Shiatsu is an alternative therapy that is popular, but has so far attracted almost no research. Therefore, I was excited when I saw a new paper on the subject. Sadly, my excitement waned quickly when I stared reading the abstract.
This single-blind randomized controlled study was aimed to evaluate shiatsu on mood, cognition, and functional independence in patients undergoing physical activity. Alzheimer disease (AD) patients with depression were randomly assigned to the “active group” (Shiatsu + physical activity) or the “control group” (physical activity alone).
Shiatsu was performed by the same therapist once a week for ten months. Global cognitive functioning (Mini Mental State Examination – MMSE), depressive symptoms (Geriatric Depression Scale – GDS), and functional status (Activity of Daily Living – ADL, Instrumental ADL – IADL) were assessed before and after the intervention.
The researchers found a within-group improvement of MMSE, ADL, and GDS in the Shiatsu group. However, the analysis of differences before and after the interventions showed a statistically significant decrease of GDS score only in the Shiatsu group.
The authors concluded that the combination of Shiatsu and physical activity improved depression in AD patients compared to physical activity alone. The pathomechanism might involve neuroendocrine-mediated effects of Shiatsu on neural circuits implicated in mood and affect regulation.
- We first evaluated the effect of Shiatsu in depressed patients with Alzheimer’s disease (AD).
- Shiatsu significantly reduced depression in a sample of mild-to-moderate AD patients.
- Neuroendocrine-mediated effect of Shiatsu may modulate mood and affect neural circuits.
Where to begin?
1 The study is called a ‘pilot’. As such it should not draw conclusions about the effectiveness of Shiatsu.
2 The design of the study was such that there was no accounting for the placebo effect (the often-discussed ‘A+B vs B’ design); therefore, it is impossible to attribute the observed outcome to Shiatsu. The ‘highlight’ – Shiatsu significantly reduced depression in a sample of mild-to-moderate AD patients – therefore turns out to be a low-light.
3 As this was a study with a control group, within-group changes are irrelevant and do not even deserve a mention.
4 The last point about the mode of action is pure speculation, and not borne out of the data presented.
5 Accumulating so much nonsense in one research paper is, in my view, unethical.