Massage Therapy Facilitates Weight Gain in Preterm Infants

Studies from several labs have documented a 31 to 47% greater weight gain in preterm newborns receiving massage therapy (three 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, 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.     

Moderate versus light pressure massage therapy leads to greater weight gain in preterm infants

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 15 min before and during the first 15-min therapy session. Weight gain was recorded over the 5-day therapy period. 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.     

Newborns of depressed mothers who received moderate versus light pressure massage during pregnancy

Sixty-four neonates (M age=6.8 days) of depressed mothers who received moderate pressure massage versus light pressure massage therapy during pregnancy (month 5 through month 8) were compared on their behaviors during 15-min observations and on their performance on the Brazelton Neonatal Behavior Assessment Scale. The group of neonates whose mothers received moderate pressure massage spent a greater percent of the observation time smiling and vocalizing, and they received better scores on the orientation, motor, excitability, and depression clusters of the Brazelton scale.     

Potential underlying mechanisms for greater weight gain in massaged preterm infants

In this paper, potential underlying mechanisms for massage therapy effects on preterm infant weight gain are reviewed. Path analyses are presented suggesting that: (1) increased vagal activity was associated with (2) increased gastric motility, which, in turn, was related to (3) greater weight gain; and (4) increased IGF-1 was related to greater weight gain. The change in vagal activity during the massage explained 49% of the variance in the change in gastric activity. And, the change in vagal activity during the massage explained 62% of the variance in the change in insulin. That the change in gastric activity was not related to the change in insulin suggests two parallel pathways via which massage therapy leads to increased weight gain: (1) insulin release via the celiac branch of the vagus; and (2) increased gastric activity via the gastric branch of the vagus.     

Effects of Hand Massage and Therapeutic Touch on Comfort and Anxiety Living in a Nursing Home in Turkey: A Randomized Controlled Trial

Journal of Religion and Health - This study was carried out to investigate the effects of hand massage and therapeutic touch on comfort and anxiety in the elderly living in nursing homes. The study...     

Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy

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. 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.     

The functions of the orbitofrontal cortex

The orbitofrontal cortex contains the secondary taste cortex, in which the reward value of taste is represented. It also contains the secondary and tertiary olfactory cortical areas, in which information about the identity and also about the reward value of odours is represented. The orbitofrontal cortex also receives information about the sight of objects from the temporal lobe cortical visual areas, and neurons in it learn and reverse the visual stimulus to which they respond when the association of the visual stimulus with a primary reinforcing stimulus (such as taste) is reversed. This is an example of stimulus-reinforcement association learning, and is a type of stimulus-stimulus association learning. More generally, the stimulus might be a visual or olfactory stimulus, and the primary (unlearned) positive or negative reinforcer a taste or touch. A somatosensory input is revealed by neurons that respond to the texture of food in the mouth, including a population that responds to the mouth feel of fat. In complementary neuroimaging studies in humans, it is being found that areas of the orbitofrontal cortex are activated by pleasant touch, by painful touch, by taste, by smell, and by more abstract reinforcers such as winning or losing money. Damage to the orbitofrontal cortex can impair the learning and reversal of stimulus-reinforcement associations, and thus the correction of behavioural responses when there are no longer appropriate because previous reinforcement contingencies change. The information which reaches the orbitofrontal cortex for these functions includes information about faces, and damage to the orbitofrontal cortex can impair face (and voice) expression identification. This evidence thus shows that the orbitofrontal cortex is involved in decoding and representing some primary reinforcers such as taste and touch; in learning and reversing associations of visual and other stimuli to these primary reinforcers; and in controlling and correcting reward-related and punishment-related behavior, and thus in emotion. The approach described here is aimed at providing a fundamental understanding of how the orbitofrontal cortex actually functions, and thus in how it is involved in motivational behavior such as feeding and drinking, in emotional behavior, and in social behavior.     

The effect of relational stage and intimacy on touch: An extension of Guerrero and Andersen

The effects of relational stage, intimacy, and gender on touch were examined. Participants were 270 partners from 135 couples involved in a heterosexual romantic relationship. Results indicated that touch varies as a function of relational stage. An examination of relational stage and subjects' perceptions of how much they touched their partner and how much their partner touched them generally indicated an asymptotic relationship. Specifically, men's and women's perceptions of how much they touched their partners, and women's perceptions of how much their partners touched them, increased from the casually dating to the seriously dating stage and then leveled off for seriously dating, engaged, and married couples. Men's perceptions of how much their partners touched them increased from the casually dating to the seriously dating stage then decreased from the seriously dating to the married stage. Relational intimacy was also curvilinearly related to self and partner perceptions of touch. Because there were no significant interaction effects between stage and gender, or intimacy and gender, the curvilinear effects of relational stage and intimacy on touch are generalizable to both men and women.     

