Traditional Japanese massage, Anma therapy has a long history and popularity in Japan. It is known to maintain well-being, promote health, treat illness and prevent disease empirically, however, it is difficult to find published studies. It is necessary to explore the mechanisms of traditional Japanese massage, Anma therapy scientifically, thus, this preliminary study was examined. In this study, three clients assigned to the Anma therapy group participated in five Anma therapy sessions (two per week for two and a half consecutive weeks) of 40 minutes duration. Three healthy volunteer students assigned to a non-intervention group participated in one session involving rest on a bed. Immediate changes between pre- and post-therapy, and longer-term changes between first and last session were observed. In the results, for the Anma therapy group immediate changes were lower subjective symptom and state anxiety scores, with general longer-term effects. Another immediate change in the Anma therapy group was an increase in secretory immunoglobulin A in saliva, but salivary cortisol concentrations did not change. These results suggest that Anma therapy may be physically and psychologically effective in ameliorating subjective symptoms and anxiety, and enhancing immune function, though sample sizes used were too small to analyze statistically. In addition, the result from salivary cortisol concentration implies that effect of Anma therapy is different from that of Western style massage.

Introduction: In Japan, onsen, or hot springs, has traditionally been associated with good quality natural water baths surrounded by beautiful nature, meals made from local products, hospitality at hot spring hotels, and massage. I would like to introduce Anma massage therapy, the massage technique most widely practiced by nationally certified massage therapists in Japan. Origin and treatment characteristics: Ancient Chinese medicine, which involves Ankyo, Doin, acupuncture, moxibustion, and herbal medicine was introduced to Japan from China via the Korean Peninsula in the 6th century. Ankyo was a massage therapy that considered acupuncture meridians. Ankyo was modified to meet the preferences of Japanese people and subsequently developed into the modern-day Anma massage therapy. Anma derives its name from its two main manual techniques; an, which is the Japanese term for applying pressure, and ma, the Japanese term for stroking.   Today, Anma massage is generally applied over the whole body, focusing not on meridians but instead on anatomy, especially muscles. Standard Anma massage techniques involve mainly kneading, with lesser amounts of stroking and pressing through clothing using rhythmic massaging motions, and occasionally, brief joint exercises. The intensity of stimulation is adjusted according to each patient’s comfort level. Results of our studies: We administered a single 40-minute full-body Anma massage session to 15 healthy women. After this session, we observed significantly reduced visual analog scale scores for their subjective symptom of muscle stiffness in the neck and shoulders, state anxiety scores, and salivary cortisol concentrations, as well as significantly increased secretory immunoglobulin A concentrations.   Next, changes in gene expression were investigated to clarify the mechanisms of the clinical effects of Anma massage therapy. Subjects were two healthy female volunteers. Blood was taken before and after a 40-minute Anma massage session and analyzed by microarray. The analysis revealed the gene ontology terms selected by both participants after the Anma massage were “immune response” and “immune system”. Although the sample size was very small, these results imply that Anma massage therapy may affect immune function.   Moreover, in our studies on outpatients with Parkinson’s disease, Anma massage therapy significantly alleviated severity of patients’ subjective symptoms of muscle stiffness, movement difficulties, pain, and fatigue, and also improved motor functions of the upper and lower limbs. Future challenges in Anma massage research: After completing a preliminary study, we are now conducting a 2-year randomized controlled trial of the efficacy of Anma massage therapy among cancer survivors.   Because Anma is a full-body massage tailored to meet the physical and mental state of individuals, it is difficult to develop standardized therapy protocols for studies. However, we aim to incorporate the unique merits of Anma massage into therapy protocols in studies to produce results that are appropriately rigorous for the global scientific community.

