Introduction: Bipolar disorder is a serious mental illness, but medications and psychosocial approaches designed to treat it leave significant room for improvement. This study investigated Progressive Muscle Relaxation (PMR), a treatment originally designed to reduce anxiety, as a way to reduce manic symptoms. Methods: Participants with bipolar I disorder (n = 44) were assigned via stratified randomization to complete PMR or a control condition (self-focused calming). Participants underwent a positive mood induction procedure, and completed several measures of manic symptoms at Session 1 and Session 2 (several weeks later). Results: Among those who experienced a successful positive mood induction, PMR and the control condition generally resulted in similar reductions in high-arousal positive affect. Participants who practiced PMR between the two sessions tended to experience greater reductions in positive affect at Session 2 compared to those who did not practice. Discussion: The relative parity of the PMR and control conditions suggests that people with bipolar I disorder have effective strategies for regulating positive emotions. Rather than teaching additional strategies, it may be more fruitful to develop methods for helping people with bipolar disorder to implement the strategies that work for them.

A study was conducted to determine the relationship between three different methods of relaxation (listening to music, progressive muscle relaxation (PMR), and a combination of music listening and PMR) and state anxiety reduction (as indicated by a feeling of reduced tension for the participant, measured on a self-rating scale). The study also examined the relationship between specific variables (age, sex, music training, music preferences, familiarity with music, degree of liking for music, knowledge of, and experience in, PMR, and learning style) and response to a relaxation method. The study involved forty male and female volunteers, ranging in age from 18 - 60 years. Participants were randomly assigned to one of three experimental groups or a control group. Both quantitative and qualitative methods were used in the analysis of results. Results indicated that for the participants in this study, all methods were associated with a decrease in state anxiety, the combined methods being no more effective in achieving reduced tension levels than the independent methods. However, a significant difference was achieved between the PMR group and the control group, with the mean decrease in tension level for the PMR group higher on average than that of the control group. There was also no significant difference observed between the relaxation sessions and the controlled opportunity for social interaction, attended by all participants. Further, case studies indicated that response to relaxation methods is a highly individual one.

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Bakgrund: Det är av vikt för fysioterapeuter att adressera perioperativ ångest för att utifrån ett biopsykosocialt perspektiv så effektivt som möjligt kunna behandla patienter som genomgår kirurgi. Progressiv muskelavslappning (PMA) har visats vara en effektiv metod för att minska ångest. Ingen systematisk översikt eller metaanalys har dock ännu utförts gällande metodens effekt på ångest i samband med kirurgi. Syfte: Syftet med studien var att sammanställa evidensläget gällande vilken effekt PMA har på nivån av ångest hos vuxna som genomgår kirurgi, bedöma studiernas risk för bias samt att bedöma det sammanvägda resultatets tillförlitlighet. Metod: Den här studien var en systematisk översikt och metaanalys. Databaserna AMED, CINAHL, MEDLINE, PsycINFO och PubMed inkluderades i en systematisk litteratursökning efter randomiserade kontrollerade studier. Datan om studiernas relevanta egenskaper extraherades genom läsning av fulltext. En metaanalys av tillgängliga data utfördes. De inkluderade studierna granskades gällande risk för bias med PEDro scale. Det sammanvägda resultatets tillförlitlighet bedömdes enligt GRADE.  Resultat: Åtta studier inkluderades i syntesen med totalt 582 deltagare. Fem studier inkluderades i metaanalysen. Den sammanslagna standardiserade medelvärdesskillnaden var -1.34, 95% konfidensintervall -.45 till -2.23, P= .003, vilket indikerar en stor effekt. De individuella studiernas risk för bias bedömdes låg. Det sammanvägda resultatets tillförlitlighet graderades till låg kvalitet p.g.a heterogenitet och saknade data.  Slutsats: PMA är generellt mycket effektiv för att minska ångestnivå i samband med kirurgi baserat på evidens av låg kvalitet. Den exakta effektstorleken verkar dock i hög grad vara kontextuell. / Background: Perioperative anxiety is an important factor for physiotherapists to address in order to treat patients efficiently from a biopsychosocial perspective. Progressive muscle relaxation (PMR) has been established to be effective in treating anxiety. However, to date no systematic review has been conducted on its effect on perioperative anxiety. Objective: The objective was to review the literature regarding the effect of PMR on the level of  perioperative anxiety in adults, to assess the risk of bias and to assess the quality of evidence.  Methods: This study was a systematic review and a meta-analysis. Databases AMED, CINAHL, MEDLINE, PsycINFO and PubMed were included in a systematic literature search for randomized controlled trials. Data was extracted through reading of full text. A meta-analysis was carried out on studies providing necessary data. The included articles were assessed for risk of bias with PEDro scale. The quality of the summarized body of evidence was assessed with the GRADE approach. Results: Eight studies were included with a total of 582 participants. Five studies were included in the meta-analysis. The pooled standardized mean difference was -1.34, 95% confidence interval -.45 to -2.23, P= .003, indicating a large effect. The PEDro assessment showed high quality. The GRADE assessment showed low quality due to heterogeneity and missing data. Conclusion: The findings suggest based on low quality evidence that PMR generally has a large effect on perioperative anxiety. However, the exact level of effect seems to be highly contextual.

