Linda Garofallou, MS, IMH-E®-III Clinical
Qigong Sensory Treatment for Children's Special Developmental Needs

Medical Research Abstracts

Autism        Anxiety      Asthma      Behavior      Cancer      Cerebral Palsy      Cocaine Exposure

           Constipation        Cystic Fibrosis        Depression        Diarrhea        Down Syndrome      

Gastric Motility      HIV      Multiple Sclerosis      Pain      Prematurity       Sickle Cell       Sleep



Silva, L, Schalock, M, Gabrielsen,  (2016).  One- And Two-year Outcomes of Treating Preschool Children with Autism with a Qigong Massage Protocol: An Observational Follow-along Study.  Journal of Alternative and Integrative Medicine 5:216.

ABSTRACT:  Background: Randomized controlled trials have repeatedly demonstrated that treatment with a five-month qigong massage protocol significantly reduces the severity of autism. The treatment protocol is known as Qigong Sensory Training (QST) autism massage and is given daily by parents and weekly by therapists for five months. Treatment reduces the tactile abnormalities that are universal in young children with autism and results in improved social skills, language and behavior. At five months, tactile abnormalities are reduced by 1/2, autistic behavior is reduced by 1/3, autism severity is reduced by 16%, and 6% of children have moved off the spectrum. What has not yet been done is to measure outcomes with longer-term treatment. This observational study investigates outcomes with up to 24 months of treatment. Methods: 75 children entered this observational study upon completion of five months of treatment with the QST protocol. They received daily parent treatment and monthly therapist treatment for the balance of the first year, and daily parent treatment without therapist support for the second year. Sequential evaluations were conducted at baseline (n=75), five months (n=75), 12 months (n=67) and 24 months (n=31). Results: Continued treatment resulted in continued improvement. At 12 and 24 months, mean tactile responses normalized by 57% and 72%, with 24% and 32% falling into the normal range; mean autism severity decreased by 27% and 44%, with 12% and 26% of children moving out of autistic range. Conclusions: Results demonstrated that longer-term treatment resulted in resolution of tactile impairment and continued improvement of social skills, language and behavior. The rate of coming off the spectrum (1 in 4 children by year-2) was far higher than the natural history of ASD would predict. Results support earlier recommendations to treat tactile abnormalities at the time of autism diagnosis in order to improve autism outcomes. 

For complete listing of Dr. Louisa Silva's 15 years of research using Qigong Sensory Training for children with Autism, Cerebral Palsy and Down's Syndrome, please see:  


Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C. & Schanberg, S. (1992).  Massage reduces anxiety in child and adolescent psychiatric patients.  Journal of the American Academy of Child and Adolescent Psychiatry, 31, 125-131.

METHODS: A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. RESULTS: Compared with a control group who viewed relaxing videotapes, the massage subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.

Escalona, A., Field, T., Singer-Strunk, R., Cullen, C., & Hartshorn, K. (2001).   Improvements in the behavior of children with autism.   Journal of Autism and Developmental Disorders, 31, 513-516.

METHODS: Twenty children with autism ranging in age from 3 to 6 years were randomly assigned to massage therapy and reading attention control groups. Parents in the massage therapy group were trained by a massage therapist to massage their children for 15 minutes prior to bedtime every night for one month while the parents of the attention control group read Dr. Seuss stories to their children on the same time schedule. Conners Teacher and Parent scales, classroom and playground observations and sleep diaries were used to assess the effects of therapy on various behaviors including hyperactivity, stereotypical and off-task behavior, as well as sleep problems. RESULTS: Results suggested that the children in the massage group exhibited less stereotypic behavior and showed more on-task and social relatedness behavior during play observations at school, and they experienced fewer sleep problems at home.


Field, T., Henteleff, T., Hernandez-Reif, M., Martinez, E., Mavunda, K., Kuhn, C. & Schanberg, S. (1998). Children with asthma have improved pulmonary functions after massage therapy. Journal of Pediatrics, 132, 854-858.

METHODS: Thirty-two children with asthma (16 4- to 8-year-olds and 16 9- to 14-year-olds) were randomly assigned to receive either massage therapy or relaxation therapy. The children’s parents were taught to provide one therapy or the other for 20 minutes before bedtime each night for 30 days. RESULTS: The younger children who received massage therapy showed an immediate decrease in behavioral anxiety and cortisol levels after massage. Also, their attitude toward asthma and their peak air flow and other pulmonary functions improved over the course of the study. The older children who received massage therapy reported lower anxiety after the massage. Their attitude toward asthma also improved over the study, but only one measure of pulmonary function (forced expiratory flow 25% to 75%) improved. The reason for the smaller therapeutic benefit in the older children is unknown; however, it appears that daily massage improves airway caliber and control of asthma.



