Progressive Muscle Relaxation Training Research Articles

Behavioral treatment of excessive daytime sleepiness in an elderly woman with multiple medical problems

The case is described of a 61-year-old woman who complained of excessive daytime sleepiness, periodic cataplexy, and nocturnal urinary frequency, in the context of several other medical problems. Behavioral treatment consisted of training in progressive muscle relaxation and fluid restriction to facilitate sleep maintenance, and the use of a rubber band which was snapped against the wrist to facilitate daytime arousal. Following this self-management program, improvements were noted in the following dependent measures: (1) sleep attacks at home; (2) sleep attacks while driving; (3) cataplectic episodes; (4) nocturnal awakenings, and (5) nocturnal urine output. These improvements were maintained at 6- and 12-month follow-up. The integration of medical and behavioral strategies was highlighted.

Health Locus of Control and Chronic Disease: An External Orientation May Be Advantageous

A total of 62 cancer chemotherapy patients completed the Multidimensional Health Locus of Control (MHLC) scale prior to receiving training in progressive muscle relaxation and/or biofeedback for the reduction of the side effects of their treatment. Physiological measures of arousal and patient-reported indices of negative affect and nausea were collected during baseline, training, and follow-up chemotherapy sessions. Results indicated that following relaxation training and/or biofeedback, chemotherapy patients with a high external health locus of control orientation, as compared to patients without such an orientation, had lower levels of physiological arousal and reported less negative affect. These findings suggest that in medical situations in which little personal control is possible, an external health locus of control may be advantageous.

Physiologic responses of clients with essential hypertension to progressive muscle relaxation training.

The effects of progressive muscle relaxation on blood pressure of hypertensive clients were examined. After collection of baseline data, 22 clients received group relaxation training followed by individual monitoring sessions over a 6-week period. The 22 persons in the control group did not receive relaxation training. The group instructed in relaxation had a lower mean systolic blood pressure than the nontrained group at 4-month follow-up. While the relaxation-trained group showed a significant decrease in diastolic pressure from baseline to follow-up, the difference between trained and non-trained groups at follow-up was not significant. Relaxation, taught initially in group with individual follow-up visits, resulted in continued practice of relaxation and subsequent lowering of blood pressure in subjects with essential, uncomplicated hypertension.

Psychological and physiological effects of relaxation and nitrous oxide training.

Training in progressive muscle relaxation can improve psychophysiological response to stress but is often time-consuming and may prove ineffective for some individuals. Nitrous Oxide (N2O)may offer an effective adjunct or alternative to training. This study evaluated the relative efficacy of these procedures. Subjects were randomly assigned to one of four treatment conditions: relaxation-only, N2O only, relaxation with N2O, and room air-control. The relaxation procedure was modeled on color videotape. Nitrous oxide was administered from a balloon. In addition to various psychological measures, treatment effects were measured for skin temperature, heart rate, systolic blood pressure, and two measures of diastolic blood pressure. Subjective reports of tension were also recorded. There was a significant multivariate difference between treatment groups. The relaxation-only procedure was generally superior to the others on most dependent measures. Subjects receiving N2O appear to have experienced an improvement in mood. Paradoxically, the initially more relaxed subjects seemed to derive the greater benefit from the inhalation of N2O. The use of videotape-modeled relaxation procedures is discussed.

The effects of progressive relaxation on stress and diabetic control

Four insulin-requiring diabetic Ss were followed in single- S designs to measure the impact of progressive muscle relaxation training on blood glucose and stress levels. Measures of blood glucose, stress, activity and caloric intake were taken four times a day, along with a daily measure of anxiety. Two of the 4 Ss showed a significant decrease in blood glucose during treatment periods as compared to baseline measures. Similarly, 2 of the 4 Ss showed a significant decrease in stress levels during treatment. A multiple regression analysis revealed some significant relationships between blood glucose, stress, activity level and caloric intake. The results support previous studies that show relaxation techniques to be a viable aid in establishing greater diabetic control.

Relaxation training for control of nausea and vomiting in patients receiving chemotherapy

ABSTRACT The study reports the use of progressive muscle relaxation (PMR) in reducing nausea and vomiting and anxiety in a group of cancer patients. The patients were identified by their oncologists as experiencing refractory drug-induced nausea and vomiting in spite of the administration of antiemetic therapy. Baseline data was collected during one cycle of chemotherapy as the patients, by virtue of their history, served as their own controls. Data collection measured pre- and post-training physiological arousal and state-trait anxiety levels, food-fluid intake, degree and frequency of nausea and vomiting, and type and quantity of antiemetic therapy 48 hours following drug infusion; change in total body weight, and upper arm skin fold were measured throughout entire chemotherapy course. The results show that nine of the 12 patients showed some decrease in nausea and vomiting after PMR training. Caloric intake was greater 48 hours post-treatment in all patients. These data are suggestive that PMR may be an effective intervention for nausea and vomiting associated with chemotherapy.

