1、A Meta-Analysis of Massage Therapy,Christopher A. Moyer, James Rounds, and James W. Huffman University of Illinois -Champaign,Viki Bedford, Radford University, 2004,Introduction,Massage Therapy (MT) has long been trying to gain empirical support as for too long it has been associated with illicit se
2、x, 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
3、 meta-analysis specifically because I am an insider- a massage therapist since 1978.,Purpose of this meta-analysis,Consumers visits to MTs have increased 36% between 1990 & 1997Consumers are spending between $4 & $6 billion annually for MT (not normally paid for w/ insurance!)Tooted benefits by MTs
4、are improved circulation, relaxation, feelings of well-being and reductions in anxiety and pain, with decreases in stress hormones (cortisol) and reduction of depression.,Purpose of this meta-analysis (cont),This meta-analysis seeks to determine how well these claims are justified.It also looked for
5、 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.,The scope of this meta-analysis,Researchers were hired to look for massage, massotherapy, acupressure, accupre
6、ssure, 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 mo
7、od, pain, cortisol, blood pressure, heart rate, trait anxiety, depression, delayed assessment of pain.,Variables and Measures,State anxiety Negative mood Immediate assessment of pain Cortisol Blood pressure Heart rate Trait anxiety Depression Delayed assessment of pain,The scope of this meta-analysi
8、s (cont.),The present studys 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 pressu
9、re 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),Various places and ways for giving massages,More massage pix
10、,The scope of this meta-analysis (cont.),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
11、 groups, which combined for a total of 1,802 participants, 795 received MT, 1,007 were either on wait lists or receiving placebo therapy.,Massage Theories Considered:,Gate Control Theory of Pain ReductionPromotion of Parasympathetic ActivityMechanical EffectsPromotion of Restorative SleepInterperson
12、al Attention, one-on-one style,Moderators,Whether 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 studie
13、s)How much does the therapists training or experience have on effects,Moderators (cont.),The six specific moderators examined were non-significant:Minutes/sessions (was the only moderator that approached an alpha level for statistical significance) Age Training Laboratory effects Comparison group ty
14、pes Percent of female participants,Predictions,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
15、 in the comparison groupsAnd no prediction was made concerning therapists training or laboratory effects.,Effects,Single-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 si
16、gnificant within this category.,Statistical Analysis,“Note: a positive g indicates a reduction for any outcome variable. *p.05, *p.01,Results,MT single-dose, didnt exhibit effects on immediate assessment of pain, which contradicts the common belief MT may provide analgesia per the gate control theor
17、y. 64% experienced reduction of state anxiety, and 60% a reduction in BP, and 66% for HR reduction over comparison groups.,Results (cont),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
18、 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 MTs largest effects.,MT Theories Outcomes,Mixed support for existing theories Strangely the ones most suppor
19、ted 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.,MT Theories
20、 (cont.),MT from a psychological perspective, not previous considered as a theory for MT effectiveness:MTs 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 th
21、e 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.,Further comparisons of MT to psychotherapy,Average psychot
22、herapy 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.,Discussion,Facts were supportive that the amount of training was not a factor in the effects.Both MT and psychotherapy rely on
23、 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 psychotherapys 50-mintwice weekly for 5 week span, that MTs effects may have matched or exceeded those of psychotherapy.,References,A Meta-Analysis of Massage Therapy Research Psychological Bulletin 2004, Vol.130, No. 1, 3-18 Copyright 2004 by the American Psychological Association, IncPhotos from random Google image search for “massage”,
