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Objectives: To determine the effect of aerobic exercises and progressive muscle relaxation in migraine patients. Method: The quasi-experimental study was conducted at the Sheikh Khalifa Bin Zayed Al Nayhan Hospital / Combined Military Hospital, Muzaffarabad, Azad Jammu and Kashmir, from February to July 2017, and comprised migraine patients of either gender aged 20-50 years. They were divided into experimental and control group. Experimental group A received supervised exercises protocol, including aerobic exercise (stationary bicycle) 30min with 10min warm-up and 5min cool-down followed by progressive muscle relaxation for 15min 3 times a week for 6 weeks along with prophylactic medicine. The control group received prophylactic medicines flunarazine 5mg twice daily, inderal 10mg thrice daily and nortriptyline 25mg at night. Patients were assessed using Numeric Pain Rating Scale, Migraine Disability Assessment Scale, Headache Disability Index, Headache Impact test-6 and the Central Sensitisation Inventory at baseline, midline and at the completion of intervention. Data was analysed using SPSS 21. Results: Of the 28 patients, there were 14(50%) in each of the two groups. Overall, there were 24(85.7%) females and 4(14.3%) males with a mean age of 29.7±10 years. There were significant improvements in all parameters in both the groups, but group A had significantly better outcome post-inervention (p

Objective Scalable, accessible forms of behavioral therapy for migraine prevention are needed. We assessed the feasibility and acceptability of progressive muscle relaxation (PMR) delivered by a smartphone application (app) in the Primary Care setting. Methods This pilot study was a non-blinded, randomized, parallel-arm controlled trial of adults with migraine and 4+ headache days/month. Eligible participants spoke English and owned a smartphone. All participants were given the RELAXaHEAD app which includes an electronic headache diary. Participants were randomized to receive 1 of the 2 versions of the app-one with PMR and the other without PMR. The primary outcomes were measures of feasibility (adherence to the intervention and diary entries during the 90-day interval) and acceptability (satisfaction levels). We conducted exploratory analyses to determine whether there was a change in Migraine Disability Assessment Scale (MIDAS) scores or a change in headache days. Results Of 139 participants (77 PMR, 62 control), 116 (83%) were female, mean age was 41.7 ± 12.8 years. Most patients 108/139 (78%) had moderate-severe disability. Using a 1-5 Likert scale, participants found the app easy to use (mean 4.2 ± 0.7) and stated that they would be happy to engage in the PMR intervention again (mean 4.3 ± 0.6). For the first 6 weeks, participants practiced PMR 2-4 days/week. Mean per session duration was 11.1 ± 8.3 minutes. Relative to the diary-only group, the PMR group showed a greater non-significant decline in mean MIDAS scores (-8.7 vs -22.7, P = .100) corresponding to a small-moderate mean effect size (Cohen's d = 0.38). Conclusion Smartphone-delivered PMR may be an acceptable, accessible form of therapy for migraine. Mean effects show a small-moderate mean effect size in disability scores.

Heart rate variability biofeedback (HRV-BF) has been confirmed to increase heart rate variability (HRV) and cardiac outflows by baroreflex in healthy populations and clinical patients. Autogenic training (AT) is common used in the psychological intervention. This study integrates a single-session of HRV-BF and AT into a high-technology mobile application (app), and examines the effects on HRV indices, breathing rates, and subjective relaxation scores. Healthy college students were recruited and assigned to the single-session HRV-BF group or AT group. Participants in the HRV-BF group received HRV-BF combined with paced breathing training, which gradually stepped down their breathing rates from 12, to 8, to 6 breaths/per min; and received feedback of HRV indices from the app. Participants in the AT group received autogenic training and feedback of heart rate from the app. A chest belt Zephyr BioHarness was connected through Bluetooth to a Zenfone5 mobile phone, it collected the signals of interbeat intervals and breathing rates at pre-training, mid-training, and post-training stages. The Kubios HRV software was used to analyze HRV indices. The results reveal higher HRV indices and lower breathing rates during mid-training and post-training in the HRV-BF group compared to the AT group. There were higher high-frequency of HRV at post-training than pre-training in the AT group. Participants of both groups increased their subjective relaxation scores after training. The HRV-BF protocol increased cardiac outflows by baroreflex and decreased breathing rates, and the AT protocol increased high-frequency of HRV. These high-technology wearable devices combined with psychological interventions will apply to various populations in the future.

Background Progressive muscle relaxation (PMR) and autogenic training (AT) are effective relaxation techniques to reduce depressive symptoms. However, no studies on their effectiveness have been conducted among people living with HIV and depressive symptoms. The primary aim of this pilot study was to assess the feasibility and acceptability of PMR and AT interventions among people living with HIV who have depressive symptoms. A secondary aim was to assess the potential effectiveness of these interventions on depressive symptoms and quality of life. Methods This study was a three-arm pilot randomized control trial with mixed methods. Participants were randomized to PMR, AT, or a control group (CG), with four assessments (baseline, and at one, three, and six months). The PMR and AT interventions consisted of six 1 h sessions of individual training over 12 weeks, plus home practice. Recruitment, attrition, and completion rates were calculated. Depressive symptoms and quality of life were assessed at all times. Participants' perceptions of the interventions were collected in semi-structured interviews. Results Following the screening, 54/63 people met the inclusion criteria, and 42/54 were randomly allocated to the PMR group (n=14), AT group (n=14), and CG (n=14). Six participants (43%; 95% CI 18–71%) in the PMR group and 10 (71%; 95% CI 42–92%) in the AT group completed the intervention. Participants reported better emotion management and improvements in depressive symptoms and quality of life. Conclusions The pilot study suggests that a randomized trial to test the effectiveness of these interventions is feasible. Trial registration ClinicalTrials.gov NCT01901016