A comparison of relaxation methods for reducing stress in nursing personnel.

The efficacy of a work-based stress reduction training program for nursing personnel was assessed. Nurses received training in EMG biofeedback, progressive muscle relaxation, or self-relaxation, via daily 1-h sessions conducted during their customary working hours for two consecutive work weeks. Progressive muscle relaxation training produced significant within-session decreases in muscle activity levels, whereas biofeedback training produced significant increases in hand temperature, signifying lower autonomic arousal. All three groups reported improvements on measures of trait anxiety after training. At a three-month follow-up, the biofeedback group reported increases in the amount of work energy and perceived effectiveness of the coping skills when used at work. The muscle-relaxation group reported increases in the ability to cope with stress, and both trained groups reported coping with stress more frequently than did the control group. The control group reported a significant increase in job dissatisfaction compared to the trained groups. The results offer some support that biofeedback and muscle relaxation may be useful methods for reducing arousal levels and improving coping skills of workers.

Effects of progressive muscle relaxation training on trait anxiety.

To measure the effects of progressive muscle relaxation training on trait and state anxiety of 27 college students enrolled in a class intended for stress reduction the Taylor Manifest Anxiety Scale was administered prior to and immediately after training. Pulse rates and peripheral skin temperatures were measured for each student prior to and after training. A significant decrease was evidenced in trait anxiety scores after training. A significant drop was found in pulse rates and a significant increase found in skin temperature responses immediately following training.

Relative effectiveness of bibliotherapy, individual and group self-control training in the treatment of problem drinkers

The effectiveness of 4 alternative forms of behavioral self-control training (BSCT) designed to reduce alcohol consumption was evaluated. Forty-one problem drinkers were assigned to 1 of 4 treatment conditions: (a) bibliotherapy, in which clients were evaluated and then provided with a self-help manual (Miller & Muñoz, 1976) and self-monitoring cards but were not given therapy sessions, (b) BSCT alone, consisting of 10 individual sessions following material presented in the manual, (c) BSCT plus relaxation training, being identical to (b) except that training in progressive deep muscle relaxation was added within the 10 sessions, and (d) group therapy identical in content to (c) but offered in a group rather than in individual format. Outcome data included information from client interviews, psychometric measures, self-monitoring cards, and interviews with significant others. All data sources indicated significant and substantial reduction in alcohol consumption, particularly in “alcoholismic” drinking patterns. No significant differences were found among the 4 treatment groups. The cost-effectiveness of a bibliotherapy approach was supported, consistent with prior research. Overall improvement rates were 84% and 69% at 3- and 12-month follow-up, respectively.

Effectiveness of relaxation training in reducing the aversiveness of chemotherapy in the treatment of cancer

Progressive muscle relaxation training was used to reduce the conditioned negative responses developed by a 30-yr-old cancer patient undergoing chemotherapy treatment. In a design that included Baseline, Phase 1 therapist-directed relaxation. Phase 1 patient-directed relaxation, Phase 2 therapist-directed relaxation, and Phase 2 patient-directed relaxation sessions, the patient underwent therapist-directed or self-directed relaxation training immediately before and during 10 consecutive chemotherapy treatments. Results indicated tha during the therapist-directed phases and one or both of the patient-directed phases the patient showed reductions in negative affect, frequency of vomiting, and post-session physiological arousal. It was concluded that progressive muscle relaxation training may be an effective procedure for reducing the adverse side effects of cancer chemotherapy.

Assessing the effects of relaxation training

Training in progressive muscle relaxation is frequently employed in behavior therapy. A fundamental question is how a clinician knows that his or her client is relaxed. The present article reviews recent research involving relaxation training to determine what criterion measures have been used to assess the effects of relaxation training procedures. Articles from four major journals which regularly publish research concerned with relaxation training were surveyed as to their report of four categories of dependent measures: self-report, physiological reading, behavior rating, or no report. Results were that in 70% of the articles reviewed no indication was made of how the effects of relaxation were assessed.

