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This study aims to determine the effects of health education (HE) and progressive muscle relaxation (PMR), individually or combined, on vasomotor symptoms and insomnia in perimenopausal women.This study is a single-center, pretest-posttest, randomized controlled trial with a factorial design. The research sample consists of 108 women who were randomly divided into three groups: HE + PMR group (n = 36), PMR group (n = 36) and control group (n = 36). 90 women completed the study. The data were collected in three steps by using instruments of Personal Information Form, Visual Analog Scale and a diary for vasomotor symptoms, Women's Health Initiative Insomnia Rating Scale.Hot flash and night sweats frequency and severity scores/24 h, the VAS scores for hot flashes and night sweats, and the WHIIRS scores significantly improved more in the intervention groups compared to the control group (p lt; 0,05). Compared to the group PMR, the group PMR + HE had a greater improvement with larger effect size in all measurements.PMR and HE counseling by nurses benefit perimenopausal women who suffer from insomnia and vasomotor symptoms.PMR combined with HE or PMR alone is effective in managing vasomotor symptoms and insomnia; therefore, they can easily be integrated into clinical practice.

Surgery for head and neck cancers are associated with significant preoperative stress. We investigated the effects of progressive muscle relaxation (PMR) on postoperative pain, fatigue, and vital signs in patients with head and neck cancers.All patients were hospitalized and randomly assigned to intervention or usual care groups. A generalized estimating equation was used to evaluate the PMR effects on pain and symptoms across the preoperative day to postoperative day 10.The PMR group displayed significantly lower overall pain and muscle tightness than control group along with the timeline of multiple measurements (p 0.01). PMR significantly reduces sleep disturbances and levels of fatigue, anxiety, and depression compared with the control group with time trend (p 0.01). PMR also lowered the respiratory rates and diastolic blood pressure (p 0.01).PMR can reduce sleep disturbances and levels of pain, fatigue, muscle tightness, anxiety, and depression in patients with head and neck cancer undergoing major surgeries. Future study should focus on improving the effectiveness of the exercise and standardization of the application.progressive muscle relaxation help relieve discomforts in patients with head and neck cancers with minimal costs and efforts.

Background A growing body of literature shows that psychological distress is not only a major threat to psychological well-being but can also have a significant impact on physical health. In cancer patients, it can negatively affect prognosis and posttreatment recovery processes. Since face-to-face psychological interventions are often inaccessible to cancer patients, researchers have recently been focusing on the effectiveness of eHealth adaptations of well-established approaches. In this context, there has been a call for high-quality randomised controlled trials that would allow for a direct comparison of different approaches, potentially addressing different needs and preferences of patients, and also for more systematic research focusing on how psychological interventions affect not only psychological but also biological markers of stress. Both of these questions are addressed in the present study. Methods A randomised controlled trial will be carried out to test and compare the effectiveness of three eight-week eHealth programmes for the mental health support of cancer patients. All programmes will be delivered through the same application for mobile devices MOU MindCare. N = 440 of breast cancer survivors will be recruited at the end of their adjuvant treatment (chemotherapy, radiotherapy, or both) and randomly assigned to one of the three interventions – Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), Positive Psychology (PP), or Autogenic Training (AT) – or the treatment-as-usual (TAU) control group. Psychological and biological markers of stress and adaptive functioning will be assessed at baseline (T0), post-treatment (T1), three-month follow-up (T2), and nine-month follow-up (T3). Primary outcomes will include heart-rate variability and self-report measures of depression, anxiety, perceived stress, general quality of life, and positive mental health. Secondary outcomes will include the levels of serum cortisol and immunomarkers, sleep quality, fatigue, common health symptoms, and several transdiagnostic psychological variables that are expected to be specifically affected by the MBCT-Ca and PP interventions, including dispositional mindfulness, emotion regulation, self-compassion, perceived hope, and gratitude. The data will be analysed using the mixed model repeated measures (MMRM) approach. Discussion This trial is unique in comparing three different eHealth interventions for cancer patients based on three well-established approaches to mental health support delivered on the same platform. The study will allow us to examine whether different types of interventions affect different indicators of mental health. In addition, it will provide valuable data regarding the effects of stress-reducing psychological interventions on the biomarkers of stress playing an essential role in cancer recovery processes and general health.

To investigate the effect of progressive muscle relaxation (PMR) exercise on pain and vital signs in patients undergoing open renal surgery.Nonrandomized evaluation with intervention (n = 31) and control (n = 30) groups.In the intervention group, PMR exercise was performed twice daily on postoperative days 0, 1, 2, and 3. Pain severity and vital signs were evaluated 15 minutes after each exercise application.The study detected significant differences in the mean visual analog scale pain severity values in the intervention group, who received PMR exercise between 0 and 3 days. The repeated measurements 15 minutes after PMR exercise exhibited a statistically significant (P.05) decrease in systolic blood pressure values as well as heart and respiratory rates.It was determined that PMR decreased the mean postoperative visual analog scale pain scores and vital signs in patients of the intervention group compared with the control group.

Progressive muscle relaxation training (PMRT) has been widely applied to improve the physical and mental health of patients. The aim of this study was to evaluate the effects of PMRT on the symptoms and quality of life (QOL) of cancer patients.Nine databases (Web of Science, CENTRAL, PubMed, Embase, CINAHL, OpenGrey, CNKI, Wanfang, and VIP database) were searched to identify randomized controlled trials (RCTs) that assessed the effects of PMRT on health-related outcomes for cancer patients. The risk of bias of the included studies and the evidence quality were appraised using the Cochrane Risk of Bias 2.0 tool and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, respectively. Meta-analysis was performed using RevMan 5.4.Twelve RCTs sampling 1147 patients were included. PMRT showed significant effects of alleviating anxiety [standardized mean difference (SMD) = -1.32, 95% CI (-1.88, -0.75), P 0.001] and pain [SMD = -1.02, 95% CI (-1.93, -0.11), P = 0.030], and improving QOL [SMD = 1.65, 95% CI (0.53, 2.76), P = 0.004] in cancer patients. Regarding depression, self-esteem, nausea, and vomiting, PMRT showed better effects compared to the control group. However, no significant effect of reducing fatigue was detected [SMD = -1.00, 95% CI (-2.27, 0.27), P = 0.120]. The overall quality of evidence was moderate to very low.PMRT is a promising complementary therapy that may improve the health-related outcomes of cancer patients. Future studies with rigorous research design are needed to obtain valid conclusions.

