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Good vibrations: Do electrical therapeutic massagers work?

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Abstract

Health, leisure and beauty activities are increasing in popularity, with a particular emphasis on self-help and alternative health practices. One product type that has increased sales with this expansion is the hand-held electric massager. These are products that use vibration as a means of alleviating muscular strains and pains, as well as promoting relaxation. Paradoxically, these products are extremely popular as gifts, but are soon discarded. A multi-disciplinary research team was commissioned by a British manufacturer of electrical consumer products to investigate user attitudes and perceptions of existing massagers, to identify areas of user dissatisfaction. The manufacturer was also concerned about a possible stigma attached to these products because of an association with sex aids. This paper provides an account of the perceptions of both consumers and therapists regarding the use of these products. Identifying the differences between the perceptions of consumers and therapists should help provide a basis for effective integration of user needs, manufacturer requirements, designers' skills and sound therapeutic practice. The results provide insight to support the development of more effective hand-held massagers.
This article is a version after peer-review, with revisions having been made. In terms of appearance only this
might not be the same as the published article.
McDonagh, D., Wilson, L., Haslam, C. and Weightman, D., 2005. Good vibrations: Do
electrical therapeutic massagers work? Ergonomics, 48: 680-691
Good vibrations: Do electric massagers work?
Deana McDonagh
1
, Lesley Wilson
2
, Cheryl Haslam
3
and David Weightman
4
1
Department of Design and Technology, Loughborough University, UK
2
Department of Health and Social Care, Brunel University, Osterley Campus,
Isleworth, Middlesex, TW7 5DU, UK
3
Institute of Work, Health and Organisations, University of Nottingham, Science and
4
Technology, William Lee Buildings 8, University Boulevard, Nottingham, NG7 2RD, UK
School of Art and Design, Staffordshire University, Stoke-on-Trent, Staffordshire, UK
Abstract
Health, leisure and beauty activities are increasing in popularity in the United Kingdom,
with a particular emphasis on self-help and alternative health practices. One product type
that has increased sales with this expansion is the hand held electric massager. These are
products that use vibration as a means of alleviating muscular strains and pains, as well as
promoting relaxation. Paradoxically these products are extremely popular as gifts, but are
discarded after an initial period of use.
Products that respond to real user needs will be successful in the market. Designers
cannot guess or assume such needs; they must immerse themselves within the user
experience to effectively ascertain user needs. Research has become a fundamental
activity within design to support evidence-based decision-making, ensuring that
answering real user needs is central to product development.
The research team was commissioned by a British manufacturer of electrical consumer
products (including massagers) to investigate user attitudes and perceptions of existing
products, to try to identify areas of user dissatisfaction. The manufacturer also concerned
about a possible stigma attached to these products because of an association with sex
aids.
In stage one, the research team of an industrial designer and design researcher consulted
on a one-to-one basis with a sample group of users and health/beauty therapists. The
team identified a significant problem with users perceptions and experience of existing
massagers. Many products had a number of operational disadvantages and this combined
with doubtful efficacy to lead to users becoming disillusioned with them.
At stage two, the research team expanded to include a health psychologist and
professional therapist, setting up focus group discussions for product handling and
evaluation with expert physiotherapists, occupational therapists and neurologist. There
was universal agreement that most existing products had little therapeutic benefit and in
This article is a version after peer-review, with revisions having been made. In terms of appearance only this
might not be the same as the published article.
the hands of untrained users they might actually aggravate the conditions they were
meant to alleviate.
This stage exposed some fundamental differences of opinion between the professional
therapists and manufacturers of existing products about the appropriateness of various
operating principles. Most therapists employ manual massage as a reliable and effective
technique for rehabilitation and relaxation. They were unconvinced that electrical
vibration produced comparable results and were concerned about the harmful effects of
vibration on muscle and nerve tissue. Although the manufacturer involved was keen to
secure product endorsements from key professionals, this proved impossible to achieve
with existing products. This stage did result in the identification of promising directions
for future product development in collaboration with users resulting in a range of
conceptual designs, which may form the basis for future products.
