Effects of progressive muscle relaxation on blood pressure and psychosocial status for clients with essential hypertension in Taiwan

The Effect of Progressive Muscle Relaxation Therapy on Anxiety in Hypertension Patients

Anxiety is a condition in which an individual experiences a concern about something that is not certain to happen, even some people experiencing anxiety but do not understand the specific cause of the anxiety source they feel. Anxiety problems, which are common in people, can be treated non-pharmacologically with deep muscle relaxation techniques, which do not require guided imagination or cause side effects in patients undergoing progressive muscle relaxation therapy. The objective of this study is to identify how progressive muscle relaxation techniques affected the anxiety levels of hypertension patients at the Kedaung Wetan Public Health Center. The study was conducted to determine if there was a difference in the level of anxiety experienced by hypertensive patients before and after receiving progressive muscle relaxation therapy. The design in this study employed a quasi-experimental pre-post-test with a control group with a progressive muscle relaxation therapy intervention. Result: there is a significant relationship between the period of occurrence of hypertension with anxiety experienced by respondents. Anxiety in hypertensive patients is more prevalent in those who are unfamiliar with hypertension. Thus, anxiety can arise from a sense of concern and fear of more serious complications which occur from the hypertension they are experiencing. The experimental group who received treatment in the form of progressive muscle relaxation therapy had a lower level of anxiety than the control group at the Kedaung Wetan Public Health Center in Tangerang City, with a p-value of 0.000.

Effects of mindful breath awareness and muscle relaxation and transcranial electrical stimulation techniques on improving blood pressure status in patients with type 2 diabetes

OBJECTIVE

The present study aimed to determine the effects of mindful breath awareness & muscle relaxation (MBMR) and transcranial electrical stimulation (tCES) techniques on improving the systolic and diastolic blood pressure status in patients with type 2 diabetes.

METHODS

The research method was randomized controlled trial (RCT) using split-plot ANOVA (SPANOVA). Thirty patients were selected through purposive sampling from Bonab County Diabetes Association (Iran) and were randomly divided into three 10-member groups, namely MBMR, tCES, and MBMR+tCES groups. Participants received their group interventions in 10 individual sessions. All patients were evaluated for systolic and diastolic blood pressure at two stages, before and immediately after each session. SPANOVA and Bonferroni pairwise comparison tests were used for data analysis.

RESULTS

The results indicated that the MBMR and tCES techniques, alone and in combination, had significant and equal effects on reducing diastolic blood pressure, but the MBMR treatment was more effective in the systolic blood pressure than the tCES.

CONCLUSIONS

The MBMR and tCES techniques were effective and safe in treating hypertension in patients with type 2 diabetes.

Competitive Anxiety, and Guilt and Shame Proneness From Perspective Type D and Non-type D Football Players

The precompetitive, competitive, and postcompetitive mental states of athletes are currently not sufficiently researched. Long-term exposure to stressors contributes to the formation of mental blocks and leads to various health problems. One of the factors that can explain the variability of athletes' reactions to stress is their personality. This study is the first to examine competitive anxiety, and guilt and shame proneness in the context of the reaction of football players to distress in sports. The study consists of 112 male football players aged 16–24 (21.00 ± 1.90) who were divided into type D and non-type D football players according to scoring on the Denollet Scale (DS14). Football players also filled out the Sport Anxiety Scale (SAS-2) and the Guilt and Shame Proneness Scale (GASP). The taxonomic approach was conducted to test and to examine differences in stressor intensity as a function of type D personality. A correlation, multivariate analysis of variance, and regression analysis were performed in the study. We found that type D football players were more afraid of failures in sports (worry), felt more often autonomous excitement concentrated in the stomach and muscles (somatic anxiety), and showed more frequent concentration disruption than did non-type D football players. We also found that although type D football players were more likely to rate their behavior as negative and inappropriate, they showed a much greater effort to correct it than did non-type D football players. Negative affectivity and social inhibition of type D football players were positively correlated with competitive anxiety. In addition, we noted lower levels of somatic anxiety and lower concentration disruption for football players who used escape strategies to manage stress. The shame proneness subscale monitoring negative self-evaluation was also closely related to the concentration disruption of football players. We found that the examination of athletes by type D personality is necessary due to the fact that negative affectivity and social inhibition are significant predictors of competitive anxiety of football players, which explains their worries at 24.0%, somatic anxiety at 8.2%, and concentration disruption at 10.6%.

Effect of progressive relaxation exercises on primary dysmenorrhea in Turkish students: A randomized prospective controlled trial

BACKGROUND

A randomized prospective controlled study was conducted concerning the effects of progressive relaxation exercises on the reduction of pain in primary dysmenorrhea.

MATERIALS AND METHODS

The research control group (CG) consisted of 60 students while the experimental group (EG) consisted of 64 students. The progressive relaxation exercises were self-administered via compact disc (CD) by participants for two menstrual cycles. A descriptive information form, a visual analog scale (VAS) and a dysmenorrhea monitoring form (DMF) were used for data collection.

