input to the brain, and the second–the affective or emotional input. C-tactile system is hypothesized to represent the neurobiological substrate for affective and rewarding properties of touch. Lower relationship quality is associated with lower resilience to stressors and can lead to increased vulnerability to mental health disorders. Based on the existing work, we know that social touch can increase well-being and lower state-anxiety. Our goal was to prove content validity for the Mongolian version with the factor structure of the original English version of the TEAQ. We translated, and adapted TEAQ for Mongolian language version. Original TEAQ-117 items were used in the pilot study. In the present study, enrolled 204 participants, age varied between 18 and 57 years (26.9±8.8), 57.8% were female. Validated TEAQ-57 items English version was used, and Exploratory factor analysis confirmed 55 items with 6 component structure. Confirmatory factor analysis demonstrated good consistency and homogeneity of the 6 factor structure of the TEAQ, and satisfactory model fit. Several subscales of the TEAQ revealed positive correlations on quality of life domains, in contrast negative correlations with anxiety and depression. In conclusion, analysed Mongolian version of the TEAQ-55 is a reliable and valid assessment tool of experiences and attitudes towards touch, and similar to component structure for different cultures (Validated British TEAQ-57, and TEAQ-37 RUS). We expected that Mongolian version of the TEAQ might be a helpful tool for screening mental health issues and researchers.
... A reported benefit of C-LTM touch, for infants, is reduced stress hormone production (44), whereas, touch deprivation increases socio-cognitive deficits (45) and increases autism rates four-fold (46). Children receiving a shoulder massage showed improved scores on abstract reasoning tests (47), whereas adults improved on accuracy, speed and alertness on a maths test (48). Furthermore, C-LTM touch is suggested to increase positive mood (49) and decrease hospital patients' reported stress (50). ...
Preprint
Full-text available
The sense of touch codes the detection and properties of physical objects on the body via mechanoreceptors within the skin. Technological advancements, such as ultrasonic haptic devices, are now able to ‘touch without touching’, claiming this is virtual touch. An initial aim of the study was to investigate subjective intensity and pleasantness ratings of ultrasound stimulation and the influence of top-down factors using the Touch Experience and Attitudes Questionnaire (TEAQ). Self-reported intensity and pleasantness ratings were measured in response to ultrasound stimuli. A second aim was to record from individual low threshold mechanoreceptors using the technique of microneurography in an attempt to determine which mechanoreceptors are activated by ultrasound stimulation of the skin. The major findings here were that microneurography found SAI and SAII units did not respond to ultrasound stimuli; intensity and pleasantness ratings were significantly different between age groups. Ultrasound can produce a variety of sensations with varying intensity and pleasantness ratings. A limitation of the study was the unexpected force difference generated between modulations. These findings have implications for mid-air haptics, somatosensory affective research, and virtual reality. Future research should focus on microneurography investigation of FA fibre responses to ultrasound.
... Massage therapy may incorporate a social component that may be responsible for its effectiveness in improving birth outcomes (81). In addition, it represents a form of tactile stimulation, which was shown to dampen an activated stress response (82,83), reduce symptoms of depression (81,84), and modulate gene expression linked to immune functions (85,86), thus potentially changing preterm birth risk. In terms of healthcare, over the years India has moved along an impressive path; however, the accessibility to these resources is limited in many underdeveloped regions due to the wide geographical distribution. ...