Interpretations,Evaluations, and Consequences of Interpersonal Touch

Key elements of an expectancy violations (EV) framework are forwarded as a possible organizing framework for understanding how touch functions in interpersonal communication. Central to applying an EV framework to touch is assessing the expectedness, interpretations, and evaluations of touch and its influence on such communication outcomes as evaluations of communicator attractiveness and credibility. To address these considerations, an experiment required participants to engage in dyadic problem-solving discussions during which they were touched or not touched by high-valence (attractive, high status, expert) or low-valence (unattractive, low status, inexpert) confederates. Brief touches by high-valence communicators were less expected than from low-valence communicators but positively evaluated from both. Touch also carried many favorable relational message interpretations, and the combination of touch and high communicator valence generally produced the highest credibility and attraction ratings. Some gender effects emerged, which appeared to moderate touch effects. Results suggest that brief touches among strangers may have positive consequences, especially when initiated by high-valence communicators, for whom they may qualify as positive violations.     

Preterm newborn pain research review

This narrative review is based on a literature search of PubMed and PsycINFO for research on preterm newborn pain published during the last ten years. The high prevalence of painful procedures being performed with preterm newborns without analgesia (79%), with a median of 75 painful procedures being received during hospitalization and as many as 51 painful procedures per day highlights the importance of this problem. This review covers the pain assessments that have been developed, the short-term effects of the painful procedures, the longer-term developmental outcomes and the pharmacological and alternative therapies that have been researched. The most immediate effects reported for repeated painful procedures include increased heart rate, oxidative stress and cortisol as well as decreased vagal activity. Lower body weight and head circumference have been noted at 32 weeks gestation. Blunted cortisol reactivity to stressors has been reported for three-month-olds and thinner gray matter in 21 of 66 cerebral regions and motor and cognitive developmental delays have been noted as early as eight months. Longer-term outcomes have been reported at school age including less cortical thickness, lower vagal activity, delayed visual– perceptual development, lower IQs and internalizing behavior. Pharmacological interventions and their side effects and non-pharmacological therapies are also reviewed including sucrose, milk and nonnutritive sucking which have been effective but thought to negatively affect breast-feeding. Full-body interventions have included tucking, swaddling, kangaroo care and massage therapy. Although these have been effective for alleviating immediate pain during invasive procedures, research is lacking on the routine use of these therapies for reducing long-term pain effects. Further, additional randomized controlled replication studies are needed.     

触觉的情绪功能及其神经生理机制

触觉是个体探知外部世界的重要感觉通道,其情绪功能在维系社会联结、促进人际沟通等方面具有重要作用。触觉的情绪功能一方面表现为通过触觉动作本身直接传递情绪信息,另一方面则是通过增强注意和锐化社会评价的方式促进个体对跨通道情绪信息的加工。神经生理学研究发现,触觉情绪信息由无髓鞘C纤维介导,经脊髓丘脑束通路投射于岛叶(头面部触觉情绪信息的传导路径尚不明确),并在杏仁核、内侧前额叶、后颞上沟等"社会脑"网络的核心区域被精细加工。未来还应对触觉情绪的人际依赖性、文化独特性、操作标准化,及其在神经水平上与感觉-辨识系统间的关联性与独立性做深入探究。     

The effect of a short course of moderate pressure sunflower oil massage on the weight gain velocity and length of NICU stay in preterm infants

ObjectiveThe aim of this study was to evaluate the efficacy of five-day course of sunflower oil massage with moderate pressure on the weight gain and length of NICU stay in preterm infants.MethodsForty-four healthy preterm infants with a corrected gestational age of 30–36 weeks at the time of the study, were randomly assigned to the study group receiving body massage with sunflower oil and the control group receiving only routine NICU care. The massage was performed three times per day, each session including three consecutive five-minute stages, for five days. The primary outcome was to evaluate the efficacy of a short course of moderate pressure sunflower oil massage on the weight gain velocity. The secondary outcome was to compare the length of NICU stay between the two groups.ResultsDuring the study period, the increase in the average daily and fifth-day weight gain was significant in the intervention group. The length of NICU stay was shorter in the intervention group significantly.ConclusionOur findings suggest that even a short course of body massage with sunflower oil for only five days increases preterm infants’ weight gain and decreases their duration of NICU stay significantly.     

