Comparative Efficacy of Robotic and Manual Massage Interventions on Performance and Well-Being: A Randomized Crossover Trial

Background: Manual massage (MM) interventions can improve psychophysiological states of relaxation and well-being. In this context, robotic massage (RM) represents a promising, but currently understudied, solution. Hypothesis: Both MM and RM would improve flexibility of the hamstrings and lumbopelvic muscles and promote a psychophysiological state of relaxation through decreased sympathetic activity. Study Design: Single-blind randomized crossover trial. Level of Evidence: Level 2. Methods: A total of 21 participants experienced 2 massage interventions targeting back soft tissues. During a first condition, the intervention was performed by a physical therapist, whereas during a second condition the intervention was performed by a robot. We collected objective and subjective indexes of performances and well-being before and after each massage intervention. We also collected physical therapists’ self-reports of perceived fatigue, tension, and ability to maintain the massage routine. Results: Skin conductance decreased from the pretest to the posttest in both conditions (partial R2 = 0.44, 95% CI [0.30, 1.00], P < 0.01), although the decrease was more pronounced after MM. Whereas both interventions were associated with improved subjective sensations, eg, pain, warmth, well-being (partial R2 = 0.08, 95% CI [0.06, 1.00], P < 0.01), MM yielded additional benefits compared with RM. The physical therapist reported greater fatigue and tension and reduced perceived massage efficiency along with repeated massage interventions. MM outperformed RM to elicit a psychophysiological state of relaxation. Conclusion: RM exhibited a pattern of changes comparable with that of MM, for both objective and subjective indexes of relaxation and well-being. Clinical Relevance: RM could represent a prophylactic option to prevent the onset of counterproductive fatigability in physical therapists.