This paper provides an interesting account of the differing perceptions that various
constituencies bring to bear on the product design and evaluation process. Identifying
these differences provides the basis of an effective integration of user needs,
manufacturer requirements, designers’ skills and sound therapeutic practice. It provides
valuable insight to support the development of more effective hand-held massagers for
the future, but also acts as a model of product development practice in the wider context.
Keywords: electric massagers, user-centred design, supra-functionality
Introduction
Products satisfy needs beyond the functional. The emotional domain within user-product
interaction provides insight into user experience and aspirations. It is not enough that a
product functions well. It also needs to reflect the lifestyle and supra-functional needs of
the individual. These supra-functional needs can include social, cultural, emotional,
aspirational and spiritual (McDonagh-Philp and Lebbon 2000). When searching the
shelves in the retail outlet for a product, its actual function has less impact that its
appearance. The use of colour, texture, form, product language (product semantics),
cultural cues and branding has a significant influence upon the individual at the point of
purchase. If a product performs well but does not respond to a users needs, then product
bonding and emotional attachment becomes less likely. For manufacturers, it is not only
important to sell products be also develop product loyalty. Therefore, now that adequate
product functionality is the norm, supra-functional factors are recognised as even more
important (Weightman and McDonagh 2003).
The growth of health and beauty activities in the United Kingdom
With the increase in popularity of leisure, health and beauty activities, the retail sales of
hand-held massagers reached a value of £2.7 million in the UK during 2000 (MINTEL
2001). As awareness of the uses of such products grows in the UK, so the purchasing
and ownership is likely to increase. Many consumers are becoming more open to the
concept of promoting relaxation and treating their own symptoms of pain and stiffness as
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an alternative to the use of drugs or medicine and so increasing favour self-help remedies.
Before this study was conducted, the use of hand-held massagers would appear to have
met this need.
Existing massagers
A massager is a hand-held object that applies vibration to the surface of the skin. This
vibration tends to be applied to relieve muscular tension/strain and/or encourage
relaxation. The majority of the products on the market tend to be either battery operated
or mains powered. For this study a sample of eight electronic products was used (refer to
Table 1) ranging from those that combined aromatherapy oils and heat to promote
relaxation (Morphy Richards ‘Essential’ and Visiq infra-red body massager) to the more
sport orientated products, that use strong vibrations to relieve aches and strains
(Remington ‘Sports Thumper’ and Scholl ‘Massage Master’).
In addition, a sample of non-electronic products was included within the study to
demonstrate the wide range of products available through mainstream retail outlets (refer
to Table 2). The majority of this sample is hand held with the exception of the foot
massager.
Manufacturers interest and brief
A British manufacturing company had initiated the project to address concerns about the
apparent lack of usage of these products after purchase. Usually purchased as gifts, they
were being used once or twice before being stored away. They perceived the target user
was female and come from the lower socio-economic categories. Massagers are
regarded either as a luxury item to promote relaxation or more specifically to treat a
sports injury. Hasdogan (1996) has recognised that purchasing products as gifts for
others attracts priorities such as brand and cost, rather than function and ease of use.
Therefore, the focus for this study concentrated on the final user not the purchaser.
The manufacturer also expressed the desire for an endorsement from a high profile
professional to help boost sales. Such endorsements from celebrity chefs and
hairdressers have already been instrumental in increasing cooking and hair styling
products.
What was it that prevented the users from interacting with these products? Why did they
feel the need to store these products away from sight?
Stage one research
The research team comprised of an industrial designer and design researcher. Following
user-centred design methodologies the team placed actual users as the central focus of the
research activities.
This article is a version after peer-review, with revisions having been made. In terms of appearance only this
might not be the same as the published article.
