Effects of Manual Lymphatic Drainage and Classical Massage on Autonomic and Hemodynamic Responses in Community-Dwelling Older Adults

November 5, 2026 updated by: Gizem Kalay Çelik, Mersin University

The Effects of Manual Lymphatic Drainage and Classical Massage on Autonomic and Hemodynamic Responses in Community-Dwelling Older Adults: A Randomized Controlled Trial

**Study Objective**

The aim of this randomized controlled trial is to evaluate the effects of manual lymphatic drainage massage and classical massage on autonomic and hemodynamic responses in community-dwelling older adults aged 60 years and older. The study is expected to contribute to understanding the effects of massage interventions on autonomic and hemodynamic responses and to the development of evidence-based, non-pharmacological interventions supporting older adults' health.

**Study Hypotheses**

Primary Hypothesis (H01): The effects of a single 15-minute session of manual lymphatic drainage massage and classical massage on cardiac autonomic function in community-dwelling older adults differ from those observed in the delayed-intervention control group.

Secondary Hypothesis (H02): The effects of a single 15-minute session of manual lymphatic drainage massage and classical massage on hemodynamic responses in community-dwelling older adults differ from those observed in the delayed-intervention control group.

**Study Design and Procedures**

A total of 75 participants will be randomly assigned to one of three groups: manual lymphatic drainage massage, classical massage, or a delayed-intervention control group.

Participants in the manual lymphatic drainage massage group will receive a single 15-minute session involving gentle, rhythmic massage techniques applied to the neck and supraclavicular regions. Participants in the classical massage group will receive a single 15-minute session involving traditional massage techniques applied to the neck and shoulders. Participants in the delayed-intervention control group will rest for 15 minutes without receiving massage.

Heart rate variability (HRV), heart rate, and blood pressure will be measured before and immediately after the 15-minute massage or rest period in all three groups. HRV measures the natural variation in time between heartbeats and provides information about the regulation of heart function by the autonomic nervous system.

Changes in these measurements will be compared among the three groups to evaluate short-term autonomic and hemodynamic responses.

After completion of the study, participants in the delayed-intervention control group will be offered a massage intervention based on the study findings.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

75

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

60 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Being 60 years of age or older.
  • Providing written informed consent to participate in the study.
  • Voluntarily participating in the study through Yenişehir Egemenlik Family Health Center, Mezitli Nafiz Çolak Family Health Center, or Yenişehir Mimar Sinan Family Health Center in Mersin, Türkiye.

Exclusion Criteria:

  • Presence of a cardiac pacemaker or implantable cardioverter-defibrillator (ICD).
  • Clinically significant arrhythmias that may affect heart rate variability (HRV).
  • Acute or decompensated heart failure.
  • Acute deep vein thrombosis (DVT) or thrombophlebitis.
  • Acute infection, febrile illness, or active infection in the massage area.
  • Open wounds, active dermatological conditions, hematomas, or impaired skin integrity in the massage area.
  • Cervical disc herniation.
  • Refusal to provide informed consent.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Manual Lymphatic Drainage Massage Group

Participants in this group will receive a single 15-minute manual lymphatic drainage massage session targeting the cervical and supraclavicular regions in the supine position. The massage will follow the basic principles of the Dr. Vodder method, using gentle, rhythmic, superficial pressure and stationary circular movements at a rate of 20-30 movements per minute. Heart rate variability (HRV), heart rate, and blood pressure will be measured before (Z0) and after (Z1) the intervention.

Participants will be placed in a comfortable supine position with head and neck support. Privacy and hand hygiene will be ensured. Manual lymphatic drainage will follow Dr. Vodder principles, using gentle, rhythmic, superficial pressure without sliding or deep tissue compression. The skin will be gently stretched within its elastic limits and released. Stationary circular movements will be applied from the cervical region toward the supraclavicular terminal area, with very gentle lateral-to-medial movements near the supraclavicular fossa. The massage will last 15 minutes at 20-30 movements per minute, avoiding pain. Afterward, participants will remain supine, be monitored for adverse effects, and undergo post-intervention measurements of heart rate variability (HRV), heart rate, and blood pressure without changing position.

Experimental: Classical Massage Group

Participants assigned to this group will receive a single 15-minute classical massage session targeting the neck and shoulder regions bilaterally. The massage will begin with gentle, rhythmic effleurage (stroking), followed by petrissage (kneading) and controlled friction movements, and will end with gentle effleurage. Fragrance-free baby oil without colorants, preservatives, or added vitamins will be used. The massage will be performed without causing pain or discomfort. Heart rate variability (HRV), heart rate, and blood pressure will be measured before (Z0) and after (Z1) the intervention.

Before the massage, participants will be positioned comfortably, and the neck and shoulders will be prepared. Privacy and hand hygiene will be ensured. Fragrance-free baby oil without colorants, preservatives, or vitamins will be used, and the hands will be warmed. Classical massage will be applied bilaterally to the neck and shoulders using effleurage (stroking), petrissage (kneading), and friction techniques. The session will begin with gentle, rhythmic effleurage, followed by petrissage of the neck and shoulder muscles and controlled friction over appropriate muscle areas. Gentle effleurage will conclude the session. All movements will avoid pain or discomfort. The massage will last 15 minutes to match the MLD-m intervention duration. Afterward, participants will rest, be monitored for adverse effects, and undergo post-intervention measurements of heart rate variability (HRV), heart rate, and blood pressure.

No Intervention: Delayed-Intervention Control Group

Participants assigned to the delayed-intervention control group will not receive any massage intervention during the main study period. They will rest for 15 minutes under the same environmental conditions as the intervention groups. Heart rate variability (HRV), heart rate, and blood pressure will be measured before (Z0) and after (Z1) the rest period, using the same measurement intervals as the intervention groups. After completion of the study, participants will be offered one session of the massage intervention found to be more effective based on the study results.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Change in Heart Rate Variability (SDNN)
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Change in Heart Rate Variability (RMSSD)
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Change in Heart Rate Variability (pNN50)
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Change in Heart Rate Variability (LF)
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Change in Heart Rate Variability (HF)
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Change in Heart Rate Variability (LF/HF Ratio)
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)

Secondary Outcome Measures

Outcome Measure
Time Frame
Change in Heart Rate
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Change in Systolic Blood Pressure
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Change in Diastolic Blood Pressure
Time Frame: Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)
Baseline (Z0) and immediately after the 15-minute massage or rest period (Z1)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 1, 2026

Primary Completion (Estimated)

June 30, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

November 5, 2026

First Submitted That Met QC Criteria

November 5, 2026

First Posted (Actual)

November 12, 2026

Study Record Updates

Last Update Posted (Actual)

November 12, 2026

Last Update Submitted That Met QC Criteria

November 5, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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