To examine the effects of progressive muscle relaxation and mindfulness meditation on the severity of diabetic peripheral neuropathic pain (DPNP), fatigue, and quality of life in patients with type 2 diabetes.An assessor-blinded prospective randomized controlled trial.Participants were randomly assigned to the relaxation group (RG; n = 28), meditation group (MG; n = 25), or control group (CG; n = 24). The mean age of participants was 64.2 ± 8.1 years in the RG, 61.6 ± 8.0 years in the MG, and 64.1± 6.6 years in the CG. Patients in the intervention groups performed progressive muscle relaxation or mindfulness meditation at their home for 12 weeks, 20 min daily. The CG received only an attention-matched controlled education on pancreas anatomy and diabetes. Data collection was performed at baseline and at weeks 12 and 14 using the VAS, FACIT Fatigue Scale (FACIT-F), and Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL).VAS scores were significantly lower in the RG and MG at week 12 (p.05) and were statistically significant in the RG at week 14. Additionally, fatigue severity decreased significantly in the RG at weeks 12 and 14, compared to that in the CG (p.05). While no significant difference was found in the quality of life scores between the study groups at weeks 12 and 14 (p.05), a significant improvement in quality of life scores in the RG were provided at week 12 compared to those at baseline and week 14 (p.05).Both progressive muscle relaxation and mindfulness meditation had a positive impact on providing pain relief in patients with DPNP. Moreover, progressive muscle relaxation also appeared to have a beneficial effect on fatigue.Based on the results, progressive muscle relaxation and mindfulness meditation can be recommended as supportive therapies for the management of DPNP.

Patients receiving hemodialysis treatment may experience several symptoms at the same time, such as fatigue and pain. Progressive relaxation exercises (PRE) have been reported to have positive effect on the control of these symptoms. In this study, a randomized, controlled, and experimental study was conducted to examine the effect of PRE on pain, fatigue, and quality of life in hemodialysis patients; the study was carried out with 48 intervention and 48 control patients receiving treatment in the hemodialysis units of 2 hospitals. Data were collected by a questionnaire prepared by the researcher, which included questions about sociodemographic variables and the disease; Piper Fatigue Scale; Visual Analog Scale that measures pain severity; and SF-36 Quality of Life Scale. The results of study revealed that mean total fatigue score and mean pain score decreased in the intervention group after the application of PRE; whereas no change was observed in the control group (P < .05). It was also found that quality of life physical component mean score and mental component mean score increased in the intervention group after the application of PRE (P < .05).

In the present study, we assessed the impact of kindergarten-based progressive muscle relaxation (PMR) on attention and executive functioning of 5–6-year-old children. In this randomized-controlled trial, 52 children (26 female; 26 male; M age = 5.4, SD = 0.2 years) from two private Tunisian kindergartens were randomly assigned to experimental and control groups. Over 12 weeks, 18 children performed PMR in two 30-minute sessions/week, another 17 children performed generic physical education (PE) for two 30-minute sessions/week, and 17 children in a control group (CG) had no systematically guided physical activity and engaged in usual self-chosen activities like free play or artisanal activities during kindergarten hours. Prior to (T0) and after (T1) the 12-week PMR intervention, all participants completed the Visuomotor Precision and Statue subtests of the Neuropsychological Evaluation Battery (NEPSY-2), the Teddy Bear Cancellation Test, and the Rey Simple Figure Test. Although there were no significant group differences at T0, repeated measures analysis of variance revealed higher scores for the PMR group relative to both the PE and CG groups on measures of attention, visuomotor precision, memory, and motor inhibition. PMR provided an effective relaxation technique and enhanced attention and executive functioning of these 5–6-year-old children, with important implications for assisting learning and academic achievement among young children.

Objectives Anxiety is a negative emotion that acts as a mediator between stress stimuli and emotional (physiological) reaction patterns. The myofascial system is particularly sensitive to stress. The aim of this study was to determine which of the 2 popular methods used to reduce psychophysical tension, i.e., soft tissue manipulation and Jacobson's progressive relaxation, is more effective. Material and methods This study was conducted at Gdansk University of Physical Education and Sports in the sports psychology laboratory and the manual therapy room. After performing specialist consultations and interviews to exclude potential participants with contraindications to any of the interventions, the final sample included 90 people who were randomly assigned to 1 of 2 treatment groups. In group I, soft tissue techniques were applied, including the techniques of post-isometric muscle relaxation, elements of myofascial relaxation of tissues, and elastic tissue deformation using the Swedish massage limited to the cervicothoracic complex. In group II, Jacobson's progressive relaxation was performed. The training consisted of tightening and relaxing specific muscle groups. The experiment was conducted under an ambulatory condition, consisting of a single physiotherapeutic session (group I) or a single progressive relaxation session using the Jacobson method (group II). The level of anxiety was assessed twice, i.e., immediately before and after the therapy. Results According to a repeated-measures ANOVA, each therapeutic impact was effective in reducing the level of perceived anxiety. Furthermore, the level of perceived anxiety in group I decreased significantly more than that in group II. Conclusions In conclusion, both the soft tissue manipulation and Jacobson's progressive relaxation techniques were efficient methods of minimizing the negative effects of stress. Int J Occup Med Environ Health. 2019;32(6):817-24.

BACKGROUND: Fibromyalgia is accompanied by symptoms of fatigue, depression, sleep disorders, and physical and mental stress [1]. It is a difficult-to-treat disorder because its exact causes are unknown. OBJECTIVE: This study aimed to examine the effect of progressive muscle relaxation therapy (PMRT) on pain, fatigue, and stress in patients with fibromyalgia syndrome. METHODS: Thirty-seven patients with fibromyalgia syndrome (age: 20–65 years) were randomly allocated to the PMRT group (n1= 18, 2 men and 16 women) or non-PMRT group (n2= 19, 2 men and 17 women). The PMRT group received PMRT twice a week for 8 weeks and the non-PMRT group received conventional physical therapies such as electro-stimulation and heat therapies during this period. The outcome was evaluated before and after 8 week sofintervention using the Visual Analogue Scale, Multidimensional Assessment of Fatigue, Perceived Stress Scale, and measurement of the blood pressure and pulse rate. RESULTS: Pain and fatigue significantly decreased in the PMRT group compared with the non-PMRT group (both P< 0.001). In addition, perceived stress (P< 0.001), systolic blood pressure (P< 0.001), diastolic blood pressure (P< 0.05), and pulse rate (P< 0.001) significantly decreased in the PMRT group compared with the non-PMRT group. CONCLUSIONS: The findings indicate that progressive muscle relaxation therapy is a viable rehabilitative therapy for pain, fatigue, and stress symptoms in patients with fibromyalgia syndrome.