Cue-controlled relaxation is looked at to determine whether a component is efficacious as the entire procedure. Subjects were 40 male and 40 female undergraduates. Subjects were randomly assigned to one of four conditions: cue-controlled relaxation, progressive muscle relaxation, breathing exercises with a paired. cue word, on a presentation of the cue word without being paired. It was hypothesized that cue-controlled relaxation would be superior to a component of cue-controlled relaxation. It was determined that cue-controlled relaxation is not more efficacious than a particular component. Data suggests the majority of anxiety reduction takes place when the treatment focuses on the same modality from which the subject receives the most information about their anxiety. Implications and suggestions for further research are presented.

Providing care for a frail older adult who is suffering from dementia has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. The present study investigated the effectiveness of Mindfulness-Based Stress Reduction (MBSR), among older family caregivers of persons with neurocognitive disorders, compared with an intervention based on progressive muscle relaxation (PMR). Participants were randomly assigned to either MBSR or PMR (n = 28). The MBSR group showed significantly greater reductions in self-reported levels of depression and isolation from pre- to post-intervention, and those changes remained significant at 8 weeks post-intervention. Both groups showed similar decreases in levels of perceived stress, cortisol awakening response, daily average cortisol, and in resting systolic blood pressure from pre- to post-intervention. Results suggest that MBSR and relaxation-based interventions may both be effective for caregivers, however, further research, employing waitlist control participants will be necessary for unambiguous interpretation of the present results.

M.Tech. (Chiropractic) / Purpose: The trapezius muscle is thought to be the muscle most commonly associated with the presence of active myofascial trigger points (MFTP’s). Studies of the trapezius muscle clearly show that muscular activity significantly increases in response to psychological stress. Cervical spine manipulation has been proven to be highly effective in the treatment of active MFTP’s and muscular tension. Progressive muscle relaxation (PMR) therapy is frequently utilized as a relaxation technique in subjects complaining of increased levels of muscular tension, possibly due to an increased perception of psychological stress. Although cervical spine manipulation alone is effective in the treatment of active MFTP’s and muscular tension, chiropractors often search for adjunctive therapies to improve current treatment protocols. The purpose of this study was to determine whether the combination of cervical spine manipulation and PMR therapy is a more efficient, and possibly effective, treatment protocol for active MFTP’s of the trapezius muscle. Method: This study was a comparative study and consisted of two groups of fifteen participants each. All participants were between the ages of eighteen and thirty-five years of age, with a male to female ratio of 1:1. Potential participants were examined and accepted according to the inclusion and exclusion criteria. Group A received chiropractic spinal manipulative therapy of the cervical spine. Group B was the combination group and therefore received chiropractic spinal manipulative therapy of the cervical spine together with the application of PMR therapy. Subjective measurements consisted of a Perceived Stress Scale (PSS) Questionnaire, Visual Analog Pain Scale (VAS) and the Vernon-Mior Neck Pain and Disability Index Questionnaire. Objective measurements consisted of pressure pain threshold algometry readings taken from active trigger points one (TP1) and/or trigger point two (TP2) on the right and/or left side of the upper trapezius muscle.

