title: Short- and long-term effects of tactile massage on salivary cortisol concentrations in Parkinson's disease: a randomised controlled pilot study.
abstract: BACKGROUND
  Parkinson's disease (PD) is a chronic neurodegenerative disorder with limited knowledge about the normal function and effects of non-pharmacological therapies on the hypothalamic-pituitary-adrenal (HPA) axis. The aim of the study was to analyse the basal diurnal and total secretion of salivary cortisol in short- and long-term aspects of tactile massage (TM).
  
  
  METHODS
  
  
  
  METHODS
  Prospective, Controlled and Randomised Multicentre Trial.
  
  
  METHODS
  Forty-five women and men, aged 50-79 years, were recruited. Twenty-nine of them were blindly randomised to tactile massage (TM) and 16 of them to the control group, rest to music (RTM). Ten interventions were given during 8 weeks followed by a 26 weeks of follow up. Salivary cortisol was collected at 8 am, 1 pm, 8 pm, and 8 am the next day, on five occasions. With the first and eighth interventions, it was collected immediately before and after intervention.
  
  
  METHODS
  The primary aim was to assess and compare cortisol concentrations before and immediately after intervention and also during the follow-up period. The secondary aim was to assess the impact of age, gender, body mass index (BMI), duration and severity of PD, effects of interventional time-point of the day, and levodopa doses on cortisol concentration.
  
  
  RESULTS
  The median cortisol concentrations for all participants were 16.0, 5.8, 2.8, and 14.0 nmol/L at baseline, later reproduced four times without significant differences. Cortisol concentrations decreased significantly after TM intervention but no change in diurnal salivary cortisol pattern was found. The findings of reduced salivary cortisol concentrations immediately after the interventions are in agreement with previous studies. However, there was no significant difference between the TM and control groups. There were no significant correlations between cortisol concentrations and age, gender, BMI, time-point for intervention, time interval between anti-parkinson pharmacy intake and sampling, levodopa doses, duration, or severity of PD.
  
  
  CONCLUSIONS
  Diurnal salivary cortisol rhythm was normal. Salivary cortisol concentrations were significantly reduced after the TM intervention and after RTM, but there were no significant differences between the groups and no sustained long-term effect. No associations were seen between salivary cortisol concentration and clinical and/or pharmacological characteristics.
  
  
  BACKGROUND
  ClinicalTrial.gov, NCT01734876 and FoU Sweden 108881.
authors: Department of Pediatrics, Skaraborg Hospital, SE-541 85 Skovde, Sweden. carl-johan_tornhage@hotmail.com.
authors: Carl-Johan
authors: CJ
authors: Törnhage
authors: Örjan
authors: Ö
authors: Skogar
authors: Astrid
authors: A
authors: Borg
authors: Birgitta
authors: B
authors: Larsson
authors: Laila
authors: L
authors: Robertsson
authors: Lena
authors: L
authors: Andersson
authors: Lena
authors: L
authors: Andersson
authors: Paulina
authors: P
authors: Backström
authors: Per-Arne
authors: PA
authors: Fall
authors: Gunnar
authors: G
authors: Hallgren
authors: Birgitta
authors: B
authors: Bringer
authors: Miriam
authors: M
authors: Carlsson
authors: Ulla Birgitta
authors: UB
authors: Lennartsson
authors: Håkan
authors: H
authors: Sandbjörk
authors: Johan
authors: J
authors: Lökk
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D019540:Area Under Curve; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D010300:Parkinson Disease / Q000378:metabolism* / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism*; D013315:Stress, Psychological / Q000378:metabolism / Q000628:therapy*
chemical_list: D006854:Hydrocortisone