Assessing the feasibility of a therapy package application on reducing psychological and physiological stress in women : a pilot study

Abstract

INTRODUCTION AND AIM: There is mounting evidence regarding the existing relationship between stress and adverse health outcomes. As stress is multidimensional, the need for a multimodal approach to manage stress is warranted. There is a high incidence of stress among women compared to men, which can be due to various factors including financial, housing, personal health and occupational stress. Despite some literature indicating the positive effect massage therapy has on stress, there is limited research demonstrating the effects general osteopathic therapy has, either with or without stress management education on reducing stress. Therefore, the aim for this project was to conduct a pilot study assessing the feasibility of a therapy package application on reducing stress in women.

METHOD: This was a pilot uncontrolled trial with mixed pragmatic and exploratory design. The therapy package comprised of ten general osteopathic techniques and ten minutes of scripted stress management education, which was applied in two sessions over two consecutive days. The effects of the therapy package were assessed by measuring pre- and post-intervention scores of self-reported perceived stress (Perceived Stress Scale-10 and Profile of Mood Scale) and salivary levels of physiological biomarkers (cortisol, secretory Immunoglobulin A and Interleukin-6). In addition, feedback from participants and challenges experienced by both participants and the researcher assessed.

RESULTS: The therapy package was easy to administer to apply to the small sample size in an osteopathic clinical setting. A total of 11 female participants (age = 33.72 years, SD = 12.8) were enrolled, with a 100% retention rate. There were no recorded dropouts and no follow ups. The early morning sessions over two consecutive days were challenging for the majority of the participants. However, all women felt “relaxed” after the therapy package with no reported adverse effects. A significant decrease was observed across all participants in the scores of Perceived Stress Scale-10 over the course of the intervention (p = < 0.03). There were also significant decreases in the subscale scores of the Profile of Mood Scale (Tense, Fatigue, Depression, Anger). Cortisol, interleukin-6 and secretory immunoglobulin-A levels did not show any specific pattern of change over the course of the intervention. Overall there was no clear relationship observed between perceived, psychological stress scores and physiological stress biomarker levels or any clear patterns of change.

CONCLUSIONS: The application of the therapy package was feasible. The overall decrease in the Perceived Stress Scale-10 scores in the majority of participants suggests that the plausibility of this therapy package (ten selected osteopathic techniques, in combination with stress management education), contributed to reducing perceived stress. However, the effect on physiological stress was not clear, the results need further investigation. Future studies may benefit by employing randomised controlled trial design, with a larger sample size. Additionally, future researchers may need to consider utilising physiological biomarkers without diurnal variation and employing a flexible time for therapy application.