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.
Luebbert, K., Dahme, B., & Hasenbring, M. (2001). The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non-surgical cancer treatment: A meta-analytical review. Psycho-Oncology, 10, 490-502.
Databases searched were MEDLINE, PsycINFO, PSYNDEX, and CANCERLIT (1980-Dec., 1995).
Search keywords were relaxation techniques, progressive muscle relaxation (PMR), autogenic training, hypnosis, imagination, and guided imagery in combination with neoplasms, cancer treatment, chemotherapy, radiotherapy, drug therapy, and bone marrow transplantation.
A total of 280 abstracts were found, 58 studies were relevant, and 15 met the inclusion criteria for meta-analysis. Moderator variables included intensity, schedule, and focus of intervention.
A total of 742 primarily female subjects with variable malignancies receiving highly emetogenic chemotherapy and trained in progressive muscle relaxation (PMR) were part of this review.
Consistent positive results in meta-analysis studies showed clinically significant reductions in nausea and other symptoms. Relaxation during the courses of treatment made the experience less stressful, reducing side effects. Studies supported the implementation of relaxation training into clinical routines as standard adjunctive treatment.
Miller, M., & Kearney, N. (2004). Chemotherapy-related nausea and vomiting—Past reflections, present practice and future management. European Journal of Cancer Care, 13(1), 71-81.
Support for the use of nonpharmacologic interventions for the treatment of chemotherapy-induced nausea and vomiting (CINV) was weak.
Many studies were flawed because of small sample sizes and confounding variables (e.g., stage of disease, various chemotherapy regimens, culture, patient compliance).
Preliminary available evidence suggests positive benefits through nonpharmacologic techniques; however, larger randomized trials are needed to demonstrate the exact benefits, including economic.
Borjeson, S., Hursti, T.J., Tishelman, C., Peterson, C., & Steineck, G. (2002). Treatment of nausea and emesis during cancer chemotherapy: Discrepancies between antiemetic effect and well-being. Journal of Pain and Symptom Management, 24, 345–358.
To evaluate the relationship between antiemetic effect and well being over four different antiemetic treatment strategies
This study was conducted in the greater Stockholm, Sweden, area, with two gynecologic oncology wards.
Patients were randomly admitted to one of the two hospital wards for the study. Study II was a randomized, double-blind trial on the same hospital wards.
Campos de Carvalho, E., Martins, F.T., & dos Santos C.B. (2007). A pilot study of a relaxation technique for management of nausea and vomiting in patients receiving cancer chemotherapy. Cancer Nursing, 30(2), 163-167.
To determine the effect of progressive muscle relaxation (PMR) on chemotherapy-induced nausea and vomiting (CINV)
Patients receiving chemotherapy underwent an intervention consisting of 25-minute sessions of PMR (tensing-releasing) and control of respiration in an environment characterized by little artificial illumination and adequate music, without interruptions. Before and after the interventions, specific physiologic and self-report variables were measured. A registered nurse, who was trained in measuring physiologic alterations and muscle reactions, collected the data. Patients were asked to consider the presence of nausea one hour before and one hour after the intervention.
The study consisted of 30 patients who were over 18 years of age, had been diagnosed with hematologic cancers, were receiving chemotherapy, were experiencing nausea and vomiting at the time of data collection, and were hospitalized. Participants were capable of maintaining a logical conversation and had not received antiemetics five hours before undergoing the relaxation intervention. Patients were excluded from the study if they had evolving multiple myeloma or suspected bone fractures.
The study was conducted at a large hospital in Brazil.
This was a pre-and post-test pilot study.
PMR was associated with decreased physiologic conditions and muscle reactions, as well as a statistically significant reduction in the intensity of nausea and vomiting levels.
PMR techniques may be an effective intervention to reduce nausea in patients receiving chemotherapy.
PMR is a low-cost technique that can be easily taught to patients for use as an intervention for the management of CINV.
Sahler, O.J.Z., Hunter, B.C., & Liesveld, J.L. (2003). The effect of using music therapy with relaxation imagery in the management of patients undergoing bone marrow transplantation: A pilot feasibility study. Alternative Therapies, 9(6), 70–74.
A 45-minute music-assisted intervention with relaxation imagery sessions was provided twice a week by a trained therapist from the date of enrollment in the study to discharge.
The study was conducted at a university bone marrow transplant center.
Patients were undergoing the active treatment phase of care.
The study had a case-controlled, nonrandomized convenience sample design.
Patient self-reported pre- and postintervention nausea and pain on a 0–10 scale. Time to engraftment also was measured.
Nausea, pain, and time to engraftment decreased from pre- to postintervention.
The intervention was implemented successfully with a very ill population (i.e., transplant environment).