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The effect of massage on heart rate variability in preterm infants

A Corrigendum to this article was published on 27 February 2013



To test the hypothesis that massage would improve autonomic nervous system (ANS) function as measured by heart rate variability (HRV) in preterm infants.

Study Design:

Medically stable, 29- to 32-week preterm infants (17 massage, 20 control) were enrolled in a masked, randomized longitudinal study. Licensed massage therapists provided the massage or control condition twice a day for 4 weeks. Weekly HRV, a measure of ANS development and function, was analyzed using SPSS generalized estimating equations.


Infant characteristics were similar between groups. HRV improved in massaged infants but not in the control infants (P<0.05). Massaged males had a greater improvement in HRV than females (P<0.05). HRV in massaged infants was on a trajectory comparable to term-born infants by study completion.


Massage-improved HRV in a homogeneous sample of hospitalized, medically stable, preterm male infants and may improve infant response to exogenous stressors. We speculate that massage improves ANS function in these infants.

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We thank Julie Hatch, RN for her assistance in anthropometric data collection and Nancy Allen at the University of Utah Cardiovascular Research and Training Institute for her contributions to the heart rate variability analysis. We are sincerely grateful to the licensed massage therapists: Elizabeth Bingham, Andy Drake, Heidi Huish, Teri Josephson, Susie Kay, Shannon Northroup, Angela Rinehart, Change Vriens and Karen Salas Wheeler for their commitment and dedication in providing the intervention to the infants. This study was supported by grants from the National Institutes of Health (NCCAM R21 AT004185-01); University of Utah Interdisciplinary Research Committee, College of Nursing Research Committee, and Division of Neonatology Development Fund.

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Correspondence to S L Smith.

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Smith, S., Lux, R., Haley, S. et al. The effect of massage on heart rate variability in preterm infants. J Perinatol 33, 59–64 (2013).

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  • massage therapy
  • heart rate variability
  • premature infant

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