Acute effects of traditional Thai massage on electroencephalogram in patients with scapulocostal syndrome

The influence of traditional Thai massage on recovery from gastrocnemius muscle fatigue: A single-blind randomised controlled trial

OBJECTIVE

To determine the effects of traditional Thai massage (TTM) on improving fatigue recovery and fatigue-related parameters of the gastrocnemius muscle after a heel-raise exercise.

DESIGN

A single-blind randomised controlled trial.

SETTING

Mae Fah Luang University Hospital, Thailand.

PARTICIPANTS

Fifty-four healthy participants were randomly assigned to two groups: TTM (n = 27; 51.85 % women; mean age 23.15 ± 4.90 years; number of exercises/week: 4.78 ± 1.58) and control (n = 27; 59.26 % women; mean age 22.63 ± 4.88 years; number of exercises/week: 4.48 ± 1.25).

INTERVENTIONS

After the participants performed a heel-raise exercise to induce fatigue of the gastrocnemius muscle, they received either 30 min of TTM to the gastrocnemius muscle or 30 min of control (29 min of rest and 1 min total gastrocnemius stretching).

OUTCOME MEASURES

The outcome measures were the median frequency (MDF) of the electromyography signal, muscle power (MP) and feelings of muscle fatigue (FMF). All the outcome measures were evaluated before (T1) and after (T2) the fatigue-inducement protocol as well as immediately (T3), 1 h (T4) and 2 h (T5) after the interventions.

RESULTS

The results show that MDF and MP were significantly increased and FMF significantly decreased in both groups immediately after the interventions and at 1 h and 2 h after the interventions (repeated measures ANOVA: p < .05). In the between-group comparisons, participants in the TTM group showed significantly greater improvement than those in the control group on all outcomes at all post-intervention assessment time points (T3, T4, T5), reflecting faster recovery from muscle fatigue (ANCOVA: p < .05).

CONCLUSION

TTM proved an effective intervention for maximising recovery from fatigue of the gastrocnemius muscle.

Standardised 25-Step Traditional Thai Massage (TTM) Protocol for Treating Office Syndrome (OS)

Traditional Thai massage (TTM) is a unique form of whole body massage practiced to promote health and well-being in Thailand since ancient times. The goal of the present study was to create a standardised TTM protocol to treat office syndrome (OS) diagnosed based on the identification of the palpation of at least one so-called myofascial trigger point (MTrP) in the upper trapezius muscle. The new 90 min TTM protocol, which was developed following appropriate review of the literature and in consultation with relevant experts, has 25 distinct steps (20 pressing steps, 2 artery occlusion steps, and 3 stretching steps). Eleven TTM therapists treated three patients each using the new 90 min TTM protocol. All of the therapists reported scores greater than 80% in respect to their satisfaction and confidence to deliver the protocol, and all of the patients gave the treatment a satisfaction score of greater than 80%. The treatment produced a significant reduction in pain intensity measured on a Visual Analogue Scale (VAS), with minimum and maximum values of 0 and 10 cm, of 2.33 cm (95% CI (1.76, 2.89 cm), p < 0.001) and significant increase in pain pressure threshold (PPT) of 0.37 kg/cm² (95% CI (0.10, 0.64 kg/cm²), p < 0.05). The protocol was revised based on the feedback and the results obtained, and the new standardised TTM protocol will be applied in a randomised control trial (RCT) to compare the efficacy of TTM and conventional physical therapy (PT) for treating OS.

Foam Rolling Elicits Neuronal Relaxation Patterns Distinct from Manual Massage: A Randomized Controlled Trial

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.

A comparative study of Thai massage and muscle energy technique for chronic neck pain: A single-blinded randomized clinical trial

BACKGROUND

Myofascial pain syndrome (MPS) is the most common form of muscle disorders. Traditional Thai massage (TM) and muscle energy (ME) technique have been used to treat patients with MPS for long time but head-to-head comparisons of these interventions have not been established.

AIM

The aim of the current study was to compare the effects of TM and the ME technique on pain intensity (PI), pressure pain threshold (PPT), neck disability (ND), and neck flexion range of motion (NFROM) in patients with chronic neck pain associated with myofascial trigger points (MTrPs).

DESIGN

A randomized, single-blinded clinical trial.

SETTING

Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University.

POPULATION

Forty-five patients with chronic neck pain associated with MTrPs were recruited.

METHODS

The patients were randomly allocated to the TM, ME, or control groups, with each having eight treatment sessions over a period of two weeks. PI, PPT, ND, and NFROM were assessed before, immediately after the first treatment session, and one day after the last treatment session.

RESULTS

Based on the results, both TM and the ME technique resulted in a significant improvement in all parameters (p < 0.05) compared to the control group. Additionally, no significant difference was observed between TM and the ME technique in all parameters.

