I was pleasantly surprised at how well made it was and it's quite a learning experience. I did not use it for a massage but to recover from an eye surgery that required me to lie face down 20 hours a day for 7 days. I've used it in the car coming back from surgery and every day in bed to shift the support bar. between the bed mattress and the springs. In terms of comfort I would give maybe 4.5. The headrest is either faux leather or vinyl, not sure, but I also ordered a washable headrest from Converse, which made it better with extended use. If you're using this for a massage that lasts 45 minutes to an hour, it's fine even if you don't put a cover on it. My only complaint and suggestion is that the manufacturer should include a larger guide with better photos on how to assemble and use the portable desktop system. I had to pull out a magnifying glass to read the instructions. Overall I would order again if I needed another and I would recommend it to anyone having eye surgery that requires a face down recovery position.
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