Some nontraditional (Unconventional and/or innovative) sychosocial treatments for children and adolescents: Critique and proposed screening principles

Five examples of nontraditional psychosocial treatments used for children/adolescents are reviewed: eye movement desensitization and reprocessing, electroencephalographic (EEG) biofeedback, deep pressure/touch therapies, stress-challenge treatments, and confrontational scare treatments. The generic recommendations from the September 1992 National Institutes of Health Conference on Unconventional Medical Treatments are summarized. Additional screening principles specific for psychosocial treatments are proposed and applied to the five treatments. The screens do not validate treatment efficacy or evaluate the quality of any previous research, but only facilitate decisions as to whether treatments deserve controlled investigation. Scientific evaluation of the nontraditional treatments reviewed could in general benefit from blinds (at least for assessment); control conditions matched for intensity, frequency, and duration (double blind where feasible); dose-response studies; testing of generalization and endurance supplements or boosters for quick, cheap treatments with time- or domain-limited effects; and comparing cost-effectiveness with established treatments. Two unscientific pitfalls must be avoided: embracing new treatments uncritically and rejecting them without fair examination. These pitfalls must be skirted without dissipating scarce research resources.The views and proposals in this article are those of the author, and do not in any way reflect any official National Institute of Mental Health (NIMH) position. Further, mention or review of any particular treatment does not constitute endorsement of that treatment by either NIMH or the author.     

Can dancers suppress the haptically mediated interpersonal entrainment during rhythmic sway?

Interpersonal entrainment emerges spontaneously when partners performing rhythmic movements together exchange sensory feedback about the other's movements. In this study, we asked whether couples of expert dancers, non-dancers and mixed couples can suppress the spontaneous haptically mediated inter-personal entrainment when their rhythmic sway is paced by differing metronome tempos. Fifty-four young participants formed three types of couples: nine dancer couples, consisting of individuals with at least eight years systematic practice in traditional Greek dance; nine non-dancer couples, consisting of individuals with no prior experience in dance and nine mixed couples, consisting of one dancer and one novice partner. Partners swayed rhythmically for 60 s, at different pacing frequencies (one at 0.25 Hz and the other at 0.35 Hz) under three haptic contact conditions: no contact between them; light fingertip touch established in the 2nd trial segment (30 s); and light fingertip touch released in the 2nd trial segment (30 s). Spectral analysis of the antero-posterior center of pressure displacement revealed that light touch increased the deviation of the dominant from the target (pacing) sway frequency, decreased the proportion of the signal's power at the target frequency and increased the coherence between the partners' sway signals (inter-personal coherence). These effects were specific to the mixed group whereas touch interference was weaker in non-dancers and absent in dancers. In addition, the coherence between the trial segments (intra-personal coherence) significantly decreased with touch only for the non-dancer while it remained unchanged for the dancer partner of the mixed group suggesting that the dancer was leading the non-dancer partner. It is concluded that systematic practice with traditional dance can modulate the spontaneous tendency towards haptically mediated interpersonal entrainment.     

Sustained attention to spontaneous thumb sensations activates brain somatosensory and other proprioceptive areas

The present experiment was designed to test if sustained attention directed to the spontaneous sensations of the right or left thumb in the absence of any external stimuli is able to activate corresponding somatosensory brain areas. After verifying in 34 healthy volunteers that external touch stimuli to either thumb effectively activate brain contralateral somatosensory areas, and after subtracting attention mechanisms employed in both touch and spontaneous-sensation conditions, fMRI evidence was obtained that the primary somatosensory cortex (specifically left BA 3a/3b) becomes active when an individual is required to attend to the spontaneous sensations of either thumb in the absence of external stimuli. In addition, the left superior parietal cortex, anterior cingulate gyrus, insula, motor and premotor cortex, left dorsolateral prefrontal cortex, Broca’s area, and occipital cortices were activated. Moreover, attention to spontaneous-sensations revealed an increased connectivity between BA 3a/3b, superior frontal gyrus (BA 9) and anterior cingulate cortex (BA 32), probably allowing top-down activations of primary somatosensory cortex. We conclude that specific primary somatosensory areas in conjunction with other left parieto-frontal areas are involved in processing proprioceptive and interoceptive bodily information that underlies own body-representations and that these networks and cognitive functions can be modulated by top-down attentional processes.     

