MASSAGE & RELAXATION THERAPHY

Posted by Canadian Pharmacy on Wednesday, December 5th, 2007

Massage therapy. Relaxation therapy
Filed under Depression


MASSAGE THERAPY
There are several different forms and traditions of massage therapy. (72) In the context of this article, massage uses typically a gentle manual stroking technique over the body (usually the back). This has a number of complex physiological and psychological effects, not least of which is relaxation of both the musculature and the mind. (72) A treatment, usually carried out by an NMQT, would normally last for 20 to 30 minutes and a series of approximately 6 twice weekly sessions would constitute a typical prescription.

Most publications relating to massage and depression were found to consist of anecdotal accounts and case studies. (73, 74) A recent review (75) of massage therapy uncovered only a few controlled trials. An RCT (76) allocated 122 intensive care unit patients to receive either massage, massage with 1% lavender (Lavendula vera) oil, or rest periods. Those who received the massage with lavender oil reported a greater improvement in mood as measured by a self-rating 4-point scale. The study did not involve patients with depression, was short-term, and used a crude outcome measure. It is thus not possible to draw firm conclusions from its results.

In a well-conducted RCT, (77,78) 72 hospitalized children and adolescents, half with adjustment disorder and half with depression, either received 30-minute back massages (n=52) daily for 5 days or watched a relaxing video (n=20) for the same period. Profile of mood states depression scores were significantly lower immediately after massage compared with pretreatment values (P=.005). In addition, the premassage profile of mood states scores significantly declined during the 5-day treatment period (P=.01), and the massage group was less depressed than the control group at the end of the study. Because of the small sample size and the short treatment period, the data are insufficient to judge the value of massage for depression.

RELAXATION THERAPY

Relaxation therapy is an umbrella term for several techniques primarily aimed at decreasing physical and mental tension. Such treatments may include elements of meditation, yoga, and other mind-body therapies. They would normally be carried out by NMQTs.

Three RCTs (82-84) investigating the effects of relaxation therapy were found. In the first study, 30 psychiatric outpatients with depression, all taking medication, were randomized to 3 groups. (82) Two of the groups were given different forms of relaxation therapy during 3 days, while the third group acted as a control. Compared with controls, both relaxation-therapy groups showed a significant improvement in symptom scores (P<.05). However, a symptom score list was used that had not been validated, the sample size was small, and the treatment period short.

In an RCT (83) involving 37 moderately depressed patients assigned to cognitive behavior therapy, relaxation therapy, or tricyclic antidepressants, the first 2 interventions resulted in significantly better mean Beck Depression Inventory scores than the pharmacological treatment (P<.01). The results should be viewed with caution because of the small sample size, lack of control for the nonspecific effects of attention from professionals, and reported noncompliance with the medication regime.

An RCT (84) in 30 moderately depressed adolescents showed that relaxation training or cognitive behavior therapy resulted in a greater improvement than no intervention. Again, the sample size was small and there was no control for nonspecific effects.

On balance, therefore, relaxation treatments are promising, but further research and replications are required