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American Academy of Pediatrics
Article

A Randomized Placebo-Controlled Trial of Massage Therapy on the Immune System of Preterm Infants

Jocelyn Y. Ang, Jorge L. Lua, Ambika Mathur, Ronald Thomas, Basim I. Asmar, Sureyya Savasan, Steven Buck, Michael Long and Seetha Shankaran
Pediatrics December 2012, 130 (6) e1549-e1558; DOI: https://doi.org/10.1542/peds.2012-0196
Jocelyn Y. Ang
aDivisions of Infectious Diseases,
bDepartment of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
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Jorge L. Lua
bDepartment of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
cNeonatal and Perinatal Medicine, and
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Ambika Mathur
bDepartment of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
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Ronald Thomas
dChildren’s Research Center of Michigan, Detroit, Michigan;
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Basim I. Asmar
aDivisions of Infectious Diseases,
bDepartment of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
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Sureyya Savasan
bDepartment of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
eHematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan;
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Steven Buck
eHematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan;
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Michael Long
fDepartment of Pathology/Immunology Section, Wayne State University/Detroit Medical Center, Detroit, Michigan; and
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Seetha Shankaran
bDepartment of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
cNeonatal and Perinatal Medicine, and
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Abstract

OBJECTIVES: The aim of this study was to investigate the effects of massage therapy (MT) on the immune system of preterm infants. The primary hypothesis was that MT compared with sham therapy (control) will enhance the immune system of stable premature infants by increasing the proportion of their natural killer (NK) cell numbers.

METHODS: A randomized placebo-controlled trial of MT versus sham therapy (control) was conducted among stable premature infants in the NICU. Study intervention was provided 5 days per week until hospital discharge for a maximum of 4 weeks. Immunologic evaluations (absolute NK cells, T and B cells, T cell subsets, and NK cytotoxicity), weight, number of infections, and length of hospital stay were also evaluated.

RESULTS: The study enrolled 120 infants (58 massage; 62 control). At the end of the study, absolute NK cells were not different between the 2 groups; however, NK cytotoxicity was higher in the massage group, particularly among those who received ≥5 consecutive days of study intervention compared with control (13.79 vs 10 lytic units, respectively; P = .04). Infants in the massage group were heavier at end of study and had greater daily weight gain compared with those in the control group; other immunologic parameters, number of infections, and length of stay were not different between the 2 groups.

CONCLUSIONS: In this study, MT administered to stable preterm infants was associated with higher NK cytotoxicity and more daily weight gain. MT may improve the overall outcome of these infants. Larger studies are needed.

KEY WORDS
  • immune system
  • natural killer cells
  • massage
  • mode of delivery
  • preterm infants
  • weight gain
  • Abbreviations:
    AE —
    adverse event
    CI —
    confidence interval
    LU —
    lytic unit
    MOD —
    mode of delivery
    MT —
    massage therapy
    NK —
    natural killer
    PMA —
    postmenstrual age
    • Accepted July 26, 2012.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 130, Issue 6
    1 Dec 2012
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    A Randomized Placebo-Controlled Trial of Massage Therapy on the Immune System of Preterm Infants
    Jocelyn Y. Ang, Jorge L. Lua, Ambika Mathur, Ronald Thomas, Basim I. Asmar, Sureyya Savasan, Steven Buck, Michael Long, Seetha Shankaran
    Pediatrics Dec 2012, 130 (6) e1549-e1558; DOI: 10.1542/peds.2012-0196

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    A Randomized Placebo-Controlled Trial of Massage Therapy on the Immune System of Preterm Infants
    Jocelyn Y. Ang, Jorge L. Lua, Ambika Mathur, Ronald Thomas, Basim I. Asmar, Sureyya Savasan, Steven Buck, Michael Long, Seetha Shankaran
    Pediatrics Dec 2012, 130 (6) e1549-e1558; DOI: 10.1542/peds.2012-0196
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    • immune system
    • natural killer cells
    • massage
    • mode of delivery
    • preterm infants
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