title: A preliminary study of the effects of repeated massage on hypothalamic-pituitary-adrenal and immune function in healthy individuals: a study of mechanisms of action and dosage.
abstract: OBJECTIVE
  This study gathers preliminary data about the biologic effects of repeated Swedish massage therapy compared to a light-touch control condition.
  
  
  METHODS
  The study design was a 5-week comparison of repeated Swedish massage and light touch on oxytocin (OT), arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocyte markers, and mitogen-stimulated cytokine function.
  
  
  METHODS
  The setting was an outpatient research unit in an academic medical center.
  
  
  METHODS
  The study subjects were medically and psychiatrically healthy young adults.
  
  
  METHODS
  The study comprised 45 minutes of Swedish massage or light touch, using highly specified and identical protocols, either weekly or twice weekly for 5 weeks.
  
  
  METHODS
  The outcome measures were mean differences between massage and light touch on OT, AVP, ACTH, CORT, lymphocyte markers, and cytokine levels.
  
  
  RESULTS
  Compared to the touch control condition, weekly Swedish massage stimulated a sustained pattern of increased circulating phenotypic lymphocyte markers and decreased mitogen-stimulated cytokine production, similar to what was previously reported for a single massage session, while having minimal effect on hypothalamic-pituitary-adrenal function. Twice-weekly massage produced a different response pattern with increased OT levels, decreased AVP, and decreased CORT but little effect on circulating lymphocyte phenotypic markers and a slight increase in mitogen-stimulated interferon-γ, tumor necrosis factor-α, interleukin (IL)-1b and IL-2 levels, suggesting increased production of pro-inflammatory cytokines.
  
  
  CONCLUSIONS
  There are sustained cumulative biologic actions for the massage and touch interventions that persist for several days or a week, and these differ profoundly depending on the dosage (frequency) of sessions. Confirmatory studies in larger samples are needed.
authors: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA. mrapapo@emory.edu
authors: Mark H
authors: MH
authors: Rapaport
authors: Pamela
authors: P
authors: Schettler
authors: Catherine
authors: C
authors: Bresee
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001127:Arginine Vasopressin / Q000097:blood; D016207:Cytokines / Q000097:blood; D005260:Female; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System; D007249:Inflammation / Q000097:blood*; D018836:Inflammation Mediators / Q000378:metabolism; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008405:Massage / Q000379:methods*; D010121:Oxytocin / Q000097:blood; D010641:Phenotype; D010913:Pituitary-Adrenal System
chemical_list: D016207:Cytokines; D006728:Hormones; D018836:Inflammation Mediators; D001127:Arginine Vasopressin; D010121:Oxytocin; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone