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Massage therapy in the workplace: Reducing employee strain and blood pressure

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Abstract

Assess the effects of workplace-based massage therapy on physiological and psychological outcomes. We used afield experiment in which 28 participants were randomly assigned into either an experimental (n = 14) or control (n = 14) group. The experimental group received weekly massage treatments at work for a four week period while the control group did not. Both strain and blood pressure were significantly reduced during treatment for the experimental group but not for the control group. This study provides initial support for the effectiveness of workplace-based massage therapy as part of a comprehensive workplace health strategy.
A.L. Day1, L. Gillan1, L. Francis1, E.K. Kelloway1, M. Natarajan2
Massage therapy in the workplace: Reducing employee strain
and blood pressure
1Dept of Psychology, Saint Mary’s University
2ICT Northumberland College
Introduction
In recent years, the study of stress has become wide-
spread, with individuals in many health-related profes-
sions and social science fields showing increased con-
cerned for the subject and its impact on the overall pop-
ulation at large (1). Leaders in business and industry
have recognized the need to reduce organizational stres-
sors. Despite organizational efforts to achieve this goal,
employees still experience stress and strain at work.
Therefore, some organizations are beginning to provide
services to help employees cope with and alleviate
stress and strain (1). Studies have found that massage
therapy is effective in alleviating psychological and
physiological strain, as made evident by reduced blood
pressure, decreased urinary and salivary cortisol levels,
and lowered catecholamine levels as well as through de-
creases in self-reported perceived stress (2-5). Work-site
massage therapy offered to employees may offer addi-
tional benefits in terms of increased positive employee
outcomes related to both physical and psychological
health, as well as increased employee productivity and
job satisfaction (4). Massage therapy treatment may al-
so be effective in reducing negative psychological,
physiological, and behavioural strain symptoms, and
could therefore be employed as a strain reduction strat-
egy directly within organizations. Few studies, however,
have systematically examined the effectiveness of mas-
sage therapy at work. Therefore, the purpose of the pre-
sent study was to investigate the effects of worksite
massage therapy treatment on employees’ physiological
and psychological health.
Stress, Stressors, and Strain
Occupational stress is defined as “the cumulative pres-
sures in the workplace that can cause psychophysiological
symptoms and vulnerabilities to work injuries and dis-
ease” (6). Stressors are concrete situations or factors that
have the potential to create strain in an individual (7) if the
individual perceives the situation or factor to be stressful.
That is, perceived stress reflects the extent to which an in-
dividual experiences a stressor “as taxing or exceeding his
or her resources and endangering well-being” (8). Thus,
stress is a subjective state of appraising concrete and ob-
ABSTRACT. AIM: Assess the effects of workplace-based
massage therapy on physiological and psychological outcomes.
METHODS: We used a field experiment in which 28 participants
were randomly assigned into either an experimental (n=14)
or control (n=14) group. The experimental group received
weekly massage treatments at work for a four week period
while the control group did not.
RESULTS: Both strain and blood pressure were significantly
reduced during treatment for the experimental group but
not for the control group.
CONCLUSIONS: This study provides initial support for the
effectiveness of workplace-based massage therapy as part
of a comprehensive workplace health strategy.
Key words: workplace, massage, comprehensive health strategy.
RIASSUNTO. OBIETTIVI: Valutare l’esito nelle misure
fisiologiche e psicologiche della terapia di massaggio
effettuata sul luogo di lavoro.
METODI: Sono stati reclutati ventotto partecipanti, allocati
in modo randomizzato in un gruppo sperimentale (n=14)
e in uno di controllo (n=14). I soggetti del gruppo
sperimentale hanno ricevuto un massaggio sul luogo
di lavoro con frequenza settimanale per quattro settimane.
RISULTATI: Sia lo strain che la pressione arteriosa hanno
mostrato una diminuzione significativa nel gruppo trattato
e non nel gruppo controllo.
CONCLUSIONI: Lo studio fornisce un primo supporto
di efficacia al massaggio effettuato sul luogo di lavoro
come parte di una strategia atta a sostenere la salute
nel luogo di lavoro.
Parole chiave: lavoro, massaggio, strategia multidisciplinari
orientate alla salute.
Giornale Italiano di Medicina del Lavoro ed Ergonomia Supplemento B, Psicologia
©PI-ME, Pavia 2009 2009; Vol. 31, N. 3: B25-B30
http://gimle.fsm.it ISSN 1592-7830
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jective stressors in the environment as being negative or a
threat (9). Perceived stress then may result in physical,
psychological, or behavioural strain. This interactional ap-
proach to stress stipulates that situational variables (stres-
sors) interact with personal variables (subjective appraisal
and coping) to cause strain (10). That is, strain does not al-
ways result from stress. Because stressors will be per-
ceived differently among individuals as being more or less
stressful, individual strain outcomes also will differ (11).
Research highlights the importance of both individuals’
subjective perception of the environment as being ‘stress-
ful’, and their available coping resources in determining
health outcomes and the manifestation of strain symp-
toms. Moreover, these strain symptoms may then create,
or be perceived as, other stressors, thus creating a cyclical
pattern of stress.
Cumulative stressors in the workplace are a signifi-
cant contributing factor to a multitude of health problems
in employees, and can manifest themselves in a variety of
ways (10, 6, 12). Although some individuals may present
psychophysiological strain symptoms, other individuals
may display psychological distress, lowered productivity,
an increased vulnerability to work injury, a range of acute
or chronic health conditions, or a general increased sus-
ceptibility to illness or disease (10, 6, 12). Some physio-
logical strain outcomes of ongoing workplace stress in-
clude an increase in the symptoms of musculoskeletal
disorders, back pain, headaches, blood pressure, heart
rate, and fatigue (13, 3, 6), which can ultimately translate
into worker absence and sick leave. According to Field
(14), lower back pain is one of the most frequent causes
of absenteeism and worker’s compensation claims. On-
going stress is also a leading risk factor in heart disease,
stroke, arthritis, and duodenal ulcers, and can significant-
ly increase an individual’s overall susceptibility to dis-
ease and injury (13, 3, 6).
