Benefit of a connective tissue reflex massage for patients with peripheral arterial disease

Introduction: Peripheral arterial disease (PAD) is a common disease worldwide and is associated with a high rate of disability. Connective tissue massage may reduce symptoms and improve intermittent claudication by increasing blood circulation to the musculature. Objectives: The objective of this study was to evaluate the efficacy of connective tissue massage to improve blood circulation and intermittent claudication symptoms in patients with PAD. Methods: A randomized, placebo-controlled trial was undertaken. Eighteen patients with stage II or III PAD (Leriche-Fontaine classification) were randomly assigned to connective tissue massage group or to a placebo group treated using standard physiotherapy. Peripheral arterial circulation was determined by measuring differential segmental arterial pressure, oxygen saturation and a walking distance. Measurements were taken before and at the end of the program of rehabilitation. Results: No significant difference between baseline characteristics was observed between the two groups. After completion of 12 sessions, the two groups differed in terms of improving the walking distance (p= 0.03), an index of distal systolic pressure (p= 0.01), and the sum of the questionnaire assessment of gait (p= 0.009). Despite an improvement in oxygen saturation at the right and left foot, the difference between the two groups was not significant (p= 0.08). The linear regression analysis revealed an independent positive correlation between the number of session of connective tissue massage and improvement of walking distance (R=0.54; p<0.01) and index of distal systolic pressure (R=0,62; p < 0.01). Conclusion: Connective tissue massage improves blood circulation in the lower limbs of patients at stage II or III and may be useful to slow the progression of PAD.