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

Abstract

RESEARCH QUESTION: How feasible and effective is the therapy package in reducing perceived and physiological stress in men?

ABSTRACT:

BACKGROUND Stress is thought to have negative effects on the cardiovascular, nervous, immune, gastrointestinal and reproductive systems. Multimodal interventions may confer benefits for stressed populations. They are time effective and are thought to address multiple types of stresses. However, there is limited research examining the effects of manual therapy with or without psychoeducation on promoting relaxation and reducing stress. In particular, studies examining male population are rare, despite the incidence of stress and mental health concerns in men coming more into focus.

METHODS: This pilot, uncontrolled trial with mixed pragmatic and explanatory design, assessed the feasibility of applying a therapy package designed to reduce stress in men. The objectives of this study were to: (1) assess the feedback from participants and challenges encountered; (2) assess the health status in 7 men using health screening measures, such as blood pressure, pulse and adapted medical history; (3) to determine baseline levels of physiological stress biomarkers (cortisol, sIgA and IL-6); (4) to assess baseline perceived stress in 7 men, using the adapted Perceived Stress Scales and Profile of Mood Scale; and (5) to undertake an uncontrolled trial with mixed pragmatic and explanatory design to assess the feasibility and effects of a therapy package on stress (psychological and physiological), delivered on 7 men, on two consecutive days. The therapy package included ten general osteopathic techniques, ten minutes of stress management education and an education pamphlet. The effect of the therapy package was assessed through pre- and post-intervention salivary levels of stress biomarkers (cortisol; secretary Immunoglobulin A; Interleukin-6) and self-report of stress (Perceived Stress Scale- 10; Profile of Mood Scale).

RESULTS: The therapy package was easy to administer and its application in a clinical osteopathic practice setting with a small number of male participant (n=7) was feasible. The follow up and retention of participants was positive. The timing of sessions on consecutive days was challenging and this may have affected the recruitment of participants. A significant decrease was observed across all participants in Perceived Stress Scale-10 over the course of the intervention (ps < 0.05). There were also significant decreases in some of the subscales of the Profile of Mood Scale (Tense, Fatigue, Depression, Anger). In contrast, cortisol, secretary Immunoglobulin A and Interleukin-6 levels increased in the majority of participants and no clear relationship between psychological and physiological stress measures could be observed.

DISCUSSION: The application of the therapy package and the collection of saliva was feasible. Participants of the study showed an overall decrease in psychological stress suggesting that manual therapy in conjunction with stress management education may work to promote relaxation and reduce stress. The effect on physiological stress in men was, however, less clear. Future studies with larger sample size and the use of non-diurnal samples, such as hair samples, may usefully extend the examination of the effects of a therapy package consisting of manual therapy and stress management education.