Given previous research suggests an association between stress and the intake of energy-dense foods, this study investigated whether poststressor relaxation practice can attenuate stress-induced eating.Twenty-five men and women were exposed to four conditions on separate days: an acute laboratory stressor (S), acute stressor followed by 20 min of relaxation (SR) in the form of Abbreviated Progressive Muscle Relaxation (APMR), relaxation alone (R), and a control condition (C). Physiological and psychological responses to stress and relaxation were assessed, in addition to the subsequent energy intake of high-energy snacks.Salivary cortisol, blood pressure, heart rate, and perceived stress were transiently elevated postlaboratory stressor (S and SR compared with R and C; p.05). Meanwhile, perceived relaxation was acutely enhanced after APMR alone (R) compared with S, SR, and C (p.05) and in SR (immediately after the APMR) compared with S (p.05). No difference in mean energy intake was observed between conditions (p.05). Likewise, no differences in perceived appetite or the levels of ghrelin, leptin, and insulin were found between conditions (p.05).Much variation exists in stress-induced dietary responses, and APMR either postacute stressor or in isolation does not appear to consistently alter the intake of commonly eaten snacks.

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 Persons with multiple sclerosis (PwMS) often have reduced aerobic capacity and report fatigue as the most disabling symptom impacting their health-related quality of life (HRQoL). A multidisciplinary rehabilitation approach is recommended for successful management of symptoms, although there is little supporting evidence. The aim of this study is to evaluate the effect of a multimodal therapy approach, including endurance training and patient education, during a three-week inpatient rehabilitation stay, on HRQoL in PwMS at six months follow-up. Inpatient energy management education (IEME) + high-intensity interval training (HIIT) will be compared with progressive muscle relaxation (PMR) + moderate continuous training (MCT). Methods This study has a two-armed single-blind randomized controlled superiority trial design. One hundred six PwMS-related fatigue (relapsing-remitting or chronic progressive phenotypes; Expanded Disability Status Scale (EDSS) ≤ 6.5) will be recruited at the Valens clinic, Switzerland, and randomized into either an experimental (EG) or a control group (CG). EG: participants will perform IEME twice and HIIT three times per week during the three-week rehabilitation stay. IEME is a group-based intervention, lasting for 6.5 h over three weeks. HIIT contains of five 1.5-min high-intensive exercise bouts on a cycle ergometer at 95–100% of peak heart rate (HRpeak), followed by active breaks of unloaded pedalling for 2 min to achieve 60% of HRpeak. CG: participants will perform PMR twice and MCT three times per week during the three-week rehabilitation stay, representing local usual care. PMR consists of six 1-h relaxation group sessions. MCT consists of 24-min continuous cycling at 65% of HRpeak. The primary outcome is HRQoL (Physical and Mental Component Summaries of the Medical Outcome Study 36-item Short Form Health Survey; SF-36), measured at entry to the clinic (baseline, T0), three weeks after T0 (T1) and at four (T2) and six (T3) months after T0. Secondary outcomes comprise cardiorespiratory fitness, inflammatory markers (measured at T0 and T1), fatigue, mood, self-efficacy, occupational performance, physical activity (measured at T0, T1, T2 and T3) and behaviour changes in energy management (measured at T2 and T3). Discussion This study will provide detailed information on a multimodal therapy approach to further improve rehabilitation for PwMS. Trial registration This trial was prospectively registered at ClinicalTrials.gov (NCT04356248; 22 April 2020).

This study intended to discover the effect of education and muscle relaxation (EMR) program on anxiety, depression and care burden among caregivers of acute stroke survivors. This randomized, controlled study enrolled a total of 110 caregivers of first-ever acute stroke patients, and randomly assigned to EMR (N = 55) and control (N = 55) groups. The caregivers in the EMR group received 12-month health education and progressive muscle relaxation, and those in control group were provided common rehabilitation advices. Hospital Anxiety and Depression Scale (HADS) and Zarit Caregiver Burden Scale in caregivers were evaluated at the time of patients’ discharge from hospital (M0), then at month(M) 3, M6 and M12 after the discharge. HADS-anxiety score, anxiety rate and severity were similar at M0, M3, while were reduced at M6 and M12 in EMR group compared to control group. Furthermore, HADS-depression score was similar at M0 and M3 but was decreased at M6 and M12 in EMR group compared with control group, however, there was no difference of depression rate and severity between the 2 groups at each time point. Moreover, Zarit Caregiver Burden Scale score was similar at M0 and M3, but was decreased at M6 and M12; meanwhile, degree of care burden was similar at M0, M3 and M6, but was reduced at M12 in EMR group compared to control group. EMR program decreases anxiety, depression and care burden in caregivers of acute stroke survivors, suggesting its potential in improving mental health and further promoting quality of lives in these caregivers.

This study investigates the effect of progressive muscle relaxation training on negative mood and sleep quality in Coronavirus Pneumonia (COVID-19) patients. COVID-19 is an emerging infectious disease, and there is still uncertainty about when the outbreak will be contained and the effectiveness of treatments. Considering that this disease is highly contagious, patients need to be treated in isolation. This may lead to psychological symptoms such as anxiety and depression, and even sleep problems. This study is a clinical observation study. Participants included 79 COVID-19 patients admitted to a designated hospital for COVID-19 patients in Wuhan from February to March, 2020. Patients were selected and assigned to the control group and the observation group according to their wishes, with 40 and 39 cases in each group, respectively. The control group received routine treatment and nursing, and the observation group received progressive muscle relaxation training, in addition to the routine treatment and nursing. We compared scores of the Pittsburgh Sleep Quality Index Scale (PSQI), the Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaire (PHQ-9) before and after the intervention. There was no significant difference in PSQI, GAD-7, and PHQ-9 scores between the control group and the observation group before the intervention (P > .05). After the intervention, the difference in scores of PSQI, GAD-7, and PHQ-9 in the 2 groups were statistically significant (P