Khilnani, S., Field, T., Hernandez-Reif, M., & Schanberg, S. (2003). Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder. Adolescence, 38, 623-638.

METHODS: The present study involved 30 children and adolescents between the ages of 7 and 18 (M = 13) diagnosed with attention-deficit/hyperactivity disorder (ADHD). The children were randomly assigned to a wait-list control and a massage group. The latter group received massage therapy for 20 minutes twice per week over the course of one month. RESULTS: Mood state improved for the massage but not the control group based on smiley face and thermometer scales. The massage group also improved in classroom behavior in the areas of the Conners Teacher Rating Scales on anxiety, daydreaming and hyperactivity. The wait-list control group did not show these gains. In sum, the results revealed that massage therapy benefited children and adolescents with ADHD by improving short-term mood state and longer-term classroom behavior.

Escalona, A., Field, T., Cullen, C., Hartshorn, K., & Cruz, C. (2001). Behavior problem preschool children benefit from massage therapy.  Early Child Development &Care, 161, 1-5.

METHODS: Twenty preschool children with behavior problems were randomly assigned to a massage group or a story reading attention control group. The sessions occurred for 15-minutes twice a week for a month. Pre and post session ratings were made on the first and last days of the study by teachers who were blind to the child’s group assignment. RESULTS: These revealed that the children in the massage therapy group: 1) were more drowsy, less active, less talkative and had lower anxiety levels after the sessions; and 2) were less anxious and more cooperative by the end of the study.



Post-White, J., Fitzgerald, M., Savik, K., Hooke, M.C., Hannahan, A.B., Sencer, S.F. (2009).  Massage therapy for children with cancer. Jour of Pediatric Oncology Nursing, 26:16-28.

METHODS:  Children with cancer received 4 weekly massages alternated with 4 weekly quiet-time control sessions. RESULTS: Massage was more effective than quiet time at reducing heart rate and anxiety in children as well as parent anxiety.

Field, T., Cullen, C., Diego, M., Hernandez-Reif, M., Sprinz, P., Beebe, K., Kissel, B., & Bango-Sanchez, V. (2001). Leukemia immune changes following massage therapy. Journal of Bodywork and Movement Therapies, 5, 271-274. 

METHODS: Twenty children with leukemia were provided with daily massage therapy by their parents and were compared to a standard treatment control group. RESULTS: Following a month of massage therapy, depressed mood decreased in the children's parents, and the children's white blood cell and neutrophil counts decreased.

Smith, M.C., Kemp, J., Hemphill, L., & Vojir, C.P. (2002). Outcomes of therapeutic massage for hospitalized cancer patients.   Journal of Nursing Scholarship, 34, 257-262.

METHODS: To examine the effects of therapeutic massage on perception of pain, subjective sleep quality, symptom distress, and anxiety in patients hospitalized for treatment of cancer, twenty participants received therapeutic massage and 21 received the control therapy, nurse interaction. RESULTS: Mean scores for pain, sleep quality, symptom distress, and anxiety improved from baseline for the subjects who received therapeutic massage; only anxiety improved from baseline for participants in the comparison group. Sleep improved only slightly for the participants receiving massage, but it deteriorated significantly for those in the control group. 

Hernandez-Reif, M., Field, T., Ironson, G., Beutler, J., Vera, Y., Hurley, J., Fletcher, M., Schanberg, S., Kuhn, C., & Fraser, M. (2005).   Natural killer cells and lymphocytes increase in women with breast cancer following massage therapy. International Journal of Neuroscience, 115, 495-510

METHODS: Women diagnosed with breast cancer received massage therapy or practiced progressive muscle relaxation (PMR) for 30-minute sessions three times a week for 5-weeks or received standard treatment. The massage therapy and relaxation groups reported less depressed mood, anxiety and pain immediately after their first and last sessions. By the end of the study, however, only the massage therapy group reported being less depressed and less angry and having more vigor. Dopamine levels, Natural Killer cells and lymphocytes also increased from the first to the last day of the study for the massage therapy group.