CONCLUSIONS

The application of TM or the ME technique can be a practical alternative approach for the treatment of chronic neck pain associated with MTrPs.

Massage Therapy's Effectiveness on the Decoding EEG Rhythms of Left/Right Motor Imagery and Motion Execution in Patients With Skeletal Muscle Pain

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.

The effects of unilateral Swedish massage on the neural activities measured by quantitative electroencephalography (EEG)

Purpose

It is generally accepted that massage can provide a lot of benefits to human health, especially for the brain functions. Little is known about the effect of unilateral massage on the brain activities. Nowadays, Swedish massage is a modern massage technique that is popular in both treatment and research fields. The purpose of this paper is to investigate the effect of unilateral Swedish massage on brain activities with electroencephalography (EEG) recording.

Design/methodology/approach

In total, 18 healthy adult participants (5 men, 13 women) aged between 22 and 36 years were massaged over one side of arm, forearm, hand, neck and face. Then the same procedures were repeated to another side of the body. EEG was recorded before (baseline) and during each massage condition. The absolute power of four common brain waves consisting of δ (0.5-4 Hz), θ (4-8 Hz), α (8-13 Hz), and β activities (13-30 Hz) from the quantitative EEG analysis between baseline and each massage condition were used to compare with the paired t-test.

Findings

The study found the reduction of δ and θ powers over bilateral frontal, fronto-central, and central areas. The increments of α power over the similar brain areas were also observed. These findings indicated the generalized effect of unilateral Swedish massage for inducing relaxation. Moreover, the significant reduction of β power was also found over right central area when left-arm massage was applied. This finding revealed the initial inhibitory effect of Swedish massage over right somatosensory cortex that received sensory stimulation through massage from left side of the body.

Originality/value

Unilateral Swedish massage induced the inhibitory effect at the contralateral somatosensory cortex and then produced the generalized effect which is compatible with relaxation.

Effects of manual lymph drainage for abdomen on the brain activity of subjects with psychological stress

[Purpose] The present study investigated the effects of manual lymph drainage for abdomen on electroencephalography in subjects with psychological stress. [Subjects and Methods] Twenty-eight subjects were randomly allocated to undergo a 20-min session of either manual lymph drainage or abdominal massage on a bed. [Results] Analysis of electroencephalograms from the manual lymph drainage group showed a significant increase in relaxation, manifested as an increase in average absolute, relative alpha activity and a decrease in relative gamma activity. [Conclusion] Our results suggest that the application of manual lymph drainage from the abdomen provides acute neural effects that increase relaxation in subjects with psychological stress.

Integrative Evaluation of Automated Massage Combined with Thermotherapy: Physical, Physiological, and Psychological Viewpoints

Various types of massages are reported to relieve stress, pain, and anxiety which are beneficial for rehabilitation; however, more comprehensive studies are needed to understand the mechanism of massage therapy. In this study, we investigated the effect of massage therapy, alone or in combination with infrared heating, on 3 different aspects: physical, physiological, and psychological. Twenty-eight healthy university students were subjected to 3 different treatment conditions on separate days, one condition per day: control, massage only, or massage with infrared heating. Physical (trunk extension [TE]; maximum power of erector spinae), physiological (heart-rate variability [HRV]; electroencephalogram [EEG]), and psychological (state-trait anxiety inventory [STAI]; visual analogue scale [VAS]) measurements were evaluated and recorded before and after each treatment condition. The results showed that massage therapy, especially when combined with infrared heating, significantly improved physical functioning, increased parasympathetic response, and decreased psychological stress and anxiety. In the current study, we observed that massage therapy contributes to various physical, physiological, and psychological changes, where the effect increases with thermotherapy.

The effects of the court-type Thai traditional massage on anatomical relations, blood flow, and skin temperature of the neck, shoulder, and arm

Background

Court-type Thai traditional massage (CTTM) has specific major signal points (MaSP) for treating musculoskeletal conditions. The objectives of this study are to investigate the anatomical surfaces and structures of MaSPs, and to examine blood flow (BF) and skin temperature (ST) changes after applying pressure on the MaSPs on neck, shoulder, and arm areas.

Methods

In the anatomical study, 83 cadavers were dissected and the anatomical surfaces and structures of the 15 MaSPs recorded. In human volunteers, BF, peak systolic velocity (PS), diameter of artery (DA), and ST changes were measured at baseline and after pressure application at 0, 30, 60, 180, and 300 s.