To examine the effects of progressive muscle relaxation combined with music on stress, fatigue and coping styles amongst intensive care unit (ICU) nurses.A randomised controlled trial of 56 nurses aged 18 years and older, with at least three months experience. The intervention group (n = 28) received a 20 minute session comprising progressive muscle relaxation combined with music for a total of eight weeks in the form of group sessions, while the control group (n = 28) received only a single-time face-to-face attention-matched education (20 minutes). The data collection tools were administered at baseline, at week four, eight and twelve.Internal Medicine, Anaesthesia, and Coronary Intensive care Unit of a training and research hospital.Primary outcome: Stress level. Secondary outcome: Fatigue severity and coping styles.Stress scores in the intervention group decreased significantly at week 8 and week 12 (p 0.05). Similarly, the fatigue scores were observed to be significantly lower in the intervention group at week 8 and week 12 in comparison to those in the control group (p 0.05). The scores of coping styles, obtained for the acceptance sub-dimension were significantly higher in the intervention group compared to the control group at week 4, 8, and 12 (p 0.05). The use of instrumental support, venting and the emotional support scores were observed to be significantly higher in the intervention group compared to the control group at week 12 (p 0.05).The results indicated that progressive muscle relaxation combined with music appears to be effective in decreasing stress and fatigue, and in improving the coping styles amongst intensive care nurses. Future studies should be conducted on a larger scale to make conclusions with higher probability.

Background and purpose Self-efficacy is considered as one of the influential parameters affecting the health of patients. This study aimed to investigate the effect of relaxation techniques on self-efficacy of patients suffering from cancer. Materials and methods This study was a clinical trial in which 80 patients suffering from cancer were randomly assigned to two groups of experimental and control. Data collection instruments consisted of demographic information and Strategies Used by People to Promote Health questionnaires. In the experimental group, the patients performed relaxation techniques once a day for 30 min over two months. In the control group, the patients received the routine care. Results A statistically significant difference was observed between the mean self-efficacy indices in the experimental group (p = 0.001). There was no significant difference in the control group (p = 0.3). Conclusion Muscle relaxation can enhance self-efficacy of cancer patients. Therefore, it can be used as an alternative method for patients who are willing to use this technique.

Background Patients with Coronavirus Disease 2019(COVID-19) will experience high levels of anxiety and low sleep quality due to isolation treatment. Some sleep-improving drugs may inhibit the respiratory system and worsen the condition. Prolonged bedside instruction may increase the risk of medical infections. Objective To investigate the effect of progressive muscle relaxation on anxiety and sleep quality of COVID-19. Methods In this randomized controlled clinical trial, a total of 51 patients who entered the isolation ward were included in the study and randomly divided into experimental and control groups. The experimental group used progressive muscle relaxation (PMR) technology for 30 min per day for 5 consecutive days. During this period, the control group received only routine care and treatment. Before and after the intervention, the Spielberger State-Trait Anxiety Scale (STAI) and Sleep State Self-Rating Scale (SRSS) were used to measure and record patient anxiety and sleep quality. Finally, data analysis was performed using SPSS 25.0 software. Results The average anxiety score (STAI) before intervention was not statistically significant (P = 0.730), and the average anxiety score after intervention was statistically significant (P, Highlights • In patients with COVID-19, all confirmed patients need to be treated in isolation due to strong infectivity. According to clinical observation, anxiety and sleep disturbances increased significantly after isolation treatment. Some sleep-promoting drugs may have respiratory depression, and the new coronary virus mainly affects lung tissue, and the use of drugs may increase respiratory depression. Therefore, we use asymptotic muscle relaxation training to alleviate the anxiety and improve sleep quality of patients with COVID-19. This training can be performed remotely and multiple times after one training session, without directly facing the patient, reducing doctor-patient contact and reducing medical infection risk. Currently, COVID-19 has a large number of cases in South Korea, Japan, Iran, and Italy. I hope our clinical research will be helpful to our country's clinical treatment and the above countries.

Purpose To investigate the impact of length of autogenic training (AT) use, alone and with the addition of adjunct treatments, on intensity and duration of primary headache in adults age 19 and older. Methods We searched articles published in English and Korean from 1926 to 2016. A search of seven domestic and foreign databases was conducted from September 25, 2016 to December 30, 2016 using the search terms “autogenic training,” “autogen,” “relaxation,” and “headache.” The search was documented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search yielded a total of 262 papers; a multi-step screening and selection process ultimately yielded six articles of randomized controlled trials (RCTs) for the systematic review. Cochrane’s Risk of Bias Tool was used to evaluate the quality of the selected papers. Results Five of the six studies demonstrated statistically significant reduction in headache by AT-only or biofeedback-assisted AT. The reviewed studies varied in characteristics of subjects, length of autogenic training and practice, use of adjunct therapies, and use of headache measures. Conclusions The small number of studies retrieved in this review, with their variations in AT interventions used, in AT training/practice time, and headache measures used, did not facilitate rigorous evaluation of the effectiveness of specific AT approaches nor of the optimum length of AT practice for reduction of headache. More research is needed on the effectiveness of AT-only for headache, the most effective duration of autogenic training and practice, and the type(s) of headache for which it is most effective.