Objective: To compare the effects of static stretching with autogenic inhibition and reciprocal inhibition muscle energy techniques on pain, disability and range of motion in patients with mechanical neck pain. Methods: A parallel design randomised controlled trial was conducted at Fauji Foundation Hospital and Railway-General Hospital, Rawalpindi, Pakistan, from April to November, 2017, and comprised of patients aged 18-70 years with neck pain of moderate intensity scoring 4-8 on numeric pain rating scale with limited or painful range of motion. The patients were randomly allocated via lottery method into static stretching group, autogenic inhibition muscle energy technique group and reciprocal inhibition muscle energy technique group. All the subjects received five consecutive treatments sessions. Outcome measurements included numeric pain rating scale score, neck disability index score and goniometry for cervical range of motion. Data was collected at baseline and after first and fifth sessions, and was analysed using SPSS 21. Results: Of the 78 subjects, there were 26(33.3%) in each of the three groups. Of them 7 were lost to follow-up and the study was completed by 71(91%) subjects. The overall mean age was 41.55±11.89 years (p>0.05). There was no significant difference between the groups at baseline (p>0.05). However, at first and second follow-up, there was a significant difference (p

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.

Objective: There is scarce research on the effects of mindfulness in individual therapy. As many practitioners integrate mindfulness exercises into individual therapy, empirical evidence is of high clinical relevance. Method: We investigated the effects of a session?introducing intervention with mindfulness elements (SIIME) in a randomized, controlled design. The effects of SIIME on therapeutic alliance and symptomatic outcome were compared with progressive muscle relaxation (PMR) and treatment?as?usual (TAU) control conditions. The sample comprised 162 patients with anxiety and depression. Results: Multilevel modeling revealed a significant symptom reduction and significant increase of alliance over the course of therapy. There were no significant time-condition interactions on outcome and alliance, indicating the comparable efficiency of all three treatment conditions. Conclusions: We found no advantage of SIIME versus PMR and TAU. Add?on mindfulness might not improve individual therapy related to alliance and outcome. (DIPF/Orig.)

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.

The veterinary profession continually strives to address wellness issues such as compassion fatigue, burnout, stress, anxiety, and depression. Wellness issues may begin during the professional curriculum when students experience intense academic, clinical, social, and personal demands on their time. The purpose of this article was to assess the use of progressive muscle relaxation (PMR) as a simple, non-invasive stress reduction technique for first-year veterinary students ( n = 101) at a US veterinary college. Students completed a 38-item questionnaire, the Smith Relaxation States Inventory 3 (SRSI3), both before and after performing PMR. Scores for the categories of basic relaxation, mindfulness, positive energy, transcendence, and stress were assessed. Female students ( n = 92) had significant ( p < .05) improvement in basic relaxation, mindfulness, and stress after completing PMR. Male students ( n = 9) had significant ( p < .05) improvement in basic relaxation and stress after completing PMR. When grouped according to age, all students had significant ( p < .05) improvement in the categories of basic relaxation and stress. Students in the 22-year-old ( n = 31), 23-year-old ( n = 29), 24-year-old ( n = 15), and 25-year-old or greater ( n = 17) groups also had significant improvement ( p < .05) in mindfulness. Additionally, students in the 23-year-old group had significant ( p < .05) improvement in positive energy. These results support the use of PMR as a potential self-care strategy for students to implement during their academic and professional careers.

Classic physical interventions for cervical dystonia (CD) have focused on treating motor components or, on motor components and relaxation programs. However, no CD treatment study has focused on a relaxation program alone. We developed a pilot study to assess whether a therapy completely based on a relaxation program could improve the physical and mental symptomatologies of patients with CD. Fifteen persons were included in the experimental group, which received individual sessions of aquatic (Watsu) therapy (WT) and autogenic training (AT). In addition, 12 persons were included in passive control group. We administered different questionnaires related to quality of life (SF-36), pain (Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Visual Analog Scale (VAS)) and mood (Beck Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI)). A significant interaction was observed between treatment and time with regard to the SF-36, VAS, and TWSTRS within the experimental group (

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.

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.

Background: The present study examined the efficacy of virtual reality (VR) exposure therapy for treating individuals with storm fears by comparing a one-session VR exposure treatment with a one-session progressive muscle relaxation (PMR) and psychoeducation session. Aims: It was predicted that there would be a reduction in storm-related fear post-treatment for individuals in both conditions, but that this reduction would be greater for those in the VR exposure condition. It was predicted that improvements would be maintained at 30-day follow-up only for those in the VR exposure condition. Method: Thirty-six participants each received one of the two treatment conditions. Those in the PMR treatment group received approximately 30 minutes of PMR and approximately 15 minutes of psychoeducation regarding storms. Those in the VR treatment group received approximately 1 hour of VR exposure. Additionally, participants were asked to complete a pre-treatment and post-treatment 5-minute behavioural approach test to assess changes in storm fears. They were also asked to complete a measure assessing storm phobia. Results: There was a significant interaction between treatment group and self-reported fear at post-treatment, such that fear decreased for both groups, although the reduction was stronger in the VR group. Results also showed that reductions in storm fear were maintained at 30-day follow-up for both groups. Conclusions: Although this study used a small non-clinical sample, these results offer preliminary support for the use of VR exposure therapy in the treatment of storm-related fear.

To evaluate the effects of progressive muscle relaxation training (PMRT) combined with fifive elements music therapy of Chinese medicine (CM) for improving anxiety and depression of cancer patients. From June 2015 to March 2016, 60 cancer patients were included into the study. The patients were randomly assigned to a control group and a treatment group by envelope randomization, receiving PMRT and PMRT plus CM five elements music therapy, respectively, for 8 weeks. Hospital Anxiety and Depression Scale (HADS), Benefit Finding Scales (BFS), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), and Intervention Expectations Questionnaire (IEQU) were adopted to assess the depression of the two groups before and after the treatment. Four cases dropped out during the study, and 29 cases in the treatment group and 27 in the control group were included in the fifinal analysis. Prior to the treatments, the baselines of the 4 questionnaires in the two groups showed no difference. After the 8-week treatment, the treatment group presented better levels of HADS, BFS and FACIT-Sp scores compared with the control group (P

