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Updated: Apr 18, 2026
Measuring Cardiac Autonomic Nervous System ANS Activity in Children
Published on: April 29, 2013
The effect of massage therapy on autonomic activity in critically ill children
Ling Guan1, Jean-Paul Collet1, Nataliya Yuskiv1
1Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 1Z3 ; Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, Canada V5Z 4H4.
Insights
Foot and hand massage positively impacts autonomic nervous system (ANS) activity in pediatric intensive care unit (PICU) patients. This gentle intervention improves parasympathetic activity and shows lasting benefits with repeated sessions.
Area of Science:
- Pediatric Intensive Care
- Autonomic Nervous System Physiology
- Massage Therapy Research
Background:
- Autonomic nervous system (ANS) dysfunction is common in critically ill children.
- Assessing ANS activity is crucial for understanding patient status and guiding treatment in the pediatric intensive care unit (PICU).
- Non-pharmacological interventions like massage are being explored to support physiological regulation in PICU settings.
Purpose of the Study:
- To investigate the effects of foot and hand (F&H) massage on autonomic nervous system (ANS) activity in hospitalized children.
- To determine the relationship between ANS function and clinical severity in this population.
- To explore the impact of repeated F&H massage sessions on ANS activity.
Main Methods:
- A descriptive experimental study design was employed.
- Intervention involved single or multiple (six) sessions of F&H massage.
- Autonomic nervous system (ANS) function was evaluated using frequency-domain analysis of heart rate variability, focusing on high frequency (HF) and low frequency (LF) power.
Main Results:
- A significant negative correlation was found between HF + LF and clinical severity (ρ = -0.77).
- During massage, parasympathetic activity (HF) increased by 75% (P = 0.04) and sympathetic activity (LF) increased by 56% (P = 0.026).
- Repeated massage sessions demonstrated a sustained positive effect on HF and LF, stabilizing after the second session.
Conclusions:
- Autonomic nervous system (ANS) activity, measured by HF + LF, is inversely correlated with clinical severity in PICU patients.
- Foot and hand (F&H) massage effectively enhances ANS activity in critically ill children.
- The beneficial effects of F&H massage on ANS function are persistent, especially with repeated administration.
Abstract:
Objectives. Our main objective was to describe the effect of foot and hand (F&H) massage on the autonomic nervous system (ANS) activity in children hospitalized in a pediatric intensive care unit (PICU); the secondary objectives were to assess the relationship between ANS function and the clinical severity and to explore the effects of repeated massage sessions on the ANS. Methods. Design was a descriptive experimental study. Intervention was single or six session(s) of F&H massage. ANS function was assessed through the frequency-domain analysis of heart rate variability. Main metrics included high and low frequency power (HF and LF), HF + LF, and LF/HF ratio. Results. Eighteen children participated in the study. A strong Spearman's correlation (ρ = -0.77) was observed between HF + LF and clinical severity. During massage, the parasympathetic activity (measured by HF) increased significantly from baseline (P = 0.04) with a mean percentage increase of 75% (95% CI: 20%∼130%). LF increased by 56% (95% CI: 20%∼92%) (P = 0.026). Repeated sessions were associated with a persistent effect on HF and LF which peaked at the second session and remained stable thereafter. Conclusions. HF + LF is positively correlated with clinical severity. F&H massage can improve the ANS activity and the effect persists when repeated sessions are offered.
