Comparison of Acute Effects of Classical Massage and Connective Tissue Massage on Lower Extremity Blood Flow Changes
Yıl 2025,
Cilt: 9 Sayı: 1, 1 - 9, 30.06.2025
İsmail Palalı
,
Özlem Altındağ
Öz
This study aimed to compare the immediate effects of connective tissue massage and classical massage on lower extremity blood circulation in healthy adults, and to better understand the mechanism of connective tissue massage. Twenty healthy participants underwent a 40-minute classical massage on the left lower limb. One week later, the same individuals received a connective tissue massage. Using color Doppler ultrasound, the diameter, flow velocity, and blood volume of the popliteal and posterior tibial arteries were measured before and after each session. Both massage methods led to significant increases in blood flow velocity, vessel diameter, and blood volume (p<0.05). However, connective tissue massage was more effective than classical massage in increasing the flow velocity and volume in the popliteal artery, as well as the diameter and volume in the posterior tibial artery (p<0.05). There was no significant difference between the two techniques regarding the diameter of the popliteal artery and the flow velocity of the posterior tibial artery (p>0.05). Overall, while both methods improved circulation, connective tissue massage produced greater improvements in peripheral blood volume, suggesting it may be more beneficial when enhanced vascular response is desired.
Etik Beyan
Approval for the study was obtained from the Clinical Trials Ethics Committee of Erenköy Mental Health and Neurology Training and Research Hospital with decision no. 27 dated 06.11.2017.
Destekleyen Kurum
No contribution and/or support was received during the writing process of this study.
Kaynakça
-
Akbaş, E., Ünver, B., & Erdem, E. U. (2019). Acute effects of connective tissue manipulation on autonomic function in healthy young women. Complementary Medicine Research, 26(4), 250–257.
-
Bakar, Y., Sertel, M., Oztürk, A., Yümin, E. T., Tatarli, N., & Ankarali, H. (2014). Short-term effects of classic massage compared to connective tissue massage on pressure pain threshold and muscle relaxation response in women with chronic neck pain: A preliminary study. Journal of Manipulative and Physiological Therapeutics, 37(6), 415–421.
-
Baratchi, S., Khoshmanesh, K., Woodman, O. L., Potocnik, S., Peter, K., & McIntyre, P. (2017). Molecular sensors of blood flow in endothelial cells. Trends in Molecular Medicine, 23(9), 850–868.
-
Bartsch, K., & Schleip, R. J. (2021). Connective tissue manipulation. In Fascia: The Tensional Network of the Human Body (pp. 454–461).
-
Clar, C., Tsertsvadze, A., Court, R., Hundt, G. L., Clarke, A., & Sutcliffe, P. (2014). Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: Systematic review and update of UK evidence report. Chiropractic & Manual Therapies, 22(1), 12.
-
Er, G., & Yüksel, İ. (2023). A comparison of the effects of connective tissue massage and classical massage on chronic mechanical low back pain. Medicine, 102(15), e33516.
-
Espí-López, G. V., Serra-Añó, P., Cuenca-Martínez, F., Suso-Martí, L., & Inglés, M. (2020). Comparison between classic and light touch massage on psychological and physical functional variables in athletes: A randomized pilot trial. International Journal of Therapeutic Massage & Bodywork, 13(3), 30–37.
-
Franklin, N. C., Ali, M. M., Robinson, A. T., Norkeviciute, E., & Phillips, S. A. (2014). Massage therapy restores peripheral vascular function after exertion. Archives of Physical Medicine and Rehabilitation, 95(6), 1127–1134.
-
Goats, G. C. (1994). Massage—the scientific basis of an ancient art: Part 2. Physiological and therapeutic effects. British Journal of Sports Medicine, 28(3), 153–156.
-
Hinds, T., McEwan, I., Perkes, J., Dawson, E., Ball, D., & George, K. (2004). Effects of massage on limb and skin blood flow after quadriceps exercise. Medicine & Science in Sports & Exercise, 36(8), 1308–1313.
-
Holey, E., & Dixon, J. (2018). Connective tissue manipulation and skin rolling. In Chaitow, L. (Ed.), Fascial Dysfunction: Manual Therapy Approaches (2nd ed.). Edinburgh: Handspring Publishing.
-
Holey, L. A., & Dixon, J. (2014). Connective tissue manipulation: A review of theory and clinical evidence. Journal of Bodywork and Movement Therapies, 18(1), 112–118.
-
Holey, L. A., Dixon, J., & Selfe, J. (2011). An exploratory thermographic investigation of the effects of connective tissue massage on autonomic function. Journal of Manipulative and Physiological Therapeutics, 34(7), 457–462.
