Our hypotheses regarding the effects of PS-AM massage are described below (Fig 6). However, we consider there may be other unknown mechanisms that also have an influence on the changes we observed. Peripheral BF is expressed by the classical Poiseuille-Hagen equation: BF = π(Pa —PV)r4/ 8Lµ = (Pa — PV)/R (R = 8Lµ / πr4), Where Pa=arterial pressure, Pv = venous or capillary pressure, r=diameter of artery, L=length of artery, and µ = viscosity of blood (Fig6A). Cuff 1-pressure (40mmHg) of the PS-AM device (Fig 6B) is applied to the lower part of the extremities only during the cardiac diastolic phase, with no pressure being applied when arterial BFs during the systolic phase. This intensifies the venous return by forcing blood through the counter current venous valve towards the central parts of the vein (under cuff 2), without disturbing arterial BF (Fig6B). The vein under cuff 1 collapses, resulting in a decrease in venous pressure (Pv) during the systolic phase, leading to an increase in (Pa-Pv). At the next beat, cuff 2-pressure is also applied only during the diastolic phase, forcing the blood towards the central parts of the vein (Fig6C). These beat-to-beat actions are then applied sequentially to cuffs 3 and 4. These mechanisms may enhance. peripheral BF by decreasing Pv, and also stimulate parasympathetic nervous system activity by increasing venous return as a consequence of baroreflex control.