Results

There was no statistical difference in anatomical surfaces and structures of MaSP between the left and right side of the body. The 3 MaSPs on the neck were shown to be anatomically separated from the location of the common carotid arteries. The BF of MaSPs of the neck significantly and immediately increased after pressure application for 30 s and for 60 s in the arm (p < 0.001). ST increased significantly and immediately after pressure application for 300 s (p < 0.001). There was no significant correlation between BF and ST at any of the MaSPs.

Conclusions

This study showed that MaSP massages were mainly directed towards muscles. MaSPs can cause significant, but brief, increases in BF and ST. Further studies are suggested to identify changes in BF and ST for all of the MaSPs after actual massage treatment sessions as well as other physiological effects of massage.

Short-term effects of traditional Thai massage on electromyogram, muscle tension and pain among patients with upper back pain associated with myofascial trigger points

OBJECTIVE

To investigate effects of traditional Thai massage (TTM) on electromyographic (EMG) activity, muscle tension and pain intensity in patients with upper back pain associated with myofascial trigger points (MTrPs).

DESIGN

A single-blind, randomized clinical trial.

SETTING

The Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Thailand.

INTERVENTION

Fifty patients were randomly assigned to receive a 30-min session of either TTM or control (sham microwave diathermy).

OUTCOMES

Electromyogram (EMG), Muscle tension rating, and pain intensity rating

RESULTS

TTM were associated with significant decreases in EMG, muscle tension and pain intensity after the end of treatment session (p<0.05). For all outcomes, similar changes were not observed in the control group (p>0.05) except for muscle tension (p<0.05). In addition, there was a significantly greater reduction in all parameters for the TTM group when compared with the control group.

CONCLUSION

We therefore suggest that TTM can increase physical relaxation and reduce pain in patients with upper back pain associated with MTrPs.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02067325.

The Impact of Massage Therapy on Function in Pain Populations-A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population

PURPOSE

Pain is multi-dimensional and may be better addressed through a holistic, biopsychosocial approach. Massage therapy is commonly practiced among patients seeking pain management; however, its efficacy is unclear. This systematic review and meta-analysis is the first to rigorously assess the quality of massage therapy research and evidence for its efficacy in treating pain, function-related and health-related quality of life outcomes across all pain populations.

METHODS

Key databases were searched from inception through February 2014. Eligible randomized controlled trials were assessed for methodological quality using SIGN 50 Checklist. Meta-analysis was applied at the outcome level. A diverse steering committee interpreted the results to develop recommendations.

RESULTS

Sixty high quality and seven low quality studies were included in the review. Results demonstrate massage therapy effectively treats pain compared to sham [standardized mean difference (SMD) = -.44], no treatment (SMD = -1.14), and active (SMD = -0.26) comparators. Compared to active comparators, massage therapy was also beneficial for treating anxiety (SMD = -0.57) and health-related quality of life (SMD = 0.14).

CONCLUSION

Based on the evidence, massage therapy, compared to no treatment, should be strongly recommended as a pain management option. Massage therapy is weakly recommended for reducing pain, compared to other sham or active comparators, and improving mood and health-related quality of life, compared to other active comparators. Massage therapy safety, research challenges, how to address identified research gaps, and necessary next steps for implementing massage therapy as a viable pain management option are discussed.

The immediate effect of traditional Malay massage on substance P, inflammatory mediators, pain scale and functional outcome among patients with low back pain: study protocol of a randomised controlled trial

BACKGROUND

The treatment of low back pain is very challenging due to the recurrent nature of the problem. It is believed that traditional Malay massage helps to relieve such back pain but there is a lack of scientific evidence to support both the practice of traditional Malay massage and the mechanism by which it exerts its effect. The aim of this study is to investigate the immediate effect of traditional Malay massage on the pain scale, substance P, inflammatory mediators, and functional outcomes among low back pain patients.

METHODS

A non-blinded, randomised controlled trial will be conducted. A total of sixty-six patients who fulfil the inclusion criteria will be recruited. The participants will be randomly allocated into intervention (traditional Malay massage) and control (relaxation position) groups. Blood and saliva samples will be collected before and immediately after intervention. All collected samples will be analysed. The primary outcomes are the changes in the level of substance P in both saliva and blood samples between both groups. The secondary outcomes include the levels of inflammatory mediators [i.e. TNF-α, IL-1β, IL-8, monocyte chemotactic protein-1, IL-6 and IL-10, and the soluble form of the intercellular adhesion molecule], the pain intensity as measured by a visual analogous scale and functional outcomes using the Roland-Morris Disability Questionnaire.

