Massage Therapy for People with Disabilities across the Lifespan

written by Kyra Catabay, undergraduate, University of Florida

Massage therapy has been used for the treatment of muscle soreness and tightness. It can be used to alleviate inflammation, increase circulation, and induce muscle relaxation (1). Athletes and stressed individuals are not the only people that may benefit from the therapeutic effects of massage. Massage has shown positive effects in people with disabilities, improving organic, intellectual, social, and emotional aspects of their lives. Massage therapy, when paired with exercise therapy, may have positive implications for future management of certain disabilities.

People with spinal cord injuries (SCI) may exhibit feelings of depression, helplessness, and hopelessness, which in turn can lead to difficulty sleeping and a lack of appetite (2). In one study, patients with complete spinal cord injuries on C5-C7 went through either physical therapy or exercise therapy (2). Compared to the exercise therapy group, massage showed that patients were less depressed and had greater improvements in muscle strength including fine wrist movements like wrist extension and flexion (2). Since people with injury to the C5-C7 vertebra cannot walk, the ability to push up from the wheelchair can relieve pressure sores (3). Pressure releases will decreases the likelihood of the formation of pressure sores, which may lead to infection (3).

Patients with incomplete spinal cord injuries (SCI) may have the ability to walk. However, they may exhibit awkward gait patterns (4). With massage, these patients achieved a more normal gait and easier movement, as they were able to move quicker and with increased stride length (4). Reduction of tightness in some muscle groups allowed antagonist muscle groups to work better (4). For example, massaging the iliopsoas allowed greater hip extension and activated the gluteus maximus (4). Implementation of exercise therapy, along with massage therapy, should be considered when working with patients with spinal cord injury. Patients may be able to obtain far more physical independence. This increased physical independence can decrease stress felt by both patients and family members.

Massage therapy can also benefit people with other neurological disorders or neurodegenerative disorders. Patients with Parkinson’s disease have many health-related problems that restrict their quality of life. They may experience difficulty walking, stiffness in extremities, muscle pain, fatigue, and hypophonia (5). Hypophonia effects the vocal musculature and may cause difficulty speaking (5). The patients in one study received a thirty-minute massage from an experienced licensed massage therapist (5). Many of their symptoms improved. Patients that complained of stiff shoulders were able to gain full range of motion (5).

The stimulation of neck muscles is associated with improved gait (5). Before a massage, one patient took 95.0 seconds to walk 10 meters, turn, and walk back (5). After the massage, which included stimulation of the neck muscles, they were able to complete the same path in 21.5 seconds (5). Hypophonia symptoms improved as well, allowing easier communication (5). Multiple studies have shown that massage can lead to better quality of life. Patients had an easier time sleeping and less stress hormones were found circulating in their bodies (5). The ability to walk with less aid, or without aid at all, gave patients and family more freedom. Families will not have to worry as much, while the patient does not have to feel like they are a burden.

Cerebral palsy is brain damage at or around the time of birth (2). The disorder affects movement and coordination and can lead to ataxia, athetosis, and spasticity (2). Treatment includes involving children with cerebral palsy in various activities to get them active in an effort to reduce muscle contraction (2). Applying pressure and force on muscles is associated with increased neuromuscular function and may greatly benefit quality of life for children with cerebral palsy.

One program sought to teach parents the basics of administering massage on their child (6). Children experienced reduced spasticity, gained flexibility, better muscle tone, and improved social interactions (1,6,7). Following a massage, the children had deeper, undisturbed sleep. Children with cerebral palsy were not the only ones to benefit from the massage. Parents actually expressed feeling less stressed and less depressed (6).

Past research has found that the family of a child with a disability may feel the burden of that disability (6). Through massage, parents are given a bigger role in the treatment of the complications due to cerebral palsy, and may feel more involved in their child's care (6). One child did not like his father to touch him. After the program, the child allowed his father to touch and massage him. The gained trust and respect between father and child allowed the father to become more involved in the child's physical care (6). Therefore, better relationships and closeness can result from parent-administered massage. The children were interacting better, smiling more, and making eye contact (6). The emotional well-being of parents improved along with the health of their child (6).

The parent-child relationship also improved in children with autism (8). In many cases, children with autism may avoid physical contact and may show an aversion to being touched (7). The predictable movements involved in massage are more acceptable to children with autism than the unpredictable movements of touch in social settings (8). Since many children with autism do not like being spontaneously touched, parents, unable to comfort and touch their child, felt helpless after their child had gone through a distressing event (8).

One parent recalled how difficult it was to watch her child cry out and have tantrums at a very young age while she was unable to comfort and soothe him (8). After massages, parents felt closer to their child, emotionally and physically. They were able to hold them and sit close to them (8). Their child cuddled more frequently with them than in the past (8). Many children, verbal and nonverbal, requested massages in their own unique way, implying that they enjoyed the activity (8). Touch became a vital form of communication, strengthening the bond between parent and child.

Massage is also associated with increased attention in children with autism, attention deficit disorders, or learning disabilities (1,9,10). Hyperactivity is associated with faulty inhibitory activity in the parasympathetic control of the heart (1,10). People with attention disorders have lower vagal tone, leading to heart rate variability. Vagus nerve stimulation is shown to decrease heart rate and blood pressure, which induces increased attentiveness (1,10).

In one study, a group of students with attention deficit disorder were given two massages per week for a month (10). Teachers noted that their students were more attentive and on task following the massage (10). Students felt that they were happier and less stressed (10). Salivary cortisol tests, taken before and after each massage session, found that there was a decrease in the stress hormone after massages. Cognitive function even improved in young children.

Compared to a control group, preschoolers given a massage prior to an IQ test performed better, particularly on the block and peg tests (1). In a recorded lecture by Richard Lavoie, Lavoie stressed that children with learning disabilities are highly distractible, meaning they pay attention to everything (3). Being able to control the heart rate of a child through massage may help them focus on fewer things, potentially leading to improved performance in school.

The implementation of massage therapy programs should be considered in the management of physical and intellectual disabilities. As demonstrated by intervention programs on people with spinal cord injury or Parkinson’s disease, patients experienced increased muscle strength and range of motion. When compared to exercise therapy, patients with spinal cord injury benefitted more from massage therapy, physically and emotionally, expressing greater feelings of happiness and relaxation (2). The implications of applying both exercise therapy and massage therapy to people with physical disabilities should be further explored as they have proved to be effective management methods when pursued individually.

Socially, massage therapy has led to improved relationships among parents and their child with a disability, notably cerebral palsy and autism. For children who cannot communicate, or have difficulty communicating with other people including their parents, being able to communicate through touch has allowed them and their families to surmount a huge barrier. Basic massage therapy should be taught to parents and family members who are willing. An entire family may feel less stressed while feeling a greater sense of closeness with each other. It is not easy to care for a person with a disability. Implementing massage as a habitual event in the family life of a person with a disability can increase the family dynamic and overall quality of life.

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