RESUMEN
BACKGROUND: Traditional Chinese Medicine (TCM) massage utilizes mechanical force stimulation, and the amount of mechanical force influences therapeutic outcome. This amount is determined by pressure, frequency, and duration; however, there are no standard definitions for these measures. METHODS: An orthogonal design was used to evaluate massage efficacy using muscle tension as an index. Pressure (2, 4, 6 kg), duration (5, 10, 15 min), frequency (60, 120, 180 repetitions/min), pain (mild, medium, severe), weight (<60, 60-75, >75 kg), and sex (male, female) were evaluated. Additionally, a porcine model of muscle tension was used to construct pressure-time curves for muscle tissues under static and dynamic pressure. RESULTS: We identified an interaction among the six massage measures (P<0.05). Of these measures, only two were individually significant: manipulation frequency and patient pain level (P<0.05). Specifically, 120 repetitions/min improved muscle tension significantly more than 60 or 180 repetitions/min (P<0.05), and patients with severe pain had significantly improved muscle tension compared to those with medium or mild pain (P<0.05). In the porcine muscle model, both static and dynamic pressure were attenuated by approximately 12.5% per cm. This attenuation dropped to 10% per cm when the pressure sensor was placed below tissues with different thicknesses instead of being inserted into tissues at different levels. CONCLUSION: Manipulation frequency and patient pain level were primarily responsible for the therapeutic effects of TCM massage. Mechanistically, pressure was attenuated by nearly 75% at a depth of 2 cm from the muscle surface during TCM massage.