Background Previous systematic reviews indicate that progressive muscle relaxation (PMR) and guided imagery (GI) are both effective interventions to decrease the psychological impact and to alleviate the adverse events in cancer patients undergoing chemotherapy treatment. To date, no review studies have investigated the effectiveness of a combination of PMR and GI. Aim To systematically review the current state of knowledge regarding the effects of the PMR–GI combination on cancer patients receiving chemotherapy. Methods A search for relevant records was carried out in four electronic databases (AMED, Cochrane Library, Pubmed and Scopus). After removing the duplicates 342 publications were screened and 71 were considered as potentially relevant. The flow of information of this study was in line with the PRISMA statement. Original articles investigating the application of both PMR and GI through a randomized trial on patients receiving chemotherapy were included. Those using PMR or GI alone and those combining other techniques together with PMR and GI were excluded. The trials' quality was assessed using the Jadad Scale. Results Eight papers reporting the results of seven independent trials were finally included. All of them included only breast cancer patients, apart from a single trial using a mixed sample of breast and prostate cancer patients. Seven of the included trials reported beneficial effects on mental state (mood, anxiety, and depression) and on toxicity (nausea and vomiting). Three trials reported an effect on biomarkers (heart rate, blood pressure, cortisol, and immunity). Four trials scored three of five points on the Jadad Scale, two trials scored two points and a single trial scored zero. Conclusions Independent trials indicate that the PMR–GI combination is an effective way to tackle the impact of nausea and vomiting and to improve patients' mental state. However, studies involving other types of primary tumors would be useful because seven of the eight clinical trials only included breast cancer patients. Future research on the identification of potential effects on disease-related parameters (e.g., cytokines and disease-recurrence) and on patient survival is highly needed.

Objective: This study aimed to investigate the effect of Benson relaxation (BR) and progressive muscle relaxation (PMR) techniques on the sleep quality of patients undergoing coronary artery bypass graft (CABG) surgery. Method: This study was a three-arm, parallel, randomized controlled trial. 120 patients who underwent CABG surgery at two academic hospitals in an urban area of Iran were randomly allocated into three groups (40 per group): the BR, PMR, and control groups. Patients in the BR and the PMR groups performed relevant exercises twice a day for four weeks. Sleep quality was measured before and immediately after the intervention using Pittsburgh Sleep Quality Index. Results: Within-group comparison in the BR (t = 3.51, p = 0.001) and the PMR (t = 4.58, p 0.05). Conclusion: The study showed that a four-week program of both PMR and BR can be effective in the overall improvement of sleep quality in patients following CABG. Further research is required to replicate the findings of the present study.

Brain computer interfaces (BCIs) allow for controlling devices through modulation of sensorimotor rhythms (SMR), yet a profound number of users is unable to achieve sufficient accuracy. Here, we investigated if visuo-motor coordination (VMC) training or Jacobsen's progressive muscle relaxation (PMR) prior to BCI use would increase later performance compared to a control group who performed a reading task (CG). Running the study in two different BCI-labs, we achieved a joint sample size of N = 154 naive participants. No significant effect of either intervention (VMC, PMR, control) was found on resulting BCI performance. Relaxation level and visuo-motor performance were associated with later BCI performance in one BCI-lab but not in the other. These mixed results do not indicate a strong potential of VMC or PMR for boosting performance. Yet further research with different training parameters or experimental designs is needed to complete the picture.

Objective The objective is to examine the effects of progressive muscle relaxation training and music therapy applied to chronic psychiatric patients attending the Community Mental Health Center (CMHC) on their anger level and sleep quality. Methods The sample of the study consisted of 66 chronic psychiatric patients (n = 32 in the control group; n = 34 in the intervention group). Progressive muscle relaxation training with music therapy were implemented in the intervention group as 2 sessions per week for 3 months. Results A statistically significant difference was found between the pre-test and post-test mean scores of the intervention group (p ≤ .001). After the intervention, a statistically significant difference was found between the PSQI, anger-in, anger-out, anger-control, and trait anger scale scores of the two groups (p ≤ .001). Conclusion Relaxation training and music therapy are effective in controlling anger and increasing sleep quality in chronic psychiatric patients. Clinical trial number NCT04620122.

ResumenLa terapia autógena se origina en el entrenamiento autógeno de Schultz y en su desarrollo incorpora diferentes métodos terapéuticos de orientación psicofisiológica creados para promover procesos cerebrales homeostáticos autorregulatorios. Los objetivos de este artículo son describir y analizar los diferentes métodos autógenos, los procesos psicofisiológicos y neurofisiológicos implicados y sus aplicaciones eficaces en la salud y la clínica. Para ello, además de revisar los primeros trabajos de Schultz y Luthe, se ha hecho una búsqueda electrónica de estudios para encontrar contribuciones relevantes sobre estos temas. Los resultados muestran un gran desarrollo de los métodos autógenos hasta los años 80, con una ingente cantidad de aplicaciones y estudios sobre los cambios psicofisiológicos y neurofisiológicos concomitantes. Sin embargo, su expansión durante los últimos 25 años ha sido mucho menor en comparación con métodos como el mindfulness o la hipnosis. Se discuten posibles causas y se plantean retos futuros para la terapia autógena.AbstractAutogenic therapy emerges from the “autogenic training” method created by Schultz, and its development incorporates different therapeutic methods based on a psychophysiological approach. All these methods promote homeostatic self-regulatory brain processes. The aims of this paper are to describe and analyse the autogenic methods, the psychophysiological and neurophysiological processes involved, and their effective applications in both health and clinical fields. For these purposes, beside reviewing the earlier work by Schultz and Luthe, an electronic search of literature was conducted in order to find relevant contributions on these topics. Results show a big development of autogenic methods until the 80s, with an enormous amount of applications and studies on the psychophysiological and neurophysiological changes related to the practice of autogenic training. However, their expansion during the last 25 years has been much lower in comparison with other methods such as mindfulness and hypnosis. Possible causes are discussed and new challenges are suggested.

