Cardiac autonomic activity was assessed by heart rate variability (HRV) following a 30min leg massage on resting subjects Methods HRV was measured for 5mins in a supine position at baseline in ten healthy males (24.7±3.4yrs) using the Polar Precision Performance software (Polar Electro, Finland). Subjects then received either a manual leg massage (MM) to both legs, or rested (R) for 30mins. HRV was then measured again for 5mins. Results Compared to Rest, heart rate for MM was significantly lower (Figure 1). This was accompanied by a significant decrease in an indicator of sympathetic activity (LFnorm) and an increase in parasympathetic activity (HFnorm) for MM. LF:HF Ratio, which is an indication of sympatho-vagal balance also decreased, indicating a parasympathetic effect exerted by manual leg massage. In contrast, during R, LFnorm was higher and HFnorm lower and not significantly different from baseline. Rate pressure product, which is a surrogate measure of myocardial oxygen consumption and cardiac workload, decreased significantly from 8218±444units at baseline to 7154±502units (p=0.021) for MM, which was significantly lower than R (8126±488units) at the end of the 30mins, indicating a lower workload of the heart. Baseline leg skin temperature was 31.5±0.5°C. At the end of the 30mins, temperature had increased to 33.4±0.33°C for MM, which was significantly higher that R (31.5±0.4°C). Baseline perception of feeling measured on a 13 point bipolar scale was 2 (IQR 1.25, 3; ‘Fairly Good’). Feeling improved over the 30min period for MM; and was +6 (IQR 5, 6 ‘Very Good’). This was significant higher than R (2 (IQR 1.25, 3)). The results indicate that MM had the greater effect when compared to R, inducing a relaxation response. Conclusion Manual leg massage is effective at decreasing cardiac sympathetic and increasing parasympathetic activity, reducing the work of the heart and inducing a relaxation effect as shown by the perception of feeling scale.