Osteomyology research reference section

Pre-term Infants

Ang, J.Y., Lua, J.L., Mathur, A., Thomas, R., Asmar, B.I., Savasan, S., Buck, S., Long, M., & Shankaran, S. (2012). A randomized placebo-controlled trial of massage therapy on the immune system of preterm infants. Pediatrics, 130, 1549-1558.

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 cells subsets, and NK cytotoxicity), weight, number of infections, and length of hospital stay were also evaluated.

RESULTS: NK cytotoxicity was higher in the massage group, particularly among those who received ≥5 consecutive days of study intervention compared with control. Infants in the massage group were heavier at the end of the study and had greater daily weight gain compared with those in the control group.


Field, T., Schanberg, S., Scafidi, F., Bauer, C., Vega-Lahr, N., Garcia, R., Nystrom, J., & Kuhn, C. (1986). Tactile/kinesthetic stimulation effects on preterm neonates. Pediatrics, 77, 654-658.

METHODS: Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements of the limbs for three, 15-minute periods per day for 10 days.

RESULTS: The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g versus 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic stimulation may be a cost effective way of facilitating growth and behavioral organization even in very small preterm neonates.

Scafidi, F., Field, T., Schanberg, S., Bauer, C., Vega-Lahr, N., & Garcia, R. (1986). Effects of tactile/kinesthetic stimulation on the clinical course and sleep/wake behavior of preterm neonates. Infant Behavior and Development, 9, 91-105.

METHODS: Forty preterm neonates treated in an intensive care nursery (M gestational age = 31 weeks, M birthweight = 1274 gms) were randomly assigned to a treatment or control group. The treatment infants received tactile/kinesthetic stimulation (body massage and passive movements of the limbs) for three 15-minute periods during three consecutive hours for a 10-day period. At the end of the treatment period the behavioral states and activity level of the neonates were monitored during sleep/wake behavior observations. In addition, neonatal behaviors were assessed on the Brazelton scale.

RESULTS: The treated infants averaged a 47% greater weight gain per day (25 vs. 17 grams), and spent more time awake and active during sleep/wake behavior observations. On the Brazelton scale the treated infants showed more mature orientation, motor, habituation, and range of state behaviors. Finally, the treated infants were discharged 6 days earlier, yielding hospital cost savings of $3,000 per infant.

Field, T., Scafidi, F., and Schanberg, S. (1987). Massage of preterm newborns to improve growth and development. Pediatric Nursing, 13, 385-387.

METHODS: The data reviewed here suggest that the growth and development of preterm neonates can be facilitated by tactile-kinesthetic stimulation.

RESULTS: Greater weight gain and superior performance on developmental assessments persisted across the first 6 months for the group of infants that received the massage treatment. These enduring effects may be mediated by better parent-infant interactions. Heightened responsiveness of the neonate may enhance the early parent-infant relationships which may, in turn, contribute to optimal growth and development at later stages in infancy.

Field, T. & Schanberg, S. M. (1990). Massage alters growth and catecholamine production in preterm newborns. Gunzenhauser, N., Brazelton, T. B., and Field, T. Johnson & Johnson. Advances in Touch. Skillman, N. J.

METHODS: Forty medically stable preterm nenonates received tactile/kinesthetic stimulation for three 15-minute periods during three consecutive hours every day for ten days.

RESULTS: Despite similar formula and caloric intake, the treatment infants averaged a 21 percent greater daily weight gain than the control infants over the treatment period. In addition, the treatment group showed superior performance on the NBAS on the habituation cluster following the treatment period, and less time in active sleep and less facial grimacing, mouthing/yawning, and clenched fists.

Scafidi, F.A., Field, T.M., Schanberg, S.M., Bauer, C.R., Tucci, K., Roberts, J., Morrow, C., & Kuhn, C.M. (1990). Massage stimulates growth in preterm infants: A replication. Infant Behavior and Development, 13, 167-188.

METHODS: Forty preterm infants (M gestational age = 30 weeks; M birthweight = 1176 gms; M duration ICU care = 14 days) were assigned to treatment and control groups once they were considered medically stable. Assignments were based on a random stratification of gestational age, birthweight, intensive care duration, and study entrance weight. The treatment infants (n = 20) received tactile/kinesthetic stimulation for three 15-minute periods during 3 consecutive hours per day for a 10-day period. Sleep/wake behavior was monitored and Brazelton assessments were performed at the beginning and at the end of the treatment period.

