Molassiotis, A., Yung, H.P, Yam, B.M.C., Chan, F.Y.S., & Mok, T.S.K. (2002). The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: A randomised controlled trial. Supportive Care in Cancer, 10, 237–246.

To assess the effectiveness of progressive muscle relaxation (PMR) and guided imagery training as an adjuvant intervention and accompanying antiemetics (metoclopramide, dexamethasone) in managing acute and delayed nausea and vomiting, anxiety, and depression

In the experimental group, PMR was initiated for 25 minutes and guided imagery for 5 minutes, each one hour before chemotherapy was administered.

The study reported on 71 Chinese chemotherapy-naive women with breast cancer who were older than 30 years and were receiving doxorubicin and cyclophosphamide.

The study was conducted at a university hospital outpatient treatment center in Hong Kong.

This was a randomized, controlled clinical trial.

The Profile of Mood States, State-Trait Anxiety Index, and Morrow Assessment of Nausea and Vomiting were translated into Chinese and back-translated. Measures were piloted on 25 patients prior to use in the study. Demographic data and vital signs measures were used.

The effects of PMR therapy and guided imagery were more pronounced at the initial stage of treatment when patients did not know what to expect. The effects were reduced on the fourth day and beyond. The study did not show a significant reduction in the intensity of nausea and vomiting after chemotherapy; the baseline nausea and vomiting values showed that the patients in this study began with considerably lower levels of nausea and vomiting than in previous studies. The combination of PMR and guided imagery was beneficial for cognitive distraction and relaxation, components that reduce stress and anxiety. The physiologic benefit to these techniques was discussed. Differences in Chinese and Western cultures related to expression of emotions was noted.

PMR therapy with guided imagery was found to be superior to standard antiemetic treatment alone in managing acute and delayed chemotherapy-induced nausea and vomiting.

• Pharmacologic agents prescribed were metoclopramide and dexamethasone for doxorubicin and cyclophosphamide treatment; 5-HT₃ was not given despite publication in 2002.
• Only one population (Chinese) was included.