Objective This research was conducted to investigate the effect of Progressive Muscle Relaxation Technique on fatigue and sleep quality in patients with COPD. This research was performed as a single-group pretest/post-test pretrial model. Methods The study was conducted with 45 patients who met the research criteria and agreed to participate in the study. A Personal Information Form was used as a data collection tool, Fatigue Severity Scale was used for measuring fatigue, and the Pittsburgh Sleep Quality Index was used for evaluating the sleep quality. Results It was determined that PMRT decreased patients' fatigue level and improved their sleep quality, patients' fatigue level increased as their sleep quality decreased. Conclusion Progressive relaxation exercises programs represent effective therapeutic intervention approaches for relieving COPD-associated fatigue and sleep quality. PMRT programs will extend the scope of the rehabilitation nurses' work, as it is an important course of COPD patients' continuity nursing.

Irritable bowel syndrome (IBS) is a widespread chronic functional gastrointestinal (GI) disorder having bidirectional comorbidity with psychiatric disorders. This review focuses on psychological treatment of IBS, focusing on symptom severity rather than IBS diagnostic criteria. We chose this dimensional approach in order to assess mind-body effects as an alternative or complement to conventional medical treatment, which focuses on symptom relief. We calculated the effect sizes for various psychosocial-mind-body therapies (MBTs) for IBS symptoms in both children and adults. Therapies included meditation, relaxation, yoga, autogenic training, progressive relaxation, general training in stress coping, hypnotherapy, biofeedback, psycho-education, psychodynamic psychotherapy, and cognitive behavioral therapy. We performed a meta-regression analyses and mixed effects contrasts to find various outcome differences, and we analyzed their relative efficacy in both children and adults. We found 53 studies in 50 reports describing randomized controlled trials. Medium to high effect sizes were found across all methods compared with various controls, with possibly higher effects for children. We found no systematic differences among treatment methods. Meta-regression analyses showed no significant effect for the presence of psychophysiological training, meditation or explicit exposure procedures as treatment components, although most MBTs include exposure as a nonexplicit treatment characteristic, and many relaxation techniques have meditative characteristics. We conclude that there is considerable evidence that an array of mind-body and other psychological therapies can be effective complements to medical treatment for IBS symptom severity, with little evidence for relative superiority of any particular approach. We suggest that the various methods may operate through different mechanisms.

Major Depression is a stress-related disorder characterized by altered hypothalamic-pituitary-adrenal axis function. Mindfulness-based interventions have shown to improve subjective parameters of stress and to reduce relapse rates in depressed patients. However, research on their effects on diurnal patterns of cortisol and associations with subjective outcomes is lacking. The present Ambulatory Assessment study investigated possible changes in daily rhythm cortisol parameters (cortisol awakening response (CAR), daily slope, total cortisol) in currently remitted individuals with recurrent depression who were randomized to a four-week mindfulness-based focused attention training (MBAT, n = 39) or a progressive muscle relaxation training (PMR, n = 39). A second aim was to investigate whether changes in cortisol were linked to improvements in affective and cognitive daily life states. On three weekdays before and after the intervention, seven saliva cortisol samples per day were collected. For analysis, multilevel models were applied. Results revealed no group-specific or general change in CAR and daily slopes from pre- to postintervention. In contrast, total cortisol increased across groups, which was however moderated by group and subjective improvement status. While cortisol increased irrespective of subjective improvement in PMR participants, MBAT participants with larger reductions in negative affect and rumination maintained their initial cortisol levels, whereas those with lower improvement paralleled the PMR group. Thereby, MBAT appeared to buffer an increase in overall cortisol secretion over time, but only in patients showing marked improvements in those affective and cognitive states that constitute core elements for depressive relapses in the vulnerability model of mindfulness-based cognitive therapy.

Night eating syndrome (NES) is a circadian rhythm disorder in which food intake is shifted toward the end of the day, interfering with sleep. According to the biobehavioral model of NES, the disorder is the result of a genetic predisposition that, coupled with stress, leads to enhanced reuptake of serotonin, thereby dysregulating circadian rhythms and decreasing satiety. Using the biobehavioral model as a guide, we developed a brief behavioral intervention using education, relaxation strategies, and exercise to address the core symptoms of NES. In this pilot randomized controlled clinical trial, 44 participants with NES were randomly assigned to an educational group (E; n = 14), E plus progressive muscle relaxation therapy (PMR; n = 15); or PMR plus exercise (PMR Plus, n = 15). Participants received a baseline intervention with 1- and 3-week follow-up sessions. Effectiveness analyses showed that participants in all three groups evidenced significant reductions on measures of NES symptoms (p

Psychological stress among breast cancer patients can inhibit immune function and contribute to disease progression. We investigated the effects of autogenic training (AT), a relaxation method for reducing stress, on salivary immunoglobulin A (sIgA) in breast cancer surgery patients. Thirty patients scheduled to undergo breast cancer surgery were randomly assigned to an AT or control group (usual care). Patients in the AT group underwent training for 7 days after surgery. Salivary IgA and heart rate variability were assessed on the day before surgery, and on the third and seventh postoperative days. Levels of sIgA were significantly higher on the seventh postoperative day in the AT group (n = 7) compared to the control group (n = 7) (p = 0.049). These findings suggest that AT may improve immune function in breast surgery patients.