RESULTS: The treated infants averaged a 21% greater weight gain per day (M=34 vs. 28 gms) and were discharged 5 days earlier. No significant differences were demonstrated in sleep/wake states and activity level between the groups. The treated infants’ performance was superior on the habituation cluster items of the Brazelton scale. Finally, the treatment infants were more active during the stimulation sessions than during the nonstimulation observation sessions (particularly during the tactile segments of the sessions).

Kuhn, C., Schanberg, S., Field, T., Symanski, R., Zimmerman, E., Scafidi, F., and Roberts, J. (1991). Tactile kinesthetic stimulation effects on sympathetic and adrenocortical function in preterm infants. Journal of Pediatrics, 119, 434-440.

METHODS: The purpose of this study was to investigate the neuroendocrine response in preterm infants to a pattern of tactile-kinesthetic stimulation that facilitates their growth and development. Preterm infants (mean gestational age 30 weeks, mean birth weight 1176 gm) received normal nursery care or tactile-kinesthetic stimulation for three 15 minute periods at the start of three consecutive hours each day for 10 days. On day 1 and day 10 of the study, a 24-hour urine sample was collected for norepinephrine, epinephrine, dopamine, cortisol, and creatinine assays and a blood sample was taken by heelstick for cortisol and growth hormone assays.

RESULTS: Urine norepinephrine and epinephrine values increased significantly only in the stimulated babies. Urine dopamine and cortisol values increased in both groups, and serum growth hormone decreased in both groups. Individual differences in urine norepinephrine, epinephrine, dopamine, and cortisol values were highly stable across the 10 days despite a 10-fold range of values among the infants. The results of this study suggest that tactile-kinesthetic stimulation of preterm infants has a fairly specific effect on maturation and/or activity of the sympathetic nervous system. In addition, this study has defined catecholamine and cortisol secretion across gestational age in normal preterm infants. Finally, these data suggest that highly stable individual levels of catecholamine and cortisol secretion are established by birth in humans.

Morrow, C. J., Field, T., Scafidi, F. A., Roberts, J., Eisen, L., Larson, S.K., Hogan, A.E., & Bandstra, E.S. (1991). Differential effects of massage and heelstick procedures on transcutaneous oxygen tension in preterm neonates. Infant Behavior and Development, 14, 397-414.

METHODS: This study investigated the effects of heelsticks and tactile-kinesthetic massage on transcutaneous oxygen tension (TcPO2) in 47 stabilized preterm neonates (average gestational age 30 weeks).

RESULTS: During the heelstick procedure, TcPO2 significantly declined an average of 14 mmHg. When compared with the tactile-kinesthetic massage, TcPO2 levels during the heelstick were significantly lower than during the stimulation. Mean TcPO2 levels remained clinically safe during the 4 massage sessions. The TcPO2 levels during kinesthetic stimulation were somewhat more varied, and movement and pressurization of the TcPO2 electrode were investigated as possible artifactual explanations for this phenomenon. Overall, findings indicate that social forms of touch such as tactile-kinesthetic massage do not appear to have a medically compromising effect on TcPO2 in the preterm neonate. Findings are evaluated in relation to the "minimal touch" policy.

Scafidi, F. A., Field, T., & Schanberg, S. M. (1993). Factors that predict which preterm infants benefit most from massage therapy. Journal of Developmental & Behavioral Pediatrics ,14, 176-180.

METHODS: Ninety-three preterm infants (M gestational age = 30 weeks; M birthweight = 1204 g; M ICU duration = 15 days) were randomly assigned to a massage therapy group or a control group once they were considered medically stable. The treatment group (N = 50) received three daily 15-minute massages for 10 days.

RESULTS: The massage therapy infants gained more weight per day (M=32 vs. 29 g) than the control infants. The treatment and control groups were divided into high and low weight gainers based on the average weight gain for the control group. Seventy percent of the massage therapy infants were classified as high weight gainers whereas only 40% of the control infants were classified as high weight gainers. Discriminant function analyses determining the characteristics that distinguished the high from the low weight gainers suggested that the control infants who, before the study, consumed more calories and spent less time in intermediate care gained more weight. In contrast, for the massage therapy group, the pattern of greater caloric intake and more days in intermediate care before the study period along with more obstetric complications differentiated the high from the low weight gainers, suggesting that the infants who had experienced more complications before the study benefited more from the massage therapy. These variables accurately predicted 78% of the infants who benefited more from the massage therapy.