Employee stress is also associated with a host of
negative psychological strain outcomes, such as em-
ployee burnout, increased anxiety and depression, and
decreased cognitive functioning (15, 16). Research has
also shown that workplace strain can be detrimental to
employee behaviour, leading to low motivation and
morale, decreased work performance, job satisfaction
and productivity, and increased absenteeism and work-
place accidents (15, 16, 6). Stress and strain can also in-
terfere with career goals and goal setting (6). It is evi-
dent that workplace stress and employee strain carry a
significant health cost to employees as well as a finan-
cial cost to organizations.
The manner in which individuals respond to stressors
and perceived stress can impact their level of strain. Folk-
man and Lazarus (11) distinguished between problem-fo-
cused coping, where individuals deal directly with the
problem causing distress, and emotion-focused coping,
whereby individuals regulate their emotional response to
stressful situations. Individual difference variables are an
integral part of coping with stress (11). Thus, massage
therapy may facilitate emotion-focused coping by influ-
encing personal variables such as anxiety levels and blood
pressure, or improved sleep and relaxation.
Massage Therapy
Massage therapy is defined as “the manipulation of
soft tissue by trained therapists for therapeutic purposes”
(14) and tends to “bring about generalized improvements
in health, such as relaxation or improved sleep, or specif-
ic physical benefits, such as relief of muscular aches and
pains” (17). Massage therapy is one of the oldest forms of
treatment in the world, and a developed practice of thera-
peutic massage exists in almost all cultures (17). Massage
therapy, however, began to dissipate from the American
medical scene at approximately the time of the medical
model and the pharmaceutical revolution of the 1940’s
(14). Typically, massage therapy consists of a client re-
ceiving massage treatment on a specially designed mas-
sage table. This process can be adapted to the constraints
of a more conventional setting by limiting work to the
hands, head, neck, or shoulders in a seated massage (17).
Physiological benefits of massage therapy
Several studies have found that massage is effective in
alleviating strain symptoms, in terms of lowered blood
pressure, decreased urinary and salivary cortisol levels,
lowered catecholamine levels, and self-report assessments
of decreased perceived stress (2-5). Because individuals
vary in their ability to cope with stress, and ultimately in
their vulnerability to injury or disease, and because mas-
sage therapy can decrease symptoms of stress, massage
therapy may be highly beneficial to individual coping re-
sponses, and help improve overall health and well-being.
Additionally, massage therapy that is offered and conduct-
ed directly in the workplace may be beneficial in alleviat-
ing occupational strain specifically.
Several studies have provided evidence for physiolog-
ical benefits resulting from massage therapy treatment,
such as the alleviation and symptom control of migraine
and tension headaches, which are a leading cause of work-
er absenteeism (14, 5, 18, 19). In one study, participants
were randomly assigned to either a massage therapy treat-
ment group or a control group who received migraine
medication. (18) Relative to the control group, the mas-
sage group reported a decrease in headache pain, had few-
er headaches weekly, found improved and uninterrupted
sleep, and increased serotonin levels (18). Arelated study
(19) examined massage therapy treatment administered to
sufferers of chronic tension headaches for four weeks fol-
lowing a four-week baseline period. Treatment was direct-
ed toward the neck and shoulders and was effective in re-
ducing the number of chronic tension headaches per week
in sufferers (19). Compared with baseline levels, headache
frequency was significantly reduced within 1 week of
massage therapy and was maintained during the 4 weeks
of the treatment period. However, the sample size was
very small (n=4) and results were based on diary data and
a visual analogue scale (19).
Several studies have indicated a significant reduction
in high blood pressure and associated symptoms through
massage therapy treatments (20, 14, 3). For example, a
seated 30-minute massage once per week significantly de-
creased sitting diastolic blood pressure after the first and
last massage therapy sessions (3). Similarly, a 15-minute
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seated massage sessions at work reduced both systolic and
diastolic blood pressure in employees (20).
Massage therapy can also increase immune function.
In one experimental study (21), two subjects received a
massage therapy treatment during the experimental phase
and no massage during the baseline phase while assays
were conducted on lymphocyte proliferation (T and B
lymphocytes), immunoglobins, and cortisol levels. There
was a consistent and significant trend of increased activi-
ty of both lymphocytes and levels of serum for both sub-
jects during the treatment phase compared to the control
phase. Although a more robust study design and larger
sample size are required, the preliminary findings present
a basis for further study. Immune disorders would also be
expected to benefit from massage therapy treatment due to
lowered cortisol and catecholamine levels noted in sever-
al studies (2, 3, 21, 5). Ironson, Field, Scafidi, and
Hashimoto (22) found increased cytotoxic capacity (Nat-
ural Killer Cell cytotoxicity and counts) in HIV positive
adults after one month of daily 45-minute massage thera-
py treatments. Similarly, improved immunological func-
tion was detected in breast cancer patients as indicated by
increased Natural Killer Cell counts and an increase in
lymphocyte markers after the women received massage
therapy treatments three times per week for five weeks,
compared to measures in the control group (18). These
studies support the existence of increased immunological
functioning after consistent massage therapy treatment,
which provides further implications for the alternative
therapy, particularly for employees dealing with work-
place stress.