Providing care for a frail older adult who is suffering from dementia has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. The burden and stress is increased when the caregivers are themselves elderly. The present study investigated an 8-week stress-reduction program, Mindfulness-Based Stress Reduction (MBSR), and compared it to a similarly structured, alternative behavioral intervention, Progressive Muscle Relaxation (PMR), to determine if MBSR was as effective or more effective than PMR at reducing subjective burden, symptoms of depression, perceived loneliness or perceived stress among middle-aged and older family caregivers of persons with dementia and other neurocognitive disorders. Twenty-eight participants were randomly assigned to either MBSR or PMR. Self-report and biological measures were collected on five occasions: At the beginning and end of intervention training, and at 8 weeks, 6 months and 1 year following the end of intervention training. In addition to a packet of self-report questionnaires and home-collected salivary cortisol, a laboratory controlled emotional stress test was designed to elicit an emotionally stressful response relevant to caregivers’ experience of caregiving, and facilitate the measurement of stress-related changes in systolic blood pressure and cortisol reactivity. At 1 year post-intervention, the PMR group showed a significantly greater reduction in perceived stress and disruptive patient behaviors. A reduction in emotional reactivity to patient problem behaviors approached significance (p = .08) at 1 year post-intervention for the PMR group. The MBSR group showed significantly greater reductions in self-reported symptoms of depression and perceived isolation from pre- to post-intervention, and those changes remained significant at 8 weeks post-intervention. However, by 1 year post-intervention, interaction effects were non-significant as both groups showed similar decreases in symptoms of depression and perceived isolation. Both groups showed similar decreases in diurnal cortisol, cortisol awakening response, and daily average cortisol (but not laboratory cortisol) from pre- to post-intervention and further decreases at 8 weeks post-intervention, and showed similar reductions in magnitude of change by 1 year post-intervention. This pattern was similar for both groups with systolic blood pressure, showing decreases from pre- to post-intervention, additional decreases at 8 weeks post-intervention, and returning towards baseline by 1 year post-intervention. Both groups also reported similar increases in levels of dispositional mindfulness and self-compassion and similar improvement in overall sleep quality that was sustained at 1 year post-intervention. No changes were seen for perceived burden or loneliness. Significant correlations with amount of daily practice of the instructed stress-reduction approaches were observed for several of the dependent measures from pre- to post-intervention and 8 weeks post-intervention. From pre-intervention to 1 year post-intervention, an overall pattern emerged, where both groups showed similar improvements from pre- to post-intervention, and additional improvements at 8 weeks post-intervention, but displayed a curvilinear reduction in improvements—with some exceptions—and a return towards baseline at 6 months and 1 year post-intervention. In general, reductions in the magnitude of changes observed by 1 year post-intervention remained below baseline levels. Results suggest that both MBSR and relaxation-based interventions may be differentially effective in reducing psychological and physiological indices of chronic stress among older caregivers of relatives with neurocognitive disorders. However, further research, employing wait-list control participants, will be necessary for unambiguous interpretation of the present results.

Relaxation procedures and anxiety relief were reviewed. Effects of cognitive and expectancy variables in reduction of avoidance behavior were also extensively reviewed. Various theoretical models for desensitization were presented. Use of symbolic control in classical conditioning and use of self-control methods in anxiety reduction were discussed. Special emphasis was given to self-desensitization and cue controlled relaxation. One goal of the experiment was to determine whether a musical stimulus associated with counter anxiety procedures could reduce or prevent subjects' phobic responses in the presence of the phobic situation. Another goal was to determine the relative efficacy of two counter anxiety procedures (anxiety relief and progressive muscle relaxation) in lowering muscle tension and in reducing or preventing speech anxiety. Several implications were drawn from the study. Relaxation alone may alleviate anxiety and phobic behavior without being paired with phobic stimuli. Cognitive variables such as expectancy and feedback of progress make a substantial contribution to treatment of situational anxiety. Progressive muscle relaxation may not be the technique of choice for producing low levels of muscle tension. Recommendations for future research were specified, including additional measures and control procedures.

Yes / Chronic non-malignant pain is a global condition with a complex biopsychosocial impact on the sufferers. Relaxation skills are commonly included as part of a pain management programme, which is currently the recommended evidence-based intervention for this group of patients. However, there is little evidence behind the choice of relaxation method implemented, or their effectiveness. The aim of this study was to investigate the effectiveness of relaxation skills in the management of chronic non-malignant pain, related to pain intensity and health-related quality of life. A systematic literature review was conducted using MEDLINE, CINAHL, AMED, PEDro and PsycARTICLES. The Cochrane, DARE and Trip databases were also accessed, and searches were carried out using the terms (relaxation OR relaxation therapy OR relaxation training) AND (pain OR chronic pain). Following critical appraisal, ten studies met the inclusion criteria. Three studies reported a decrease in pain intensity as a result of the relaxation intervention, whilst only one study reported an improvement in health-related quality of life. Progressive muscle relaxation was the most commonly implemented method throughout, although its method of delivery differed between studies. There is little evidence for the use of relaxation as a stand-alone intervention for pain intensity and health-related quality of life for patients with musculoskeletal chronic non-malignant pain. More research is needed to determine its effectiveness.