There are a number of limitations in the present study.
The sample size is relatively small and may not be able
to detect small effects on bone resorption. Moreover,
although the current results are consistent with those of
our previous study and of other studies in infants, it is
still unclear if the increase in bone formation as reflected
by bone markers will result in higher bone mass or
reduced fractures. It is of note that only a single masseur
performed the Thai traditional massage throughout the
study. The result may not be readily generalized to other
masseurs. Further studies, which include multiple practitioners,
to confirm our results, as well as to investigate
the effect of Thai traditional massage on bone mass or
fractures, are warranted.