Ameta-analytic review (14) of the therapeutic effects
of massage therapy found that this treatment was consis-
tently associated with reduced pain across a variety of
conditions including child birth, recovery from burns
(when massage therapy was used prior to debridement),
and following surgery, as well as among those with chron-
ic pain conditions, such as juvenile rheumatoid arthritis
and fibromyalgia (14). Furthermore, massage therapy fa-
cilitated growth in preterm infants (including cocaine-ex-
posed and HIV-exposed infants) in the neonatal intensive
care unit. Those infants who received 15 minutes of mas-
sage treatment three times per day for 10 days, while they
were still in the incubator, gained more weight and were
hospitalized for significantly less time (14).
Psychological benefits of massage therapy
In addition to the noted physiological benefits, recent
studies in massage therapy treatment also report encour-
aging results with regard to psychological strain symp-
toms, such as a reduction in depressive symptoms (23) and
decreased anxiety levels (2). Similarly, massage treatment
improves mood and well-being states (4), increases alert-
ness, and enhances cognitive and work performance (24,
4). For example, after healthy adults received a 10-minute
seated massage therapy session, anxiety scores decreased
for all participants across three massage therapy condi-
tions (moderate pressure massage therapy, light pressure
massage therapy and vibrator massage; 2). Moreover, the
moderate pressure massage group also experienced a de-
crease in heart rate and EEG changes including an in-
crease in delta and a decrease in alpha activity, suggesting
a relaxation response. This group also showed increased
positive affect, as indicated by a shift toward left frontal
EEG activation (2). Other studies using EEG activity as a
primary outcome measure yielded similar results (24, 23).
Following 15 minute massage therapy treatments, EEG
patterns indicated increased relaxation and alertness and
decreased right frontal lobe activity, a positive outcome
given that right frontal lobe activity is related to negative
mood and may also be a marker for depression (24, 25).
Other studies illustrate the psychological benefits of
massage treatment in clinical populations. For example,
adults with multiple sclerosis who were randomly as-
signed to receive two 45-minute massages per week for
five weeks (treatment group) reported several gains rela-
tive to similar patients who received only regular medical
treatment (control group; 18). The massage therapy group
reported improved mood, lowered anxiety, reduced hostil-
ity levels, decreased urinary and salivary cortisol levels,
and improved disease progression ratings, and enhanced
social functioning status (3).
The effectiveness of massage therapy as a method of
psychological and physiological symptom control in can-
cer patients was examined at a major U.S. cancer centre
(26). Over a three-year period over 1,200 patients were
treated. Patients reported pre- and post-massage therapy
treatment symptom severity using 0-10 rating scale for
pain, fatigue, stress/anxiety and depression. (26). Post-
massage symptom scores were reduced by approximately
50%, even for patients reporting high baseline scores, and
significant reductions were found in measures of anxiety,
depression, and fatigue (26).
Aggressive adolescents assigned to a massage therapy
intervention benefited from massage treatment showing
reduced anxiety post-treatment and reduced hostility post
treatment. Such differences were not reported among a
control group who underwent a relaxation exercise rather
than massage (27). Adolescent psychiatric patients also
benefited from 30-minute massage treatments given on 5
consecutive days (28), reporting decreased anxiety levels,
less frequent depressed mood, and improved sleep. Fur-
thermore, nurses rated these patients as more cooperative
on the final day of the study (28).
Massage Therapy and Work
Stress in the workplace often leads to employee strain
and can negatively impact employee heath and well-being
(15). These detrimental health effects can increase employ-
ee absenteeism and reduce productivity (29). Existing re-
search suggests that work-site massage is a promising tech-
nique in the alleviation to work-related stress and strain.
For example, employees who received 20-minutes of seat-
ed massage twice weekly for 8 weeks showed decreased
anxiety levels, fewer sleep disturbances, and improved
blood pressure and heart rate (4). Furthermore, their cogni-
tion scores and overall health ratings improved (4). In a
similar study, employees’systolic and diastolic blood pres-
sure decreased following a 6 week run of 15- minute, on-
site seated massages delivered once per week (20).
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Massage therapy may reduce strain symptoms and it
may positively affect employee health and well-being.
However, few studies have systematically examined the
effectiveness of massage therapy in improving employee
outcomes. For instance, the studies described above are
limited by the lack of a control group. Therefore, using
both treatment and control groups, we examined whether
massage therapy decreases employee strain and blood
pressure and improves perceived well-being. Participants
in the treatment group received weekly massage treat-
ments for four weeks. The following hypotheses were
tested:
Hypothesis 1: Massage therapy will decrease employees’
perceived strain over the four-week treat-
ment period.
Hypothesis 2: Massage therapy will significantly de-
crease systolic and diastolic blood pressure
levels in the treatment group across the
four treatment sessions.
Hypothesis 3: Massage therapy will decrease both sys-
tolic and diastolic blood pressure within
the same session (pre- and post-treatment).
Method
Participants
Twenty-eight employees (26 women and 2 men, mean
age = 39 years, SD = 9.5) from a government office based
in eastern Canada volunteered to participate. All partici-
pants gave written, informed consent prior to entering the
study. All participants were English-speaking, Caucasian,
and all but 2 participants had completed some form of
post-secondary education.
Procedure
The 28 participants were randomly assigned into one
of two groups of 14 people. The first group received treat-
ment during the 4-week phase and the second group
served as the control group. During the four control ses-
sions, participants had their blood pressure measured and
they completed the questionnaire.