Soon after monosynaptic reflexes were discovered (Erb 1875, Westphal 1875) studies concerning supraspinal influences including psychophysiological effects were carried out. A survey of methods with some historical illustrations and results of experiments from nearly a century of research is given. Lombard (1887, AmJPsychol, vol. one) was the first to show tonic variations of the ‘knee jerk’ due to psychophysiological influences, whereas Bowditch and Warren (1890) showed phasic activation with sophisticated techniques, allowing short time registration within the range of 0 to about 2000 ms after different kinds of stimuli. Lee and Kleitmann (1923) and Tuttle (1924) investigated effects of sleep and sleep deprivation. Paillard (1955) introduced simultaneous registration of T and H reflexes of the triceps surae into psychophysiological research. T reflexes were more reactive than H reflexes, in general, but one proband could reduce T and even H reflexes in a kind of biofeedback when watching the oscilloscope. Bathien and his group (1969, 1971) found increased T and H reflexes under intense attention (rsp. increased H reflexes only with highest activation). Brunia (1970, 1971ff) described significant elevations only of T reflexes during a vigilance task, and variations under different other experimental conditions including drugs. Sczesni and Kroner (1985) registered changes of T reflexes (as well as GSR parameters) under task conditions an in relaxation in probands practicing Autogenic Training (AT) compared to naive persons, but failed to prove differences between the groups. It was shown that eliciting MSR, which of course is slightly ‘invasive’, but monotonous, was not considerably disturbing. Conclusions Considering patients’ states of activation in everyday clinical examination is relevant, but MSR studies were also useful in psychophysiological research. MSR are the first parameters used in psychophysiological studies (introduced even before electro dermal measures, SCL and GSR). Changes can represent tonic as well as phasic psychological influences on the spinal level. T-reflexes are more variable than H-reflexes, but the latter also react. The differences were explained by a higher reactiveness of γ than of α motoneurons to influences from the reticular formation. Psychophysiological MSR studies were no longer carried out in the recent years, presumably because of the vast technical equipment needed, rather than other limitations.

Introduction and study aims Poor sleep exacerbates health problems which in turn can affect sleep. Behavioural approaches to insomnia management are preferred to prescribed hypnotics. This article examines whether resolving sleep problems as a result of Autogenic Training (AT) can be used as a potential indicator of effectiveness for people with chronic health problems. Methodology In an observational study at the Royal London Homeopathic Hospital, patients acted as waiting list controls before receiving standard 8 week group AT training. Data was collected on sleeping patterns, symptoms and general health. Results Of 153 participants with various health conditions completing the AT course, 11% presented with sleep problems as their main complaint, on further questioning 62% also had a sleep problem. Worry, stress, anxiety and depression were identified as the possible cause or trigger of sleep problems for 52% of patients. After an AT programme overall changes in sleep included: improvement in sleep onset latency (p = 0.049), ability to fall asleep faster after night waking (p Discussion/conclusions Sleep problems were only one of the primary reason for patients’ referral to AT. However, AT improved sleep quality despite sleep not being the focus of the training or a common presenting complaint. These changes in wellbeing may not be captured in health research, but make a critical difference to patients and their health outcomes. Measuring sleep disturbances as a potential outcome indicator for health research should be considered.

This study investigated heart rate variability (HRV) in healthy volunteers that were selected for extreme scores of trait anxiety (TA), during two opposite psychophysiological conditions of mental stress, and relaxation induced by autogenic training. R-R intervals, HF and LF powers, and LF/HF ratios were derived from short-term electrocardiographic recordings made during mental stress and relaxation by autogenic training, with respiratory rate and skin conductance being controlled for in all the analyses. The main finding was that high TA was associated with reduced R-R intervals and HF power across conditions. In comparison to mental stress, autogenic training increased HRV and facilitated the vagal control of the heart. There were no significant effects of TA or the psychophysiological conditions on LF power, or LF/HF ratio. These results support the view that TA, which is an important risk factor for anxiety disorders and predictor of cardiovascular morbidity and mortality, is associated with autonomic dysfunction that seems likely to play a pathogenetic role in the long term.

Stress factors, especially high levels of occupational stress, are associated with hypertension. Several so-called psychological techniques have been applied to hypertension: biofeedback, relaxation techniques (Schultz' autogenic training, Jacobson's progressive relaxation), transcendental meditation, and cognitive behavioral techniques for stress management. Randomized studies show that the best results come from cognitive behavioral methods, whether or not they include relaxation techniques. Other forms of psychotherapy (such as psychoanalysis) may be useful, although their benefits for blood pressure have not been tested in controlled trials. Patients should be informed about the personal benefits they may obtain from psychological treatment. Indications are hyperreactivity to stress, high levels of occupational stress, and difficulty in tolerating or complying with antihypertensive drugs.

Summary Objective To determine from the published evidence whether autogenic training as sole therapy is effective for prevention of tension-type headaches in adults. Method Systematic review of controlled trials. Literature searches were performed in January 2005 in six major databases, specifically Medline, EMBASE, AMED, CENTRAL, PsychInfo and CINAHL and information was extracted and evaluated in a pre-defined manner. Results Seven controlled clinical trials were included in the review. The methodological quality of these studies was low. Patient samples were generally representative of the more severely affected cases. None of the studies show autogenic training to be convincingly superior to other interventions care. Some trials suggested that the effect of autogenic training is no different from hypnosis and inferior to biofeedback. Conclusion There is no consistent evidence to suggest that autogenic training is superior to other interventions for prevention of tension headaches, or different from other forms of relaxation. Further studies should investigate the use of standard autogenic training in patients with moderate headache.

We have focused on several different biological indicators to seek mechanism of autogenic training (AT) and its relationship with self-efficacy. Varieties of physical and psychological phenomena are observed during the process of AT, and these symptoms provide us the important information to understand the mechanism of AT. This study indicates that AT might reduce the patients' anxiety and helps developing the psychotic energy when they need to create self-image and/or self-efficacy. We found out that AT might be effective on the point of “physical change” by improving physiological functions as well as endocrine and immunological functions. The application of AT for children, however, differs from the case for adults. Some problems and questions still remain on the application manners. The idea of AT should be considered differently in the case for children. Group AT was well investigated to see how effectively AT works on the objective observation (mind and body) and helps promoting the eagerness of practicing it through the interaction among the members. We also expect that AT might improve the stress-related psycho-physical condition, therefore a continuous daily application may contribute to the contemporary society in the sense of health promotion as to support people in any stressful situation.