Wheeden, A., Scafidi, F. A., Field, T., Ironson, G., Valdeon, C., and Bandstra, E. (1993). Massage effects on cocaine-exposed preterm neonates. Journal of Developmental & Behavioral Pediatrics, 14, 318-322.

METHODS: Thirty preterm cocaine-exposed preterm neonates (mean gestational age = 30 weeks, mean birth weight = 1212 g, mean intensive care unit duration = 18 days) were randomly assigned to a massage therapy or a control group as soon as they were considered medically stable. Group assignment was based on a random stratification of gestational age, birth weight, intensive care unit duration, and entry weight into the study. The treatment group (N = 15) received massages for three 15-minute periods 3 consecutive hours for a 10-day period.

RESULTS: Findings suggested that the massaged infants (1) averaged 28% greater weight gain per day (M=33 vs 26 g), although the groups did not differ in intake (calories or volume), (2) showed significantly fewer postnatal complications and stress behaviors than did control infants, and (3) demonstrated more mature motor behaviors on the Brazelton examination at the end of the 10-day study period.

Whipple, J. (2000). The effect of parent training in music and multimodal stimulation on parent-neonate interactions in the neonatal intensive care unit. Journal of Music Therapy, 37, 250-268.

METHODS: This study examined the effects of parent training in music and multimodal stimulation on the quantity and quality of parent-neonate interactions and the weight gain and length of hospitalization of premature and low birthweight (LBW) infants in a Neonatal Intensive Care Unit (NICU). Twenty sets of parents and premature LBW infants participated in the study. Parents in the experimental group received approximately one hour of instruction in appropriate uses of music, multimodal stimulation including massage techniques, and signs of infant overstimulation and techniques for its avoidance. Parent-neonate interactions, specifically parent actions and responses and infant stress and nonstress behaviors, were observed for subjects in both groups.

RESULTS: Infant stress behaviors were significantly fewer and appropriateness of parent actions and responses were significantly greater for experimental infants and parents than for control subjects. Parents in the experimental group also reported spending significantly more time visiting in the NICU than did parents of control infants.

Field, T. (2001). Massage therapy facilitates weight gain in preterm infants. Current Directions in Psychological Science, 10, 51-54.

REVIEW: Studies from several labs have documented a 31 to 47% greater weight gain in preterm newborns receiving massage therapy (3 15-min. sessions for 5-10 days) compared with standard medical treatment. Although the underlying mechanism for this relationship between massage therapy and weight gain has not yet been established, possibilites that have been explored in studies with both humans and rats include (1) increased protein synthesis, (2) increased vagal activity that releases food-absorption hormones like insulin and enhances gastric motility, and (3) decreased cortisol levels leading to increased oxytocin. In addition, functional magnetic resonance imaging studies are being conducted to assess the effects of touch therapy on brain development.

Ferber, S.G. Kuint, J., Weller, A., Feldman, R., Dollberg, S., Arbel, E., & Kohelet D. (2002). Massage therapy by mothers and trained professionals enhances weight gain in preterm infants. Early Human Development, 37, 37-45.

METHODS: This study compared maternal and nonmaternal administration of massage therapy to preterm infants. Healthy, preterm infants assigned to three groups: two treatment groups--one in which the mothers performed the massage, and the other in which a professional female unrelated to the infant administered the treatment. Both these groups were compared to a control group.

RESULTS: Over the 10-day study period, the two treatment groups gained significantly more weight compared to the control group.

Mainous, R.O. (2002). Infant massage as a component of developmental care: past, present, and future. Holistic Nursing Practice, 16, 1-7.

REVIEW: Infant massage has been practiced for centuries by segments on the continents of Africa and South America and in the Far East. Infant masage is a relatively new modality in North America. Nurmerous studies support its use in preterm infants, who have exhibited decreased stress levels, increased weight gain, and improved motor function when compared with non-massaged controls. Research has recently turned to the benefits of massage in the cocaine-exposed population and in those with human immunodeficiency virus. Massage in ill preterms has been targeted for clinical testing.

