© Borgis - New Medicine 1/2010, s. 18-21
*Dariusz Boguszewski1, Aneta Dąbek2, Izabela Korabiewska1, Dariusz Białoszewski1
Relation between back massage and anxiety level
1Rehabilitation Unit Medical University of Warsaw
Head: dr n. med. Dariusz Białoszewski
2Academy of Physical Education Faculty of Rehabilitation in Warsaw
Head: dr hab. n. med. prof. AWF Janusz Domaniecki
Aim. The purpose of the research was to determine the relation between procedures of classic massage and the level of anxiety as a trait and as a state.
Material and Methods. The examined group consisted of 16 people aged from 20 to 49, from various professional environments. Research participants underwent ten 30-minute procedures of classic relaxation massage. The massage focused on the back, since, due to the large surface, it has the most general influence. The time of one series of procedures was three weeks. The Spielberger et al. self-evaluation questionnaire was the probe. The questionnaire measures the level of anxiety. The examined people completed the questionnaire three times: 1. before the first massage, 2. after the first massage, 3. after the last massage. The significance of differences was measured by Student's t-test.
Results. The results indicate that under the influence of massage, the level of anxiety as a trait and as a state (measurement 1 and 3) was diminished. A considerable difference was noted for the level of anxiety as a state between the 1st and the 2nd measurement and for the level of anxiety as a trait between the 2nd and the 3rd measurement. However, there was no significant statistical difference between the 1st and the 2nd measurement.
Conclusion. The classic typology of relaxation techniques does not include massage. The research indicated, however, that classic relaxation massage is beneficial for the level of anxiety as a state and as a trait.
Massage is one of the oldest medical arts – the first references concerning massage come from Egyptian papyruses dated to 5000 B.C. A detailed description of massage appears in the Chinese book of Kung-Fu (3000 B.C.) and the Hindu book of wisdom, the Vedas (1800 B.C.). Massage, as a method of therapy, was considered by Greek doctors and thinkers: Hippocrates, Celsus and Galen. In ancient Greece, sportsmen taking part in the Olympic Games were massaged (1-4).
In the middle ages, due to the lack of interest in the bodily sphere of man, all medical arts known by the ancients declined. It was not until the 16th century that a French medical doctor and surgeon, Ambrose Parč, became interested in massage as a method of relieving pain. The creator of Swedish gymnastics, Per Henrik Ling (19th cent.), contributed most to the development of contemporary massage (classic) (1-4).
Currently, massage is undergoing a revival. It is used both in rehabilitation, and in biological regeneration and cosmetology. It is also an integral element of the offer of "spa and wellness” salons.
Classic massage is a very broad term. It stands for a wide range of methods and schools, sometimes very different from one another. It is also the basis, a model for other forms, such as: isometric massage, lymphatic massage, and segment massage. Relaxation massage is a specific type of classic massage, since, apart from the direct effect on the physical sphere, it also has an effect on the mental sphere (5). Currently, relaxation massages also include aromatherapy, energizing, synchronic and rhythmical massages (6).
Since there are few reports in the literature concerning classic relaxation massage, which, by assumption, has beneficial effects for the mental state of man, an attempt to evaluate its effects was made.
The aim of the research was to determine the relation between procedures of classic back massage and the level of anxiety as a trait, and anxiety as a state.
MATERIAL AND METHODS
The examined group included 16 people, who willingly applied to the programme, underwent all planned procedures and filled in the self-evaluation questionnaire three times. The group included 12 women and 4 men aged between 20 and 49. Examination participants are residents of Warsaw from various professional environments (students, intellectual workers, physical workers). Initially, the group numbered 20 people; however, 4 people did not finish the programme for various reasons.
Examination participants underwent ten procedures of classic relaxation massage. It is considered that this is a sufficient amount, after which one can notice desired effects. The entire series of procedures took 15 to 25 days. Breaks between individual massage sessions were not shorter than 24 hours and not longer than 72 hours. The duration of one procedure was approximately 20-30 minutes, depending on the size of the massaged body surface (3, 4, 6, 7).
The instrument was a Spielberger et al. self-evaluation questionnaire measuring the level of anxiety. The instrument consists of two parts. The first concerns anxiety as a state – currently, at the moment of examination. The examined person, defining their mood, may choose one of the following answers: "definitely not”, "rather not”, "rather yes”, "definitely yes”. The second part defines the level of anxiety as a feature (trait), which is a continuous predisposition. The examined people choose among the following answers: "almost never”, "sometimes”, "often”, and "almost always”. Both parts contain 20 questions, and, in each part, the scale of results ranges from 20 to 80 points (8, 9). The examined people filled in the questionnaire three times:
– before the first massage (measurement 1),
– directly after the first massage (measurement 2),
– directly after the last massage (measurement 3).
To perform the statistical analysis, Student's t-test was used, adopting the significance level of p<0.05 (10).
The massage was applied to the back, since, due to the large skin surface, it has the most general effect, and the nape of the neck, since excessive tension of muscles in these areas usually has a stress origin (11).
All massages were performed by one person, in the same room.
The effect of massage on the peripheral and central nervous system has been proven. Acting on the central nervous system results in sending impulses to the muscles, glands of external secretion and particular organs of the body. This may be a stimulating effect or relaxing effect, depending on the techniques used and their performance (4). According to the methodology of classic massage, those techniques were used which are recommended for achieving a state of relaxation, calmness and reduced muscle tension. Hence the techniques applied included: stroking aiming at warming up and stretching the skin, increasing secretive functions of sweat and sebaceous glands, reducing irritation of skin nerve endings and calming the central nervous system. The next technique was rubbing, aimed at causing plethora in the massaged areas, increasing muscle, tendon, and muscle-ligament stretch and eliminating callosities of various origins. Circular pressing was applied in order to regulate muscle tension (by means of mechanical action on deep sense receptors), accelerate blood and lymph circulation, and facilitate tissue exchange in muscles (nutrition and disposal of metabolism products). Weak, slow shaking was also applied to distribute lymph better in intercellular spaces, reduce muscle tension and reduce irritability of the central nervous system. All techniques were performed slowly, smoothly, with the greatest hand surface possible, avoiding spot pressures and sudden changes in force or intensiveness (2-4).
The results (averaged for the entire group) indicate that massage caused a significant reduction in the level of anxiety as a state after the first procedure. Statistically significant differences (p<0.001) in the level of anxiety as a state before the first massage (measurement 1) and after the first massage (measurement 2) were observed. The level of anxiety was also considerably different (p=0.003) before the first massage (measurement 1) and after the series of procedures (measurement 3). There was no statistically significant difference in the level of anxiety (as a state) after the first massage (measurement 2) and after the series of procedures (measurement 3) (fig. 1).
Fig. 1. Average points for STAI state anxiety in three surveys (before the first, after the first and after the last massage).
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