The immediate effect of massage combined with reflexology on the autonomic nervous system and blood circulation assessment in stressed volunteers

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Pariyapat Singthong
Warinee Sangprapai
Khamonchat Khunwongsa
Waraporn Jaiboon
Supaluk Komsopa
Taratorn Aussawatworachot


Background: When the body is stressed for a long time, oxidative stress can cause stress as a part of the disease or symptoms. Treatments include both medication and non-medication methods can be used to reduce stress.

Objectives: This research aimed to study the immediate effects of massage combined with reflexology to the autonomic nervous system and blood circulation assessment in stressed volunteers.

Methods: This study was a quasi-experimental research study. The volunteers were placed in to three groups consisting of 30 volunteers per group. The groups were:  the massage group, the massage combined with reflexology group, and the resting group.The meter rate heart rate variability (HRV), the Wilcoxon Matched-Pairs Signed Ranks Test and Kruskal Wallis Test were used in this study.

Results: When the data were compared before and after the experiment, the mean heart rate (Mean HRT), the Physical Stress Index (PSI) and the stress index decreased significantly (p=.000 p=.007 p=.002) in the massage group., The standard deviation of normal to normal beats (SDNN), the autonomic nervous system (ANS Activity), and the stress resistance significantly increased (p=.035, p=.026, and p=.039, respectively). The massage combined with the reflexology group showed that blood circulation assessment flow was significantly improved (p=.001).

Conclusions: Therefore, messages affect the autonomic nervous system causing stress to be reduced. Massages combined with reflexology signals can improve vascular blood circulation assessment flow.


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Singthong, P. . ., Sangprapai, W. . ., Khunwongsa, K. . ., Jaiboon, W., Komsopa, S. ., & Aussawatworachot, T. . (2021). The immediate effect of massage combined with reflexology on the autonomic nervous system and blood circulation assessment in stressed volunteers. HEALTH SCIENCE RESEARCH JOURNAL, 15(1), 70–80. Retrieved from
นิพนธ์ต้นฉบับ (Original Articles)


Terrill AL, Gjerde JM, Garofalo JP. Background Stress Inventory: Developing a Measure of Understudied Stress. Stress Health. 2015;31(4):290-8. doi: 10.1002/s mi.2554.

Phonthepkasemsan R. Human anatomy and physiology. 6th ed. Bangkok: Sinpa ban na khan publications; 2013. (in Thai).

Vandiver R. Effect of residual stress on peak cap stress in arteries. Math Biosci Eng. 2014;11(5):1199-214. doi: 10.3934/ mbe.2014.11.1199.

Ghezzi P, Jaquet V, Marcucci F, Schmidt HHHW. The oxidative stress theory of disease: levels of evidence and epistemological aspects. Br J Pharmacol. 2017;174(12):1784-96. doi: 10.1111/bph. 13544.

Kaneko M, Imaizumi K, Saito A, Kanemoto S, Asada R, Matsuhisa K, et al. ER Stress and Disease: Toward Prevention and Treatment. Biol Pharm Bull. 2017;40(9):1337-43. doi: 10.1248/bp b.b17-00342.

Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;21(16):1057-72. doi: 10.17179/excli 2017-480

Kessler RC. The effects of stressful life events on depression. Annu Rev Psychol. 1997;48:191-214. doi: 10.1146/annurev.p sych.48.1.191.

Park S, Lee Y, Lee JH. Association between energy drink intake, sleep, stress, and suicidality in Korean adolescents: energy drink use in isolation or in combination with junk food consumption. Nutr J. 2016;15(1):1-8. doi: 10.1186/s12937-016-0204-7.

Stewart SH, Westra HA. Benzodiazepine side-effects: from the bench to the clinic. Curr Pharm Des. 2002;8(1):1-3. doi: 10.217 4/1381612023396708.

Achananuphap S. Textbook treatment of common diseases 2. Pimpee Bangkok: 2008. (in Thai).

Sripongngam T, Eungpinichpong W, Sirivongs D, Kanpittaya J, Tangvoraphonkchai K, Chanaboon S. Immediate Effects of Traditional Thai Massage on Psychological Stress as Indicated by Salivary Alpha-Amylase Levels in Healthy Persons. Med Sci Monit Basic Res. 2015;21:216-21. doi: 10.12 659/MSMBR.894343.

Sripongngam T, Eungpinichpong W, Sirivongs D, Kanpittaya J, Tangvoraphonkchai K, Chanaboon S. Psychological Stress Can Be Decreased by Traditional Thai Massage. Journal of the Medical Association of Thailand. 2015;98(6):29-35. (in Thai).

Buttagat V, Eungpinichpong W, Chatchawan U, Kharmwan S. The immediate effects of traditional Thai massage on heart rate variability and stress-related parameters in patients with back pain associated with myofascial trigger points. J Bodyw Mov Ther. 2011;15:15-23. doi: 10.1016/j.jbmt.2009.06.005.

Kunikata H, Watanabe K, Miyoshi M, Tanioka T. The effects measurement of hand massage by the autonomic activity and psychological indicators. J Med Invest. 2012;59(1-2):206-12. doi: 10.21 52/jmi.59.206.

Jayathavaj V. Effect Size and Power of a Test in Sample Size Determination for Clinical Research. Journal of Traditional Thai Medical Research. 2018.4(1):67-75. (in Thai).

Thai Traditional Medical Rehabilitation Foundation Ayurveda school. Traditional Thai Medicine (Royal massage). Bangkok: Usa publications; 2012. (in Thai).

Rajendra Acharya U, Paul Joseph K, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Med Biol Eng Comput. 2006;44(12):1031-51. doi: 10.1007/s115 17-006-0119-0.

Cygankiewicz I, Zareba W. Heart rate variability. Handb Clin Neurol. 2013;117:379-93.

doi: 10.1016/B978-0-444-53491-0.00031-6.

Fied T, Massage Therapy Research Review. 2014;20(4):224-229. doi: 10.1016/ j.ctcp.2014.07.002.

Diego MA, Field T, Sanders C, Hernandez-Reif M. Massage therapy of moderate and light pressure and vibrator effects on EEG and heart rate. Int J Neurosci. 2004;114(1):31-44. doi: 10.1080/00207450490249446.

Field T, Morrow C, Valdeon C, Larson S, Kuhn C, Schanberg S. Massage reduces anxiety in child and adolescent psychiatric patients. J Am Acad Child Adolesc Psychiatry. 1992;31(1):125-31. doi: 10.1097/00004583-199201000-00019.

Eungpinichpong W. Therapeutic thai massage. Bankok: Suweeriyasarn Printing Press; 2008. (in Thai).

Elgendi M, Jonkman M, DeBoer F. Heart Rate Variability and the Acceleration Plethysmogram signals measured at rest. BIOSTEC. 2010; 127: 266-277. doi: 10.1007/978-3-642-18472-7_21.

Ayurveda School Applied Thai Traditional Medicine Faculty of Medicine Siriraj Hospital Mahidol University. Traditional Thai Medicine (Royal massage) Part 2: Signal massage. Bangkok: Supphawanit publications; 2014. (in Thai).

Toda N. Age-related changes in endothelial function and blood flow regulation.Pharmacol Ther. 2012;133(2):159-76. doi: 10.1016/j.pharmthera.2011.10.0004.