An initial pilot study was conducted in the Department of Design and Technology at
Loughborough University. The aim of this stage was to elicit information from product
users to feed directly into the designing process of a new generation of products
(Bruseberg and McDonagh-Philp 2001). As products that we surround ourselves with
tend to satisfy needs beyond the functional, the study also explored users needs such as
aspirational, cultural and emotional. This study took place over a ten-week period and
involved an industrial design undergraduate student, sponsored by a research bursary and
industrial support
1
, who carried out design research to elicit user feedback on a range of
products, available through mainstream retail outlets in the UK. A design audit was
conducted which was followed up by users (n=10) evaluating the products (visually and
through product handling) within their own home environment. Each participant
completed a feedback booklet, which explored their perception of the product visually,
through handling, use of colour and finally providing the product with a personality
profile (McDonagh et al 2002). Explain what it is
The findings revealed a significant lack of consumer confidence in the product. These
products are generally marketed to promote well-being through relaxation, de-stressing
and relieving muscle tension. However, user surveys determined that the vibration was
often ineffective and sometimes painful during use and afterwards. The vibrating
function made the product too noisy and disturbing to promote relaxation. Lack of
instructions and guidance and insufficient explanation of contra-indications make these
massagers potentially dangerous when operated by users within limited anatomical
knowledge (Cooper and McDonagh 2001).
This stage revealed that these products might have a stigma attached to them. The
massage effect is generated by vibration, which tends also to be associated with sex aids.
In addition, the actual size and weight of the products were found to be too big and heavy
to be used comfortably. Solo use and massage is difficult thus limiting the benefits of the
massage. Users did not tend to read the instructions prior to use, and relied upon the
product semantics to direct them. Product semantics is the way in which the product
communicates how it is used. Therefore, the user should intuitively understand how to
hold it, turn it on and off, and be able to interact relatively quickly. Prior user knowledge
and experience of similar products is often relied upon along with developing products.
The use of colour, form, texture and signage can contribute to the user developing
understanding interaction with the product. Due to poor product semantics with these
products, misuse and a general lack of product understanding was experienced. Product
attachment and emotional bonding did not develop and contributed to the products early
redundancy.
Participants raised a number of concerns these include the following:
1
The authors would like to thank the Nuffield Foundation Undergraduate Research Bursary Scheme (grant
number URB/00450/A) and Morphy Richards for their support. In addition, Stuart Cooper, the industrial
design student who carried out the first part of the pilot study, who undertook the research brief with
diligence and professionalism.
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might not be the same as the published article.
Due to the length of the power lead, they had to sit close to a plug socket rather than
a location of their choice (on their sofa or bed). They would have preferred a longer
power lead.
The visual language of the products was not clear or easy enough to understand.
Some participants struggled to switch products on or off.
Users tended to disregard the instructions and interact immediately with the product
Such products were perceived to carry a stigma with them and participants would not
feel comfortable having them on show within their home environment
Felt the products were too big (over scale)
Perceived the products to be too heavy (difficulty in holding and directing product)
The products ranged from 0.6 – 1.5kg, which becomes a significant weight when
attempting to reach particular parts of the body.
The products aimed at sporting injuries were perceived as overtly masculine and
aggressive due to their product semantics (colour, form and ‘feel’)
These findings raised various areas of concern for the research team. Further insight was
sought from a small sample of professional masseurs. They raised the following points.
Not prepared to endorse or recommend such products.
Perceived them as harmful and discouraged clients from using them.
As a team of researchers (industrial designer, design researcher and ergonomist) we
discovered the products did not live up to the expectations of users and further insight
was needed.
Stage two
At this stage experts at Nottingham and Brunel universities were consulted and joined the
research team, which now included a health psychologist and occupational therapist. Key
experts in therapy, occupational and physio took part in two focus groups.
In light of the ergonomic issues associated with these products, the aim of the second
stage was to conduct an in-depth qualitative investigation of health professionals’
assessment of the usefulness of hand-held massagers. The research team chose to focus
on the assessment of physiotherapists and occupational therapists for three reasons.
