Recharging Healthcare Professionals: A Randomized Controlled Trial on the Impact of Automated Massage Chairs on Depression, Anxiety, Stress, Musculoskeletal Pain, and Biochemical Markers

Marilyn Li Yin Ong; Adam Abdul Malik; Norhasmah Mohd Zain; Nurulilyana Sansuddin; Norazliah Hj Samsudin; Rosminah Mohamed; Idris Long; Nor Haslina Mohd; Nurul Asma Abdullah; Hairul Anuar Hashim

doi:10.1002/hsr2.71226

Recharging Healthcare Professionals: A Randomized Controlled Trial on the Impact of Automated Massage Chairs on Depression, Anxiety, Stress, Musculoskeletal Pain, and Biochemical Markers

Health Sci Rep. 2025 Sep 14;8(9):e71226. doi: 10.1002/hsr2.71226. eCollection 2025 Sep.

Affiliations

¹ Exercise and Sports Science Programme, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia.
² Nursing Programme, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia.
³ Environmental & Occupational Health Programme, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia.
⁴ Interdiciplinary Health Sciences Unit, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia.
⁵ Biomedicine Programme, School of Health Sciences, Health Campus Universiti Sains Malaysia Kubang Kerian Malaysia.
⁶ Sports & Recreation Center Universiti Sains Malaysia Gelugor Malaysia.

Abstract

Background/objectives: Massage therapy has been shown to alleviate stress and improve well-being, making it a promising intervention for healthcare professionals who often face high levels of job-related stress. This study investigated the effects of automated massage chair therapy on negative emotional states, musculoskeletal pain, and biochemical markers in healthcare professionals.

Methods: Twenty-four healthcare professionals with moderate levels of depression, anxiety, and stress were randomly assigned to either an automated massage chair group or a progressive muscle relaxation (PMR) group. Each group received 15-min sessions, three times per week for 4 weeks, totaling 12 sessions. The depression, anxiety, and stress scale-21 items (DASS-21), the visual analog scale (VAS) for pain, and blood biomarkers [brain-derived neurotrophic factor (BDNF), cortisol, beta-endorphin, superoxide dismutase 1 (SOD1), endothelial nitric oxide synthase (eNOS), and myeloperoxidase (MPO)] were measured at baseline, after six sessions, and after 12 sessions.

Results: The massage chair group showed significant reductions in depression scores at 6 sessions (Z = -2.043, p = 0.041), and in stress scores at 6 (Z = -2.499, p = 0.012) and 12 sessions (Z = -2.326, p = 0.020). Calf pain scores improved significantly at 12 sessions (right calf: Z = -2.677, p = 0.007; left calf: Z = -2.253, p = 0.024), and lower back pain reduced at both 6 (Z = -2.275, p = 0.023) and 12 sessions (Z = -2.517, p = 0.012). MPO levels were significantly reduced in the massage group post-intervention (F [1, 22] = 7.956, p = 0.01; t [11] = 2.959, p = 0.013), indicating anti-inflammatory effects. A significant time effect was also observed for beta-endorphin (F [1, 22] = 6.632, p = 0.017), with reduced levels after massage (t [11] = 3.321, p = 0.007). No significant changes were found in anxiety, blood pressure, heart rate, BDNF, cortisol, SOD1, or eNOS.

Conclusions: Automated massage chair therapy significantly alleviated depression, stress, and musculoskeletal pain, particularly in the calves and lower back, with modest biochemical changes such as reduced MPO and beta-endorphin levels. These findings support massage chair use as a convenient, noncontact strategy to enhance psychological and physical well-being in healthcare professionals.

Keywords: BDNF; automated massage chair; beta‐endorphin; cortisol; emotional distress; endothelial nitric oxide synthase; musculoskeletal pain; myeloperoxidase; superoxide dismutase.