title: A randomized placebo-controlled trial of massage therapy on the immune system of preterm infants.
abstract: OBJECTIVE
  The aim of this study was to investigate the effects of massage therapy (MT) on the immune system of preterm infants. The primary hypothesis was that MT compared with sham therapy (control) will enhance the immune system of stable premature infants by increasing the proportion of their natural killer (NK) cell numbers.
  
  
  METHODS
  A randomized placebo-controlled trial of MT versus sham therapy (control) was conducted among stable premature infants in the NICU. Study intervention was provided 5 days per week until hospital discharge for a maximum of 4 weeks. Immunologic evaluations (absolute NK cells, T and B cells, T cell subsets, and NK cytotoxicity), weight, number of infections, and length of hospital stay were also evaluated.
  
  
  RESULTS
  The study enrolled 120 infants (58 massage; 62 control). At the end of the study, absolute NK cells were not different between the 2 groups; however, NK cytotoxicity was higher in the massage group, particularly among those who received ≥5 consecutive days of study intervention compared with control (13.79 vs 10 lytic units, respectively; P = .04). Infants in the massage group were heavier at end of study and had greater daily weight gain compared with those in the control group; other immunologic parameters, number of infections, and length of stay were not different between the 2 groups.
  
  
  CONCLUSIONS
  In this study, MT administered to stable preterm infants was associated with higher NK cytotoxicity and more daily weight gain. MT may improve the overall outcome of these infants. Larger studies are needed.
authors.affiliation: Division of Infectious Diseases, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI 48201, USA. jang@med.wayne.edu
authors.forename: Jocelyn Y
authors.initials: JY
authors.lastname: Ang
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Lua
authors.forename: Ambika
authors.initials: A
authors.lastname: Mathur
authors.forename: Ronald
authors.initials: R
authors.lastname: Thomas
authors.forename: Basim I
authors.initials: BI
authors.lastname: Asmar
authors.forename: Sureyya
authors.initials: S
authors.lastname: Savasan
authors.forename: Steven
authors.initials: S
authors.lastname: Buck
authors.forename: Michael
authors.initials: M
authors.lastname: Long
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
mesh_terms: D001402:B-Lymphocytes / Q000276:immunology; D001835:Body Weight; D003428:Cross Infection / Q000276:immunology; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D006801:Humans; D007121:Immunocompetence / Q000276:immunology*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000276:immunology* / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D007694:Killer Cells, Natural / Q000276:immunology*; D007902:Length of Stay; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male; D008405:Massage; D008824:Michigan; D013601:T-Lymphocytes / Q000276:immunology