This study was the first study to investigate the acute effect of TTM on academic stress using randomized controlled trial.
Our findings indicated that there was no significant different in sativa cortisol between TTM and rest in the supine position.
There was also a significant increase in diastolic blood pressure after TTM when compared with the control group.
Both groups demonstrated a reduction in systolic blood pressur e and heart rate when compared with pre-treatment.
Diastolic blood pressure was increase after TTM when compared with the control group by 4.7 mmHg.
This could be explained by the increase of the resistance of the peripheral blood vessels caused by the TTM technique, which applied pressing pressure for around 20 s on the femoral artery, femoral vein and capillaries.
This causes the constriction of peripheral blood vessels and the temporary loss of elasticity of these vascular walls which results in an increase of vascular resistance.
If the peripheral vascular resistance increased, the amount of arterial blood left in blood vessels is increased resulting in an increase of diastolic blood pressure at the end diastole.
However, the increase in diastolic pressure in this study was not clinically significant and returned to normal values within 10 min after TTM. Thus, it seems that TTM is a safe treatment among healthy student under academic stress.
Further studies which look more deeply into the cardiovascular response, especially diastolic blood pressure, after TTM are needed to verify the results and also provide a proper physiological explanation. Heart rate was decrease after TTM and rest. This indicated that sympathetic activity decreased.
Previous studies also reported the same finding that heart rest was reduced after massage.
Although, the massage techniques were different it could be supposed that they may affect the same physiological pathways to decrease sympathetic activity by the relaxation effects of massage.
This study found that both TTM and rest could significantly decrease saliva cortisol in academic stress.
However, most of the students in the TTM group reported a lower self perceived stress score after intervention than in control group. It is possible that TTM may affect other physiological responses to academic stress, such as the release of relaxation hormones such as endorphin or amylase or even influencing parasympathetic tone which were not detected in this study. Other randomized controlled studies found that single massage could reduce the concentration of urinary and saliva cortisol in patients with both somatic and psychological conditions.
However, there are some limitations in the controls groups of these studies:
one study did not measure saliva cortisol in the control group while the other found significant differences at baseline for saliva and urinary cortisol between massage and control groups, hence they could not compare cortisol levels between the two groups after intervention. Moyer have also reported that many of these previous studies are methodologically flawed and that the results have been misinterpreted. Thus it is still unclear the effect of single massage on the concentration of cortisol in both saliva and urine would be different to that produced control group under stress conditions. In this randomized controlled study, an analysis of covariance, which has greater statistical power to detect a treatment effect than other methods, was applied to adjust the pre-existig different of mean of the saliva cortisol between two group using the covariates. Further study is needed to verify whether single massage is better than control to decrease the level of cortisol hormone in academic stress.