Charalambous, A., Giannakopoulou, M., Bozas, E., & Paikousis, L. (2015). A randomized controlled trial for the effectiveness of progressive muscle relaxation and guided imagery as anxiety reducing interventions in breast and prostate cancer patients undergoing chemotherapy. Evidence-Based Complementary and Alternative Medicine, 2015, 270876. 

To test the effectiveness of progressive muscle relaxation (PMR) and guided imagery as stress-reducing interventions

Patients randomized to usual care had weekly meetings with psychologists. Those randomized to PMR and guided imagery had four supervised sessions and daily self-practice for three weeks. To stimulate imagery, the guided imagery component included auditory, tactile, and olfactory images. The imagery script was accompanied by music. The intervention was tested and measured with biofeedback prior to study use.  Both groups were assessed at baseline and at the end of three weeks. Daily text message reminders were sent to the intervention group to remind them to practice PMR.

• N = 208  
• AGE RANGE: 40-60 years
• MALES: 50%, FEMALES: 50%
• KEY DISEASE CHARACTERISTICS: Breast and prostate cancer
• OTHER KEY SAMPLE CHARACTERISTICS: 49% had university education; 71% were married

• SITE: Multi-site  
• SETTING TYPE: Home    
• LOCATION: Cyprus

• PHASE OF CARE: Active antitumor treatment

• Single, blind. randomized, controlled trial

• Zung self-rating anxiety scale
• Beck Depression Inventory
• Salivary a-amylase and cortisol levels

The group had a decrease in mean anxiety score whereas the control group had an increase in anxiety at three weeks compared to baseline. The difference between groups of this change was significant (p < 0.001).  The same pattern of change between groups was shown for depression (p < 0.001). Salivary amylase and cortisol levels were directly related to anxiety and depression scores (p < 0.001).

PMR and guided imagery were associated with reduced anxiety and depression among patients with breast and prostate cancer during chemotherapy.

• Risk of bias (no appropriate attentional control condition)
• Other limitations/explanation: No information was provided regarding patient adherence to daily PMR practice. No information was provided regarding any medications for anxiety or depression or chemotherapy regimens involved. Very limited demographic information is provided. The manner in which the imagery scenarios and music were provided were not described.

Findings here showed that progressive muscle relaxation and guided imagery were effective in reducing anxiety and depression during chemotherapy treatment. These are very low-risk interventions that can be helpful and can be readily incorporated into standard patient care.