Wilkie, D.J., Kampbell, J., Cutshall, S., Halabisky, H., Harmon, H., Johnson, L.P., Weinacht, L., & Rake-Marona, M. (2000). Effects of massage on pain intensity, analgesics and quality of life in patients with cancer pain: A pilot study of a randomized clinical trial conducted within hospice care delivery. Hospice Journal, 15, 31-53.

METHODS: This randomized controlled clinical trial examined the effects of massage on perceived pain intensity, prescribed morphine, hospital admissions, and quality of life. Massage interventions consisted of 4, twice-weekly massages. Baseline and outcome measurements were obtained before the 1st and after the 4th massages. RESULTS: Pain intensity, pulse rate, and respiratory rate were significantly reduced immediately after the massages. At study entry, the massage group reported higher pain intensity which decreased by 42% compared to a 25% reduction in the control group.

Rexilius, S.J., Mundt, C., Erickson Megel, M., & Agrawal, S. (2002) . Therapeutic effects of massage therapy and handling touch on caregivers of patients undergoing autologous hematopoietic stem cell transplant. Oncology Nursing Forum, 29, 35-44.

METHODS: This study examined the effects of massage therapy and Healing Touch on anxiety, depression, subjective caregiver burden, and fatigue experienced by caregivers of patients undergoing autologous hematopoietic stem cell transplant. RESULTS: Results showed significant declines in anxiety scores, depression, general fatigue, reduced motivation fatigue, and emotional fatigue for individuals in the massage therapy group only. 


Cerebral Palsy

For complete listing of Dr. Louisa Silva's 15 years of research using Qigong Sensory Training for children with Autism, Cerebral Palsy and Down's Syndrome, please see:  

Hernandez-Reif, M., Field, T., Largie, S., Diego, M., Manigat, N., Seonanes, J., Bornstein, J. & Waldman, R. (2005).  Cerebral Palsy symptoms in children decreased following massage therapy.  Journal of Early Child Development and Care, 175, 445-456.

METHODS: Twenty young children (M age = 32 months) with Cerebral Palsy (CP) recruited from early intervention programs received 30-minutes of massage or reading twice weekly for 12 weeks. RESULTS: The children receiving massage therapy showed fewer physical symptoms including reduced spasticity, less rigid muscle tone overall and in the arms and improved fine and gross motor functioning. In addition, the massage group had improved cognition, social and dressing scores on the Developmental Profile and they showed more positive facial expressions and less limb activity during face-to-face play interactions.


Cocaine Exposure

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

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



Bishop, E., McKinnon, E., Weir, E., & Brown, D.W. (2003).  Reflexology in the management of encopresis and chronic constipation.  Paediatric Nursing., 15, 20-21.

METHODS: This study investigated the efficacy of treating patients with encopresis and chronic constipation with reflexology. An observational study was carried out of 50 children between three and 14 years of age who had a diagnosis of encopresis/chronic constipation. The children received six sessions of 30-minutes of reflexology to their feet. With the help of their parents they completed questionnaires on bowel movements and soiling patterns before, during and after the treatment. A further questionnaire was completed by parents pre and post treatment on their attitude towards reflexology. Forty-eight of the children completed the sessions. RESULTS: The number of bowel movements increased and the incidence of soiling decreased.


Cystic Fibrosis

Hernandez-Reif, M., Field, T., Krasnegor, J., Martinez, E., Schwartzman, M. & Mavunda, K. (1999).  Children with cystic fibrosis benefit from massage therapy.  Journal of Pediatric Psychology, 24, 175-181.

METHODS: Parents massaged their children with cystic fibrosis to reduce anxiety and their children’s anxiety and to improve the children's mood and peak air flow readings. Twenty children (5-12 years old) with cystic fibrosis and their parents were randomly assigned to a massage therapy or a reading control group. Parents in the treatment group were instructed and asked to conduct a 20-minute child massage every night at bedtime for one month. Parents in the reading control group were instructed to read for 20 minutes a night with their child for one month. On days 1 and 30, the parents and children answered questions relating to present anxiety levels and the children answered questions relating to mood, and their peak air flow was measured. RESULTS: Following the first and last massage session, the children and parents reported reduced anxiety. Mood and peak air flow readings also improved for the children in the massage therapy group.



