Вы находитесь на странице: 1из 5

THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE

Volume 11, Number 6, 2005, pp. 11031106


Mary Ann Liebert, Inc.

Local Back Massage with an Automated Massage Chair:


General Muscle and Psychophysiologic Relaxing Properties

DANIELE F. ZULLINO, M.D.,1 SONIA KRENZ, M.Sc.,2 EMMANUELLE FRSARD, M.Sc.,2


ENRICO CANCELA, M.D.,1 and YASSER KHAZAAL, M.D.2

ABSTRACT

Objectives: The objective of the present study was to test massage applied with an automated massage chair
on the back muscles with regard to the effects on the tension of other muscles or on the neurovegetative tone,
and to compare three different automated massage techniques.
Methods: Ten healthy volunteers participated in the study. The experiment consisted of an initial 5-minute
period of relaxation without massage, and 5-minute periods of three different massage programs (roll-stretch
massage, shiatsu massage, and beat massage). Subjects were randomized as to the presentation order. The fol-
lowing physiologic data were collected: frontalis and gastrocnemius electromyogram (EMG) activity, skin con-
ductance, and peripheral skin temperature. Judgments of valence and arousal were registered using the pencil-
and-paper version of the five-point Self-Assessment Manikin.
Results: Roll-stretch and shiatsu massage were rated by participants as more pleasant than the relaxation pe-
riod without massage or the beat massage. Whereas the four conditions were similar with regard to the mean
frontal EMG values (reflecting primarily affective states), they differed regarding the gastrocnemius EMG (re-
lating more to a general level of tension), roll-stretch massage, and shiatsu massage, resulting in less muscle
tension than the control condition. Shiatsu massage was associated with significantly lower skin conductance
than the control condition, whereas beat massage increased it significantly. A significant increase of skin tem-
perature was found during the roll-stretch massage compared to the no-massage condition.
Conclusions: Automated roll-stretch massage and shiatsu massage applied on the back can rapidly induce
measurable relaxation in distant muscles not directly massaged, and is accompanied by signs of neurovegeta-
tive calming. Back massage applied by an automated massage chair may be an efficient and inexpensive gen-
eral relaxation approach, and is especially interesting for patients who dislike to be touched.

INTRODUCTION creased cortisone and catecholamines. The pressure stimu-


lation associated with touch may specifically increase vagal

N ot only has massage therapy recently become popular


as part of the alternative medicine movement, but it also
received empirical support for reducing pain and alleviating
activity, which in turn lowers physiologic arousal and stress
hormones. The pressure may be critical because light strok-
ing is often aversive, and vagal effects have not been noted
stress, depression, and anxiety in the context of various so- for light stroking.
matic and psychiatric disorders.13 Massages also has been Because skilled massage therapists are not always con-
described as positively affecting neurovegetative functions veniently available, various types of mechanical devices re-
(e.g., lowering blood pressure).4 cently have been developed and marketed.
Potential benefits of massage therapy that are often dis- On the one hand, independence from interpersonal inter-
cussed may be increased parasympathetic activity and de- action can be disadvantageous for some clients, especially

1Division of Substance Abuse, University Hospitals of Geneva, Switzerland.


2Clinical Research Unit, University Department of Adult Psychiatry, PrillyLausanne, Switzerland.

1103
1104 ZULLINO ET AL.