Background and objectives Burn patients experience a high level of anxiety and poor sleep quality due to their special physical and psychological conditions. The present study aimed to investigate the effect of progressive muscle relaxation on anxiety and sleep quality in burn patients. Methodology and participants In this randomized controlled clinical trial, a total of 80 patients admitted to burn ward were enrolled using convenient sampling and randomly assigned to one of the experimental or control groups. In the experimental group, patients were intervened using Jacobson’s relaxation technique 20−30 min daily for three consecutive days. During this period, the control group received only routine care and treatment. Patients' anxiety and their sleep quality were measured and recorded before and after the intervention using the Spielberger State-Trait Anxiety Inventory (STAI) and St Mary’s Hospital Sleep Quality Questionnaire (SMHSQ) respectively. Eventually, data analysis was conducted using SPSS version 20.0 software (IBM Corp., Armonk, N.Y., USA). Results The findings of the present study showed a statistically significant decrease in anxiety and improvement in sleep quality in the experimental group compared to the control group (P Conclusion Relaxation as a complementary method can be used along with modern medicine to reduce anxiety and improve sleep quality in burn patients.

Chronic pain, the most common complication of diabetes, is treated with medication often to no avail. Our study aimed to compare the use of mindfulness meditation and progressive relaxation to reduce chronic pain in older females with diabetes. Methods The 105 study participants were divided randomly into 3 groups: Group MM (mindfulness meditation), Group CM (control meditation), and Group PM (progressive relaxation meditation). Assessment of analgesic effectiveness required changes in average daily pain Brief Pain Inventory (BPI) modified for painful diabetic peripheral neuropathy and Patient Global Impression of Change using descriptive statistics, Student’s t test, and analysis of variance where applicable. Results Both Groups MM and PM experienced significant ( P < .05) reduction in average daily pain in last 24 hours at study end compared to baseline (28.7% and 39.7%, respectively). Group MM had more significant ( P < .01) reduction of pain compared to control, a score of 5.2 ± 1.2 dropped to 3.0 ± 1.1 by week 12 of treatment. Groups MM and PM showed significant improvement in patients’ impression at study end, 75 ± 5.1% (n = 36) and 61 ± 6.5% (n = 32), respectively. In Group MM, patient satisfaction scores increased significantly ( P < .05) to 3.8 ± 1.9 by week 12. Conclusion Integrative therapies such as mindfulness meditation can be part of a comprehensive pain management plan. Benefits include reduction of pain-related medication consumption, better treatment outcomes, improvement in comorbid conditions such as anxiety and depression as well as no risk of addiction or abuse.

Background Nursing students experiencing high stress levels before exams could suffer worse academic performance. Objective We evaluated an intervention combining Progressive Muscle Relaxation (PMR) and music therapy on the decrease of before exams stress and the improvement of academic results. Design and methods Randomized controlled trial including students from the Nursing Degree during the first semester of the 2017–2018 academic year. All participants were randomized to the control (CG) or the experimental group (EG). The CG took the exam as usual whereas in the EG, PMR and music therapy were performed before exams. Blood samples were drawn to investigate variations in biochemical parameters. The academic performance was assessed by the score obtained in the “Clinical Nursing” exam. Results We included 112 students (75% females, mean age 24.3 ± 6.2 years, 56 students in every group). There were no differences in any parameter during the first measurement. Regarding the second measurement, we observed a reduction in heart rate for the EG and an increase in blood pressure, heart rate, and cortisol for the CG. Indeed, these parameters were significantly higher compared to the EG. The EG had a mean score of 5.07 ± 1.59 in the Clinical Nursing exam, which was significantly higher compared to the CG (4.42 ± 1.58, p = 0.033). The proportion of fails in the CG was also higher (62.5% vs. 42.9%, p = 0.037). Conclusion In this study including students from the Nursing degree, the combination of PMR and music therapy was effective for the control and decrease of stress before exams, and also demonstrated improvements in academic results.

Hwabyung is a psychosomatic disease resulting from the suppression of anger over an extended period. The Emotional Freedom Techniques (EFT) are meridian-based psychotherapy known to cure many psychosomatic diseases, and progressive muscle relaxation (PMR) is a therapeutic method that relieves physical and psychological tension by repeated tensing and relaxation of the muscles.In this study, we compared the effects of EFT and PMR in patients with Hwabyung.40 patients were enrolled and randomized to receive 4 weeks of group sessions with either EFT (n = 20) or PMR (n = 20). Evaluations were conducted pre- and post-treatment and at 4-week and 24-week follow-ups after session end.The Hwabyung Scale, Visual Analogue Scale of Hwabyung Symptoms (VAS-HS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and State-Trait Anger Expression Inventory (STAXI) were administered as self-report tools. The analysis excluded 8 patients who never attended treatment and 1 patient meeting the exclusion criteria.EFT (n = 15) and PMR (n = 16) improved Hwabyung symptoms (-13.95% and -11.46%, respectively), state anxiety (-12.57% and -12.64%, respectively), and depression (-32.11% and -18.68%, respectively) (p 0.05 for all). Trait anger improved in EFT group (-13.4%, p = 0.004). There were no significant differences between the groups (p 0.05) except for trait anger at post-treatment (p = 0.022 for between group). No adverse events were reported during the study.

Purpose To evaluate progressive muscle relaxation (PMR) as an intervention for anxiety, psychotic symptoms, and quality of life (QOL) in patients with chronic schizophrenia. Design and methods Eighty patients were recruited from a Taiwanese psychiatry ward. The intervention group received group PMR; control group received treatment-as-usual. Results The results indicated that PMR might have a short-term effect on reducing anxiety, improving psychotic syndromes, and QOL among patients with chronic schizophrenia; however, the effectiveness at the 3-month follow-up was not evident. Practice implications Both the psychiatric patients and the health institutions may be able to list PMR as a clinical routine care, and then become a mental health practice strategy for mental patients to improve the quality of mental care. Implications for nursing practice Our studies suggest that prevention of severe mental illness among patients with schizophrenia requires PMR interventions. PMR had an immediate effect, and it is possible that a shorter intervention period using this approach would also be successful.

