Sun, F.K., Hung, C.M., Yao, Y., Lu, C.Y., & Chiang, C.Y. (2017). The effects of muscle relaxation and therapeutic walking on depression, suicidal ideation, and quality of life in breast cancer patients receiving chemotherapy. Cancer Nursing, 40, E39-E48.

To measure the effects of muscle relaxation and therapeutic walking on depression, suicidal ideation, and quality of life in patients with breast cancer receiving chemotherapy

Two interventions. (a) muscle relaxation techniques using CD at least two times daily for 12 weeks, three visits in the hospital by the researcher who trained them in the practice of the MRT, and understood the techniques. (b) Therapeutic walking with a pedometer provided to patients. Walking technique and pedometer use taught by researcher. Asked to walk 90-120 minutes per week or three times per week for at least 30 minutes per session. Record steps, walking time, strength for 12 weeks. Control group: no intervention.

• N = 87   
• MEAN AGE: 54.1 years
• FEMALES: 100%
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Breast cancer
• OTHER KEY SAMPLE CHARACTERISTICS: Half had stage II breast cancer, half had been diagnosed for more than 1 year and had finished their chemotherapy. Most were not in relapse, had no psychiatric history, and were not using medication for depression.

• SITE: Multi-site   
• SETTING TYPE: Multiple settings    
• LOCATION: Surgical outpatient, surgical unit hospital in south Taiwan

• PHASE OF CARE: Active anti-tumor treatment
• APPLICATIONS: Elder care

Randomized control study

• Center for Epidemiological Studies Depression Scale
• Beck Scale for Suicidal Ideation
• World Health Organization Questionnaire on Quality of Life

The results showed no significant difference in any outcome variable in the pretest. The results of the post-test indicated that the two groups scored significantly differently only on the Center for Epidemiological Studies Depression Scale (U = 638, p < 0.05). The patients with breast cancer who participated in the three-month muscle relaxation and therapeutic walking interventions had a lower level of depression  (R_E = 37) than those who did not (R_C = 51.16).

No difference in groups on pretesting (initially).  After intervention, the group with the intervention scored significantly differently only on the depression scale.

• Small sample (< 100)
• Intervention expensive, impractical, or training needs

Nursing staff could teach and encourage the use of muscle relaxation techniques, as well as therapeutic walking to reduce depressive symptoms for patients undergoing chemotherapy.