Firstly, occupational and physiotherapists are involved in treating clients with sports
injuries, and therefore, have expert knowledge and experience which make them well
placed to evaluate these products. Secondly, in marketing these products, manufacturers
often seek endorsements from professional groups. Thirdly, health professionals, such as
occupational therapists and physiotherapists involved in rehabilitating people following
injury or disease are likely to be asked for their opinion and to recommend a suitable
massager to augment and enhance treatment (Westland 1993a, 1993b).
Occupational therapists and physiotherapists normally work together as members of
multidisciplinary clinical teams, although their professional remits are somewhat
different. Physiotherapists are concerned with the physical rehabilitation of people who
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have sustained injury or disease whereas occupational therapists use the engagement of a
person in meaningful activity or occupation in order to restore overall function (College
of Occupational Therapists 2003). Occupational therapists see themselves as more
holistic, addressing wider environmental issues of concern to their patients and clients
whereas physiotherapists are concerned with restoring movement and function to an
injured part of the body using a range of physical treatment techniques (Chartered
Society of Physiotherapists 2002).
Focus group techniques were employed to elicit expert opinions and evaluations of
products currently available on the market. The use of focus groups is a technique to
generate discussion as a basis for product evaluation and development (McDonagh-Philp
and Denton 1999; Langford and McDonagh 2003: 23-25). The focus group sessions in
this study were facilitated by an industrial designer and an occupational therapist and
included the evaluation of existing massagers.
Format of focus group sessions
Focus groups are groups of individuals that have been brought together to discuss
specific topics. The method relies upon participants interacting and generating a
synergetic effect (Driskell, Hogan and Salas, 1987; Hackman, 1983; Hampden-Turner,
1971; Shaw, 1971 and Kitzinger, 1994). Moderators are used to facilitate the activity,
encourage discussion and interaction.
Each session lasted 1.5 hours and involved a range of activities, such as visual evaluation,
product handling, product personality profiling (McDonagh et al 2002) and focus group
discussion (Bruseberg and McDonagh-Philp 2001). The focus group sessions were
video-recorded and photographed. The use of video recording enhanced the quality of the
data, enabling an accurate interpretation of the process, as non-verbal and verbal
communication could be observed. The participants (n=13) were relaxed in front of the
camera and were also given the opportunity to express their views in writing, to minimise
the possible effects of changed behaviour due to being filmed used in qualitative research
(Bertoff 1994).
The subsequent discussions built on reflections of existing products. In the first focus
group, joint moderators helped to diffuse the attention of the participants between two
individuals, which facilitated and enhanced the overall group’s contribution to the
discussion.
There were nine therapists in the first group and four in the second group. Table 3
provides a profile of all the focus group participants. All therapists were experienced in
their field and had informed knowledge of using massagers, some being involved in the
provision of undergraduate and post-graduate courses within their discipline.
The recordings were transcribed and the data analysed by sorting verbatim material into
emergent themes as described by (Dey, 1993). The analysis was guided by the original
research themes, namely the response to products currently available on the market, ideas
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for new products and the response to newly proposed designs. Written responses were
collated, tabulated and analysed using descriptive statistics.
Results
When the participants were asked to reflect and comment on the massagers, the overall
response was negative. A number of key themes emerged from the participants’
responses, including:
Preference for manual hand massage over the use of either manual or electronically
operated products
Preference for the manual objects over the electronic massagers
Issues related to the design and manageability of the products
Potential dangers related to the use of the products
Concern over the way in which the products are marketed
Issues related to the stigma commonly associated with many of the products
The use of manual products
All of the participants explicitly stated their preference for manual hand massage over the
use of either manual or electric products. In particular, they felt very strongly that
manual hand massage was a much more effective and sensitive method of massage.
As a hand therapist pointed out:
From my point of view I’d be a bit concerned really, because part of the whole thing
about massage is that it’s a kind of relationship between you and the person that’s
giving it to you and its about the feel and the touch and knowing what works and
what doesn’t work and knowing what to do and what not to do …
One occupational therapist described her experience of a sports massage to illustrate the
difference between electric products marketed as sports massagers and a professional
manual massage. In particular, she refers to the importance of expert knowledge in the
application of an effective sports massage:
It's also working with the terminology of the problem as well … the person explains
to you each time what he’s doing, or she’s doing and why they are doing it and so
that gives you professional reassurance that he or she knows what they are doing,
whereas with those you just bang it on the muscle and hope for the best don’t you.