-
Hwang, J. Y. (2017). Doppler ultrasonography of the lower extremity arteries: Anatomy and scanning guidelines. Ultrasonography, 36(2), 111–119.
-
Ichimura, M., Sasaki, S., Mori, M., & Ogino, T. (2015). Tapping but not massage enhances vasodilation and improves venous palpation of cutaneous veins. Acta Medica Okayama, 69(2), 79–85.
-
Karemaker, J. M. (2017). An introduction into autonomic nervous function. Physiological Measurement, 38(5), R89–R118.
-
Kontos, A., Lushington, K., Martin, J., Schwarz, Q., Green, R., Wabnitz, D., et al. (2017). Relationship between vascular resistance and sympathetic nerve fiber density in arterial vessels in children with sleep disordered breathing. Physiological Reports, 6(7), e006137.
-
Korthuis, R. J. (2011). Skeletal Muscle Circulation. Morgan & Claypool Life Sciences.
-
Nelson, N. L. (2015). Massage therapy: Understanding the mechanisms of action on blood pressure. A scoping review. Journal of the American Society of Hypertension, 9(10), 785–793.
-
Portillo-Soto, A., Eberman, L. E., Demchak, T. J., & Peebles, C. (2014). Comparison of blood flow changes with soft tissue mobilization and massage therapy. Journal of Alternative and Complementary Medicine, 20(12), 932–936.
-
Rodrigues, L. M., Rocha, C., Ferreira, H. T., & Silva, H. N. (2020). Lower limb massage in humans increases local perfusion and impacts systemic hemodynamics. Clinical Hemorheology and Microcirculation, 128(5), 1217–1226.
-
Roura, S., Álvarez, G., Solà, I., & Cerritelli, F. (2021). Do manual therapies have a specific autonomic effect? An overview of systematic reviews. PLoS One, 16(12), e0260642.
-
Sato-Suzuki, I., Kagitani, F., & Uchida, S. (2019). Somatosensory regulation of resting muscle blood flow and physical therapy. Autonomic neuroscience : Basic & Clinical, 220, 102557.
-
Shoemaker, J. K., Tiidus, P. M., & Mader, R. (1997). Failure of manual massage to alter limb blood flow: Measured by Doppler ultrasound. Medicine & Science in Sports & Exercise, 29(5), 610–614.
-
Supa’at, I., Zakaria, Z., Maskon, O., Aminuddin, A., & Nordin, N. A. (2013). Effects of Swedish massage therapy on blood pressure, heart rate, and inflammatory markers in hypertensive women. Evidence-Based Complementary and Alternative Medicine, 2013, 171852.
-
Taspinar, F., Aslan, U. B., Sabir, N., & Cavlak, U. (2013). Implementation of matrix rhythm therapy and conventional massage in young females and comparison of their acute effects on circulation. Journal of Alternative and Complementary Medicine, 19(10), 826–832.
-
Tiidus, P. M., & Shoemaker, J. K. (1995). Effleurage massage, muscle blood flow and long-term post-exercise strength recovery. International Journal of Sports Medicine, 16(7), 478–483.
-
Toprak Celenay, Ş., Coban, O., Mete, O., & Karahan, N. (2023). An investigation of the effects of connective tissue massage in women with migraine: A controlled clinical trial. Journal of Bodywork and Movement Therapies, 33, 112–119.
-
Walaszek, R. (2015). Impact of classic massage on blood pressure in patients with clinically diagnosed hypertension. Journal of Traditional Chinese Medicine, 35(4), 396–401.
-
Yamamoto, K., Imamura, H., & Ando, J. (2018). Shear stress augments mitochondrial ATP generation that triggers ATP release and Ca²⁺ signaling in vascular endothelial cells. American Journal of Physiology-Heart and Circulatory Physiology, 315(5), H1477–H1485.
-
Yuan, S. L., Matsutani, L. A., & Marques, A. P. (2015). Effectiveness of different styles of massage therapy in fibromyalgia: A systematic review and meta-analysis. Manual Therapy, 20(2), 257–264.
-
Yüksel, İ., Akbayrak, T., & B., S. (2013). Konnektif doku masajı. In Yüksel, İ. (Ed.), Masaj Teknikleri (3. Baskı, ss. 82–353). Ankara: Asil Yayın Dağıtım Ltd. Şti.