Article
Full-text available
The Problem: Global environmental stressors of human health include, but are not limited to, conflict, migration, war, natural disasters, climate change, pollution, trauma, and pandemics. In combination with other factors, these stressors influence physical and mental as well as reproductive health. Maternal stress is a known factor for adverse pregnancy outcomes such as preterm birth (PTB); however, environmental stressors are less well-understood in this context and the problem is relatively under-researched. According to the WHO, major Indian cities including New Delhi are among the world's 20 most polluted cities. It is known that maternal exposure to environmental pollution increases the risk of premature births and other adverse pregnancy outcomes which is evident in this population. Response to the Problem: Considering the seriousness of this problem, an international and interdisciplinary group of researchers, physicians, and organizations dedicated to the welfare of women at risk of adverse pregnancy outcomes launched an international program named Optimal Pregnancy Environment Risk Assessment (OPERA). The program aims to discover and disseminate inexpensive, accessible tools to diagnose women at risk for PTB and other adverse pregnancy outcomes due to risky environmental factors as early as possible and to promote effective interventions to mitigate these risks. OPERA has been supported by the Worldwide Universities Network, World Health Organization (WHO) and March of Dimes USA. Addressing the Problem: This review article addresses the influence of environmental stressors on maternal-fetal health focusing on India as a model population and describes the role of OPERA in helping local practitioners by sharing with them the latest risk prediction and mitigation tools. The consequences of these environmental stressors can be partially mitigated by experience-based interventions that build resilience and break the cycle of inter- and-transgenerational transmission. The shared knowledge and experience from this collaboration are intended to guide and facilitate efforts at the local level in India and other LMIC to develop strategies appropriate for the jurisdiction for improving pregnancy outcomes in vulnerable populations.
... Although vagal activity and EEG were not measured in these studies, they are also potential underlying mechanisms. Vagal activity increases following massage therapy, and it is associated with increased attentiveness [29] as well as increased alpha and beta activity and more accurate math computations [30]. ...
Article
Full-text available
This narrative review on pediatric massage literature from the last decade suggests that massage therapy has positive effects on several pediatric conditions. These include preterm infant growth, psychological problems including aggression, gastrointestinal problems including constipation and diarrhea, painful conditions including burns and sickle cell, muscle tone disorders including cerebral palsy and Down syndrome, and chronic illnesses including diabetes, asthma cancer, and HIV. Potential underlying mechanisms for the massage therapy effects include increased vagal activity and decreased stress hormones. Limitations of the literature include the need for more randomized controlled trials, longitudinal studies, and underlying mechanism studies.
Conference Paper
Students, office workers, or other computer and mobile device users can suffer from decrements in alertness or productivity, but many intervention methods on these can be too distracting or even affect daily routines. Using heart rate (HR) to determine a fast and slow target frequency at which to oscillate light brightness stimulation on a laptop, thirty-six participants joined a cognitive task where we hypothesized that fast frequency stimulation would increase alertness and decrease relaxation, while slow frequency stimulation would have the opposite effects. We found that slow frequency stimulation produces a statistically significant delay in response time, users react more slowly (3.8e2 ± 5.5e1 ms), when compared to the no stimulation (3.7e2 ± 4.1e1 ms) (p = 9.0e-3) conditions. The (Slow - No Stimulation) response time (1.7e1 ± 2.7e2 ms) produced a statistically significant delay in response time versus the (Fast - No Stimulation) response time (-0.74 ± 2.4e1 ms) (p = .016). These delays due to slow stimulation occurred without influencing accuracy or subjective sleepiness ratings. We observed that frequency-dependent light stimulation can potentially influence HRV metrics such as the mean normal-to-normal intervals and mean HR. Future work will target breathing rate to determine light stimulation oscillations as we further investigate the potential of using the slow-frequency domain to unobtrusively influence user performance and physiology.
Article
A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. 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.
Article
The immediate effects of relaxation therapy (RT) were assessed in 40 hospitalized children and adolescents with diagnoses of adjustment disorder and depression. These effects were assessed using a within subjects pre-test/post-test design and by comparison with a control group of 20 depressed and adjustment disorder patients who watched a 1-h relaxing videotape. The 1-h RT class consisted of yoga exercise, a brief massage and progressive muscle relaxation. Decreases were noted in both self-reported anxiety and in anxious behavior and fidgeting as well as increases in positive affect in the RT but not the video group. In addition, adjustment disorder patients and a third of the depressed patients showed decreases in cortisol levels following RT, while no changes were noted in the video group. Thus, both diagnostic groups appeared to benefit from the RT class.