Mathai, S., Fernandez, A., Mondkar, J., & Kanbur, W. (2002). Effects of tactile-kinesthetic stimulation on preterms: A controlled trial. Indian Pediatrics, 38, 1091-1098.

METHODS: The objective of this study was to determine the effects of tactile-kinesthetic stimulation on preterms on physiologic parameters, physical growth and behavioral development. Forty-eight well preterms with birthweights between 1000-2000 grams were randomly assigned to treatment and control groups. Treatment babies received tactile-kinesthetic stimulation in the form of a structured baby massage from day 3 to term corrected age. They were observed for changes in vital parameters (heart rate, respiration, temperature and oxygen saturation) during the first few days of stimulation in hospital. Thereafter, massage was continued at home. Changes in weight, length and head circumference and neuro-behavior (Brazelton Neuro-Behavioral Assessment Scale) were assessed in both groups before, during and after the study period.

RESULTS: An increase in heart rate (within physiologic range) was seen in the treatment group during stimulation. This group also showed a weight gain of 4.24 g/day more than controls. On the Brazelton Scale the massaged group showed improved scores on the "orientation", "range of state", "regulation of state" and "autonomic stability\" clusters at follow-up.

Dieter, J., Field, T., Hernandez-Reif, M., Emory, E.K., & Redzepi, M. (2003). Stable preterm infants gain more weight and sleep less after five days of massage therapy. Journal of Pediatric Psychology, 28, 403-411.

METHODS: To determine whether a shorter course of massage therapy leads to greater weight gain in grower nursery preterm infants, massage therapy was provided for preterm neonates over 5 days.

RESULTS: Massaged infants gained 47% more weight per day than control infants.

Aly, H., Moustafa, M.F., Hassanein, S.M., Massaro, A.N., Amer, H.A., & Patel, K. (2004). Physical activity combined with massage improves bone mineralization in the premature infants: A randomized trial. Journal of Perinatology, 24, 305-309.

METHODS: Osteopenia of prematurity is a known source for morbidity in preterm infants. Premature infants have shown favorable outcomes in response to massage and physical activity. This study tested the hypothesis that massage combined with physical activity can stimulate bone formation and ameliorate bone resorption in premature infants. Thirty preterm infants were randomly assigned to either a control group or intervention group. Infants in the intervention group received a daily protocol of combined massage and physical activity. Serum type I collagen C-terminal propeptide (PICP) and urinary pyridinoline crosslinks of collagen (Pyd) were used as indices for bone formation and resorption, respectively.

RESULTS: In the control group, serum PICP decreased over time, while urinary Pyd increased indicating decreased bone formation and increased bone resorption, respectively. In the intervention group, serum PICP increased over time. Urinary Pyd also increased over time. A combined massage and physical activity protocol improved bone formation (PICP) but did not affect bone resorption (Pyd).

Feijo, L., Hernandez-Reif, M., & Field, T., Burns, W., Valley-Gray, S., and Simco, E. (2006). Mothers' depressed mood and anxiety levels are reduced after massaging their preterm infants. Infant Behavior and Development, 29, 476-480.

METHODS: Forty mothers whose preterm infants were about to be discharged from the Neonatal Intermediate Care Nursery (NICU) were randomly assigned to two groups: the first group of mothers conducted preterm infant massage and the second group only observed their preterm infants receiving massage.

RESULTS: Both groups of mothers had lower depressed mood scores following the session. However, only the group who massaged their infants had lower anxiety scores after the session.

Field, T., Diego, M., Hernandez-Reif, M., Deeds, O., Figueiredo, B. & Ascencio, A. (2006). Moderate Versus Light Pressure Massage Therapy Leads to Greater Weight Gain in Preterm Infants. Infant Behavior and Development, 29, 574-578

METHODS: Sixty-eight preterm infants (M GA=30 weeks) were randomly assigned to a moderate or to a light pressure massage therapy group to receive 15 massages three times per day for 5 days. Behavior state, stress behaviors and heart rate were recorded for 15min before and during the first 15-min therapy session. Weight gain was recorded over the 5-day therapy period.