During the four treatment sessions, participants had
their baseline blood pressure measured and then received
a 20-minute seated chair massage. For the duration of the
massage treatment, participants were seated around a
boardroom table, leaned forward at the hip with their head
and arms on a pillow and received massage treatment to
the back, neck, head, arms, wrists, and hands. The lights
were dimmed while participants received treatment to en-
courage relaxation. Seven massage therapy students from
a local, professional massage therapy school provided the
massages each week under the guidance of massage ther-
apy professors. The massage was conducted according to
the following protocol. Long moderate pressure strokes
were applied to back muscles, parallel to the spine. Gentle
rocking and squeezing was applied to the shoulders and
arms. Finger and thumb pressure was applied inferiorly
along the spine. Circular palm kneading was performed at
the hips. Massage to the arms consisted of kneading and
compressions beginning at the shoulders and moving dis-
tally to the wrist. Massage to the hands included fascial
spreading, gentle finger distractions and thumb kneading
to the palms. Gentle tractioning was applied at the shoul-
der and elbow. Massage to the neck consisted of kneading,
squeezing and compressions beginning laterally at the
shoulder and moving medially along the trapezius to the
posterior cervical spine. Gentle finger pressure was ap-
plied to the skull and neck and massage applied to the
scalp. The treatment concluded with gentle compressions
and muscle squeezing from the trapezius, distally to the
arms and light fingertip stroking along the entire back.
Blood pressure was measured again after the massage
treatment, and participants completed a questionnaire.
Measures
Demographic information. Respondents indicated
their age, gender, education, and work history.
Strain. The 20-item Bartone Strain Scale (30) was used
to assess psychological and physical strain symptoms.
This scale rates the frequency which participants experi-
enced health complaints over the previous week (eg.,
‘trouble sleeping’, ‘general aches and pains’, ‘loss of in-
terest in things’ or ‘nervousness or tenseness’). The Bar-
tone Strain Scale uses a 5-point Likert-type scale ranging
from ‘Never’ (0) to ‘Always’ (5). Bartone et al. (30) re-
ported that the scale demonstrated high internal reliability:
The alphas in their original study were α= . 90 at Time 1
and α= . 93 at Time 2. In the present study, the coefficient
alpha was calculated for each of the 4 weeks and ranged
from α= .73 to α= .83.
Blood Pressure. Blood pressure was measured using
American Diagnostic Compact Wrist Blood Pressure
Monitors. Both systolic and diastolic blood pressure mea-
surements were taken at the beginning of each of the 4 ses-
sions. For the treatment group, blood pressure was taken
again after the massage treatment.
Results
Table I shows the means and standard deviations for
the study variables in weeks one and four of the sessions.
Because of the small cell sizes, all statistical analyses were
conducted using non-parametric techniques.
We examined whether strain would change during the
4-week treatment program. Strain decreased significantly
in the treatment group between weeks 1 (M=1.09) and 4
(M=0.73; Wilcoxon Signed Ranks test Z = -2.11, p < .05)
but did not significantly change for the control group.
In order to test our second hypothesis regarding
changes in blood pressure across the four treatment ses-
sions, we conducted separate tests for both systolic and di-
astolic measures. For the treatment group, both systolic
(Wilcoxon Signed Rank test Z = -2.547, p< .05) and di-
astolic (Wilcoxon Signed Rank test Z = - 2.103, p < .05)
decreased. In the control group, no significant changes
were noted for either of the blood pressure measures.
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Finally, to evaluate the third hypothesis regarding the
effectiveness of massage therapy in reducing blood pres-
sure within single massage therapy sessions, we compared
average pre-session and post-session measures for partici-
pants in the treatment group. Both systolic (Wilcoxon
Signed Ranks test Z = -2.48 p < .05) and diastolic
(Wilcoxon Signed Ranks test Z = -2.06, p < .05) blood
pressures significantly declined within each session.
Discussion
The presence of stressors within the workplace is nor-
mal and inevitable, and in some cases may even act as a mo-
tivating force for employees. However, high levels of stres-
sors or subjectively appraised stress experienced by em-
ployees is limiting, can stunt employee output, decrease
concentration, and increase strain symptoms (15, 16, 31, 6).
Massage therapy has been effective in alleviating strain
symptoms in many sample populations and in a variety of
contexts (14) and has resulted in positive psychological and
physiological health benefits. Therefore, offering massage
therapy directly within the organizational setting may be of
significant value with regard to incorporating stress man-
agement practices into employee life and facilitating com-
pliance with treatment. Moreover, studies have supported
the importance of extrinsic rewards, such as massage thera-
py, in increasing organizational commitment (32).
Our results supported the hypotheses that employee
strain and blood pressure would decline over a 4 week
treatment period. Moreover, our findings suggest that even
single sessions of massage therapy had an effect on blood
pressure. We believe that the clinical significance of these
findings is enhanced by our use of a minimal intervention
(i.e., 20 minute massage once per week) that is easily ac-
commodated in a working day. On-site massage of the
type investigated here is a promising means of stress re-
duction and health promotion within organizations.
Limitations, Future Research, & Implications
Although the present study did yield significant find-
ings in reducing employee strain and blood pressure, an
important limitation concerns the robustness of the data
analyses due to the small sample size (n=28). Because the
28 participants were further divided into sub-groups, the
treatment group consisted of only 14 people and partici-
pants in both treatment and control groups sometimes
missed sessions, which resulted in missing data across the
four weeks, further reducing the size of the sample and
limiting analyses. Several factors (e.g., meetings, rotation-
al days off, and other commitments) contributed to the
missing data across the four sessions. We were able to
demonstrate an effect of the massage therapy despite this
small sample size. We would expect that future research
conducted with a larger sample would find more substan-
tial differences in strain and health symptoms.
