***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background — Arterial hypertension is a prime cause of morbidity and mortality in the general population . Pharmacological treatment has limitations result ing from drug side effects , costs , and patient compliance . Thus , we investigated whether traditional Chinese medicine acupuncture is able to lower blood pressure . Methods and Results — We r and omized 160 out patients ( age , 58±8 years ; 78 men ) with uncomplicated arterial hypertension in a single-blind fashion to a 6-week course of active acupuncture or sham acupuncture ( 22 sessions of 30 minutes ' duration ) . Seventy-eight percent were receiving antihypertensive medication , which remained unchanged . Primary outcome parameters were mean 24-hour ambulatory blood pressure levels after the treatment course and 3 and 6 months later . One hundred forty patients finished the treatment course ( 72 with active treatment , 68 with sham treatment ) . There was a significant ( P<0.001 ) difference in posttreatment blood pressures adjusted for baseline values between the active and sham acupuncture groups at the end of treatment . For the primary outcome , the difference between treatment groups amounted to 6.4 mm Hg ( 95 % CI , 3.5 to 9.2 ) and 3.7 mm Hg ( 95 % CI , 1.6 to 5.8 ) for 24-hour systolic and diastolic blood pressures , respectively . In the active acupuncture  group , mean 24-hour ambulatory systolic and diastolic blood pressures decreased significantly after treatment by 5.4 mm Hg ( 95 % CI , 3.2 to 7.6 ) and 3.0 mm Hg ( 95 % CI , 1.5 to 4.6 ) , respectively . At 3 and 6 months , mean systolic and diastolic blood pressures returned to pretreatment levels in the active treatment group . Conclusions — Acupuncture according to traditional Chinese medicine , but not sham acupuncture , after 6 weeks of treatment significantly lowered mean 24-hour ambulatory blood pressures ; the effect disappeared after cessation of acupuncture treatment The aim of this study was to investigate the effect of connective tissue massage in the treatment of individuals with fibromyalgia . The results of this r and om study of 48 individuals diagnosed with fibromyalgia ( 23 in the treatment group and 25 in the reference group ) show that a series of 15 treatments with connective tissue massage conveys a pain relieving effect of 37 % , reduces depression and the use of analgesics , and positively effects quality of life . The treatment effects appeared gradually during the 10-week treatment period . Three months after the treatment period about 30 % of the pain relieving effect was gone , and 6 months after the treatment period pain was back to about 90 % of the basic value . As long as there is a lack of effective medical treatment for individuals with fibromyalgia , they ought to be offered treatments with connective tissue massage . However , further studies are needed in the mechanisms behind the treatment effects . Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain Swedish Massage Therapy ( SMT ) is known for its therapeutic relaxation effects . Hypertension is associated with stress and elevated endothelial inflammatory markers . This r and omized control trial measured the effects of whole body SMT ( massage group ) or resting ( control group ) an hour weekly for four weeks on hypertensive women .  Blood pressure ( BP ) and heart rate ( HR ) were measured before and after each intervention and endothelial inflammatory markers : vascular endothelial adhesion molecules 1 ( VCAM-1 ) and intracellular adhesion molecules 1 ( ICAM-1 ) were measured at baseline and after the last intervention . Massage group ( n=8 ) showed significant systolic BP ( SBP ) reduction of 12 mmHg ( P=0.01 ) and diastolic BP ( DBP ) reduction of 5 mmHg ( P=0.01 ) after four sessions with no significant difference between groups . Reductions in HR were also seen in massage group after sessions 1 , 3 , and 4 with significant difference between groups . VCAM-1 showed significant reduction after four sessions : the massage group showed reduction of 998.05 ng/mL ( P=0.03 ) and the control group of 375.70 ng/mL ( P=0.01 ) with no significant differences between groups . There were no changes in ICAM-1 . In conclusion , SMT or resting an hour weekly has effects on reducing BP , HR , and VCAM-1 in hypertensive women OBJECTIVE To determine the feasibility of conducting a r and omized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage , as well as a nontreatment control group . DESIGN R and omized controlled-comparison trial with 3 parallel groups . SETTING Private practice outpatient chiropractic clinic . PATIENTS Twenty-three subjects , aged 24 to 50 years with systolic or diastolic essential hypertension . INTERVENTIONS Two months of full-spine chiropractic care ( ie , Gonstead ) consisting primarily of specific-contact , short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation . The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation . The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room . MAIN OUTCOME MEASURES Cost per enrolled subject , as well as systolic and diastolic blood pressure ( BP ) measured with a r and om-0 sphygmomanometer and patient reported health status ( SF-36 ) . Pilot study outcome measures also included an assessment of cooperation of subjects to r and omization procedures and drop-out rates , recruitment effectiveness , analysis of temporal stability of BPs at the beginning of care , and the effects of inclusion /exclusion criteria on the subject pool . RESULTS Thirty subjects enrolled , yielding a cost of $ 161 per enrolled subject . One subject was later determined to be ineligible , and 6 others dropped out . In both the chiropractic and massage therapy groups , all subjects were classified as either overweight or obese ; in the control group there were only 2 classified as such . SF-36 profiles for the groups were similar to that of a normal population . The mean change in diastolic BP was -4 ( 95 % confidence interval [ CI ] : -8.6 , 0.5 ) in the chiropractic care group , 0.5 ( 95 % CI : -3.5 , 4.5 ) in the brief massage treatment group , and -4.9 ( 95 % CI : -9.7 , -0.1 ) in the no treatment control group . At the end of the study period , this change was -6.3 ( 95 % CI : 13.1 , 0.4 ) , -1.0 ( 95 % CI : -7.5 , 15.6 ) , -7.2 ( 95 % CI : -13.3 , -1.1 ) in the 3 study groups . The mean improvements in the chiropractic care and no treatment control groups remained consistent over the follow-up