Objective: The aim of this preliminary study was to assess whether traditional Japanese massage therapy confers benefits to body and mind not only in healthy women but also cancer survivors. Design: A case control study Settings/Location: Tsukuba University of Technology, Ibaraki, Japan Subjects: Five women who underwent surgery for uterine cervical or endometrial cancer (stage 1a1-2a; cancer survivors group) and five healthy women of the same generation (healthy women group) were recruited. All had chronic muscle stiffness of the neck and shoulder and wanted to receive massage therapy. Interventions: All participants received traditional Japanese massage therapy consisting of eight 40-min massage sessions over 4 weeks. Outcome Measures: Visual analogue scale (VAS) to assess the severity of the subjective symptom of muscle stiffness in the neck and shoulder; salivary cortisol, secretory immunoglobulin A (s-IgA), and chromogranin A (CgA) from saliva; state anxiety, trait anxiety, and depression. Results: Regarding immediate changes in variables by therapy, there were significant differences between the cancer survivors group and the healthy women group in VAS, s-IgA, and CgA. VAS, salivary cortisol, and state anxiety scores decreased, and s-IgA and CgA increased in both groups. After the four weeks of sessions, there were significant differences between the cancer survivors group and the healthy women group in VAS, CgA, and depression. VAS, trait anxiety, and depression scores decreased in both groups. Conclusions: These results imply that traditional Japanese massage therapy may confer physical and psychological benefits to cancer survivors as well as to healthy women. Further studies with a larger sample size are needed.

  We report here on the current situation, regulations by law, and education of spa therapy and massage in France, as determined through a survey study on massage conducted by our university in France between March 19 and 28, 2012. Spa therapy is one of France natural therapies and means‘health through water’in Latin. It includes balneotherapy (le thermalisme) using thermal spring water, thalassotherapy (la thalassothérapie) using sea water, and hydrotherapy (la balnéothérapie) using water. At present in France, there are 105 balneotherapy centers (Thermés) at 89 sites with thermal spring water, located mainly in mountainous regions. National medical insurance can be used for 18-day balneotherapy treatment of 12 symptoms, provided as a 3-week stay (excluding Sundays) in sites with thermal spring water. Thalassotherapy, on the other hand, is currently regarded as a form of relaxation. Balneotherapy and thalassotherapy both include bathing with jets, showers (douche), exercise in the pool, mud therapy (mud pack and wrapping), and massage among other treatments, but there are differences between the two: balneotherapy uses thermal spring water while thalassotherapy uses sea water; the aim of balneotherapy is to treat or prevent disease while that of thalassotherapy is to promote well-being (relaxation); subjects for balneotherapy are patients, whereas those for thalassotherapy are generally healthy people.   The term‘massage’in France refers only to massage provided in medical practice, by massage therapists (masseur-kinesithérapeute) who hold a national massage therapy license. The treatment they provide is covered by national medical insurance. They work in hospitals, clinics, rehabilitation centers, and balneotherapy centers and can run their own massage clinics. In contrast, the term‘relaxation massage’(praticien bien-être), which refers to massage for well-being and is never called “massage” in order to distinguish it from medical massage, is not regulated by law. There is a self-regulatory body, that issues licenses for aestheticians, Certificat d’Aptitude Professionnelle (CAP). Their practice is known as modelage. The balneotherapy centers we visited employed licensed masseur-kinesithérapeutes, hydrotherapists who received 600 hours of training, and assistants with no licenses. The thalassotherapy centers mainly employed estheticians with CAP.

  On December 11, 2013, we visited Baden, a hot spring town in Switzerland. The natural hot spring water at Baden contains sulfur, is 46.5°C with a pH of 6.43, and is used in both drinking and bathing therapies. In addition to the hot spring, the hotel spa contains a massage parlor for medical massage, relaxing massage, cosmetic massage, or various other types of massage. Previous studies have reported a preference in about half the Swiss population for hospitals that offer complementary and alternative medicine. Also, acupuncture, manual therapy, and massage are frequently used in such facilities. Medical Center Baden has both a medical department and a therapeutic department. In the medical department, medical doctors practice manual medicine (manuelle Medizin) and in the therapeutic department, physical therapists (Physiothera-peuten) practice various kinds of physical therapy (Physiotherapie) such as manual therapy (manuelle Therapie), kinetics (funktionelle Bewegungslehre), biomechanics, respiratory therapy, proprioceptive neuromuscular facilitation, and electrotherapy/ultrasound. Medical massage therapists (medizinische Masseure) in the therapeutic department practice various kinds of massage including classic massage, manipulative massage, reflexology, connective tissue massage, manual lymphatic drainage, and Fango (a type of pelotherapy). These divisions indicate that the practices of massage and manual therapy in German-speaking Switzerland are sorted and named individually by the stimulated anatomical tissue and by type of functional and physical stimulation. In contrast, Japanese manual therapy, Anma massage therapy is holistic and based on the patient’s subjective physical and mental state. These are characteristic features of Eastern Asian medicine, which tends toward whole-body, individualized treatments.