Use of Relaxation Training to Reduce Pain following Vaginal Hysterectomy

The experience of pain has cognitive and emotional components as well as sensory and physical factors; hence, psychological variables often play a key role in the control of pain (2) . Recent reviews ( 4 ) have shown the effectiveness of procedures such as cognitive modification, hypnosis, and relaxation training for increasing subjects' tolerance of laborstory pain, e.g., cold-pressor stimulation. In the present investigation, we sought to determine the effectiveness of one of these procedures, relaxation training, as a method for coping with the dinicaL pain which follows surgery. Subjects were 26 women, ages 30 to 62 yr., who were scheduled to undergo vaginal hysterectomies. Subjects were randomly assigned to either experimental or control groups. During the 10-day periods prior to their scheduled operations, the 13 women in the experimental group each received two 90-min, individual sessions of training in progressive muscle relaxation. The relaxation procedures involved ( a ) instructions to focus attention on pleasant, relatively monotonous internal feelings, e.g., deep breathing, and ( b ) systematic tension-release of gross muscle systems; see Bernstein and Borkovec ( 1 ) for detailed instructions. In keeping with ethical guidelines, the investigators informed subjects that the use of relaxation for pain control was an experimental procedure and, as such, its effectiveness could not be guaranteed. Subjects were instructed to practice the relaxation exercises twice daily and to use them as a means of coping with post-operative pain. In the control group were 13 women who underwent vaginal hysterectomies but had no contact with the experimenters prior to surgery. Subjects' pain was assessed one and three days post-operatively via the following dependent measures: (a) subjects' self-reports of pain, i.e., the McGill-Melzack Pain Questionnaire, ( b ) behavioral observations made by two independent raters, i.e., the Chambers-Price Rating Scales for Pain, and (c) the number of pain medications received by the subject. Statistical analyses showed that differences between the experimental and control groups on the dependent measures were not significant at either one or three days following subjects' surgeries (ps > .05); see Petri ( 3 ) for details regarding design, analysis, and a discussion of the results. Relaxation training was not sufficient procedure for the reduction of clinical pain, perhaps as a result of ( a ) insufficient training in the relaxation procedures, ( b ) a lack of staff reinforcement for subjects' post-operative use of the relaxation exercises, and ( c ) the ready availability of alternative, easier methods of pain control, e.g., medication.

Effect of EMG Biofeedback and Progressive Muscle Relaxation Training on Awareness of Frontalis Muscle Tension

ABSTRACTAwareness of muscle tension, as estimated by a modification of the Kinsman et al. (1975) procedure for determining probability of correct estimation (P(c)) of absolute differences in muscle tension between adjacent trials, was examined before and after volunteer subjects underwent 4 sessions of either: 1) EMG biofeedback (BF) training, 2) progressive muscle relaxation (PMR) training, or 3) a placebo‐control (MC) procedure which involved listening to music as an alleged guide for relaxation. The subjects were 30 females (mean age = 28.3 yrs) responding to an offering of experimental treatment for anxiety and tension. Measurements of frontalis muscle tension (EMG) and P(c) were made before and after training. The results showed that EMG was significantly reduced by BF and PMR training but not by the MC procedure. Increases in P(c) after training were significantly greater for BF than for PMR or MC training. There were no group differences for subjective report of tension. Correlations between pre‐ to post‐training EMG and P(c) change scores were significant only for the BF group and the combined group of BF and PMR subjects. These results suggest that: 1) both BF and PMR training were effective in producing frontalis EMG reductions, 2) the following relationship may exist among training groups in terms of relative influence upon awareness of tension—BF training > PMR training > MC training, and 3) awareness of tension appears to be related to the ability to reduce EMG although the exact nature of this relationship remains unclear.

Self-management of severe predormital insomnia

The present study examined the separate and cumulative effects of progressive muscle and mental relaxation training and cognitive control procedures for reducing pre-sleep tension and intrusive cognitions. Ten subjects were assigned to groups which focused on either separate or combined training in muscle and mental relaxation, followed by training in cognitive control procedures. Three other subjects were trained only in the cognitive control procedures. The findings indicated that muscle relaxation reduced the target pre-sleep tension but did not decrease pre-sleep intrusive cognitions. The addition of mental relaxation further reduced pre-sleep tension, and also decreased intrusive cognitions. The effects of cognitive control procedures were similar to those of mental relaxation. Reductions in both pre-sleep tension and intrusive cognitions were followed by significant reductions in latency to sleep onset, which was found to have been maintained at follow-up 4 months later.