Although there was an overall preference for manual massage, two of the participants
were able to identify advantages related to using the smaller electrical products within
their specialist field, as illustrated by the comments of one of the occupational therapists
specialising in hand therapy:
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We use them a lot in the hand therapy unit, we use them for sensory retraining
programmes, sensitisation, vibration, and we also use it for hand massage … so from
our point of view yes it does have therapeutic application.
Preference for manual objects over the use of electrically operated products
Although the overall opinion was that using the hand is the most effective method of
massage, the majority of therapists expressed a preference for the manual products when
asked to recommend massagers for their patients. Comparisons were drawn between the
manual and electric products to underline this preference, as cited by a physiotherapist:
Personally speaking I like these little simple balls and gadgets that have a rubbery,
softer feel … you can apply it very much on an individual basis. You can use it as
firmly or as gentle as you like … I mean I know some of them have power controls
… I just think these give a bit more flexibility in terms of application.
Overall design
A number of negative comments were made with regards to the design and manageability
of the products. In particular, the participants referred to the size, weight and power of
the larger electrically operated products. A respondent remarked:
Too heavy for some of the patients I can think of … they are going to be very sort of
heavy, very unwieldy, the actual degree of massage they give you is uncomfortable...
Some of the participants stated that they experienced discomfort as a result of the
vibration produced by the electronic products. As one of occupational therapists pointed
out:
For me it was about two, three minutes afterwards with one of the products, it was
still feeling really sort of uncomfortable…
Potential dangers
The strong vibrating forces from some of the larger electronic products were considered
to be a potential danger by several participants. A number of concerns related to the use
of the products with particular client groups:
I work with old people … those products are quite forceful and they could quite
damage them…
References were also made to the detrimental effect that the vibration might have on
nerves:
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Nerves don’t like being battered. I mean if you were to place that over a nerve you
would certainly have a derogatory effect on the membrane, there’s no doubt about
that …
Marketing of the products
A number of concerns were expressed over the way in which the products are marketed.
With the majority of the electric products claiming relaxation or therapeutic effects.
Most of the participants agreed that the strong vibrating force and the amount of physical
effort required to operate some of the machines would not be conducive to relaxation:
I would have thought most people, if they wanted to get a machine like this, would
think that they would just be really nice and relaxing … I mean that’s the sort of idea
I had until I switched them on.
As pointed out by one of the participants, a physiotherapist specialising in neurology, a
vibrating action would achieve the opposite physiological effect.
I think there is a fascinating point to be made about a machine which is supposed to
relax you. In fact, if it does anything physiological it would do the opposite, because
if you put vibration on … you would actually tone the muscle … so you are
achieving the opposite effect … I think the physiological effect could be useful. I
mean you could actually market it on the grounds that you were going to facilitate
somebody’s ability to contract a muscle, there’s that scope.
Stigma
All but one of the participants referred to the stigma associated with many of the
vibrating products. One of the occupational therapists referred specifically to the
problem of stigma attached to the use of small hand held massagers within the hand
therapy unit.
As soon as you say you are going to have to use vibration, they say are you going to
get your vibrator, massaging tool out … there are times when I do want a patient to
have one at home when they are doing a sensory retraining programme and its very
difficult to buy a hand sized vibrator that is not a vibrator. So from my point of view
I’d like to see something like that that’s marketed in a different way that hasn’t got
quite so much stigma.
The key findings from these focus groups with experts were as follows:
The majority of therapists preferred the non-electronic massagers
They were particularly concerned about the claims the product manufacturers make
regarding the products reducing stress and relieving muscular pain
Users do not read instructions
Product complexity should be reduced so that the product is easy ‘to read’ to avoid
misuse
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Effective product development
****
The following represents the key issues that developers (designers and manufacturers)
need to consider and respond to in order to develop the next generation of massagers.