We also noted several limiting features of our study re-
lated to our implementation of the experimental design in a
field setting. First, several of the participants stated that this
was their first experience receiving massage therapy treat-
ment. Therefore, these participants may have been tense,
nervous, or apprehensive about receiving the treatment,
which would ultimately affect baseline and subsequent
blood pressure readings, as well as the subjective outcome
measures. Conversely, despite efforts to provide a relaxing
environment, some participants appeared to be excited
about receiving the massage treatment, which may have in-
creased their blood pressure levels. Moreover, the setting in
which the treatment took place may not have been as con-
ducive with relaxation for some individuals. All participants
sat around a boardroom table, leaning into a pillow. This
proximity to other individuals may have affected some par-
ticipants’ level of relaxation, which also may affect out-
come measures. Finally, the sessions were conducted on
Mondays to accommodate the massage therapy students’
schedules. Participants reported that Mondays were often
one of the busier days within this organization, and the need
for participants to schedule their day around attending the
sessions each Monday may have actually been a stressor.
Therefore, the setting, context, and timing of the treatment
sessions should be a weighty consideration prior to replica-
tion of this study. In the current case, we suggest that these
considerations may have allowed a more robust test of our
hypotheses than would have been obtained under more con-
trolled, laboratory conditions.
Another potential limitation of the present study was
that the massage therapy treatments were provided by mas-
sage therapy students rather than registered professionals.
Massage Therapy applied by a professional registered mas-
sage therapist would follow an individualized treatment
plan indicated by the physical assessment, and not a pre-
scribed routine as applied in our study. However, because
students followed a prescribed routine as outlined by their
supervisor on how and where to massage each participant,
Table I. Means and standard deviations of the study variables for the treatment and control groups
Group
Treatment Control
Week 1 Week 4 Week 1 Week 4
M (SD) M (SD) M (SD) M (SD)
1. Strain 1.09 (.45) .73 (.34) 1.08 (.39) .66 (.40)
2. Systolic Blood Pressure 124.77 (13.2) 117.70 (17.2) 126.88 (17.9) 125.45 (16.2)
3. Diastolic Blood Pressure 77.85 (7.83) 77.7 (12.9) 84.75 (15.6) 84.73 (14.06)
Note: Based on nonparametric analyses, all comparisons for the treatment group are significant (p<.05), and all comparisons for the control group are non-significant.
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the treatments were standardized, which would maintain
reliability. For this reason, the use of students rather than
professionals may have actually been beneficial with re-
gard to standardizing the treatment method used. Never-
theless, we may expect even stronger results in future re-
search when using a standardized treatment protocol ad-
ministered by professional massage therapists.
Our studies employed a short seated massage, focusing
on the head and neck region. More intense, full-body mas-
sages, or chair massages (in which the head, neck, back, and
arms are treated) may further reduce strain and blood pres-
sure and increase employee well-being. Similarly, future re-
search also may target problem areas (e.g., carpal tunnel syn-
drome) to improve circulation and overall health. Finally, fu-
ture research should also consider the use of a diary format
study to examine long-term treatment and strain outcomes,
and to control for individual work and non-work stressors.
Concluding Remarks
Our study has expanded on previous research on mas-
sage therapy by focusing on its effects in the workplace.
These results have important implications for organizations
who are wishing to improve employee health and reduce
employee stress and strain. Massage therapy treatment of-
fered to employees as a health benefit directly in the work-
place may be a practical, enjoyable, and cost-effective
means to reduce strain and blood pressure, and increase
general health, creating a safer, healthier workplace.
Acknowledgments
We would like to thank the students of ICT Northumberland Colle-
ge for performing the massage treatments and the faculty members Mo-
nica Perry, Cheryl Church, and Stephen Jay for their contributions. This
research was supported by a grant from the Nova Scotia Health Resear-
ch Foundation to the first author.
References
1) Humphrey JH. Job Stress. New York: Prentice Hall, 1998.
2) Diego M, Field T, Hernandez-Reif M, Shaw J, Rothe E, Castellanos
D, et al. Massage therapy and light pressure and vibrator effects on
EEG and heart rate. Int J Dev Neurosci 2004; 114: 31-45.
3) Hernandez-Reif M, Field T, Krasnegor J, Theakston H, Hossain Z,
Burman I. High blood pressure and associated symptoms reduced by
massage therapy. J Bodyw Mov Ther 2000; 4(1): 31-38.
4) Hodge M, Robinson C, Boehmer J, Klein S. Employee outcomes
following work-site acupressure and massage. Massage Therapy
Journal 2000; 39(3): 48-64.
5) Zeitlin D, Keller S, Shiflett S, Schleifer S, Bartlett J. Immunological
effects of massage therapy during academic stress. Psychosom Med
2000; 62(83-84): 79-83.
6) Stein F. Occupational stress, relaxation therapies, exercise and
biofeedback. Work 2001; 17(1): 235-245.
7) Barling J. Employee stress and family functioning. New York: John
Wiley & Sons, 1990.
8) Folkman S, Lazarus R, Gruen R, DeLongis A. Appraisal, coping,
health status, and psychological symptoms. J Pers Soc Psychol
1986; 50(3): 571-579.
9) Day A, Livingstone H. Gender differences in the perceptions of
stressors and utilization of social support among university students.
Can J Behav Sci 2003; 35(2): 73-83.
10) Layne C, Hohenshil T, Singh K. The relationship of occupational
stress, psychological strain, and coping resources to the turnover in-
tentions of rehabilitation counselors. Rehabil Couns Bull 2004;
48(1): 143-150.
11) Folkman S, Lazarus R. Stress processes and depressive symptoma-
tology. J Abnorm Psychol 1986; 50(3): 571-579.
12) Strandins L, D’Souza R, Lim L, Broom D, Rodgers B. Job strain, job
insecurity, and health: Rethinking the relationship. J Occup Health
Psychol 2004; 9(4): 296-305.
13) Engel G. Memorial Lecture: The psychosomatic approach to individ-
ual susceptibility to disease. Gastroenterology 1974; 67: 1085-1093.
14) Field T. Massage therapy effects. Am Psychol 1998; 53(12): 1270-1281.