RESULTS: The moderate versus light pressure massage group gained significantly more weight per day. During the behavior observations the moderate versus light pressure massage group showed significantly lower increases from the pre-session to the session recording on: (1) active sleep; (2) fussing; (3) crying; (4) movement; and (5) stress behavior (hiccupping). They also showed a smaller decrease in deep sleep, a greater decrease in heart rate and a greater increase in vagal tone. Thus, the moderate pressure massage therapy group appeared to be more relaxed and less aroused than the light pressure massage group which may have contributed to the greater weight gain of the moderate pressure massage therapy group.

Diego, M., Field, T., Hernandez-Reif, M. (2007). Preterm infant massage consistently increases vagal activity and gastric motility. Acta Paediatrica, 96, 1588-1591.

METHODS: EKG and EGG were recorded in 80 preterm infants randomly assigned to a moderate pressure massage therapy group or to a standard care control group to assess vagal activity and gastric motility responses to massage therapy.

RESULTS: Massaged infants exhibited consistent short-term increases in vagal activity and gastric motility on both the first and the last days of the 5-day study that were associated with weight gain during the 5-day treatment period. No changes in basal vagal activity or gastric motility were noted across the 5-day treatment period.

Jain, S., Kumar, P. & Kumar, P. (2006). Prior leg massage decreases pain responses to heel stick in preterm babies. Journal of Paediatric and Child Health, 42, 505-508.

METHODS: 13 infants received a 2-min massage of the ipsilateral leg prior to heel stick on the first study sampling and no massage on the next sampling 2-7 days later and 10 infants had the reverse order. The bedside nurse, blinded to the intervention, measured pain, heart rate, respiratory rate, and oxygen saturation prior to massage, after massage, and 5 min after the heelstick. Serum cortisol was measured with the blood sampling.

RESULTS: In 23 infants there were no adverse physiologic effects of massage. After heel stick, pain and heart rate were increased in the no-massage group compared with the massage group.

Chen, .L.L., Su, Y.C., Su, C.H., Lin, H.C., Kuo, H.W. (2008). Acupressure and meridian massage: combined effects on increasing body weight in premature infants. Journal of Clinical Nursing, 17, 1174-1181.

METHODS: For 15 minutes per session, one hour before meals and three times daily over 10 days.

RESULTS: The daily average weight gain of the infants in the massage group was 33 g versus 27 g in the control group. The group difference in weight gain was significant by the second week.

Diego, M., Field, T., Hernandez-Reif, M. (2008). Temperature Increases During Preterm Infant Massage Therapy. Infant Behavior and Development, 31, 149-152.

METHODS: Temperature was assessed in 72 preterm infants randomly assigned to a control or a massage therapy group.

RESULTS: A greater increase in temperature was noted for preterm infants receiving massage therapy versus a control group, even though the incubator portholes remained open during the 15 min massage therapy session but not for the control group over an equivalent time period.

Diego, M., Field, T., Hernandez-Reif, M., Deeds, O., Ascencio, A. & Begert, G. (2008). Preterm infant massage elicits consistent increases in vagal activity and gastric motility that are associated with greater weight gain. Acta Pediatrica, 96, 1588-1591.

METHODS: EKG and EGG were recorded in 80 preterm infants randomly assigned to a moderate pressure massage therapy group or to a standard care control group to assess vagal activity and gastric motility responses to massage therapy.

RESULTS: Massaged infants exhibited consistent short-term increases in vagal activity and gastric motility on both the first and the last days of the 5-day study that were associated with weight gain during the 5-day treatment period. No changes in basal vagal activity or gastric motility were noted across the 5-day treatment period.

Hernandez-Reif, M., Diego, M., & Field, T. Preterm Infants Show Reduced Stress Behaviors and Activity after 5 days of Massage Therapy. (2008). Infant Behavior and Development, 30, 557-561.

METHODS: Preterm infants residing in an NICU were randomly assigned to a massage therapy or to a control group. The preterm infants in the massage therapy group received three 15-min massages each day for 5 consecutive days, with the massages consisting of moderate pressure stroking to the head, shoulders, back, arms and legs and kinesthetic exercises consisting of flexion and extension of the limbs. Infant stress behaviors and activity were recorded on the first and last day of the study.

RESULTS: Preterm infants receiving massage therapy showed fewer stress behaviors and less activity from the first to the last day of the study. The findings suggest that massage has pacifying or stress reducing effects on preterm infants, which is noteworthy given that they experience numerous stressors during their hospitalization.