Klasik Masaj ve Konnektif Doku Masajı Uygulamalarının Alt Ekstremite Kan Akış Değişiklikleri Üzerine Olan Akut Etkilerinin Karşılaştırılması
Yıl 2025,
Cilt: 9 Sayı: 1, 1 - 9, 30.06.2025
İsmail Palalı
,
Özlem Altındağ
Öz
Bu çalışma, sağlıklı yetişkinlerde konnektif doku masajı ile klasik masajın alt ekstremite kan dolaşımı üzerindeki anlık etkilerini karşılaştırmayı ve konnektif doku masajının etki mekanizmasını daha iyi anlamayı amaçlamıştır. Yirmi sağlıklı katılımcıya sol alt ekstremiteye 40 dakikalık klasik masaj uygulanmıştır. Bir hafta sonra aynı bireylere konnektif doku masajı yapılmıştır. Popliteal ve posterior tibial arterlerin çapı, kan akış hızı ve kan hacmi her uygulamadan önce ve sonra olmak üzere renkli Doppler ultrason ile ölçülmüştür. Her iki masaj yöntemi de kan akış hızı, damar çapı ve kan hacminde anlamlı artış sağlamıştır (p<0,05). Ancak, konnektif doku masajı popliteal arterdeki akış hızı ve hacim ile posterior tibial arterdeki çap ve hacmi klasik masaja göre daha fazla artırmıştır (p<0,05). Popliteal arter çapı ile posterior tibial arter akış hızı açısından iki yöntem arasında anlamlı bir fark bulunmamıştır (p>0,05). Genel olarak her iki masaj yöntemi de dolaşımı artırsa da, konnektif doku masajı periferik kan hacmini artırmada daha etkilidir. Bu bulgular, terapötik hedeflere göre uygun masaj tekniğinin seçilmesinde klinisyenlere yol gösterebilir.
Etik Beyan
Çalışma için Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu'ndan 06.11.2017 tarih ve 27 sayılı karar ile onay alınmıştır.
Kaynakça
-
Akbaş, E., Ünver, B., & Erdem, E. U. (2019). Acute effects of connective tissue manipulation on autonomic function in healthy young women. Complementary Medicine Research, 26(4), 250–257.
-
Bakar, Y., Sertel, M., Oztürk, A., Yümin, E. T., Tatarli, N., & Ankarali, H. (2014). Short-term effects of classic massage compared to connective tissue massage on pressure pain threshold and muscle relaxation response in women with chronic neck pain: A preliminary study. Journal of Manipulative and Physiological Therapeutics, 37(6), 415–421.
-
Baratchi, S., Khoshmanesh, K., Woodman, O. L., Potocnik, S., Peter, K., & McIntyre, P. (2017). Molecular sensors of blood flow in endothelial cells. Trends in Molecular Medicine, 23(9), 850–868.
-
Bartsch, K., & Schleip, R. J. (2021). Connective tissue manipulation. In Fascia: The Tensional Network of the Human Body (pp. 454–461).
-
Clar, C., Tsertsvadze, A., Court, R., Hundt, G. L., Clarke, A., & Sutcliffe, P. (2014). Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: Systematic review and update of UK evidence report. Chiropractic & Manual Therapies, 22(1), 12.
-
Er, G., & Yüksel, İ. (2023). A comparison of the effects of connective tissue massage and classical massage on chronic mechanical low back pain. Medicine, 102(15), e33516.
-
Espí-López, G. V., Serra-Añó, P., Cuenca-Martínez, F., Suso-Martí, L., & Inglés, M. (2020). Comparison between classic and light touch massage on psychological and physical functional variables in athletes: A randomized pilot trial. International Journal of Therapeutic Massage & Bodywork, 13(3), 30–37.
-
Franklin, N. C., Ali, M. M., Robinson, A. T., Norkeviciute, E., & Phillips, S. A. (2014). Massage therapy restores peripheral vascular function after exertion. Archives of Physical Medicine and Rehabilitation, 95(6), 1127–1134.
-
Goats, G. C. (1994). Massage—the scientific basis of an ancient art: Part 2. Physiological and therapeutic effects. British Journal of Sports Medicine, 28(3), 153–156.
-
Hinds, T., McEwan, I., Perkes, J., Dawson, E., Ball, D., & George, K. (2004). Effects of massage on limb and skin blood flow after quadriceps exercise. Medicine & Science in Sports & Exercise, 36(8), 1308–1313.
-
Holey, E., & Dixon, J. (2018). Connective tissue manipulation and skin rolling. In Chaitow, L. (Ed.), Fascial Dysfunction: Manual Therapy Approaches (2nd ed.). Edinburgh: Handspring Publishing.
-
Holey, L. A., & Dixon, J. (2014). Connective tissue manipulation: A review of theory and clinical evidence. Journal of Bodywork and Movement Therapies, 18(1), 112–118.