Field, T., Diego, M., Hernandez-Reif, M., Deeds, O. & Figueiredo, B. (2009).  Pregnancy massage reduces prematurity, low birthweight and postpartum depression.   Infant Behavior and Development, 32, 454-460.

METHODS: Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group. RESULTS: The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.  

Hou, W.H., Chiang, P.T., Hsu, T.Y., Chiu, S.Y., & Yen. Y.C. (2010)  Treatment effects of massage therapy in depressed people: a meta-analysis.   Journal of Clinical Psychiatry, 71, 894-901.

METHODS: A meta-analysis of randomized controlled trials of massage therapy in depressed people was conducted. RESULTS:  17 studies were included and all trials showed positive effect of massage therapy on depressed people.

Oswalt, K.L., Biasini, F.J., Wilson, L.L. & Mrug, S. (2009).  Outcomes of a massage intervention on teen mothers: A pilot study.  Pediatric Nursing, 35, 284-289.       

METHODS: Adolescent mothers were randomly assigned to an intervention group that practiced massage with their infants or a control group. RESULTS: Teaching infant massage enhanced maternal-infant physical contact and lowered depression.

Feijo, L, Hernandez-Reif, M., Field, T,  et al (2006)  Mothers’ depressed mood and anxiety levels are reduced after massaging their preterm infants, Infant Behav   Dev, 29(3), 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.

Fujita, M., Endoh, Y., Saimon, N, Yamaguichi, S.  (2006)  Effect of massaging babies on mothers:  Pilot study on the changes in mood states and salivary cortisol level, Complementary Therapies in Clinical Practice, 12(3), 181-185.

METHODS:  Thirty-nine Japanese mothers, 5-6 weeks postnatal, were randomly assigned to experimental and control groups. Nineteen mothers in the experimental group were examined before the first day of the baby massage, and 3 months after delivery. The psychological measurements used were profile of mood states (POMS). Salivary cortisol level was analyzed for physiological measurements.    RESULTS:  revealed that significant differences in the POMS score were seen in depression and vigor between the two groups at 3 months. There were no significant differences in the salivary cortisol levels.   Baby massage was found to positively affect the mood status of the mothers. We propose that midwives and other health-care professionals should recommend mothers to do baby massage to improve their own mood status.

Onozawa, K., Glover, V., et al (2001)   Infant massage improves mother-infant interaction for mothers with postnatal depression,  Journal of Affective Disorders, 63(1-3).

METHODS:  Thirty-four primiparous depressed mothers were randomly allocated either to an infant massage class and a support group (massage group) or to a support group (control group). Each group attended for five weekly sessions. Changes in maternal depression and mother-infant interaction were assessed at the beginning and the end of the study by comparing EPDS scores and ratings of videotaped mother-infant interaction.  RESULTS:  This study suggests that learning the practice of infant massage by mothers is an effective treatment for facilitating mother-infant interaction in mothers with postnatal depression.

Onozawa, K., Glover, V., Adams, D., Modi, N., & Kumar, R.C. (2001).  Infant massage improves mother-infant interaction for mothers with postnatal depression.  Journal of Affective Disorders, 63, 1-3.       

METHODS:  Thirty-four primiparous depressed mothers at 4 weeks postpartum were randomly assigned either to an infant massage class and a support group (massage group) or to a support group (control group). Each group attended five weekly sessions. RESULTS: The depression scores fell in both groups. However, improvement of mother-infant interactions was seen only in the massage group. 

Jones, N., Field, Davalos, M. (1998)   Massage therapy attenuates right frontal EEG asymmetry in one-month old infants of depressed mothers.  Infant Behavior & Development, 21(3), 527-530.

METHODS:  Twenty-five  1-mo-old infants and their mothers participated in the study that hypothesized that massage therapy would alter right frontal EEG patterns toward asymmetry in 1-mo-old infants of depressed mothers. RESULTS:   Massage therapy attenuated right frontal EEG asymmetry in one-month-old infants of depressed mothers. Right frontal EEG asymmetry (a pattern associated with depression) decreased during and immediately following the massage session, indicating that massage therapy reduced EEG asymmetry and might possibly reduce symptoms of depression. 

Pelaez-Nogueras, M., Field, T., Hossaine, Z., Pickens, J. (1996)   Depressed Mothers' Touching Increases Infants' Positive Affect and Attention in Still-Face Interactions.  Child Development, 67(4), 1780-11792.