The paper first discusses the changes in paradigms involved in the development of self-regulation method (SRM) from autogenic training (AT). Further, an experiential paradigm for SRM and AT is presented. In this paradigm, SRM and AT are seen as ‘modes of relating’ within the patient and modes of relating within the doctor–patient relationship. This paradigm enables SRM and AT to be used in conjunction with other psychotherapies, particularly focusing-oriented therapy (FOT). The procedure for SRM/AT used in combination with FOT is shown and two case examples are presented. Discussions of these cases show that patients regard the nature of the relationship as therapeutic more than the technique of SRM. This view supports the experiential paradigm where AT and SRM are seen as modes of relationships.

Mental health of workers in Japan has become one of the most serious health problems in the workplace. To tackle this problem, the Ministry of Health, Labour and Welfare set guidelines for promoting mental health of workers in 2000, in which every worker was recommended to learn autogenic training (AT) from the standpoint of “self-care”. Before the guidelines, however, some healthcare professionals had already advocated that AT should be utilized as a relaxation method to help workers cope with stress. Although knowledge about AT has spread among occupational healthcare staffs since then, there are only a small number of companies whose employees regularly practice AT. In order to overcome difficulties, we need to solve problems such as how to motivate workers without any health problems to learn AT, and how to effectively teach them the AT. In this report, we explain our activities to find solutions to these problems, which include studying what conditions are characteristic of companies whose employees have kept practicing AT, and developing a new method of teaching AT by correspondence.

Purpose Group autogenic training (AT) programs are conducted in medical institutions in Japan. An additional interview with patients was conducted before the group AT session to inform patients of details regarding the program. The purpose of this study was to examine the effectiveness of this interview. Methods Outpatients, mostly suffering from anxiety and psychosomatic diseases, were assigned to a control (n = 27) or an experimental group (n = 22). In the experimental group, a pretreatment interview was conducted before starting the AT program. Four patients were excluded after the interview due to severe symptoms and time limitations for participating in all sessions. At the first and the last AT sessions, the participants completed the State–Trait Anxiety Inventory and the Center for Epidemiological Study of Depression scale. They also reported the perceived controllability of their symptoms by using the Visual Analogue scale. At the last session, the participants and physicians rated the achievement of treatment goals. Results Patients who completed the program were significantly increased in the experimental group (95%) compared with the control group (63%). Emotional level improved equally in both groups. Participants' self-rating of controllability, as well as participant's and physician's rating achieving treatment goals were not significantly different in the two groups. Conclusions This study indicates the important role of pretreatment interviews. As a result of the interview, appropriate patients could be selected and more patients could complete the program.

Chronic headache is a significant public health problem in Western nations. Although controlled trials demonstrate the efficacy and cost-effectiveness of face-to-face behavioral therapy, most headache sufferers have limited access to these treatments. Delivery of behavioral interventions using Internet technology has the potential to reach a larger number of headache sufferers and reduce the burden of disease. This randomized controlled study evaluated an Internet-delivered behavioral regimen composed of progressive relaxation, limited biofeedback with autogenic training, and stress management versus a symptom monitoring waitlist control. Treatment led to a significantly greater decrease in headache activity than symptom monitoring alone. Thirty-nine percent of treated individuals showed clinically significant improvement on self-report measures of headache symptoms at post-treatment. At two-month follow-up, 47% of participants maintained improvement. Treatment had a significant impact on general headache symptoms and headache-related disability. There was a 35% within-group reduction of medication usage among the treated subjects. The Internet program was more time-efficient than traditional clinical treatment. Treatment and follow-up dropout rates, 38.1% and 64.8%, respectively, were typical of behavioral self-help studies. This approach to self-management of headache is promising; however, several methodological and ethical challenges need to be addressed.

Background. Hypnorelaxation has a potentially beneficial effect in the treatment of masticatory myofascial pain disorders (MPD). However, there are no data regarding the efficacy of hypnorelaxation in the treatment of MPD compared with other accepted modes of treatment (such as occlusal appliance) or with the mere effect of time. Objective And Subjects. The purpose of the present study was to evaluate the effectiveness of hypnorelaxation in the treatment of MPD compared with the use of occlusal appliance and/or to minimal treatment. The study population consisted of 40 female patients with myofascial pain who were allocated to 1 of 3 possible treatment groups: (1) hypnorelaxation (n = 15), (2) occlusal appliance (n = 15), and (3) minimal treatment group (n = 10). Results. Both active treatment modes (hypnorelaxation and occlusal appliance) were more effective than minimal treatment regarding alleviating muscular sensitivity to palpation. However, only hypnorelaxation (but not occlusal appliance) was significantly more effective than minimal treatment with regard to the patient's subjective report of pain on the Visual Analog Scale. Conclusion. Hypnorelaxation is an effective mode of treatment in MPD, especially with regard to some of the subjective pain parameters. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:429-34)

In order to clarify the differences in source localization of brain electric activity between positive, neutral and negative emotional states, we recorded 19-channel, eyes-closed EEG: (a) before and after autogenic training in 12 right-handed normal subjects (5 males, 7 females, mean age 22.3±1.9 years) and (b) during listening to independently assessed joyful and sad music in 12 right-handed normal subjects (5 males, 7 females, mean age 23.6±1.8 years). Forty artifact-free seconds/subject/condition were analyzed using FFT Dipole Approximation and Low Resolution Electromagnetic Tomography (LORETA). Global tests revealed differences (p

Physical and emotional pain are an inevitable part of human existence and are without natural antidotes. In view of this, and in the light of increasing professional reluctance to depend on analgesics, this paper proposes the widespread application of autogenic training, a relaxation technique which has been seen to confront pain very effectively, and also to reduce substantially drugs dependency. It analyses autogenic training in respect of some of the more common pain-allied disorders such as childbirth, headaches and migraines, back pain, cancer and palliative care, and cardiology.

