Assuming you keep a fair amount of space on the disk, NTFS does a pretty good job of keeping itself defragmented. As long as it can find space to write a file in one continuous lump, it will. It's when the disk gets full that it starts splitting clusters up, and that causes slowdowns.
IMHO, the best method I've found is to first make sure that your swap file is defragmented:
http://technet.microsoft.com/en-us/s.../bb897426.aspx
I generally go with the 'double ram size' rule on swap files, and fix them to that size, then run pagedefrag over them. Then forget about it! Best done as one of the absolute first things when you install Windows, as it doesn't have much of an effect long-term if you do it later.
For the odd few files that do get horribly fragmented, you need contig:
http://technet.microsoft.com/en-us/s.../bb897428.aspx
You can run it on a specific file, or directory structure, and it'll push those files into one piece.
I rarely defrag, as I keep things tidy anyway. Giving windows space to write things is the best bet.