Reduce and/or eliminate stigma
Product semantics need to be more considered
Avoid false claims
Explore the relaxation route rather than the sports injury route
Involve users within the product development process (prior to concept generation
through to concept refinement)
Conclusion
What does the future hold for this product type? Health, beauty and relaxation as
activities are increasing in popularity in the United Kingdom. As technology develops,
the authors are confident that lighter products will be possible that can stimulate a manual
massage in the not too distant future.
Massagers need to be lighter in weight
Integrate visually within the home environment
Respond to supra-functional needs (emotional, aspirational and cultural etc)
Stimulate the effects of manual massage techniques
Focus on relaxation
This study has evaluated the hand-held massagers currently available on the market from
two perspectives, that of users and that of experts. It has initiated an exploration of
possible new design solutions, as intended by the original research aims. It emerged that
the best form of massage is still achieved by human hands and although it might have
been speculated that therapists would welcome electrical and manual devices to assist
them in their treatment, this was not found to be the case.
It is of some concern that the manufacturers’ claims for these products are misleading at
best and potentially damaging to the general public, especially to those with sports
injuries, at whom the larger massagers are targeted. This might be one of the reasons why
the focus group participants were unwilling to recommend the massagers since it would
compromise their professional integrity to do so (Health Professions Council 2002).
Although the outcome of this study may be somewhat disappointing from the product
development team’s point of view, it nevertheless highlights the importance of consulting
with users in the early stages of a new design development in order, in this case, to
prevent a perpetuation of the “unused massager syndrome”.
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The company was advised to explore the use of massagers for relaxation rather than for
the alleviating sports injuries. Though the manufacturer had identified problems with the
use of existing products they had not grasped the extent to which the product failed to
satisfy fundamental needs. Based on the results of this study, the authors conclude that
current products are inadequate sometimes potentially harmful to users. Rather than
mirror improvements in details of product design, a radical revision of design approach
needs to occur, supported by research with users and expert therapists.
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Article
Full-text available
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Author Acknowledgments: Sarah Cook, Charlotte Munday and Irene Ilott Price £10.00 This document should be referenced as Creek J 2003, Occupational therapy defined as a complex intervention, London, College of Occupational Therapists This work was commissioned,to Jennifer Creek by the College of Occupational Therapists in partnership with the South London and Maudsley NHS Trust. The College wishes to acknowledge the supervision of Sarah Cook and support of Charlotte Munday and Irene Ilott in completion of the research study. 1 OT Defined,text,5/27/03 9:43 Page,2 Contents,Page
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First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.
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Descriptive research on group performance has produced neither a set of empirical generalizations sturdy enough to guide the design and management of work teams, nor interventions that reliably improve team effectiveness. As an alternative, a normative model of group effectiveness is proposed and discussed. The model identifies potentially manipulable aspects of the group and its context that are particularly potent in promoting team effectiveness, and organizes those factors to make them useful in diagnosing the strengths and weaknesses of task-performing teams. The final section of the paper explores the implications of the normative model, and outlines the beginnings of an action model for creating and maintaining effective work groups in organizations.
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Consumer products fulfil a variety of needs. Products do not exist to merely perform tasks, they satisfy other functional requirements. These include aspirations, cultural, social and emotional needs. There is currently interest in the emotional relationship between a product and its user. It is important that the designer can empathise with specific user groups in order for their designs to create this emotional relationship.User-Centred Design is concerned with more than functional issues. Major manufacturing companies such as Sony, Philips and Apple Macintosh are already applying responsive design methods to meet perceived consumer needs. How is design education encouraging prospective designers to engage with User-Centred Design strategies and methodologies? How can such strategies and methodologies be incorporated into the curriculum to help students imbue a new product with qualities that implicitly reflect the emotional needs of the target consumer? This paper discusses soft design, and then examines some of the ways in which the undergraduate product design programmes at Loughborough and Staffordshire Universities are tackling this aspect of design studies.