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Massage Today
July, 2011, Vol. 11, Issue 07

Massage Therapists Team With Pediatric Cardiology Professionals to Examine the Effects of Massage on Exercise Performance and Heart/Lung Function in a Sample of Children With and Without Heart Disease.

By Massage Therapy Foundation Contributor

This month's Massage Therapy Foundation research summary reviews a study that evaluated the effects of massage therapy in a pediatric population with and without congenital heart disease (CHD).

This research was a collaborative effort between massage therapists, a pediatric cardiologist and other staff at the UCLA Medical Center in California. It is a stellar example of how massage therapists can collaborate with other medical professionals and researchers to conduct meaningful research. With a common interest in improving the quality of life for children with CHD, this research was conducted to determine if massage therapy could improve exercise performance and heart and lung function.

The research team had three main questions: Is it safe to perform massage on children with CHD? How will providing massage to children affect their performance on an exercise test? Does massage affect healthy children and children with CHD in the same way?

With minimal budget resources and no previous studies involving children to guide them, a pilot study was deemed most appropriate for collecting preliminary data to determine feasibility and potential effects.

The cardiologist recruited children aged 6-13 from clinical practice to participate in the study. Of the 16 children that participated, 6 were healthy and 10 had CHD; 10 were boys and 6 were girls. All children had to be able to ride an exercise bike; healthy children had to be free of any systemic disease. Using the same protocol, each child had two exercise tests: one test with pre-exercise massage and one without massage. Tests were spaced 2-3 months apart to avoid learning and/or treatment effects.

The exercise tests were conducted in a pediatric exercise lab with the cardiologist, parent, and research assistant present. Each child wore a mouthpiece and electrocardiograph leads. At rest, measures included heart rate, blood pressure, and oxygen uptake. After a brief warm-up, children were encouraged to pedal the bike for 8-10 minutes. During this exercise, peak measures of heart rate, blood pressure, oxygen uptake, anaerobic threshold, work rate, oxygen pulse, and minute ventilation were recorded. Each participant received a 30-minute massage from a certified therapist trained in pediatric massage. None of the children reported adverse experiences related to their participation or dropped out of the study.

Findings indicate there were no differences in the measures at rest, with or without pre-exercise massage. In other words, having a massage did not seem to impact heart rate, blood pressures or oxygen uptake before exercise.

However, when children received a massage before exercise testing, they had significantly higher peak heart rate, peak minute ventilation, and peak oxygen uptake during exercise. This was true for both groups, healthy children and children with CHD. Statistical tests confirmed that the effects were not likely due to order (whether the children had the massage before the first test or the second test).

Authors hypothesized that the mechanism for the beneficial effect of massage on oxygen uptake was related to decreased anxiety opposed to a change in underlying heart or lung function. This hypothesis is consistent with other research findings that demonstrate that massage therapy reduces anxiety in children.

Although not systematically examined in this study, the massage therapist shared observations during the study. For example, the authors reported that parents were supportive during the study and became interested in massage for themselves or their other children. In addition, the massage therapist reported that although she was not told which children were healthy and which had CHD, she could guess by the way the children with CHD guarded their chests and had increased muscular tension in their chest and shoulder areas.

Although cardiac birth defects are relatively uncommon, the effects on children with CHD can be a lifelong challenge. Many of these children have several surgeries over the course of their childhood, are not able to exercise as intensely as their peers, and are at risk for obesity and psychological conditions. The results of this study suggest massage for children with CHD is feasible, but also warrant larger more rigorous research to confirm that massage therapy can improve quality of life and function for children with CHD.

This publication also supports the central role of massage therapists in collaborative research with other health professionals and researchers. Ideally, massage therapists need to have input in the development and implementation of research to test and demonstrate the effects of massage with diverse populations. With this research paradigm, therapists can ensure that research reflects and informs massage therapy practice.

Source: Beider, S, Boulanger, KT, Joshi, M, Ping Pan, Y, Chang, RKR. Measuring the effects of massage on exercise performance and cardiopulmonary response in children with and without heart disease: a pilot study. International Journal of Therapeutic Massage and Bodywork 2010, 3(3).

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