Progressive muscle relaxation (PMR) is a technique of alternately tensing and relaxing muscles groups in sequence throughout the body. When going through muscle groups, individuals can start with the head and neck and progress to the feet, or vice versa. Similarly, individuals may do one side of the body at a time or both sides at the same time. Listening to a prerecorded script may be used to guide individuals through the process. PMR has been examined for effectiveness in patients with cancer for anxiety, depression, dyspnea, sleep-wake disturbances, fatigue, and chemotherapy-induced nausea and vomiting. PMR often is combined with the technique of guided imagery.
Decker, T. W., Cline-Elsen, J., & Gallagher, M. (1992). Relaxation therapy as an adjunct in radiation oncology. Journal of Clinical Psychology, 48, 388–393.
Patients were instructed in six individual one-hour sessions on the use of progressive muscle relaxation (PMR) and were provided with a relaxation tape and written instructions. In addition to relaxation training, the session provided support focused on concerns related to cancer radiation treatment and its effects and on the physical and emotional sensations experienced. During the fourth session, cue-controlled relaxation was presented as an active coping process that included four steps: PMR, deep breathing, pairing the relaxed state with a self-induced cue word (“calm\"), and coping with tension by self-administration of the cue-controlled relaxation response. During the last session, client concerns about cancer, treatments, stress, and relaxation were reviewed, and further questions were answered. The importance of practicing relaxation regularly at home was emphasized. The control group received usual care.
Outpatient radiation treatment facility
Patients were undergoing the active treatment phase of care.
The study was a randomized, controlled trial with a usual care control group.
Profile of Mood States (POMS)
Patients receiving relaxation training reported a significant reduction in tension and anger and a trend toward less depression. Comparisons between the relaxation therapy and control groups using MANOVA indicated that there were no statistically significant differences in the pre- and posttest scores for the controls, with the exception of fatigue; patients in the control group became significantly more fatigued (p = 0.01).
Demiralp, M., Oflaz, F., & Komurcu, S. (2010). Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. Journal of Clinical Nursing, 19, 1073–1083.
To investigate the effect of progressive muscle relaxation (PMR) training on sleep quality and fatigue in Turkish women with breast cancer undergoing adjuvant chemotherapy.
Following the eligibility assessment and obtaining informed consent, patients in the PMR group were invited to a private practice room for relaxation training. Patients in the PMR group were given PMR therapy in addition to chemotherapy and routine nursing services at the outpatient unit. Patients in the control group had chemotherapy and routine nursing services without PMR therapy. PMR therapy was performed in 25- to 30-minute sessions on the first and fifteenth days of each chemotherapy cycle. Patients in the intervention group were given a CD and encouraged to do exercises every day at home.
The study was conducted in the outpatient unit of the medical oncology department of the Gulhane Military Medical Academy in Turkey.
Patients were undergoing the active treatment (chemotherapy) phase of care.
The study used a prospective, repeated-measures, quasiexperimental design with a control group.
The PMR group experienced a greater increase in improved sleep quality and a greater decrease in fatigue than the control group. Mean sleep efficiency, sleep distrubances, and total PSQI scores were significantly lower in the control group (p < 0.05). Total fatigue scores were significantly better in the experimental group compared to the control group (p = 0.014).
The findings suggested that PMR training may improve sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy.
PMR training given by a nurse may improve sleep quality and fatigue in patients with breast cancer. It is important to start relaxation training just before chemotherapy to decrease the frequency and severity of sleep problems and symptoms, such as fatigue during chemotherapy.