Rationale and Objectives. Imagery as a hypnotic technique can produce analgesia and anxiolysis, but effective use may be restricted to select, highly hypnotizable individuals. This study assessed (a) whether patients not selected for hypnotizability can produce imagery during interventional radiologic procedures and (b) the type of imagery produced. A secondary goal of the study was to familiarize health care providers with a simple, time-efficient technique for imagery. Materials and Methods. Fifty-six nonselected patients referred for interventional procedures were guided to a state of self-hypnotic relaxation by a health care provider according to a standardized protocol and script. Patient hypnotizability was assessed according to the Hypnotic Induction Profile test. Results. Patients as a group had average distribution of hypnotizabilty. The induction script was started in all patients and completed in 53. All patients developed an imagery scenario. Chosen imagery was highly individual, but common trends were nature and travel, family and home, and personal skills. Being with loved ones was an important element of imagery for 14 patients. Thirty-two patients chose passive contemplation, and 24 were action oriented. Conclusion. Average patients who present for interventional radiologic procedures and are not preselected for hypnotizabilty can engage in imagery. Topics chosen are highly individual, thus making prerecorded tapes or provider-directed imagery unlikely to be equally successful.

Prior to entering a pharmacotherapy trial for the treatment of cocaine dependence, 19 patients participated in a pretreatment cue-reactivity protocol that concluded with a relaxation exercise. Measures included self-reported craving and skin conductance level (SCL). Post hoc exploratory analyses suggest that neither craving nor change in SCL in response to cocaine cues differentiated patients who subsequently achieved abstinence from those who did not. Craving following the relaxation procedure did differentiate the two groups: patients who subsequently initiated abstinence in treatment reported a reduction in cue-elicited craving to below baseline levels; craving reported by patients who did not successfully complete treatment remained elevated.

Objective To assess the preferred methods to quit smoking among current smokers. Method Cross-sectional, population-based study conducted in Lausanne between 2003 and 2006 including 988 current smokers. Preference was assessed by questionnaire. Evidence-based (EB) methods were nicotine replacement, bupropion, physician or group consultations; non-EB-based methods were acupuncture, hypnosis and autogenic training. Results EB methods were frequently (physician consultation: 48%, 95% confidence interval (45–51); nicotine replacement therapy: 35% (32–38)) or rarely (bupropion and group consultations: 13% (11–15)) preferred by the participants. Non-EB methods were preferred by a third (acupuncture: 33% (30–36)), a quarter (hypnosis: 26% (23–29)) or a seventh (autogenic training: 13% (11–15)) of responders. On multivariate analysis, women preferred both EB and non-EB methods more frequently than men (odds ratio and 95% confidence interval: 1.46 (1.10–1.93) and 2.26 (1.72–2.96) for any EB and non-EB method, respectively). Preference for non-EB methods was higher among highly educated participants, while no such relationship was found for EB methods. Discussion Many smokers are unaware of the full variety of methods to quit smoking. Better information regarding these methods is necessary.

Stress, unpleasant emotions and autonomic imbalance may play a main role in precipitating asthmatic attacks. In this study two homogeneous groups of asthmatic patients (N = 24) are treated over an eight-month period. The experimental group was treated with autogenic therapy and the control group with supportive group psychotherapy. Respiratory function parameters measured were Forced Vital Capacity (FVC), Forced Expiratory Volume in the first sec (FEV I), Forced Expiratory Flow between 25% and 75% of the FVC (FEF25-75%). and Mesoexpiratory Flow (MEF50%). The group under Autogenic Therapy obtained a relevant clinical improvement (> 15% of pretreatment values) in respiratory function. No significant changes were observed in the control group. These results suggest that autogenic therapy could be an effective adjunctive treatment in bronchial asthma.

Adolescents are being taught relaxation techniques by health-care professionals with increased frequency. The present study examined the effect, on self-reported relaxation, of labeling passive relaxation techniques as “hypnotic relaxation” or as “relaxation training.” Subjects were 64 adolescent college students who scored above the 50th percentile, from a subject pool of 189 potential subjects, on the Spielberger Trait Anxiety Inventory. A two by two by two factorial design was utilized with sex, label (hypnotic relaxation versus relaxation training) and relaxation technique (hypnotic induction versus autogenic training) as the independent variables. Under the guise of an investigation of the physiologic correlates of relaxation, subjects were assigned at random to one of four groups. Manipulations of label and relaxation technique were presented on tape via an intercom system. The dependent variable, perceived degree of relaxation, was obtained using a form presented as a “double check” of the accuracy of the physiologic monitoring equipment to which subjects seemingly were attached. Results indicate that the label attached to relaxation techniques can have a significant effect on an individual's subjective report of relaxation depending on the subject's sex.

This study compares autogenic training and training in multiple self-hypnosis strategies in a sample of 56 patients diagnosed as having chronic tension headache on the basis of medical evaluation by a neurologist. At posttreatment and follow-up, no differences between the two treatment regimens in the reduction of headache and psychological distress were observed. During treatment, patients reduced their headache activity and level of psychological distress significantly in contrast to the waiting-list period (p < 0.05). Follow-up measurements indicated that therapeutic improvement was maintained (p < 0.05). Short-term and long-term pain reduction was accompanied by an increase in perceived pain control (p < 0.003). Moreover, those patients who attributed the pain reduction obtained during therapy to their own efforts manifested long-term pain reduction (p < 0.003).