those for whom personal and particularly skin contact plays ductive paste was applied. The electrodes were placed on
an important role for efficacy. On the other hand, physical the volar surfaces of the index and middle fingers (middle
contact may represent an obstacle or impair the relaxing ef- segments) of the nondominant hand. A Temp-Flex/Pro sen-
fect for those clients who are apprehensive. sor (thermistor), used to measure peripheral skin tempera-
An increasingly popular automated massage machine is ture, was connected to a slow 32/sec sampling, and the sen-
the mechanical massage chair, which like other mechanical sor was strapped on the index of the dominant hand using
devices (e.g., hand-held massagers), does not require active Velcro. Photoplethysmography and a respiration sensor also
handling from the user during massage, contributing further were used. Because the recordings could not be analyzed
to relaxation. owing to excessive movement-induced artifacts, their use is
Because the main selling argument claimed for automated not described in this article.
massagers are muscle tension relief and neurovegetative
tone benefits, the objectives of the present pilot study were: Procedure
(1) to test the effects of back massage on the tension of other
After arrival, participants filled out a questionnaire and
muscles and the neurovegetative tone, and (2) to compare
the experimenter provided them with an outline of the ex-
three different automated massage techniques.
perimental procedure. They were instructed to minimize all
body movements during the entire experiment so as not to
disturb the physiologic measurements. The experiment con-
METHODS
sisted of an initial 5-minute period of relaxation without
massage, and a 5-minute period of three different massage
Setting and participants programs (roll-stretch massage, shiatsu massage, beat mas-
The study was conducted at the Clinical Research Unit of sage). The presentation order of subjects was randomized.
the Department of Adult Psychiatry in Lausanne. All ses-
sions took place between 2 and 4 PM in a quiet room with Psychometric assessments
natural light. Ambient temperature was between 23C and
Preceding the experiment participants filled out a ques-
25C. Ten healthy volunteers (five women and five men) par-
tionnaire containing the State-Trait Anxiety Inventory,6
ticipated to the study. Their mean age was 35.6  7.9 years.
forms Y-A and Y-B. The State-Trait Anxiety Inventory for
Adults is an instrument designed for measuring anxiety in
Devices adults, and comprises 40 multiple choice questions. It as-
The massage chair used for this study was NAiS Easy sesses both anxiety as an emotional state and individual dif-
Chair EP 790 L. The device permits three massage tech- ferences in anxiety as personality traits.
niques for the back: (1) Pressure point massage, (2) roll- After each 5-minute period, judgments of valence and
strech massage, and (3) beat massage. The applied power arousal were registered using the pencil-and-paper version
was left in the standard position. The foot rest was raised of the 5-point Self-Assessment Manikin (SAM).7 SAM is a
and the back rest fixed at 120 degrees. nonverbal pictorial assessment technique that directly mea-
The physiologic data was collected via a ProComp/Bio- sures the pleasure and arousal associated with a persons af-
graph psychophysiologic data acquisition system produced by fective reaction to a wide variety of stimuli. For the valence
Thought Technology (Montreal, Canada) via a PRO-SB in- dimension, the SAM ranges from a smiling, happy figure to
terface. Subjects recordings were analyzed via the Biograph a frowning, unhappy figure. For the arousal dimension, the
version 2.1 data collection program. For surface electromyo- SAM ranges from a sleeping, calm figure to an energetic,
graphy MyoScan-Pro Triode electrodes (silver/silver chloride) highly aroused figure.
were used at a sampling rate of 32/sec. Frontalis and gas-
trocnemius EMG activity (in V) were obtained after prepa- Analyses
ration of the skin and placement of the electrodes over the re-
In order to compare the four experimental conditions,
spective muscle groups. The two muscle groups were chosen
general linear model analyses were performed and each of
because the frontalis may reflect primarily affective states and
the three massage conditions were contrasted to the no-mas-
the gastrocnemius reflects the general level of tension.
sage condition (simple contrast procedure).
The two muscle groups previously were found to respond
differently to stress and anxiolytic medication.5 As electri-
cal interferences from the heart muscle were not expected RESULTS
with these placements, the bandwidth was set at 400 W
(wide bandwidth, i.e., 20500 Hz), where the standard am-
Anxiety scores
plitude is 400 V. Skin conductance (in microSiemens) was
measured with a SC-Flex/Pro sensor and connected to a The mean state anxiety score (STAI-YA) was 29.0  4.6
channel sampling at 32 s/sec. Two replacable electrodes (sil- (range 2035) and the trait anxiety score (STAI-YB) was
ver/silver chloride) were sewn inside Velcro straps. No con- 34.5  7.9 (range 2251).
LOCAL BACK MASSAGE WITH AN AUTOMATED MASSAGE CHAIR 1105

TABLE 1. PARTICIPANTS RATING OF INTERVENTIONS

No massage Roll-Stretch Shiatsu Beat F p

SAM valence 2.4  0.8 1.7  1.3* 1.7  1.3* 1.9  0.9 1.64 0.204
SAM arousal 3.7  1.3 3.9  1.1 3.9  1.4 3.7  0.8 0.31 0.818

Mean EMG frontalis muscle (mV) 2.17  2.19 2.12  1.80 2.29  2.22 2.09  1.60 0.17 0.919
Mean EMG gastrocnemius muscle (mV) 3.36  2.18 1.79  1.16* 1.91  1.27* 3.38  3.19 2.65 0.112
Mean skin conductance (mS) 1.29  1.66 1.28  1.57 0.97  1.04* 1.85  2.26* 4.39 0.059
Mean temperature (C) 32.65  2.62 33.46  2.77* 33.38  3.06 33.10  2.98 3.76 0.022

SAM, Self-Assessment Manikin; EMG, electromyogram.


*Contrast versus no massage p  0.05.