15) Kohler S., Kemp, J. American Workers Under Pressure. Technical Re-
port. 1992; St Paul, MN: St. Paul Fire and Marine Insurance Company.
16) Murphy L.R. Stress management in work settings: A critical review
of health effects. American Journal of Health Promotion, 1996; 11:
112-135.
17) Vickers A, Zollman C. Massage therapies. Br Med J 1999; 319:
1254-1257.
18) Hernandez-Reif M, Field T, Theakston H. Multiple sclerosis patients
benefit from message therapy. J Bodyw Mov Ther 1998; 2(3): 168-174.
19) Quinn C, Chandler C, Moraska A. Massage therapy and the fre-
quency of chronic tension headaches. J Public Health 2002; 92(10):
1657-1662.
20) Cady S, Jones G. Massage therapy as a workplace intervention for
reduction of stress. Percept Mot Skills 1997; 84: 157-158.
21) Lovas J, Craig A, Raison R, Weston K, Segal Y, Markus M. The ef-
fects of massage therapy on the human immune response in healthy
adults. J Bodyw Mov Ther 2002; 6(3): 143-150.
22) Ironson G, Field T, Scafidi F, Hashimoto M. Massage therapy is as-
sociated with enhancement of the immune system’s cytotoxic ca-
pacity. Int J Neurosci 1996; 84(1-4): 205-217.
23) Jones N, Field T. Massage and music therapies attenuate frontal
EEG asymmetry in depressed adolescents. Adolescence 1999;
34(135): 530-534.
24) Field T, Ironson G, Scafidi F, Nawrocki T. Massage therapy reduces
anxiety and enhances EEG pattern of alertness and math computa-
tions. Int J Neurosci 1996; 86(3-4), 197-206.
25) Niedermeyer, E. & Da Silva, F.L. Electroencephalography: Basic
Principles, Clinical Applications, and Related Fields (5th Ed). Balti-
more, MA, Lippincott Williams & Wilkins; 2005.
26) Cassileth B, Vickers A. Massage therapy for symptom control: Out-
come study at a major cancer center. J Pain Symptom Manage 2004;
28(3): 244-249.
27) Diego M, Field T, Hernandez-Reif M, Shaw J, Rothe E, Castellanos
D, et al. Aggressive adolescents benefit from massage therapy. Ado-
lescence 2002; 37(147): 597-607.
28) Christensen H, Lundberg U. Musculoskeletal problems as a result of
work organization, work tasks and stress during computer work.
Work Stress 2001; 16(2): 244-249. Hernandez-29) Reif M, Field T,
Krasnegor J, Theakston H. Lower back pain is reduced and range of
motion increased after massage therapy. Range of motion and back
pain. Int J Neurosci 2001; 106(3-4), 131-145.
30) Bartone PT, Ursano,RJ, Wright KM, Ingraham LH. The impact of a
military air disaster on the health of assistance workers: A prospec-
tive study. J Nerv Ment Dis, 1989; 177: 317-327.
31) Randolfi E. Developing a stress management and relaxation centre
for the worksite. Worksite Health 1997; 17(1): 235-245.
32) Walko SE, Pratt CW, Siiter R, Ellison K. Predicting staff retention in
psychiatric rehabilitation. Psychosocial Rehabilitation Journal
1993; 16: 150-153.
Reprint request: Dr. Arla L. Day, Department of Psychology, Saint Mary’s University, Halifax, NS B3H 3C3; Phone: (902) 420-5854;
Fax: (902) 496-8287; E-mail: Arla.Day@smu.ca
... Occupational stress is a serious and chronic health problem and is the cause of behavioral problems such as increased alcohol and tobacco consumption. [5][6][7] In addition, it is the cause of growing concern among employers and employees. [8] Stress reduces employee productivity and increases absenteeism, retirement and disability costs, and economic costs imposed directly on employers. ...
... Massage therapy is commonly used to relieve pain and anxiety. [7,27] Present studies show that massage in the workplace is an appropriate way to relieve stress. For example, a study suggested that staff who received 20 min of massage twice a week for 8 weeks reported lower levels of anxiety and sleep disturbance, and decreased blood pressure and heart rate. ...
... [29] In a similar study on massage therapy for 15 min for 6 weeks, systolic and diastolic blood pressure was reduced. [7] In a meta-analysis of 37 massage therapy studies, involving 1802 participants, of whom 795 received massage therapy and 1007 patients did not, significant differences were observed between the treatment groups at different levels. Furthermore, participants who had received massage had considerably lower rate of anxiety, blood pressure, and heart rate. ...
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One of the main causes of stress in the lives of people is their jobs. Occupational stress is causing a wide range of significant issues in health and community services. Nursing is the most stressful profession in the health services. Massage therapy is one way of coping with stress. This study was conducted to determine the effect of massage therapy on stress in nurses. This study was a clinical trial on 66 male and female nurses working in intensive care units (dialysis, ICU, and CCU) of Isfahan University of Medical Sciences, Iran, in 2013. Participants were selected according to the aims and inclusion criteria of the study. Then, they were randomly divided into experimental and control groups. The Occupational Stress Inventory (OSI) (Osipow and Spokane, 1987) was completed by participants of the two groups before, immediately after, and 2 weeks after the intervention. General Swedish massage was performed on participants of the experimental group for 25 min in each session, twice a week for 4 weeks. Data were analyzed by descriptive and inferential statistics [Chi-square, t-test, and repeated measures analysis of variance (ANOVA)] using SPSS software. Results showed that the difference in overall mean occupation stress scores between experimental and control groups 2 weeks after the intervention was significant (P < 0.001). According to the results, it is recommended that massage, as a valuable noninvasive method, be used for nurses in intensive care units to reduce their stress, promote mental health, and prevent the decrease in quality of nursing work life.