period . CONCLUSIONS This pilot study eluci date d several procedural issues that should be addressed before undertaking a full-scale clinical trial on the effects of chiropractic adjustments in patients with essential hypertension . A multidisciplinary approach to recruitment may need to be used in any future efforts because of the limited subject pool of patients who have hypertensive disease but are not taking medications for its control . Measures need to be used to assure comparable groups regarding prognostic variables such as weight . Studies such as these demonstrate the feasibility of conducting a full-scale 3-group r and omized clinical trial in the private practice setting BACKGROUND Massage therapy is an attractive treatment option for osteoarthritis ( OA ) , but its efficacy is uncertain . We conducted a r and omized , controlled trial of massage therapy for OA of the knee . METHODS Sixty-eight adults with radiographically confirmed OA of the knee were assigned either to treatment ( twice-weekly sessions of st and ard Swedish massage in weeks 1 - 4 and once-weekly sessions in weeks 5 - 8 ) or to control ( delayed intervention ) . Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) pain and functional scores and the visual analog scale of pain assessment . The sample provided 80 % statistical power to detect a 20-point difference between groups in the change from baseline on the WOMAC and visual analog scale , with a 2-tailed alpha of .05 . RESULTS The group receiving massage therapy demonstrated significant improvements in the mean ( SD ) WOMAC global scores ( -17.44 [ 23.61 ] mm ; P < .001 ) , pain ( -18.36 [ 23.28 ] ; P < .001 ) , stiffness ( -16.63 [ 28.82 ] mm ; P < .001 ) , and physical function domains ( -17.27 [ 24.36 ] mm ; P < .001 ) and in the visual analog scale of pain assessment ( -19.38 [ 28.16 ] mm ; P < .001 ) , range of motion in degrees ( 3.57 [ 13.61 ] ; P = .03 ) , and time to walk 50 ft ( 15 m ) in seconds ( -1.77 [ 2.73 ] ; P < .01 ) . Findings were unchanged in multivariable models controlling for demographic factors . CONCLUSIONS Massage therapy seems to be efficacious in the treatment of OA of the knee . Further study of cost effectiveness and duration of treatment effect is clearly warranted . BACKGROUND : Prehypertension is considered as a cardiovascular disease predicator . Management of prehypertension is an appropriate objective for clinicians in a wide range of medical centers . Treatment of prehypertension is primarily non-pharmacological , one of which is massage therapy that is used to control the blood pressure . This study aim ed to evaluate the effect of Swedish massage ( face , neck , shoulders and chest ) on blood pressure ( BP ) of the women with prehypertension . METHODS : This was a single-blind clinical trial study . Fifty prehypertensive women selected by simple r and om sampling which divided into control and test groups . The test group ( 25 patients ) received Swedish massage 10 - 15 min , three times a week for 10 sessions and the control groups ( 25 patients ) also were relaxed at the same environment with receiving no massage . Their BP was measured before and after each session . Analyzing the data was done using descriptive and inferential statistical methods ( chi square , Mann-Whitney , paired t-test and student t-test ) through SPSS software . RESULTS : The results indicated that mean systolic and diastolic blood pressure in the massage group was significantly lower in comparison with the control group ( p < 0.001 ) . CONCLUSIONS : Findings of the study indicated that massage therapy was a safe , effective , applicable and cost-effective intervention in controlling BP of the prehypertension women and it can be used in the health care centers and even at home Background Clinical trials on Traditional Chinese Medicine ( TCM ) should be registered in a publicly accessible international trial register and report on all outcomes . We systematic ally assessed and evaluated TCM trials in registries with their subsequent publications . Objective To describe the characteristics of TCM trials , estimate bias risk and outcome -reporting bias in clinical trials . Data sources and study selection Fifteen trial registries were search ed from their inception to July 2012 to identify r and omised trials on TCM including Chinese herbs , acupuncture and /or moxibustion , cupping , tuina , qigong , etc . Data extraction We extracted data including TCM specialty and treated disease/conditions from the registries and search ed for subsequent publications in PubMed and Chinese data bases . We compared information in the registries of completed trials with any publications focusing on study design , sample size , r and omisation , bias risk including reporting bias from the register protocol . Results 1096 registered r and omised trials were identified evaluating TCM , of which 505 were completed studies ( 46.1 % ) . The most frequent conditions were pain ( 13.3 % ) , musculoskeletal ( 11.7 % ) , nervous ( 8.7 % ) , digestive ( 7.1 % ) , circulatory ( 6.5 % ) , respiratory ( 6.3 % ) , mental and behavioural disorders ( 6.2 % ) and cancer ( 6.0 % ) . The trial register data identified parallel , phase II/III r and omised trials with sample size estimations and blinding , but limited information about r and omisation ( sequence generation and allocation concealment ) . Comparing trial registration data of 115 completed trials ( 22.8 % ) with their subsequent 136 publications , inconsistencies were identified in one or more of the following : sample size ( 11 % ) , outcome assessor blinding ( 37.5 % ) , primary outcomes ( 29 % ) and safety ( 28 % ) reporting . Conclusions Increasing numbers of clinical trials investigating a variety of TCM interventions have been registered in international trial registries . The study design of registered TCM trials has improved in estimating sample size , use of blinding and placebos . However , selective outcome reporting is widespread and similar to conventional medicine and therefore study conclusions should be interpreted with caution Abstract Objectives : To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain . Design : Prospect i ve , r and omised , placebo controlled trial . Setting : Three outpatient departments in Germany . Participants : 177 patients aged 18–85 years with chronic neck pain . Interventions : Pat 
    Output:
    
Safety of massage is still unclear .
There is some encouraging evidence of massage for EH .