Affective valence and arousal cle relaxation was confirmed by gastrocnemius EMG. Roll-
stretch and shiatsu massage reduced EMG values below
As shown in Table 1, roll-stretch and shiatsu massage
those measured during a period of rest without massage.
were rated by participants as more pleasant than no massage
That short periods of automated massage may have an im-
or beat massage. Whereas roll-stretch and shiatsu massage
pact on neurovegetative tone was corroborated by a reduc-
were also more relaxing than the two other conditions as as-
tion of skin conductance during shiatsu massage and by an
sessed by the SAM arousal, the differences were not statis-
increase of skin temperature during roll-stretch massage.
tically significant.
Based on subjects appraisal of the pleasant aspects of
each massage technique as well as on psychophysiologic
Muscular relaxation measures, the beat massage appeared to be the less appro-
In order to test the relaxing effect of the different mas- priate relaxation means among the three massage modes
sage modes on muscles not directly worked on by the chair, evaluated in this study. As the skin conductance measure-
EMG of the frontalis and the left gastrocnemius muscles ment indicated, it may even be distressing rather than com-
were recorded. The frontalis was considered to reflect pri- forting. Post-test participants commentaries confirmed this
marily affective states and the gastrocnemius a more gen- assumption. Roll-stretch and shiatsu massage were compa-
eral level of tension.5 Whereas the four conditions were sim- rable in subjective appraisal of pleasantness and psy-
ilar for the mean frontal EMG values, the gastrocnemius chophysiologic measures, although shiatsu massage resulted
EMG differed for roll-stretch massage and shiatsu massage, in lower skin conductance and roll-stretch massage showed
resulting in less muscle tension than the control condition. some effect on skin temperature.
The results of this study need to be viewed against their
Autonomic-vegetative response methodologic limitations. Because this study was conceived
as a pilot study, only a small number of participants were re-
Skin conductance response and skin temperature were cruited. Thus it was not possible to control for possible car-
recorded as indicators of vegetative status. Shiatsu massage ryover effects that might have biased the results despite the
was associated with significantly lower skin conductance randomization. Furthermore, although the subjects were ran-
than the control condition, whereas beat massage increased domized as to the presentation order of the three massage
it significantly, and the roll-stretch massage resulted in sim- modes, the no-massage relaxation period was always the ini-
ilar conductance than relaxation without massage. tial phase. Because of a possible general trend toward in-
A significant increase in skin temperature was found dur- creased relaxation over the whole experimental period, the
ing the roll-stretch massage compared to the no-massage massage effects theoretically may be overstated. However,
condition. The two other massage procedures produced no the lack of relaxing properties of the beat massage, and es-
significant temperature changes. pecially the rise of skin conductance under this condition, are
arguments against this limitation. Another potential short-
coming is the lack of control for other confounding variables,
DISCUSSION such as previous massage experiences and physical activi-
ties. Again, the small number of recruited subjects in our pi-
The objective of the present study was to test the effects lot study did not permit multifactor analyses. Furthermore,
of massage applied with an automated massage chair on the because only healthy volunteers were included in this pilot
back muscles, the tension of other muscles, or the neuro- study, the transferability to people in real life who might use
vegetative tone, and to compare three different automated such a chairsuch as those who are stressed or in painre-
massage techniques. mains indeterminate. Further studies should address patients
The working hypothesis that even a short automated mas- with a specific health problem (e.g., anxiety disorder) and
sage limited to the back may produce a more general mus- use control groups as well as nonmassage control procedures.
1106 ZULLINO ET AL.

In conclusion, roll-stretch massage and shiatsu mass- 4. Cady SH, Jones GE. Massage therapy as a workplace inter-
age applied on the back by an automated massage chair in- vention for reduction of stress. Percept Mot Skills 1997;84(1):
duced rapidly measurable relaxation in distant muscles not 157158.
directly massaged, which was accompanied by signs of 5. McLeod DR, Hoehn-Saric R, Labib AS, Greenblatt DJ. Six
weeks of diazepam treatment in normal women: Effects on psy-
neurovegetative calming. Roll-stretch and shiatsu massage
chomotor performance and psychophysiology. J Clin Psycho-
were also considered as more pleasant by participants. Back
pharmacol 1988;8:8399.
massage applied by an automated massage chair may be 6. Spielberger CD. Manual for the State-Trait Anxiety Inventory:
an efficient and inexpensive general relaxation approach STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press,
that is especially interesting for patients who dislike to be 1983.
touched. 7. Bradley MM, Lang PJ. Measuring emotion: the Self-Assess-
ment Manikin and the Semantic Differential. J Behav. Ther Exp
Psychiatry 1994;25(1):4959.

REFERENCES Address reprint requests to:


Daniele F. Zullino, M.D.
1. Field TM. Massage therapy effects. Am Psychol 1998;53(12):- Service dAbus de Substances
12701281.
Rue Verte 2
2. Field T, Ironson G, Scafidi F, et al. Massage therapy reduces
anxiety and enhances EEG pattern of alertness and math com-
1205 Genve
putations. Int J Neurosci 1996;86(34):197205. Switzerland
3. Hernandez-Reif M, Field T, Diego M, Beutler J. Evidence-
based medicine and massage. Pediatrics 2001;108:1053. E-mail: Daniele.Zullino@hcuge.ch

Вам также может понравиться