METHODS:  The effects of depressed mothers' touching on their infants' behavior were investigated during the still-face situation. 48 depressed and nondepressed mothers and their 3-month-old infants were randomly assigned to control and experimental conditions.     RESULTS:  The results suggest that by providing touch stimulation for their infants, the depressed mothers can increase infant positive affect and attention and, in this way, compensate for negative effects often resulting from their typical lack of affectivity (flat facial and vocal expressions) during interactions.

Field, T., Grizzle, N., Scafidi, F., Abrams, S., & Richardson, S. (1996).  Massage therapy for infants of depressed mothers.  Infant Behavior and Development 19, 109-114.     

METHODS: Forty full-term 1- to 3-month-old infants born to depressed adolescent mothers who were low socieconomic status (SES) and single parents were given 15 minutes of either massage or rocking for 2 days per week for a 6-week period. RESULTS: The infants who experienced massage therapy compared to infants in the rocking control group spent more time in active alert and active awake states, cried less, and had lower salivary cortisol levels, suggesting lower stress. After the massage versus the rocking sessions, the infants spent less time in an active awake state, suggesting that massage may be more effective than rocking for inducing sleep. Over the 6-week period, the massage-therapy infants gained more weight, showed greater improvement on emotionality, sociability, and soothability temperament dimensions and had greater decreases in urinary stress catecholamines/hormones (norepinephrine, epinephrine, cortisol).

Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996).   Massage and relaxation therapies' effects on depressed adolescent mothers.   Adolescence, 31, 903-911.   

METHODS: Thirty-two depressed adolescent mothers received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group. RESULTS: Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group.   



Jump, V.K. Fargo, J.D. & Akers, J. (2006).  Impact of massage therapy on health outcomes among orphaned infants in Ecuador: Results of a randomized clinical trial.   Family Community Health, 29, 314-319.

Diarrhea is the second leading cause of death among infants and young children in the developing world. This project investigated whether therapeutic infant massage could reduce diarrheal episodes and decrease overall illness of infants. METHODS: Infants living in 2 orphanages in Quito, Ecuador, were matched by age and randomly assigned to a massage therapy or a control group. Daily infant massage therapy was provided by orphanage staff or volunteers, which lasted an average of 53 days, and symptoms of illness data were documented daily by volunteers in the orphanages. RESULTS: the control group infants had a 50% greater risk of having diarrhea than experimental infants. Control group infants were also 11% more likely than experimental infants to experience illness of any kind.


Down Syndrome

For complete listing of Dr. Louisa Silva's 15 years of research using Qigong Sensory Training for children with Autism, Cerebral Palsy and Down's Syndrome, please see:  

Hernandez-Reif, M., Field, T., Bornstein, J. & Fewell, R. (2006).  Children with Down Syndrome improved in motor function and muscle tone following massage therapy.  Journal of Early Child Development and Care, 176, 395-410.

METHODS: Twenty-one moderate to high functioning young children (M age = 2 years) with Down syndrome receiving early intervention (PT, OT and speech therapy) were randomly assigned to also receive two ½-hour massage therapy or reading sessions (control group) per week for two months. On the first and last day of the study, the children were assessed on functioning using the Developmental Programming for Infants and Young Children Scale and muscle tone using a new Likert scale. RESULTS: Children in the massage therapy group experienced developmental gains in fine and gross motor functioning and showed less severe hypotonicity in their limbs. These findings suggest that the addition of massage therapy to an early intervention program may enhance motor and muscle functioning for children with Down syndrome.


Gastric Motility

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.

Diego MA, Field T, Hernandez-Reif M. (2005).  Vagal activity, gastric motility, and weight gain in massaged preterm neonates.   Journal of Pediatrics, 147, 50-55

METHODS: The present randomized study explored this potential underlying mechanism by assessing gastric motility and sympathetic and parasympathetic nervous system activity in response to massage therapy (moderate pressure) versus sham massage (light pressure) and control conditions in a group of preterm neonates. RESULTS: Compared with preterm neonates receiving sham massage, preterm neonates receiving massage therapy exhibited greater weight gain and increased vagal tone and gastric motility during and immediately after treatment. Gastric motility and vagal tone during massage therapy were significantly related to weight gain.



Shor-Posner, G., Hernandez-Reif, M., Miguez, M. Fletcher, M., Quintero, N., Baez, J., Perez-Then, E. Soto, S., Mendoza, R., Castillo, R. & Zhang, G. (2006).  Impact of a massage therapy clinical trial on immune status in young Dominican children infected with HIV-1.  Journal of Alternative and Complementary Medicine, 12, 511-516.