... In addition to the extension of diarthrodial range, it influences stress hormones (epinephrine and norepinephrine), which can trigger the activation of sympathetic nerves such as an increase in heart rate, contraction of blood vessels and muscle tension, as well as circulation throughout the body via blood 10) . Thus, massage has been confirmed to have positive effects on changes in hormones 11,12) , blood pressure 13,14) and heart rate 15) . This study was performed to provide a theoretical rationale for the application of massage as stress therapy in female office workers. ...
... After performing scalp massage in adults at the normotensive or prehypertensive stage, blood pressure was found to have decreased significantly 23) . Additionally, 4 weeks of massage at work was shown to significantly decrease strain and blood pressure 14) . ...
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[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.
... The classification and the need for standardized diagnostic methods for assessment of neck and upper limb musculoskeletal disorders are reviewed, are emphasized by Buckle and Devereux (12). The study of Day et all provides initial support for the effectiveness of workplace-based massage therapy as part of a comprehensive workplace health strategy (13). With this approach, he proved that massage treatments at work, received weekly for a four-week period, significantly reduced strain and blood pressure. ...
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AbSTRAcT INTRODUCTION: Continuous static load during computer work results in the gradual development of pathological changes in the musculature of the upper back, neck, and arms. OBJECTIVE: The aim of this paper was to identify problems in the area of the neck, shoulder area, and upper limbs associated with a static load on employees working on a computer. METHODS: The study was conducted on 162 workers, aged 20 to 60, in the city of Siroki Brijeg, Bosnia and Herzegovina, in 2011. A questionnaire consisting of parts of two standardized questionnaires: “Workplace Appraisal on the Keybo- ard” from ergonomics in professional therapy and a questionnaire for upper limbs from the Maastricht region (MUEQ) have been used. Complaints were sought on at least one problem related to the aforementioned anatomical structures present in a minimum duration of one week over the past 12 months. RESULTS: Out of a total of 162 workers, 110 have or have had problems in the past. The number of hours spent on the computer, the years spent at the workplace, the presence of the symptoms, the location of the same, have statistical significance. Numerous workers do not have a custom work desk, and many of them have not sought adequate medical assistance. CONCLUSION: Long-lasting static work on the computer can be a predisposing factor for the appearance of certain problems on the structures of the neck, shoulder area, and upper limbs. An inadequate desk may also have a negative impact on the problem. Keywords: cumulative traumatic disorders, musculoskeletal disorders, computer.
... This was continued for four weeks. (31) No intervention was performed on the participants in the control group of the study. Immediately after the completion of the almost one month of intervention, the occupational stress questionnaire was once again provided to the participants in both groups. ...
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Background Results of various studies indicate that emergency medical service (EMS) staff suffer from occupational stress that adversely affects their quality of life and their care quality. Purpose This study aimed at determining the effect of massage on occupational stress experienced by emergency medical service staff. Setting Prehospital emergency medical services stations of a city in the southwest of Iran. Participants A total of 58 members of staff of the emergency medical services, working in prehospital emergency medical services stations. Research Design In this randomized controlled trial, a total of 58 EMS staff were selected from prehospital EMS stations, according to inclusion and exclusion criteria, and then assigned in two groups (29 in massage and 29 in control group) randomly by the minimization method. The intervention group received Swedish massage, twice a week for four weeks in the morning after the end of the work shift. Each massage session lasted 20–25 minutes. Subjects in the control group received no intervention. The level of occupational stress of the two groups was measured under the same conditions before and after the intervention by using the expanded nurses’ occupational stress scale (ENSS). Data were analyzed with the SPSS16 software by using the chi-squared test, paired and independent-sample t tests, one-way ANCOVA. P value < .05 was considered as the level of significance. Results The mean and SD of total occupational stress scores in the control group was 114.41±30.11 in pretest and reach to 112.58± 30.62 in posttest stage. Also the mean and SD of total occupational stress scores in the intervention group was 130.20±26.45 in pretest and reach to 110.41±21.75 in posttest stage. A one-way ANCOVA showed that there is a significant effect of massage on EMS staff’s occupational stress level after controlling for pretest score (p = .001). Conclusions The training and the application of massage therapy can serve as an effective method in reducing occupational stress in emergency medical centers.
... ;Dimoff, Kelloway, & Burnstein, 2016; Goetzel Ozminkowski, Sederer, & Mark, 2002;Irvine, 2011; MHCC, 2012) as well as on-site meditation rooms and complementary mindfulness training or massage therapy (see for instanceDay, Gillan, Francis, Kelloway, & Natarajan, 2009) are increasingly common. Such programs have resulted in significant reductions in disability costs (seeBaicker, Cutler, & Song, 2010; Conti ...
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en Mental health is an issue of increasing concern to both individuals and organizations in Canada. The articles presented in this special issue present several approaches to dealing with workplace mental issues and highlight the need for more research in this area. In particular there is a pressing need for evaluative research to, identify which strategies work to improve individual and organizational well‐being. © 2018 ASAC. Published by John Wiley & Sons, Ltd. Résumé fr La santé mentale est un problème qui préoccupe de plus en plus les personnes et les organisations au Canada. Les auteurs des articles contenus dans ce numéro spécial présentent plusieurs approches utilisées pour se pencher sur les problèmes de santé mentale au travail et soulignent la nécessité d'effectuer plus de recherches dans ce domaine. Plus spécifiquement, il y a un besoin pressant de recherche évaluative axée sur l'identification des stratégies efficaces capables d'améliorer le bien‐être individuel et organisationnel. © 2018 ASAC. Published by John Wiley & Sons, Ltd.