-
Holey, L. A., Dixon, J., & Selfe, J. (2011). An exploratory thermographic investigation of the effects of connective tissue massage on autonomic function. Journal of Manipulative and Physiological Therapeutics, 34(7), 457–462.
-
Hwang, J. Y. (2017). Doppler ultrasonography of the lower extremity arteries: Anatomy and scanning guidelines. Ultrasonography, 36(2), 111–119.
-
Ichimura, M., Sasaki, S., Mori, M., & Ogino, T. (2015). Tapping but not massage enhances vasodilation and improves venous palpation of cutaneous veins. Acta Medica Okayama, 69(2), 79–85.
-
Karemaker, J. M. (2017). An introduction into autonomic nervous function. Physiological Measurement, 38(5), R89–R118.
-
Kontos, A., Lushington, K., Martin, J., Schwarz, Q., Green, R., Wabnitz, D., et al. (2017). Relationship between vascular resistance and sympathetic nerve fiber density in arterial vessels in children with sleep disordered breathing. Physiological Reports, 6(7), e006137.
-
Korthuis, R. J. (2011). Skeletal Muscle Circulation. Morgan & Claypool Life Sciences.
-
Nelson, N. L. (2015). Massage therapy: Understanding the mechanisms of action on blood pressure. A scoping review. Journal of the American Society of Hypertension, 9(10), 785–793.
-
Portillo-Soto, A., Eberman, L. E., Demchak, T. J., & Peebles, C. (2014). Comparison of blood flow changes with soft tissue mobilization and massage therapy. Journal of Alternative and Complementary Medicine, 20(12), 932–936.
-
Rodrigues, L. M., Rocha, C., Ferreira, H. T., & Silva, H. N. (2020). Lower limb massage in humans increases local perfusion and impacts systemic hemodynamics. Clinical Hemorheology and Microcirculation, 128(5), 1217–1226.
-
Roura, S., Álvarez, G., Solà, I., & Cerritelli, F. (2021). Do manual therapies have a specific autonomic effect? An overview of systematic reviews. PLoS One, 16(12), e0260642.
-
Sato-Suzuki, I., Kagitani, F., & Uchida, S. (2019). Somatosensory regulation of resting muscle blood flow and physical therapy. Autonomic neuroscience : Basic & Clinical, 220, 102557.
-
Shoemaker, J. K., Tiidus, P. M., & Mader, R. (1997). Failure of manual massage to alter limb blood flow: Measured by Doppler ultrasound. Medicine & Science in Sports & Exercise, 29(5), 610–614.
-
Supa’at, I., Zakaria, Z., Maskon, O., Aminuddin, A., & Nordin, N. A. (2013). Effects of Swedish massage therapy on blood pressure, heart rate, and inflammatory markers in hypertensive women. Evidence-Based Complementary and Alternative Medicine, 2013, 171852.
-
Taspinar, F., Aslan, U. B., Sabir, N., & Cavlak, U. (2013). Implementation of matrix rhythm therapy and conventional massage in young females and comparison of their acute effects on circulation. Journal of Alternative and Complementary Medicine, 19(10), 826–832.
-
Tiidus, P. M., & Shoemaker, J. K. (1995). Effleurage massage, muscle blood flow and long-term post-exercise strength recovery. International Journal of Sports Medicine, 16(7), 478–483.
-
Toprak Celenay, Ş., Coban, O., Mete, O., & Karahan, N. (2023). An investigation of the effects of connective tissue massage in women with migraine: A controlled clinical trial. Journal of Bodywork and Movement Therapies, 33, 112–119.
-
Walaszek, R. (2015). Impact of classic massage on blood pressure in patients with clinically diagnosed hypertension. Journal of Traditional Chinese Medicine, 35(4), 396–401.
-
Yamamoto, K., Imamura, H., & Ando, J. (2018). Shear stress augments mitochondrial ATP generation that triggers ATP release and Ca²⁺ signaling in vascular endothelial cells. American Journal of Physiology-Heart and Circulatory Physiology, 315(5), H1477–H1485.
-
Yuan, S. L., Matsutani, L. A., & Marques, A. P. (2015). Effectiveness of different styles of massage therapy in fibromyalgia: A systematic review and meta-analysis. Manual Therapy, 20(2), 257–264.
-
Yüksel, İ., Akbayrak, T., & B., S. (2013). Konnektif doku masajı. In Yüksel, İ. (Ed.), Masaj Teknikleri (3. Baskı, ss. 82–353). Ankara: Asil Yayın Dağıtım Ltd. Şti.