Arakawa, S. (1997). Relaxation to reduce nausea, vomiting, and anxiety induced by chemotherapy in Japanese patients. Cancer Nursing, 20, 342-349.

To evaluate the use of progressive muscle relaxation training in the management of nausea, vomiting, and anxiety induced by chemotherapy

The experimental group received training that consisted of tensing and releasing 16 muscle groups and breathing deeply for a total of 25 minutes. Each subject was provided with an audiotape and instructed to practice independently twice daily before meals or two hours afterward. The investigator met with the control group for 15 minutes per day to discuss concerns.

• The study consisted of 60 Japanese patients with cancer (30 subjects in the experimental group and 30 subjects in the control group) who were actively receiving chemotherapy.
• Patients' ages ranged from 21–75 years.
• Patients did not practice progressive muscle relaxation in their daily lives.

This study was conducted at a 415-bed, hospital-based cancer center in Japan.

The study was a randomized pretest, post-test control group design with repeated measures.

The Rhodes Index of Nausea and Vomiting-Form 2 (Japanese version) and the Spielberger State-Trait Anxiety Inventory were used. Reliability and validity were described in depth.

• Progressive muscle relaxation decreased the total index of nausea and vomiting scores of the experimental group.
• Index of nausea and vomiting scores for the control group increased to their highest levels 60–72 hours after chemotherapy.

Progressive muscle relaxation may contribute to a reduction in delayed nausea and vomiting. This study did confirm the usefulness of progressive muscle relaxation in decreasing the incidence of vomiting. Progressive muscle relaxation decreased subjective feelings of anxiety.

• The number, type, and dosage of chemotherapy and antiemetics were not controlled.
• Vomiting scores were very low for the experimental and control groups.
• Only one investigator conducted the study, which introduces potential investigator bias.
• The study involved only one population (Japanese patients).