Table 1.

Summary of studies regarding massage techniques, based on a systematic review of published literature.

Study	Study Design	Control Group	Study Sample	Intervention and Dosage	Outcome Variables	Main Results	Study’s Risk of Bias
Badenhorst, Fourie, Vosloo, 2017 [17]	Randomized cohort	No	10 dressage, 10 endurance, 10 saddlebred horses. Inclusion: - Exclusion: -	Swedish massage (stroking, kneading, stretching): two 40 min sessions once a week for five weeks	Heart rate, AST, CK, flexion and lateral flexion of the neck, height of passive front limb protraction, reach of hind limb in walk	Lower heart rates; improved neck, back, and shoulder range of motion.	High
Birt, Guay, Treiber, Ramirez, Snyder, 2015 [18]	Randomized controlled trial	Yes, placebo	14 quarter horses: 5 control, 9 treatment horses Inclusion: - Exclusion: -	A specific, pressure on/off type of method: 20 min, four times with 9–13 day intervals	Heart rate, surface temperature, behavior	Decrease in heart rate, changes in surface temperature, relaxation-related behavior changes.	Moderate
Hill, Crook, 2010 [19]	Randomized cross-over	Yes, placebo	8 mixed breed horses Inclusion: - Exclusion: skin disease, infection, soft tissue injury, or orthopedic condition	Effleurage and kneading of hindquarters: 30 min, once	Active and passive hind limb protraction	Both active and passive hind protraction increased.	High
Huneycutt, Davis, 2015 [20]	Randomized cross-over	Yes, control	8 minimally conditioned Alaskan husky sled dogs	Massage (petrissage, effleurage, compression): 14 min	Degree of CK release	No significant change in the CK due to massage.	Moderate
Kedzierski, Janczarek, Stachurska, Wilk, 2017 [21]	Randomized controlled trial	Five groups: one “clean” control, two massage, two music	60 3-year-old Arabian horses Inclusion: - Exclusion: -	Relaxing massage (friction, petrissage, shaking, tapotement): either once before official race or every day for 6 months	Heart rate, heart rate variability, cortisol level (saliva), racing performance	Daily massage had more effect than the less frequent one, but both had an effect.	High
Kowalik, Janczarek, Kędzierski, Stachurska, Wilk, 2017 [22]	Randomized controlled trial	Yes, control	72 Arabian horses: 24 control, 48 treatment Inclusion: - Exclusion: -	In specific areas of proximal body, relaxing massage (friction, petrissage, shaking, tapotement): 25 min, 3 days a week, for 1 year	Heart rate and heart rate variability, racing performance	Heart rate and rate variability were positively affected. Massaged horses performed better in races.	Moderate
McBride, Hemmings, Robinson, 2004 [23]	Cohort	No	10 healthy ponies and horses Inclusion: - Exclusion: -	Effleurage on specific areas of proximal body	Heart rate, behavior	Massage of withers and neck decreased the heart rate and caused most positive behavioral responses.	High
Normando, Trevisan, Bonetti, Bono, 2007 [24]	Non-randomized controlled trial	“Clean” control	27 horses: 12 with stereotypic behaviors, 15 without (control) Inclusion: - Exclusion: -	Allogrooming type of fingertip massage along the spine and withers	Heart rate	Massage increased the heart rate of animals with stereotypical behavior and decreased it on the control horses.	High
Sullivan, Hill, Haussler, 2008 [25]	Non-randomized controlled clinical trial	Yes: chiropractic, phenylbutazone, ridden exercise, and no exercise (control)	40 horses without clinical signs of back pain Inclusion: - Exclusion: lameness	Single session of effleurage and petrissage on proximal body and limbs for 35–45 min	Spinal mechanical nociceptive threshold	Mechanical nociception threshold was significantly higher after massage 7 days after treatment.	High