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عرومجوت() ۳اه عنوراهی()-۱0ع() ظ)
Pkerapy
Christopher A. Moyer, James Rounds, and James W. Huffman
University of llinais Champaign
Viki Bedford, Radford University, 2004
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۱
© Massage Therapy (MT) has long been
trying to gain empirical support as for too
long it has been associated with illicit sex,
erotica or pampering for the rich.
© Empirical support of efficacy of massage
therapy as a healing modality is required
before it will be accepted by insurance
companies.
© In general interest in massage therapy
has grown in both professional and
consumer groups as a complementary
medicine.
| chose this meta-analysis specifically
because | am an insider--- a massage
therapist since 1978.
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(Purpose oP this weto-ucdsis
© Consumers visits to MT’s have increased 36%
between 1990 & 1997
© Consumers are spending between $4 & $6 billion
annually for MT (not normally paid for w/
insurance!)
© Tooted benefits by MT’s are improved circulation,
relaxation, feelings of well-being and reductions
in anxiety and pain, with decreases in stress
hormones (cortisol) and reduction of depression.
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(أمصم) جص دده مادف جا خام جوووى 15
© This meta-analysis seeks to determine
how well these claims are justified.
© It also looked for MT as a valid
treatment for psychological problems
that drugs are often used for treatment
in combination w/ psychotherapy, even
though it is more known as a more
physical type of therapy.
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The svvpe oF this weto-ccdsis
© Researchers were hired to look for
massage, massotherapy, acupressure,
accupressure, applied kinesiology,
bodywork, musculoskeletal manipulation,
reflexology, relaxation fecaniques, Rolfing,
Touch Research Institute, and Trager. Those
found were used to find other articles.
© Mean effect sizes were calculated from 37
studies for 9 dependent variables, state
anxiety, negative mood, pain, cortisol,
blood pressure, heart rate,, trait anxiety,
depression, delayed assessment of pain.
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Onunubles unt Oeusures
. State anxiety
. Negative mood
. Immediate assessment of pain
. Cortisol
. Blood pressure
. Heart rate
. Trait anxiety
. Depression
. Delayed assessment of pain
CON AUR WN
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(ممم) جور راكحه- مادص جذاا خام ووسو ۳
© The present study’s operational definition of
massage therapy (MT) is defined “as the
manual manipulation of soft tissue intended
to promote health and well-being.”
© The AMTA definition is broader: manual soft
tissue manipulation [that] includes holding,
causing movement, and/or applying
pressure to the body” and massage therapy
s “a profession in which the practitioner
applies manual techniques, and may apply
adjunctive therapies, with the intention o
positively affecting the health and well-being
of the client” (AMTA, 1999a)
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wossuyes مشش places ond ways Por عون
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(ممم) جور مجه مادص عا 2۳ وومسو ع۳/
© Studies were limited to human, other
than infants, in English; ---studies using
mechanical devices, ice or hot stones,
chiropractic, passive motion, etc, were
excluded.
© These criteria yielded 144 studies, 37
actually used as they had random
assignment, w/control groups, which
combined for a total of 1,802
participants, 795 received MT, 1,007
were either on wait lists or receiving
placebo therapy.
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Oussaye MRevries Cvusidered:
© Gate Control Theory of Pain
Reduction
© Promotion of Parasympathetic
Activity
© Mechanical Effects
° Promotion of Restorative Sleep
° Interpersonal Attention, one-on-one
style
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جسرو سرد لدج (1)
© Whether the length effects the magnitude
of results, minimal or optimal times have
never been examined as a variable
© Are results due to the characteristics of
the therapist or recipient
© What are “the laboratory effects” (most
has been done at TRI-32% of studies)
© How much does the therapists’ training or
experience have on effects
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Ovderators (cos't.)
The six specific moderators examined
were non-significant:
1. Minutes/sessions (was the only moderator
that approached an alpha level for
statistical significance)
Age
Training
Laboratory effects
Comparison group types
Percent of female participants
et 1 2 Se
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سل
© That MT will “promote significant and
desirable reductions” of their 9 dependent
variables.
© That greater reductions will be associated
with higher doses.
© That effects are not expected to vary by age
or gender.
© MT effects will be larger than those
generated in the comparison groups
© And no prediction was made concerning
therapists’ training or laboratory effects.
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(BPP ects
° Single-dose- The term used for one
time sessions; only state-anxiety,
blood pressure, heart rate were
significant
© Multiple-dose- repeated sessions
over time; all outcome variables
were significant within this
category.
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95% Cl
0.21, 0.48
0.14, 0.59
-0.08, 0.76
-0.01, 0.57
-0.10, 0.38
0.03, 0.48
0.19, 0.62
0.27, 1.22
0.37, 0.88
0.10, 0.52
g (d)
0.34"
0.37"
0.34
0.28
0.14
0.25*
0.41"
0.75**
0.62**
0.31"
Graisicd @Poapsis
3
37
21
15
10
5
Outcome variables
Overall
Single-dose effects
State anxiety
Negative Mood
Immediate pain
Cortisol
Blood pressure
Heart rate
Multiple-dose effects
Trait anxiety
Depression
Delayed pain
“Note: a positive و indicates a reduction for any outcome variable. *p<.05, **p<.01
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Results
° MT single-dose, didn’t exhibit
effects on immediate assessment of
pain, which contradicts the common
belief MT may provide analgesia per
the gate control theory.
° 64% experienced reduction of state
anxiety, and 60% a reduction in BP,
and 66% for HR reduction over
comparison groups.
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Results (cow)
© For multiple-doses: “despite the fact
that MT did not demonstrate an effect on
immediate assessment of pain, a
significant effect was found for delayed
assessment of pain”, lower weeks later by
62% over the comparison groups, which
may be due to the theory of sleep
improvement.
© Reduction of trait anxiety and depression
after a course of treatments were MT’s
largest effects.
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OPV Vkevries Outrowes
© Mixed support for existing theories
* Strangely the ones most supported by
therapists were least supported in this
meta-analysis.
* Reduction of BP and HR do support that
MT promotes a parasympathetic
response.
* Lasting pain relief may be due to
mechanical theories, through promotion
of circulation, improved sleep and
breakdown of adhesions that cause
pain.
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OV Vkevres (cow't.)
© MT from a psychological perspective,
not previous considered as a theory for MT
effectiveness:
MT’s benefits may be because they parallel
the “common-factors model” of
psychotherapy--- a client who expects therapy
will help, a therapist who is warm and has
positive regard for the client, and the
development of a healing alliance are
considered more important in psychotherapy
than the specific concepts one follows.
Findings show MT has a magnitude of effects
on trait anxiety and depression to what would
be expected in psychotherapy.
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Curtker cowparsrcs oP OT te psychotherapy
° Average psychotherapy clients fare
better than 79% of untreated
clients.
© Average MT client experienced
reduction of 77% for anxiety and
73% reduction for depression than
comparison groups.
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Oismussion
© Facts were supportive that the amount of training
was not a factor in the effects.
© Both MT and psychotherapy rely on repeated
private interpersonal contact between 2 people.
© Most of these studies used an average 30 minute
session, but these authors feel if that matched
more closely to psychotherapy’s 50-mintwice
weekly for 5 week span, that MT’s effects may
have matched or exceeded those of
psychotherapy.
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و۱
A Meta-Analysis of
Massage Therapy
Research
Psychological Bulletin
2004, Vol.130, No. 1, 3-18
Copyright 2004 by the
American Psychological
Association, Inc
Photos from random
Google image search
for “massage”