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. 2005 Sep 1;123(5):215-8.
doi: 10.1590/s1516-31802005000500003. Epub 2005 Dec 8.

Salivary cortisol as an indicator of adrenocortical function in healthy infants, using massage therapy

Monalisa de Cássia Fogaça  1 , Werther Brunow Carvalho, Clóvis de Araújo Peres, Mayra Ivanoff Lora, Lilian Fukusima Hayashi, Ieda Therezinha do Nascimento Verreschi
Affiliations

Salivary cortisol as an indicator of adrenocortical function in healthy infants, using massage therapy

Monalisa de Cássia Fogaça et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context and objective: The evaluation of adrenocortical function with the use of therapeutic massage has been little studied in Brazil. The purpose of this study was to evaluate the salivary cortisol levels before and after Shantala massage therapy on healthy infants.

Design and setting: Prospective case series, in a public nursery, in São Paulo.

Methods: Saliva was obtained from 11 infants at the times of 8:00-9:00 a.m. and 4:00-5:00 p.m. in a nursery and 9:00-10:00 p.m. at home. They received a 15-minute therapeutic massage on two consecutive days, and saliva was collected before and after the massage. The procedure was repeated after a one-week interval. Cortisol values (intra-assay < 5%; inter-assay < 10%) at different times of the day were compared by ANOVA.

Results: The mean cortisol values (nmol/l +/- SD) on the first day were: morning (M) = 14.1 +/- 5.7, afternoon (A) = 8.3 +/- 2.7, night (N) = 3.3 +/- 1.1; after two consecutive days of therapeutic massage: M = 22.3 +/- 13.5, A = 13.4 +/- 6.0, N = 5.8 +/- 3.5; after a one-week interval: M = 15.8 +/- 7.7, A = 14.3 +/- 7.7, N = 3.4 +/- 2.0.

Conclusion: There was a modification in the salivary cortisol values following massage, thus reflecting possible adaptation of the hypothalamic-pituitary-adrenal axis.

CONTEXTO E OBJETIVO:: A avaliação da função adrenocortical com uso da massagem terapêutica no Brasil tem sido pouco estudada. O objetivo foi avaliar os níveis de cortisol salivar antes e após a massagem terapêutica Shantala em lactentes sadios.

TIPO DO ESTUDO E LOCAL:: Prospectivo/série de casos, numa creche pública em São Paulo.

MÉTODOS:: Amostras de saliva foram obtidas de 11 lactentes durante um dia entre 08h00 e 09h00, 16h00 e 17h00 na creche, e entre 21h00 e 22h00 na residência. Durante dois dias consecutivos os lactentes receberam 15 minutos de massagem terapêutica, coletando-se a saliva antes e após a massagem. O procedimento foi repetido após intervalo de uma semana. Os valores de cortisol (duplicatas; coeficiente de variação intra e interensaio < 5% e < 10%) nos diferentes períodos do dia foram comparados por análise de variância com medidas repetidas (ANOVA) e análise descritiva.

RESULTADOS:: Os valores médios no primeiro dia (± desvio padrão) de cortisol (nmol/l) foram: manhã (M) = 14,1 ± 5,7; tarde (T) = 8,3 ± 2,7; noite (N) = 3,3 ± 1,1; e, após dois dias consecutivos com massagem terapêutica, foram: M = 22,3 ± 13,5; T = 13,4 ± 6,0; N = 5,8 ± 3,5, respectivamente. Após intervalo de uma semana, foram: M = 15,8 ± 7,7; T = 14,3 ± 7,7 e N = 3,4 ± 2,0 nmol/l.

CONCLUSÃO:: Houve modificação nos valores de cortisol salivar pós-massagem, refletindo possível adaptação do eixo hipotalâmico-hipofisário-adrenal nos lactentes.

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Conflict of interest statement

Conflict of interest: Not declared

Figures

Figure 1
Figure 1. Pictures from moments during Shantala massage therapy on an infant (published with permission from the mother).
Figure 2
Figure 2. Circadian rhythm variation in salivary cortisol among healthy infants (#6 and #8 excluded) over the day before massage therapy (A); over the day after two consecutive days of 15 minutes of standard massage therapy (B); over one day after a one-week interval (C); and individual data for the twin brothers #9 and #10 (A*, B*, C*). Graphs A*, B* and C* show the individual variability in these twins, regarding the timing of the appearance of cortisol circadian rhythm and responsiveness of the hypothalamic-pituitary-adrenal axis. The massage therapy gave different results for each of the twin brothers. This example of twin brothers perhaps demonstrates that massage therapy produces different adaptive effects in the hypothalamic-pituitary-adrenal axis.
See this image and copyright information in PMC

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