DISCUSSION

Massage is a type of physical therapy that has been proven to be potentially capable of reducing unpleasant pain sensations by a complex sensory response and chemical mediators such as substance P and various inflammatory mediators. Previous studies conducted using Thai, Swedish, or other forms of massage therapies, have showed inconsistent findings on substance P levels pre and post the interventions. Each massage genre varies in terms of massage and joint mobilization points, as well as the lumbar spinous process. Traditional Malay massage, known locally as "Urut Melayu", involves soft-tissue manipulation of the whole body applied using the hands and fingers. This massage technique combines both deep muscular tissue massage and spiritual rituals. This trial is expected to give rise to new knowledge underlying the mechanisms for pain and inflammation relief that are activated by traditional Malay massage.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials ACTRN12615000537550 .

Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review

QUESTION

Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment?

DESIGN

Systematic review of randomised clinical trials.

PARTICIPANTS

People with musculoskeletal disorders.

INTERVENTIONS

Massage therapy (manual manipulation of the soft tissues) as a stand-alone intervention.

OUTCOME

The primary outcomes were pain and function.

RESULTS

The 26 eligible randomised trials involved 2565 participants. The mean sample size was 95 participants (range 16 to 579) per study; 10 studies were considered to be at low risk of bias. Overall, low-to-moderate-level evidence indicated that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain. Furthermore, low-to-moderate-level evidence indicated that massage improves function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain. Low-to-very-low-level evidence from single studies indicated no clear benefits of massage over acupuncture, joint mobilisation, manipulation or relaxation therapy in people with fibromyalgia, low back pain and general musculoskeletal pain.

CONCLUSIONS

Massage therapy, as a stand-alone treatment, reduces pain and improves function compared to no treatment in some musculoskeletal conditions. When massage is compared to another active treatment, no clear benefit was evident.

Modulatory effects of aromatherapy massage intervention on electroencephalogram, psychological assessments, salivary cortisol and plasma brain-derived neurotrophic factor

OBJECTIVES

Aromatherapy massage is commonly used for the stress management of healthy individuals, and also has been often employed as a therapeutic use for pain control and alleviating psychological distress, such as anxiety and depression, in oncological palliative care patients. However, the exact biological basis of aromatherapy massage is poorly understood. Therefore, we evaluated here the effects of aromatherapy massage interventions on multiple neurobiological indices such as quantitative psychological assessments, electroencephalogram (EEG) power spectrum pattern, salivary cortisol and plasma brain-derived neurotrophic factor (BDNF) levels.

DESIGN

A control group without treatment (n = 12) and aromatherapy massage group (n = 13) were randomly recruited. They were all females whose children were diagnosed as attention deficit hyperactivity disorder and followed up in the Department of Psychiatry, Jeju National University Hospital. Participants were treated with aromatherapy massage for 40 min twice per week for 4 weeks (8 interventions).

RESULTS

A 4-week-aromatherapy massage program significantly improved all psychological assessment scores in the Stat-Trait Anxiety Index, Beck Depression Inventory and Short Form of Psychosocial Well-being Index. Interestingly, plasma BDNF levels were significantly increased after a 4 week-aromatherapy massage program. Alpha-brain wave activities were significantly enhanced and delta wave activities were markedly reduced following the one-time aromatherapy massage treatment, as shown in the meditation and neurofeedback training. In addition, salivary cortisol levels were significantly reduced following the one-time aromatherapy massage treatment.

CONCLUSIONS

These results suggest that aromatherapy massage could exert significant influences on multiple neurobiological indices such as EEG pattern, salivary cortisol and plasma BDNF levels as well as psychological assessments.

Manual lymph drainage attenuates frontal EEG asymmetry in subjects with psychological stress: a preliminary study

[Purpose] The purpose of this preliminary study was to investigate the effect of manual lymph drainage (MLD) of the neck on frontal electroencephalogram (EEG) asymmetry in subjects with psychological stress. [Subjects] Thirteen subjects with psychological stress participated in the study. [Methods] Subjects received MLD of the neck for 15 min. [Results] Analysis of the frontal asymmetry index showed that the energy shift in the alpha frequency band from the left hemisphere to the right hemisphere after MLD resulted in greater left-side activation (positive asymmetry values), which could be related to the positive emotional state observed particularly in the F7-F8 area. [Conclusion] These preliminary findings suggest that frontal EEG asymmetry was significantly attenuated after MLD.

Effects of manual lymph drainage of the neck on EEG in subjects with psychological stress

[Purpose] The present study investigated the effect of manual lymph drainage (MLD) of the neck on electroencephalography (EEG) in subjects with psychological stress. [Methods] Twenty-six subjects were randomly allocated to receive one 15-min session of either MLD or resting on a bed (control). [Results] Analysis of EEG in the MLD group showed a significant increase in relaxation, manifested as an increase in average absolute and relative delta and alpha activity. [Conclusion] It is suggested that MLD provides acute neural effects that increase relaxation in subjects with psychological stress.