Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder

Adolescence, Winter, 2003 by Sonya Khilnani, Tiffany Field, Maria Hernandez-Reif, Saul Schanberg

The participants were between the ages of 7 and 18 years (M = 13 years). Eighty percent were male and 20% were female. They came from middle socioeconomic backgrounds (M = 2.5 on the Hollingshead Two Factor Index), and the ethnic distribution was 77% Caucasian, 13% Hispanic, and 10% African-American.

Procedure

Massage therapy. The students were randomly assigned to a massage therapy group or wait-list control group. The massages were held in a large, quiet room located in the school building. Each student in the massage therapy group received two 20-minute massages per week for a total of nine treatment sessions. Massages were conducted on portable massage tables, and all participants remained fully clothed during each massage. Students were told that the massages might help them relax. The massage entailed moderate-pressure stroking for four-minute periods in each of five regions: head/neck, arms, torso, legs, and back. Massage while in the supine position lasted ten minutes and included lateral stroking of the forehead, gentle rocking (torso and legs), and continuous stretching of the Achilles tendon. Massage while in the prone position also lasted ton minutes and included lateral lumbar stretches, neck squeezes, and kneading of the back.

The massages were given at the same time of day (mid-afternoon) over the course of a month. Treatments were performed by licensed massage therapists and coordinated by the first author. The gender of the massage therapists was counterbalanced. Last day assessments were conducted after the eighth (penultimate) massage session instead of the ninth in order to minimize potential termination effects such as feeling disappointed that the massages were over.

Wait-list control group. Participants in this group were informed that they would have an opportunity to experience the massage procedure on a voluntary basis during the following month and that the reason all students were not massaged at the same time was due to the limited number of available massage therapists. Like the massage therapy group, the wait-list control group completed the identical short-term and longer-term measures during the same time frame. However, the wait-list control group did not receive any massages for the first month of the study. For the assessment sessions, they were asked simply to relax for the 20-minute period.

Short-Term Measures

Pre-post measures were administered at the first session and read-ministered four weeks later, at the eighth (penultimate) session, for the massage group. These measures were also administered at the first and second assessment sessions for the control group. The intent was to assess the immediate effects of the treatment.

Stress. Salivary samples were obtained (participants placed a dental swab dipped in sugar-free lemonade crystals along their gumline for 30 seconds) immediately before and 20 minutes after the sessions (on the assessment days) to be assayed for cortisol (a hormone indicative of stress level). They were collected 20 minutes postsession because the cortisol response has a 20-minute lag time. The second sample of saliva reflected the participants' stress level during the massage therapy/control session.