METHODS: Dominican HIV+ children without current access to antiretroviral therapies were randomized to receive either massage or a control/friendly visit twice weekly for 12 weeks. Blood was drawn at baseline and following the 3-month intervention for determinations of the HIV disease markers CD4 and CD8 cell counts. RESULTS: Despite similar immune parameters at baseline in the two groups, significantly more of the control group exhibited a decline in CD4 cell count postintervention. The decrease was particularly evident in older (5-8 years) children in the control group, who demonstrated a significant reduction in both CD4 and CD8 cell counts compared to massage-treated older children who remained stable or showed immune improvement. Additionally, a significant increase in CD4 cells was observed over the 12-week trial in the massage-treated older children but not in the control group. In younger massage-treated children, (2-4 years old), a significant increase in natural killer cells was shown.

Scafidi, F. & Field, T. (1996).  Massage therapy improves behavior in neonates born to HIV positive mothers.  Journal of Pediatric Psychology, 21, 889-898.

METHODS: Neonates born to HIV-positive mothers were randomly assigned to a massage therapy or control group. The treatment infants were given three 15-minute massages daily for 10 days. RESULTS: The massaged group showed superior performance on almost every Brazelton newborn cluster score and had a greater daily weight gain at the end of the treatment period unlike the control group who showed declining performance.

Diego, M.A., Hernandez-Reif, M., Field, T., Friedman, L. & Shaw, K. (2001).  HIV adolescents show improved immune function following massage therapy.  International Journal of Neuroscience, 106, 35-45.

METHODS: HIV+ adolescents (M CD4= 466mm3) recruited from a large urban university hospital’s outpatient clinic were randomly assigned to receive massage therapy (n= 12) or progressive muscle relaxation (n= 12) two-times per week for 12 weeks. To assess treatment effects, participants were assessed for depression, anxiety and immune changes before and after the 12 week treatment period. RESULTS: Adolescents who received massage therapy versus those who experienced relaxation therapy reported feeling less anxious and they were less depressed and showed enhanced immune function by the end of the 12 week study. Immune changes included increased Natural Killer cell number.In addition, the HIV disease progression markers CD4/CD8 ratio and CD4 number increased for the massage therapy group only.


Multiple Sclerosis

Siev-Ner, I., Gamus, D., Lerner-Geva, L., & Achiron, A. (2003).  Reflexology treatment relieves symptoms of multiple sclerosis: A randomized controlled study.  Multiple Sclerosis, 9, 356-361.

METHODS: Seventy-one MS patients were randomized to either a study or control group, to receive an 11-week treatment. Reflexology treatment included manual pressure on specific points in the feet and massage of the calf area. The control group received nonspecific massage of the calf area. RESULTS: Significant improvement in paresthesias, urinary symptoms and spasticity was detected in the reflexology group. Improvement with borderline significance was observed in muscle strength between the reflexology group and the controls. The improvement in the intensity of paresthesias remained significant at three months of follow-up.



Parlak Gürol, A., Polat, S. & Akçay, M.N. (2010).  Itching, pain, and anxiety levels are reduced with massage therapy in burned adolescents.  Journal of Burn Care and Research, 31, 429-432. 

METHODS:  Adolescents were massaged after admission to a burn unit. RESULTS:  After 5 weeks, massage therapy reduced pain, itching and state anxiety.

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.

Suresh, S., Wang, S., Porfyris, S, Kamasinski-Sol, R., Steinhorn, D.   (2008).  Massage therap in oupatient pediatric chronic pain patients: do they facilitate significant reductions in levels of distress, pain, tension, discomfort and mood alterations?.  Pediatric Anesthesia,18:884-887.   

METHODS: Pilot study with fifty-seven patients presenting at outpatient chronic pain clinic at a children's hosital. RESULTS:  Reductions in ratings of distress, pain, tension, discomfort and upset mood were highly significant in pediatric outpatient pain patients after massage therapy.  No significant reductions in comparable ratings after a "no intervention" control time period were found.  These pilot data suggest that massage therapy may be effective in reducing pain-related symptoms in children with chronic pain syndromes and that these reductions are not associated with the effects of the patients simply rating themselves.  

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.

