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Blood pressure biofeedback at home was compared with relaxation training and a combination of the two procedures for the treatment of essential hypertension, Ten subjects were taught to monitor blood pressure (BP) at home with electronic sphygmomanometers designed for self-use. Although situational factors appeared to have rather potent effects on BP levels, results suggested that training to control BP did generalize across situations. Although pretreatment BP level seemed to be related to the amount of reduction obtained, there was some evidence to indicate that subjects trained in behavioral methods of control could maintain BP in the average range after medication was discontinued, even if no significant reductions were obtained during treatment . Home practice of BP biofeedback was found to be the most successful single treatment for reducing systolic BP in the practice setting.

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.

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