Tension headaches can form a chronic (very long duration) condition. EMG biofeedback, relaxation training and analgesia by hypnotic suggestion can reduce the pain. So far, no differences have been demonstrated between the effects of various psychological treatments. In a constructively designed study, we firstly compared an abbreviated form of autogenic training to a form of hypnotherapy (future oriented hypnotic imagery) which was not presented as hypnosis and secondly we compared both treatments to the same future oriented hypnotic imagery, but this time explicitly presented as hypnosis. The three treatments were equally effective at post-treatment, but after a 6-month follow-up period, the future oriented hypnotic imagery which had been explicitly presented as hypnosis was superior to autogenic training. Contrary to common belief, it could be demonstrated that the therapists were as effective with the treatment modality they preferred as with the treatment modality they felt to be less remedial.

Essential hypertension, a widespread health problem, is commonly treated with palliative medications. Pessimism in the medical community about behavioral treatments including biofeedback derives from early evaluations of interventions using relatively weak interventions. Current relations-based interventions using self-regulation of autonomic indices are demonstrating greater efficacy than early work with direct blood pressure biofeedback or with muscle biofeedback. Treatments may be appropriate both in early hypertension and in instances of more advanced disease process. Current national policy stipulates that, after hypertension is controlled by medication for 1 year, medications should be gradually withdrawn and an attempt made to control blood pressure through nonpharmacologic means.

A case of relaxation induced anxiety in a patient with Panic Disorder is reported. The study reports the use of an attentional training procedure which was effective in eliminating panic and facilitated tension reduction without producing anxiety. A two treatment (ABCB) design revealed that a procedure evoking external attentional focus eliminated panic attacks, whereas autogenic training increased the frequency of panic attacks and the intensity of anxiety. The possible roles of self-focus in mediating panic and the effects of relaxation are briefly discussed.

Summary The aim of this investigation was to test the benefit of autogenic training in patients with reflex sympathetic dystrophy. Eighteen patients with reflex sympathetic dystrophy of the upper limb were recruited and randomized in Group A (autogenic training) and C (controls). All patients received home therapy, including elevation of the affected extremity, therapeutic exercise, and cryotherapy. In Group A, additional autogenic training was applied once a week for ten weeks. Before and at completion of this treatment period, patients underwent a clinical examination comprising measurements of limb volume, skin temperature and range of motion. In addition, pain was assessed by means of a visual analogue scale. The results show beneficial changes in both groups related to pain, range of motion and limb volume. Yet cross-sectional comparisons revealed no differences in these parameters. Only the changes in skin temperature showed significant inter-group differences. It is concluded that autogenic training may be helpful in certain aspects of reflex sympathetic dystrophy but its potential value requires further study.

Question Can improvements in sleep be used as an indicator of the wider health benefits of Autogenic Training? Methods This pragmatic observational prospective study investigated whether resolving sleep problems provides an additional indicator of AT benefits. All new patients attending an AT service in a conventional medical setting at the NHS Royal London Homeopathic Hospital (RLHH) between April 2007 and April 2008 were invited to participate, irrespective of presenting complaint. Participants completed a standard AT course as delivered at RLHH. Eight weekly, 2-h group sessions used six exercises to reduce autonomic activity by focussing the mind on sensations representing relaxation (including heaviness and warmth in the limbs, a calm, regular heart beat, easy natural breathing, abdominal warmth and a cool forehead). Outcome measures were an adapted Pittsburgh sleep quality index, the Hospital Anxiety and Depression scale (HADS) and a patient centred outcome Measure Your own Medical Outcome Profile (MYMOP). Data were collected at initial assessment, start and end of treatment and at follow-up. Results Complete data were obtained from 142 out of 186 patients. Most (88%) participants had a sleep problem (current or past), despite only 14% reporting a sleep problem at initial assessment. Worry, stress, anxiety or depression was identified as the cause of sleep problems by 51% of patients. In total, 94% of those presenting with insomnia reported stress as their main problem. Evaluation at 8 weeks showed AT resulted in improvements in sleep onset latency ( p =0.04), difficulty getting back to sleep ( p =0.006), dream recall ( p =0.006), energy levels ( p =0.023) and feeling refreshed on waking ( p p p p p Conclusions These findings support clinical and anecdotal observations by AT trainers that AT improves sleep quality despite sleep neither being the focus or presenting complaint. Stress and anxiety are both likely consequences and causes of sleep problems and AT provided a ‘tool’ to help patients cope. Improvements in sleep exemplify the nonspecific effects of AT, which may not be captured in research but are of real importance and make a difference to patients. This study demonstrated that changes in sleep could be used as a possible outcome measure for evaluating more holistic effects of AT.

Introduction Relaxation techniques are an important part of medical prevention. In this regard, medical students could already profit from a high standard of knowledge in these techniques, both as an individual stress-coping strategy and for the future patients’ consultation process. The aim of the present study was to evaluate knowledge and practical experience in medical students, and for comparison, in students of economics, with respect to progressive relaxation (PR), autogenic training (AT), and meditation, depending on the social background. Materials and methods German medical and economics students’ representative bodies were asked to refer their local students to a 41-item questionnaire on the three relaxation techniques, which was posted on the Internet and had to be filled in online. The stored data were evaluated by SPSS. Results The questionnaire was filled in by 576 medical students and 596 students of economics. As a consequence of a very predominant female participation, a random sample with a more balanced gender proportion was generated from the original sample by a statistical procedure with SPSS. In both groups 458 students were evaluated. The level of information of the medical students about the relaxation techniques was superior to that of the economics students ( p p p p p Discussion Both groups of students had high deficits in the knowledge of the three relaxation techniques. As both groups are prone to high stress levels during their studies and also later in their career, it would be desirable to integrate these techniques into their course of studies.