Introduction: surgery is a stressful experience for patients and most surgical patients have some degree of anxiety. The purpose of this study was to investigate the effect of a relaxation technique in addition to narcotic analgesic on health promotion in surgical patients. Methods: in this clinical trial, 70 patients who were candidates for elective upper and lower gastrointestinal system surgery were selected. They were randomly divided into two groups: case (morphine 0.15 mg/kg daily in divided doses and progressive muscle relaxation (PMR)) and control (morphine 0.15 mg/kg daily in divided doses). In each patient, the PMR intervention would be performed for 20 minutes every 6 hours for 2 days until 2 hours before the operation. Vital signs and anxiety were evaluated in the two groups after surgery. Data were analysed by t-test, analysis of variance, and chi-square test. Results: a statistically significant difference was seen in vital signs, pain and anxiety between the two groups. However, there was also a significant difference between them in terms of economic status and insurance coverage, which could have had an effect on stress and anxiety. Conclusion: PMR could increase the pain threshold, stress and anxiety tolerance and adaptation level in surgical patients. Therefore, using this technique could be an appropriate way to reduce analgesic drug consumption.

WOS: 000462899400010, PubMed: 30203546, Aim This study aimed to investigate the effect of progressive muscle relaxation on the caregiver burden and level of depression among the caregivers of older patients with a stroke. Methods This randomized, controlled experimental study was conducted between December, 2015 and July, 2017 with the caregivers of older patients with a stroke who had been admitted to the home care unit of a state hospital. The caregivers were randomly assigned to intervention (n = 23) and control (n = 21) groups, based on the study's inclusion criteria. The caregivers in the intervention group practiced progressive muscle relaxation exercises at home 3 days per week for 8 weeks. The control group had no intervention. Results The mean age of the older patients with a stroke was 80.15 +/- 9.86 years and the mean duration of the disease was 39.07 +/- 44.69 months. The mean age of the caregivers was 50.29 +/- 12.62 years, 84.1% of whom were female, 38.6% were elementary school graduates, and 86.4% were married. It was found that there was a statistically significant decrease in the mean Zarit Caregiver Burden Scale and Beck Depression Scale scores of the caregivers in the intervention group after practicing progressive muscle relaxation, but this decrease was not statistically significant when the intervention and control groups were compared. Conclusion This study showed that there was a statistically significant decrease in the caregiver burden and level of depression among the caregivers in the intervention group after progressive muscle relaxation exercises, but that there was no statistically significant difference when the intervention and control groups were compared.

Objective The current study extended upon previous research efforts by evaluating the utility and feasibility of an 8-session Internet-based interpretation bias modification (IBM) training protocol targeting evaluation- and appearance-related threat biases characteristic of the disorder compared to a progressive muscle relaxation (PMR) condition for treatment of body dysmorphic disorder (BDD). Method Fifty participants with BDD were recruited from across the United States and randomly assigned to eight sessions of either IBM or PMR. Assessments of interpretation bias, BDD symptoms, depression, and anxiety were administered at pretreatment, 1-week posttreatment, and 3-month follow-up. Results Compared to the PMR group, individuals in the IBM condition reported less negative/threat interpretation biases and greater positive/benign interpretation biases at posttreatment and follow-up. There were no significant differences between groups with regard to BDD symptoms, depression, or anxiety. Clinically significant improvement was common in both conditions (IBM = 64.0%; PMR = 52.0%), though it did not differ between them. Conclusions Contrary to our hypothesis, IBM did not outperform PMR with regard to BDD symptom reduction, though both treatments yielded significant improvements on symptom outcomes. Findings suggest that IBM and/or PMR may be promising treatment strategies for BDD, perhaps adjunctively. Overall, these findings provide helpful future directions for IBM research and provide an additional lens through which to examine its potential effectiveness for BDD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Computerized interpretation bias modification (IBM) programs show promise for the treatment of anxiety disorders, though they have rarely been compared to active treatments. The goal of the present study was to compare the efficacy of IBM to progressive muscle relaxation (PMR) for the treatment of social anxiety disorder (SAD). Sixty-four participants with SAD were recruited from across the United States and randomly assigned to 8 internet-delivered twice-weekly sessions of IBM or PMR. Participants were administered assessments of primary symptom outcomes and interpersonal suicide risk factors at posttreatment and 3-month follow-up. IBM led to significantly lower negative interpretation bias than PMR at posttreatment but not follow-up. Both conditions experienced comparable reductions in social anxiety from pretreatment to follow-up (IBM d = 1.37, PMR d = 1.28). They also experienced significant reductions in depression and general anxiety that did not differ from one another. Additionally, IBM led to greater reductions in thwarted belongingness than PMR at posttreatment but not follow-up. Overall, these findings suggest IBM is not more effective than PMR for reducing social anxiety, though there was some evidence of its superiority in decreasing suicide risk. Limitations and directions for future research are discussed.

This study aimed to examine the effect of progressive muscle relaxation therapy (PMRT) on cortisol level, the Stress Arousal Checklist (SACL) score, blood pressure, and heart rate in colorectal cancer patients undergoing laparoscopic surgery. Forty-six patients were divided into control and experimental groups. Cortisol levels, blood pressure, and heart rate were measured before surgery and between 8:00 and 11:00 a.m. on the first, third, and fifth days after surgery. SACL score was measured before surgery and on the fifth day after surgery at the same time points. PMRT was performed twice a day for 5 days. Analyses of covariance with advanced covariate levels and t tests showed that PMRT helps colorectal cancer patients achieve a lower stress response and provides an important basis for stress control.

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.

The increased anxiety experienced by nursing students during simulations can serve as a significant barrier to learning. The use of anxiety-reducing techniques such as autogenic training (AT) can mitigate the negative effects of anxiety and improve the overall learning experience. The investigators in this study sought to understand the effect of AT on student performance and self-efficacy during simulation experiences. The use of AT was an effective technique to decrease anxiety and increase performance among nursing students during nursing simulations. Reducing anxiety during simulations can improve the student learning experience.

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.

