The Impact of Giving a Massage
Condition: Mental State, Reported as Depression, Anxiety or Stress
MeSH terms: Depression; Depressive Disorder; Anxiety Disorders
Study type: Interventional
Phase: Early Phase 1

Summary: 
      The aim of this study is to investigate if giving a massage impacts the mental state of a
      massage therapist, including depression, anxiety, and stress . It is speculated that feelings
      of depression, anxiety and stress will reduce following the giving of a massage.
    

Detailed description: 
      Background It is well established that massage is beneficial for musculoskeletal conditions
      such as low back pain1-3 and neck pain. In addition, massage has been shown to alleviate
      depressive symptoms and reduce state anxiety and perceived stress. Furthermore, the
      therapeutic benefits of touch itself are recognized for many conditions and in many stages of
      life.

      Thus far all massage research has investigated the impact of massage on the massage client,
      or the receiver of the massage. No peer-reviewed study was found that reported any
      biopsychosocial effects on the giver of the massage, the massage therapist.

      With touch therapies such as massage, it is impossible to touch without being touched
      oneself. Therefore, it is speculated that the giver of a touch therapy will also receive a
      therapeutic benefit. In fact, it has been reported anecdotally that massage therapists often
      feel "better" after they give a massage than before. Feelings of exhilaration, enhanced
      well-being, and improved energy are common.

      The aim of this study is to investigate if giving a massage impacts the state of mind of
      massage therapists, including depression, anxiety, and stress.

      Methods

      Participants For this study, 22 participants who are massage therapists, students of massage
      or recent graduates will be recruited from the Parker School of Massage Therapy(PSMT).
      Participants will be included if they are healthy and aged between 18 and 65 years old, and
      excluded if they currently have any of the following conditions: contusion, fracture,
      inflammatory arthritides, peripheral neuropathy, or pregnancy. Of the eligible volunteers,
      ten participants will be randomly selected to the experimental group, while the other ten
      participants will act as controls. All interventions will occur in the PSMT.

      Interventions Participants in the experimental group will be asked to give one 50-minute
      Swedish massage to another volunteer. Control participants will be asked to wait in a
      classroom (i.e. do nothing) for the same amount of time.

      Objectives The aim of this study is to investigate if giving a massage impacts the mental
      state of a massage therapist, including depression, anxiety, and stress. It is speculated
      that feelings of depression, anxiety and stress will reduce following the giving of a
      massage.

      Outcomes The primary assessment measure will be the Depression, Anxiety, Stress Scales
      (DASS). The DASS is a set of three self-report scales measuring the affective states of
      depression ("D"), anxiety ("A") and stress ("S"). Each of the 21 items is scored from "0"
      (Did not apply to me at all) to "3" (Applied to me very much or most of the time). A template
      is used to score the test and subscore is achieved for each of the three subcategories.
      Subscores can range from 0 to 28+, with normals being at the lower end of the range. The DASS
      was found to have adequate convergent and discriminant validity and good reliability,
      including test-retest reliability.

      Secondary outcome measure will be the State-Trait Anxiety Inventory-II (STAI). The STAI is a
      self-report measure that assesses both state anxiety (i.e. feelings at present moment) and
      trait anxiety (i.e. general feelings). The 40 items are measured on a 4-point Likert scale
      (1=Almost Never to 4=Almost Always). Scores are obtained for each subscale (State and Trait
      Anxiety) with the higher scores indicating higher anxiety. The STAI has been shown to be
      valuable in both research and clinical settings, and has been found to have high internal
      consistency, and excellent test-retest reliability.

      Sample Size Sample size estimation was performed based on the primary outcome measure, the
      DASS. A minimum change in the total DASS score of 10 points is predicted using results from a
      similar effectiveness studies. Using the DSS Research Sample Size Calculator Software
      http://www.dssresearch.com/toolkit/sscalc/size_a2.asp), and a 5% level of confidence a total
      of 22 participants (11 per group) would be required for a statistical power of 0.81. We do
      not anticipate any loss-to-follow up and thus have not made any further adjustment for
      attrition.

      Randomization & Blinding Participants meeting the eligibility criteria will be pooled and a
      random drawing will determine which individuals will be in the experimental group and give
      the massage and which will act as controls. An independent assistant will perform the
      randomization process. Another independent assistant who is blind to group allocation will
      administer the assessment measures. Participants will be blind to group allocation for the
      duration of the study. While it is very difficult to blind participants when hands-on
      therapies are investigated, in this study this will be accomplished because giving a massage
      is a routine part of the day for these participants.
    

Intervention name(s): Give a massage
Intervention type(s): Behavioral
Intervention description(s): Participants in this arm will give a 50-minute Swedish massage to a volunteer.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Other
Keywords: Massage; Therapist, Massage; DASS; Depression; Anxiety, State; Anxiety, Trait; Stress; Touch; Therapeutic Relationship