Mendes, E.W. & Procianoy, R.S. (2008). Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates. Journal of Perinatology, 28, 815-820.

METHODS: Preterm neonates were randomly assigned to a massage or control group. Massages were performed four times a day on the face and limbs. Passive exercising of upper and lower limbs were also done by the mothers.

RESULTS: Late-onset sepsis was less frequent in the massage group and they were discharged from the hospital 7 days earlier.

Diego, M., Field, T., & Hernandez-Reif, M. (2009). Procedural pain heart rate responses in massaged preterm infants. Infant Behavior and Development, 32, 226-229.

METHODS: Heart rate (HR) responses to the removal of a monitoring lead were assessed in 56 preterm infants who received moderate pressure, light pressure or no massage therapy.

RESULTS: The infants who received moderate pressure massage therapy exhibited lower increases in HR suggesting an attenuated pain response. The heart rate of infants who received moderate pressure massage also returned to baseline faster than the heart rate of the other two groups, suggesting a faster recovery rate.

Massaro A.N., Hammad, T.A., Jazzo, B., & Aly, H. (2009). Massage with kinesthetic stimulation improves weight gain in preterm infants. Journal of Perinatology, 29, 352-357.

METHODS: Medically stable preterm neonates were randomized either to receive no intervention (control), massage therapy alone or massage therapy with kinesthetic stimulation.

RESULTS: For infants with birthweight>1000 g, average daily weight gain was increased in the intervention groups compared to control. This effect was greater in the group who received both massage and kinesthetic stimulation.

Procianoy, R.S., & Mendes, E.W., & Silveira, R.C. (2009). Massage therapy improves neurodevelopment outcome at two years corrected age for very low birth weight infants. Early Human Development, 86, 7-11.

METHODS: preterm infants were randomly assigned to massage therapy by mothers plus skin-to-skin care or just skin-to-skin care during their hospital stay.

RESULTS: Growth at 2years corrected age was similar in both groups. The massage group had borderline higher motor scores and significantly higher mental scores.

Field, T. (1992). Interventions in early infancy. Special Section: Australian Regional Meeting: Attachment and the relationship between the infant and caregivers. Infant Mental Health Journal, 13, 329-336.

REVIEW: This review describes 3 interventions to help infants of high-risk pregnancies and deliveries facilitate attachment both to and from their caregivers. Prenatal intervention included giving high-risk pregnant women video feedback during prenatal ultrasound, which reduced maternal anxiety, obstetric complications, and fetal activity and improved neonatal outcome (increased weight gain, better performance on the Brazelton Neonatal Behavioral Assessment Scale, and decreased irritability). Intervention aimed at reducing stress in the neonatal intensive care unit included providing preterm neonates nonnutritive sucking opportunities to reduce stress during heelsticks and gavage feedings and providing preterm neonates and preterm cocaine-exposed neonates massage therapy, which facilitated weight gain and better performance on the Brazelton scale. Following improved neonatal behavior, infants would be expected to have better interactions with their caregivers.

Field, T. (2001). Massage therapy facilitates weight gain in preterm infants. Current Directions in Psychological Science, 10, 51-54.

REVIEW: Studies from several labs have documented a 31 to 47% greater weight gain in preterm newborns receiving massage therapy (three 15-minute sessions for 5-10 days) compared with standard medical treatment. Although the underlying mechanism for this relationship between massage therapy and weight gain has not yet been established, possibilities that have been explored in studies with both humans and rats include (a) increased protein synthesis, (b) increased vagal activity that releases food-absorption hormones like insulin and enhances gastric motility and (c) decreased cortisol levels leading to increased oxytocin. In addition, functional magnetic resonance imaging studies are being conducted to assess the effects of touch therapy on brain development. Further behavioral, physiological, and genetic research is needed to understand these effects of massage therapy on growth and development.

Field, T. (2002). Massage therapy. Medical Clinics of North America, 86, 163-171.

REVIEW: The author and other investigators have documented improvement in several medical and psychiatric conditions after massage therapy, including growth in preterm infants, depression and addictive problems, pain syndromes, and immune and autoimmune conditions. Although some potential underlying mechanisms have been explored for the massage therapy-improved clinical condition relationship, including decreased stress (and decreased cortisol), improved sleep patterns, and enhanced immune function, further research is needed in this area.