Dental anxiety causes patients to refuse or delay treatment, which may exacerbate oral diseases. The aim of the current randomized controlled trial was to determine whether progressive muscle relaxation therapy could relieve dental anxiety. The trial included 68 periodontal patients with dental anxiety scores of ≥13 who were randomly assigned to either an intervention group or a control group (n = 34 per group). The intervention group was administered progressive muscle relaxation therapy for 20 min and oral health education for 15 min before periodontal treatment once per week for 4 wk. The control group was provided with oral health education only, for the same duration. Changes in dental anxiety, depression symptoms, blood pressure, heart rate, and salivary cortisol were evaluated 4 wk and 3 months after the intervention. The intervention group exhibited statistically significantly greater reductions in dental anxiety scores than did the control group at the 4-wk (-3.82 vs. -0.89) and 3-month (-4.22 vs. -0.28) assessments. They also exhibited significantly greater reductions in depression symptoms, systolic and diastolic blood pressure, pulse rate, and salivary cortisol levels at both time-points. Progressive muscle relaxation therapy relieves tension and anxiety in dental patients.

ObjectiveUsing electronic diaries as part of a randomized controlled trial of stress reduction for epilepsy, we evaluated factors associated with successful seizure self-prediction.MethodsAdults with medication-resistant focal epilepsy were recruited from 3 centers and randomized to treatment with progressive muscle relaxation or control focused attention. An 8-week baseline was followed by 12 weeks of double-blind treatment. Twice daily, participants rated the likelihood of a seizure in the next 24 hours on a 5-point scale from very unlikely to almost certain, along with mood, premonitory symptoms, stress ratings, and seizure counts. We analyzed the association of mood, premonitory symptoms, stress, and circadian influences on seizure self-prediction.ResultsSixty-four participants completed the trial (3,126 seizures). Diary entry adherence was >82%. Participant self-prediction was associated with seizure occurrence at 6, 12, and 24 hours (p < 0.0001). Odds ratio (OR) of seizure prediction increased systematically with participants’ prediction of seizure likelihood (p < 0.0001, all levels of prediction and all time intervals). For the 12-hour prediction window, median specificity for seizure prediction was 0.94 and negative predictive value 0.94; median sensitivity was 0.10 and positive predictive value 0.13. A subset of 13 participants (20% of sample) met criteria for good predictors (median OR for seizure prediction 5.25). Mood, stress, premonitory symptoms, seizure time, and randomized group were not associated with seizure occurrence.ConclusionIn this prospective study, participants’ prediction of a high probability of seizure was significantly associated with subsequent seizure occurrence within 24 hours. Future studies should focus on understanding factors that drive self-prediction.Clinicaltrials.gov identifierNCT01444183.

The ability to delay gratification at a young age is a predictor of psychological, cognitive, health, and academic later-life outcomes. This study aimed to extend earlier research and explore whether a metacognitive intervention, Wells' (1990) Attention Training Technique (ATT), could improve young children's ability to delay gratification compared to an active-control (Progressive Muscle Relaxation: PMR), and no-intervention group. One hundred and one children aged 5-6 years old were recruited from schools. Classes of children were randomly allocated to receive the ATT, PMR or no-intervention and tested at pre- and post-intervention on measures of delay of gratification (the Marshmallow Test) and verbal inhibition (Day/Night Task). Results showed that, even when covariates were controlled for, following ATT, children delayed gratification significantly longer than after PMR or no-intervention. ATT also improved verbal inhibition compared with the no-intervention group, whilst PMR did not. The results add to earlier findings; ATT appears to provide a simple and effective way of improving young children's ability to delay gratification which has previously been shown to predict positive outcomes in later-life.

Assessment of the impact of Jacobson Progressive Muscle Relaxation (PMR) on depression-anxiety-stress symptoms, sense of coherence, health-related quality of life and well-being in long-term unemployed people with anxiety disorders.An intervention study was conducted at a relevant Organization, in Athens, Greece.50 long-term unemployed individuals suffering from anxiety disorders participated in the study. Participants were separated into two groups: (a) the intervention group (30 individuals) that was trained on an 8-week on Progressive Muscle Relaxation program and also received counseling services and (b) the control group (20 individuals) that received only counseling services.Depression, Anxiety, Stress Scale, Sense of Coherence, Health-Related Quality of Life and Well-being were evaluated at baseline and after the intervention.Significant changes were noted in the studied variables between the two groups, with improved outcomes in the intervention group. The intervention group showed a decrease in the symptoms of depression, anxiety, stress (p 0.001) [depression (p 0.001), anxiety (p 0.001), stress (p 0.001)], a higher score of sense of coherence (p 0.001), improved health-related quality of life regarding the mental health domain (p 0.001), and improvement in well-being (p 0.001). No significant change was observed in the control group during the follow-up period.

Purpose To describe a distinct phenotypic outcome of outer retinal degeneration in a cohort of genetically confirmed patients with recessive Stargardt disease (STGD1). Design Retrospective case series. Methods Twelve patients, who were clinically diagnosed with STGD1 and exhibited a unique degenerative phenotype, were included in the study. Two disease-causing mutations were found in all patients by direct sequencing of the ABCA4 gene. Clinical characterization of patients were defined on fundus photographs, autofluorescence images (488-nm and 532-nm excitation), spectral-domain optical coherence tomography (SD-OCT), and full-field electroretinogram (ffERG) testing. Results Mean age at initial presentation was 67.8 years and reported age of symptomatic onset was 14.1 years (mean disease duration = 53.8 years). Best-corrected visual acuity ranged from 20/400 to hand motion. All patients exhibited advanced degeneration across the posterior pole resulting in a reflectively pale, blonde fundus owing to unobstructed exposure of the underlying sclera. SD-OCT revealed complete loss of the outer retinal bands (external limiting membrane, ellipsoid zone, interdigitation zone, and retinal pigment epithelium) and choroidal layers. Scotopic and photopic waveforms on ffERG were nonrecordable or severely attenuated in 8 patients who were tested. Conclusions Widespread scleral exposure is a clinical outcome in a subset of STGD1 following a long duration of disease progression (∼50 years). The blonde fundus in such cases may exhibit phenotypic overlap and shared therapeutic implications with other aggressive chorioretinal dystrophies such as end-stage choroideremia, gyrate atrophy, or RPE65-Leber congenital amaurosis.