Past and present experiences with maternal touch affect infants’ attention toward emotional faces

Maternal touch is considered crucial in regulating infants’ internal states when facing unknown or distressing situations. Here, we explored the effects of maternal touch on 7-month-old infants’ preferences towards emotions. Infants’ looking times were measured through a two-trial preferential looking paradigm, while infants observed dynamic videos of happy and angry facial expressions. During the observation, half of the infants received an affective touch (i.e., stroke), while the other half received a non-affective stimulation (i.e., fingertip squeeze) from their mother. Further, we assessed the frequency of maternal touch in the mother-infant dyad through The Parent-Infant Caregiving Touch Scale (PICTS). Our results have shown that infants’ attention to angry and happy facial expressions varied as a function of both present and past experiences with maternal touch. Specifically, in the affective touch condition, as the frequency of previous maternal affective tactile care increased (PICTS), the avoidance of angry faces decreased. Conversely, in the non-affective touch condition, as the frequency of previous maternal affective tactile care increased (PICTS), the avoidance of angry faces increased as well. Thus, past experience with maternal affective touch is a crucial predictor of the regulatory effects that actual maternal touch exerts on infants’ visual exploration of emotional stimuli.     

Is touch a valid therapeutic intervention? Early returns from a qualitative study of therapists' views

Findings are reported from six semi‐structured interviews with experienced psychotherapists, focusing on the reasons for using touch and the sort of touch used. They suggest that there is a distinction being made by therapists between ‘social space’ and ‘therapeutic space’, and a different view of touch taken if it is judged by the therapist to be ‘out of the therapeutic environment’. Whether or not touch was initiated by the therapist or the client would also appear to influence its further discussion by the therapist, either in processing it with the client or in supervision. What also emerged from the interviews was the finding that an exploration of touch in supervision was unusual. The implications for practice, supervision and training are discussed as areas for further exploration in the main survey, which will be conducted in the second year of the research.     

Interoceptive and exteroceptive attention have opposite effects on subsequent somatosensory perceptual decision making

Evidence suggests that interoceptive and exteroceptive attention might have different perceptual effects. However, the effects of these different types of body-focused attention have never been directly compared. The current research investigated how interoceptive and exteroceptive attention affect subsequent performance on the somatic signal detection task (SSDT). In Experiment 1, 37 participants completed the SSDT under usual testing conditions and after performing an interoceptive heartbeat perception task. This task led to a more liberal response criterion, leading to increased touch reports in the presence and absence of a target vibration. This finding is consistent with suggestions that attending internally contributes to physical symptom reporting in patients with medically unexplained symptoms (MUS). In Experiment 2, 40 participants completed the SSDT before and after an exteroceptive grating orientation task. This task led to a more stringent response criterion, leading to decreased touch reports in the presence and absence of the target, possibly via a reduction in sensory noise. This work demonstrates that internal and external body-focused attention can have opposite effects on subsequent somatic perceptual decision making and suggests that attentional training could be useful for patients reporting MUS.     

Differential effects of massage and heelstick procedures on transcutaneous oxygen tension in preterm neonates

The present study investigated the differential effects of heelsticks and tactile-kinesthetic massage on transcutaneous oxygen tension (TcPO₂) in preterm infants. The sample was comprised of 37 stabilized preterm neonates from the Neonatal Intensive Care Unit. During the heelstick procedure, TcPO₂ significantly declined an average of 14 mmHg. When compared to the tactile-kinesthetic massage, TcPO₂ levels during the heelstick (M = 39.8) were significantly lower than during the stimulation (M = 72.8). Mean TcPO₂ levels remained clinically safe during the four massage sessions evaluated. 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, the 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. These findings are evaluated in relation to the “minimal touch” policy, and implications for future handling of the stabilized preterm neonate are discussed.     

Interoceptive and exteroceptive attention have opposite effects on subsequent somatosensory perceptual decision making

Evidence suggests that interoceptive and exteroceptive attention might have different perceptual effects. However, the effects of these different types of body-focused attention have never been directly compared. The current research investigated how interoceptive and exteroceptive attention affect subsequent performance on the somatic signal detection task (SSDT). In Experiment 1, 37 participants completed the SSDT under usual testing conditions and after performing an interoceptive heartbeat perception task. This task led to a more liberal response criterion, leading to increased touch reports in the presence and absence of a target vibration. This finding is consistent with suggestions that attending internally contributes to physical symptom reporting in patients with medically unexplained symptoms (MUS). In Experiment 2, 40 participants completed the SSDT before and after an exteroceptive grating orientation task. This task led to a more stringent response criterion, leading to decreased touch reports in the presence and absence of the target, possibly via a reduction in sensory noise. This work demonstrates that internal and external body-focused attention can have opposite effects on subsequent somatic perceptual decision making and suggests that attentional training could be useful for patients reporting MUS.