Hernandez-Reif, M., Field, T., Largie, S., Hart, S., Redzepi, M., Nierenberg, B., & Peck, M. (2001). Children s’ distress during burn treatment is reduced by massage therapy.  Journal of Burn Care and Rehabilitation, 22, 191-195.

METHODS: Before dressing changes, 24 young children (mean age = 2.5 years) hospitalized for severe burns received standard dressing care or massage therapy in addition to standard dressing care. The massage therapy was conducted to body parts that were not burned. RESULTS: During the dressing change, the children who received massage therapy showed minimal distress behaviors and no increase in movement other than torso movement. In contrast, the children who did not receive massage therapy responded to the dressing change procedure with increased facial grimacing, torso movement, crying, leg movement and reaching out. Nurses also reported greater ease in completing the dressing change procedure for the children in the massage therapy group. These findings suggest that massage therapy attenuates young children's distress responses to aversive medical procedures and facilitates dressing changes.

 Kubsch, S.M., Neveau, T., & Vandertie, K. (2000).  Effect of cutaneous stimulation on pain reduction in emergency department patients.  Complementary Therapies in Nursing & Midwifery, 6, 25-32.

METHODS: Tactile stimulation was used with 50 emergency department patients to relieve pain. Another objective was to determine the effect of tactile stimulation on blood pressure and heart rate. RESULTS: Following stimulation, subjects reported significantly reduced pain, and demonstrated reduced heart rate, and blood pressure readings.

Field, T., Peck, M., Hernandez-Reif, M., Krugman, S., Burman, I., & Ozment-Schenck, L. (2000).  Postburn itching, pain, and psychological symptoms are reduced with massage therapy.   Journal of Burn Care & Rehabilitation, 21, 189-193.

METHODS: Twenty patients with burn injuries were randomly assigned to a massage therapy or a standard treatment control group during the remodeling phase of wound healing. The massage therapy group received a 30-minute massage with cocoa butter to a closed, moderate-sized scar tissue area twice a week for 5 weeks. RESULTS: The massage therapy group reported reduced itching, pain, and anxiety and improved mood immediately after the first and last therapy sessions, and their ratings on these measures improved from the first day to the last day of the study.



Procianoy, R.S., Mendes, E.W. & Silveira, R.C. (2010). Massage therapy improves neurodevelopmental outcome at two years corrected age for very low birth weight infants. Early Human Development, 86, 7-11.

METHODS: Newborns with very low birthweight and gestational age were randomly assigned to massage therapy by mothers plus skin-to-skin care (Intervention Group) or just skin-to-skin care (Control Group) during their hospital stay. RESULTS: The Intervention Group had borderline higher Psychomotor Development Index and  Mental Development Index scores than the Control Group.

Field, T., Diego, M., & Hernandez-Reif, M. (2010).  Preterm infant massage therapy research: a review.  Infant Behavior and Development, 33, 115-124.

In this paper, preterm infant massage therapy studies are reviewed. Massage therapy has led to weight gain in preterm infants when moderate pressure massage was provided. In studies on passive movement of the limbs, preterm infants also gained significantly more weight, and their bone density also increased. Research on ways of delivering the massage is also explored including using mothers versus therapists and the added effects of using oils. The use of mothers as therapists was effective in at least one study. The use of oils including coconut oil and safflower oil enhanced the average weight gain, and the transcutaneous absorption of oil also increased triglycerides. In addition, the use of synthetic oil increased vagal activity, which may indirectly contribute to weight gain. The weight gain was associated with shorter hospital stays and, thereby, significant hospital cost savings. Despite these benefits, preterm infant massage is only practiced in 38% of neonatal intensive care units. This may relate to the underlying mechanisms not being well understood. The increases noted in vagal activity, gastric motility, insulin and IGF-1 levels following moderate pressure massage are potential underlying mechanisms. However, those variables combined do not explain all of the variance in weight gain, highlighting the need for additional mechanism studies.

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.

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.

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

Field, T., Diego, M., Hernandez-Reif, M., Dieter, J., Kumar, A., Schanberg, S. & Kuhn, C. (2008). Insulin and insulin-like growth factor-1 increased in preterm neonates following massage therapy.  Journal of Developmental and Behavioral Pediatricts, 29, 463-466.

METHODS: Forty-two preterm neonates who averaged 34.6 weeks (M = 29.5 wk gestational age; M birth weight = 1237 g) and were in the "grower" (step-down) nursery were rando