A Meta-Analysis of Massage Therapy

A Meta-Analysis of Massage Therapy

اسلاید 1: www.tabaye.ir

اسلاید 2: A Meta-Analysis of Massage TherapyChristopher A. Moyer, James Rounds, and James W. HuffmanUniversity of Illinois -ChampaignViki Bedford, Radford University, 2004

اسلاید 3: Introduction 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.I chose this meta-analysis specifically because I am an insider--- a massage therapist since 1978.

اسلاید 4: Purpose of this meta-analysisConsumers visits to MT’s have increased 36% between 1990 & 1997Consumers 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.

اسلاید 5: Purpose of this meta-analysis (con’t)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.

اسلاید 6: The scope of this meta-analysisResearchers were hired to look for massage, massotherapy, acupressure, accupressure, applied kinesiology, bodywork, musculoskeletal manipulation, reflexology, relaxation techniques, 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.

اسلاید 7: Variables and MeasuresState anxietyNegative moodImmediate assessment of painCortisolBlood pressureHeart rateTrait anxietyDepressionDelayed assessment of pain

اسلاید 8: The scope of this meta-analysis (con’t.)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 as “a profession in which the practitioner applies manual techniques, and may apply adjunctive therapies, with the intention of positively affecting the health and well-being of the client” (AMTA, 1999a)

اسلاید 9: Various places and ways for giving massages

اسلاید 10: More massage pix

اسلاید 11: The scope of this meta-analysis (con’t.)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.

اسلاید 12: Massage Theories Considered:Gate Control Theory of Pain ReductionPromotion of Parasympathetic ActivityMechanical EffectsPromotion of Restorative SleepInterpersonal Attention, one-on-one style

اسلاید 13: ModeratorsWhether the length effects the magnitude of results, minimal or optimal times have never been examined as a variableAre results due to the characteristics of the therapist or recipientWhat are “the laboratory effects” (most has been done at TRI-32% of studies)How much does the therapists’ training or experience have on effects

اسلاید 14: Moderators (con’t.)The six specific moderators examined were non-significant:Minutes/sessions (was the only moderator that approached an alpha level for statistical significance)AgeTrainingLaboratory effectsComparison group typesPercent of female participants

اسلاید 15: PredictionsThat 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 groupsAnd no prediction was made concerning therapists’ training or laboratory effects.

اسلاید 16: EffectsSingle-dose- The term used for one time sessions; only state-anxiety, blood pressure, heart rate were significantMultiple-dose- repeated sessions over time; all outcome variables were significant within this category.

اسلاید 17: Statistical Analysis“Note: a positive g indicates a reduction for any outcome variable. *p<.05, **p<.01

اسلاید 18: ResultsMT 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.

اسلاید 19: Results (con’t)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.

اسلاید 20: MT Theories OutcomesMixed support for existing theoriesStrangely 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.

اسلاید 21: MT Theories (con’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.

اسلاید 22: Further comparisons of MT to psychotherapyAverage 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.

اسلاید 23: DiscussionFacts 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.

اسلاید 24: ReferencesA Meta-Analysis of Massage Therapy ResearchPsychological Bulletin2004, Vol.130, No. 1, 3-18Copyright 2004 by the American Psychological Association, Inc Photos from random Google image search for “massage”