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Recent clinical evidence suggests that the therapeutic effect of massage involves the immune system and that this can be exploited as an adjunct therapy together with standard drug-based approaches. In this study, we investigated the mechanisms behind these effects exploring the immunomodulatory function of stroking as a surrogate of massage-like therapy in mice. C57/BL6 mice were stroked daily for 8 days either with a soft brush or directly with a gloved hand and then analysed for differences in their immune repertoire compared to control non-stroked mice. Our results show that hand- but not brush-stroked mice demonstrated a significant increase in thymic and splenic T cell number (p < 0.05; p < 0.01). These effects were not associated with significant changes in CD4/CD8 lineage commitment or activation profile. The boosting effects on T cell repertoire of massage-like therapy were associated with a decreased noradrenergic innervation of lymphoid organs and counteracted the immunosuppressive effect of hydrocortisone in vivo. Together our results in mice support the hypothesis that massage-like therapies might be of therapeutic value in the treatment of immunodeficiencies and related disorders and suggest a reduction of the inhibitory noradrenergic tone in lymphoid organs as one of the possible explanations for their immunomodulatory function.
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Although researchers have found that social support is an effective coping mechanism to deal with stress, there has been little research on gender differences in perceived stress and use of social support. In the present study, 186 undergraduate students from a Maritime university rated the perceived stressfulness of five scenarios, and identified the type and source of social support they would use to cope with each of the situations. Women perceived three of the five scenarios as significantly more stressful than did men. Women indicated that they would turn to their partner and friends to a greater extent than men would. Women also reported that they would seek emotional support to a greater degree than did men. However, when the perceived stressfulness of the scenarios was controlled, some of the gender differences in the sources and types of support disappeared. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Reports clarification of the original article by T. Field ( American Psychologist , 1998[Dec], Vol 53[12], 1270–1281). Some of the content of the article was published in "Touch Therapies," by Tiffany M. Field (in R. R. Hoffman, M. F. Sherrick, & J. S. Warm, Eds., Viewing Psychology as a Whole; The Integrative Science of William N. Dember, 1998, pp. 603–624, Washington, DC: American Psychological Association). There is also some overlap with a journal article: "Touch Therapy Effects on Development," by Tiffany M. Field ( International Journal of Behavioral Development, 1998, Vol. 22, No. 4, pp. 779–797). (The following abstract of this article originally appeared in record 1998-11439-002 .) Massage therapy is older than recorded time, and rubbing was the primary form of medicine until the pharmaceutical revolution of the 1940's. Popularized again as part of the alternative medicine movement, massage therapy has recently received empirical support for facilitating growth, reducing pain, increasing alertness, diminishing depression, and enhancing immune function. In this article studies are reviewed that document these effects, and models are proposed for potential underlying mechanisms.
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The Occupational Stress Inventory—Revised (Osipow, 1998) and an individual data form were used to determine the turnover intentions of rehabilitation counselors, based on an interactive model of stress, strain, and coping as well as various demographic variables. The sample consisted of counselors who considered themselves to be employed full-time as rehabilitation counselors, regardless of job setting, and who are members of the American Rehabilitation Counseling Association. The results indicate that it is the occupational stress inherent in the job functions of rehabilitation counselors, and not individual coping resources or demographic variables, that accounts for the turnover intentions of counselors in the field of rehabilitation.
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Little scientific investigation has been conducted to examine objectively the belief that massage therapy can effect the immune system of healthy people. If there are any links between massage therapy and improved immune function, the mechanisms by which they operate are not known. This study evaluated the effects of massage therapy on immune functions of two healthy females.Using a single-case experimental ABAB design, two subjects received a relaxing massage during the experimental phases (B) and no massage during baseline phases (A). Assays were conducted for T and B lymphocyte mitogen-induced proliferation, enumeration of T and B lymphocyte subsets, quantification of immunoglobulins A, G and M (IgA, IgG, IgM) and cortisol levels. Trait and state anxiety levels were also examined.The results indicated a consistent and significant trend of increased activity of both T and B lymphocytes and levels of serum IgG for both subjects during the B phases compared to the A phases. There were no other significant differences between experimental and control conditions for the remaining measures, although serum IgM levels approached significance (P=0.06). Both subjects demonstrated a reduction in trait anxiety over the period of massage therapy.Further studies with larger sample sizes in control and experimental groups, over a longer experimental period are necessary. The study of the effects of massage therapy poses an exciting challenge in psychoneuroimmunology.
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Twenty-four adults with multiple sclerosis were randomly assigned to a standard medical treatment control group or a massage therapy group that received 45-minute massages twice a week for 5 weeks. The massage group had lower anxiety and less depressed mood immediately following the massage sessions and, by the end of the study, they had improved self-esteem, better body image and image of disease progression, and enhanced social functional status.
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High blood pressure is associated with elevated anxiety, stress and stress hormones, hostility, depression and catecholamines. Massage therapy and progressive muscle relaxation were evaluated as treatments for reducing blood pressure and these associated symptoms. Adults who had been diagnosed as hypertensive received ten 30 min massage sessions over five weeks or they were given progressive muscle relaxation instructions (control group). Sitting diastolic blood pressure decreased after the first and last massage therapy sessions and reclining diastolic blood pressure decreased from the first to the last day of the study. Although both groups reported less anxiety, only the massage therapy group reported less depression and hostility and showed decreased urinary and salivary stress hormone levels (cortisol). Massage therapy may be effective in reducing diastolic blood pressure and symptoms associated with hypertension.
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280 staff members from 28 psychiatric rehabilitation programs in New Jersey were surveyed to determine factors contributing to their organizational commitment. Measures of intrinsic commitment, extrinsic commitment, and commitment to the field of psychiatric rehabilitation were compared with a measure of general organizational commitment. Results indicate that the organizational commitment of staff members can be explained by intrinsic (emotional) reasons and commitment to the field of psychiatric rehabilitation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)