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Micah Filippov
Micah Filippov

Progressive Muscle Relaxation As An Interventio...

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Objective. To test the effectiveness of guided imagery (GI) and progressive muscle relaxation (PMR) as stress reducing interventions in patients with prostate and breast cancer who undergo chemotherapy. Methods. Patients were randomly assigned to either the control group or the intervention group (PMR and GI). Patients were observed for a total duration of 3 weeks and assessed with the SAS and BECK-II questionnaires for anxiety and depression, respectively, in addiotion to two biological markers (saliva cortisol and saliva amylase) (trial registration number: NCT01275872). Results. 256 patients were registered and 236 were randomly assigned. In total 104 were randomised to the control group and 104 to the intervention group. Intervention's mean anxiety score and depression score changes were significantly different compared to the control's (b = -29.4, p < 0.001; b = -29.4, p < 0.001, resp.). Intervention group's cortisol levels before the intervention (0.30 0.25) gradually decreased up to week 3 (0.16 0.18), whilst the control group's cortisol levels before the intervention (0.21 0.22) gradually increased up to week 3 (0.44 0.35). The same interaction appears for the Amylase levels (p < 0.001). Conclusions. The findings showed that patients with prostate and breast cancer undergoing chemotherapy treatment can benefit from PMR and GI sessions to reduce their anxiety and depression.

Clinicians in acute care settings are often called upon to manage cancer pain unrelieved by medications. Cognitive-behavioral strategies, such as relaxation and imagery, are recommended for cancer pain management; however, there appear to be individual differences in their effects. This pilot study examined variation in pain outcomes achieved with progressive muscle relaxation (PMR) and analgesic imagery interventions among hospitalized patients with cancer pain, and assessed the influence of four individual difference variables (cognitive ability, outcome expectancy, previous experience, and concurrent symptoms) on pain relief achieved with each intervention. A crossover design was used in which 40 hospitalized cancer patients received two trials of PMR, two trials of analgesic imagery, and two trials of a control condition. In comparing means between treatment and control conditions, both PMR and analgesic imagery produced greater improvements in pain intensity, pain-related distress, and perceived control over pain than the control condition. However, individual responder analysis revealed that only half of the participants achieved a clinically meaningful improvement in pain with each intervention. Patients who achieved a meaningful improvement in pain with analgesic imagery reported greater imaging ability, more positive outcome expectancy, and fewer concurrent symptoms than those who did not achieve a meaningful reduction in pain. Similar relationships were not significant for the PMR intervention. Investigators should continue efforts to identify factors that moderate the effects of cognitive-behavioral pain coping strategies so that clinicians can identify the most beneficial treatments for individual patients.

Findings from the present study provided evidence that chemotherapy-related nausea, vomiting and retching experience, occurrence and distress were significantly lower in the intervention group compared to the control group. Morrow and Hickok [44] reported that progressive muscle relaxation training was effective in preventing as well as decreasing the frequency of post-chemotherapy nausea and vomiting. In a study of 60 women with breast cancer, Yoo et al [18] assessed the effectiveness of progressive muscle relaxation training and guided imagery in reducing the anticipatory nausea and vomiting, and post-chemotherapy nausea and vomiting in patients with breast cancer. Patients in the intervention group experienced reduced nausea and vomiting before and after chemotherapy. Results from a study by Arakawa [45] in 60 Japanese


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