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

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.

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.

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.