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

Purpose: This study compared the effects of 6 and 12 sessions of relaxation training on emotional distress, short-term memory, and sustained attention in primary school children. Methods: Participants (N = 132) aged 10 and 11 years old participated in this study. All participants and their parents provided written informed consent. Participants completed the measurement instruments before and after the completion of relaxation training. Results: Nearly half (49%) of all respondents reported moderate to extremely severe stress, and 80 and 61% reported moderate to extremely severe anxiety and depression, respectively. The results of a one-way analysis of variance revealed a significant difference among the groups in mean changes in short-term memory. A greater memory increase was observed in the 12-session than in the six-session and no-training group. Conclusion: It can be conceived that 12-session of training should be considered when prescribing relaxation regimens as a nonspecific clinical treatment (i....

The inadequate quality and nature of sleep is a commonly reported problem among hospitalized patients. The purpose of this study is to examine the effects of progressive muscle relaxation training program on sleep quality, sleep state, pain, and quality of life in patients who underwent pulmonary resection. Our study was planned as a single-blind prospective randomized controlled trial. The study was conducted on 26 patients who underwent surgery by using posterolateral thoracotomy method. Progressive muscle relaxation training were given to the training group with a therapist two times a day. Sleep quality, daytime sleeping, pain, and quality of life were respectively evaluated in the morning before the surgery and 1 week after the surgery by using Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, visual analogue scale, and Euro Quality of Life-5D (EQ-5D). There is no significant difference between preoperative groups in the total Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Euro Quality of Life-5D, and visual analogue scale scores (p > 0.05). The intra-group change in the study group showed a significant deterioration in the Euro Quality of Life-5D and visual analogue scale scores (p

'Metacognitive training for borderline personality disorder' (B-MCT) represents a complementary group intervention. It aims at raising awareness for cognitive biases that may play an important role in the development and maintenance of borderline symptomatology. For the present study, we evaluated the effectiveness of this new approach against a control condition. Seventy-four inpatients with borderline personality disorder (BPD) were randomly assigned to metacognitive training for BPD or progressive muscle relaxation training as an add-on intervention to treatment as usual. Severity of symptomatology was assessed at baseline, four weeks after beginning and six months after completion of the intervention. The per-protocol and intention-to-treat analyses revealed that patients in the metacognitive training group showed significantly greater reductions on the primary outcome (Borderline Symptom List-23) after six months. Progressive muscle relaxation was superior in alleviating depressive symptoms (secondary outcome: Beck Depression Inventory) at the long-term follow-up. Findings provide preliminary evidence that metacognitive training for BPD yields surplus effects to standard treatment.

Purpose To explore the effect of Progressive Muscle Relaxation (PMR) and Guided Imagery (GI),in reducing anxiety levels among parents of children diagnosed with any type of malignancy receiving active treatment at a Paediatric Oncology Unit in Republic of Cyprus and in Greece. Method A randomized non-blinded control trial was conducted between April 2012 to October 2013, at two public paediatric hospitals. Fifty four eligible parents of children hospitalized with a malignancy were randomly assigned to the intervention (PMR and GI) (n = 29) and a control group (n = 25). The study evaluated the changes in anxiety levels(HAM-A) and mood changes(POMSb). Results There was a statistically significant difference in the mean scores of the subjects in the intervention group in HAM-A scale between the T0 (14.67 ± 9.93) and T1 (11.70 ± 8.15) measurements (p = 0.008) compared to the control group in which a borderline difference (16.00 ± 11.52 vs 13.33 ± 8.38) was found (p = 0.066). The effect size for the intervention group was low to moderate (0.37). Regarding mood changes, there was a statistically significant difference in tension for parents in the intervention group between T0 and T1 (11.15 ± 5.39 vs 9.78 ± 4.26), (p = 0.027). Furthermore, the parents in the intervention group were significantly less sad following the intervention (T1) (2.81 ± 1.07 vs 2.19 ± 1.21), (p = 0.001), and felt significantly less tense (2.93 ± 0.91 vs 2.26 ± 0.90), (p = 0.001) and anxiety (2.63 ± 1.21 vs 2.19 ± 1.07), (p = 0.031) compared to those in the control group. Conclusions These findings provided evidence on the positive effect of the combination of PMR and GI in reducing anxiety and improving mood states in parents of children with malignancy.

Cognitive-behavioral therapy for pathological gambling has a long-term success rate of more than 50%. This study evaluated the effect of self-hypnosis in cognitive-behavioral treatment of pathological gamblers. Forty-nine participants were assigned to 2 groups. Both groups received a cognitive-behavioral protocol, and Group 1, the no-hypnosis group, received an 11-session intervention and Group 2, the hypnosis group, received 7 sessions that included self-hypnosis. Both groups were equal in gambling chronicity, frequency, intensity, change motivation, and problems derived from gambling. All participants reported significant improvement in gambling behavior and consequences at both treatment end and 6-month follow-up. Data show no differences between the interventions in abstinence, therapeutic compliance, fulfillment, and satisfaction. Results suggest that self-hypnosis reinforces treatment and can be a supportive technique for future brief interventions.

The present study was designed to examine the effect of heart rate variability (HRV) biofeedback on the cardiorespiratory resting function during sleep in daily life. Forty-five healthy young adults were randomly assigned to one of three groups: HRV biofeedback, Autogenic Training (AT), and no-treatment control. Participants in the HRV biofeedback were instructed to use a handheld HRV biofeedback device before their habitual bedtime, those in the AT were asked to listen to an audiotaped instruction before bedtime, and those in the control were asked to engage in their habitual activity before bedtime. Pulse wave signal during sleep at their own residences was measured continuously with a wristwatch-type transdermal photoelectric sensor for three time points. Baseline data were collected on the first night of measurements, followed by two successive nights for HRV biofeedback, AT, or control. Cardiorespiratory resting function was assessed quantitatively as the amplitude of high-frequency (HF) component of pulse rate variability, a surrogate measure of respiratory sinus arrhythmia. HF component increased during sleep in the HRV biofeedback group, although it remained unchanged in the AT and control groups. These results suggest that HRV biofeedback before sleep may improve cardiorespiratory resting function during sleep.