RESULTS

The difference between the average first and final post-exercise measurements of the VAS scores of students in the experimental group was statistically significant (p < 0.001), whereas the difference in the control group was not statistically significant (p > 0.05).

CONCLUSION

Progressive relaxation exercises are an effective method for reducing dysmenorrhea when they are performed on a regular basis.

Effectiveness of Cognitive Behavioral Therapy to Reduce Depression, Anxiety and Stress among Hospitalized Patients with Congestive Heart Failure in Central Java

Introduction: Psychological problems in patients with heart failure are the result of a combination of the influence of behavior and interactions with physiological responses, which if not handled properly will contribute to worsening clinical symptoms and have a higher risk of rehospitalization. The objective of the study was to evaluate the effects of cognitive behavior therapy (CBT) on psychological symptoms among CHF patients.Methods: This was a quasi-experimental, pretest-posttest control study that applying a CBT to overcome depression, anxiety, and stress. Thirty eligible respondents were recruited and were randomly divided into a case group and waiting list group. Psychological symptoms of respondents were measured using Depression, Anxiety and Stress Scale – 21 questionnaires (DASS-21). Chi-square was used to compare demographic data between groups and T-test analysis was used to describe changes in mean scores between and within groups. Both groups had similar characteristics and psychological symptoms level at baseline.Results: The mean score of depression, anxiety and stress showed a significant difference within the group after the intervention (p<0.05).Conclusion: A recent study found that CBT was effective to reduce psychological symptoms among CHF patients. Based on the study results it can be highlighted that it is important for nurses to provide brief CBT to hospitalized patients in an effort to reduce short term psychological symptoms.

Efficacy of Progressive Muscle Relaxation on Pregnancy Outcome among Anxious Indian Primi Mothers

Background:

Progressive Muscle Relaxation (PMR) helps to improve the emotional state of antenatal mothers with stress and anxiety, which is necessary to keep the fetus healthy inside the womb. This study assesses the efficacy of progressive muscle repose on stress and anxiety among primigravidae.

Materials and Methods:

A randomized controlled study was conducted from May 2015 to June 2017 with 250 primigravidae. The women were assigned using a lottery method to intervention and control groups, 125 in each group. Information on background variables, pregnancy outcome, maternal complications, fetal complications, and postpartum depression was collected during the interval following delivery. PMR was the intervention (video) installed on one-to-one basis for two consecutive days. Pearson correlation, ANOVA, and regression analysis were used to evaluate the data to determine pregnancy outcome and performance of PMR.

Results:

There was a significant reduction ((F₃ = 24.81, p < 0.001) in all aspects of stress among the intervention and control groups during the posttest. The mean gestational age at birth was significantly different (F₂ = 6.08, p = 0.014) in the control group. There was significant increase in the occurrence of fetal complications such as birth asphyxia (F₂ = 5.67, p < 0.050), respiratory distress (F₂ = 8.68, p < 0.050), and jaundice (F₂ = 3.91, p < 0.050) in the control group. There was a negative correlation between PMR and stress (r = −0.22, p < 0.001), and PMR and state anxiety (r = −0.26, p < 0.001). There was an increased occurrence of maternal complications among the control group in comparison with the intervention group.

Conclusions:

The study suggests that PMR practice is useful during pregnancy to decrease stress, anxiety, and for reducing the occurrence of postpartum complications.

Use of Chinese herbal medicines by rheumatoid arthritis patients was associated with lower risk of stroke: A retrospective cohort study

BACKGROUND AND PURPOSE

Rheumatoid arthritis (RA) patients have increased risk of developing stroke. The use Chinese herbal medicines (CHMs) is increasing, but whether they can reduce the risk of developing stroke remains unclear. We conducted a longitudinal cohort study to compare the effect of CHMs use on the subsequent stroke risk in RA individuals.

MATERIALS AND METHODS

Using claims data from the National Health Insurance of Taiwan, we identified 7925 newly-diagnosed RA patients with no history of previous stroke who were 20 years of age or older between 1998 and 2010. From this sample, we enrolled 3134 CHMs users and 3134 non-CHMs users, randomly selected using propensity scores matching from the remaining cases. They were followed until the end of 2012 to record stroke incidence. A Cox proportional hazards regression model was used to compute the hazard ratio of stroke with regard to CHMs use.

RESULTS

During the follow-up, 299 CHMs users and 395 non-CHMs users developed stroke, representing incidence rates of 10.94 and 16.69, respectively, per 1000 person-years. CHMs use was associated with 38% (adjusted HR: 0.62; 95% confidence interval: 0.54-0.73) lower subsequent risk of stroke. The most prominent effect was observed in those receiving CHMs for over two years. The following seven commonly-prescribed CHMs were found to lessen the stroke risk: Dan-Shen, Tian-Hua-Feng, Fu-Zi, Shao-Yao-Gan-Cao-Tang, Jia-Wei-Xiao-Yao-San, Ge-Gen-Tang, and Gui-Zhi-Shao-Yao-Zhi-Mu-Tang.

CONCLUSION

The CHMs use was associated with lower risk of stroke for RA patients, suggesting that it could be integrated into conventional therapy to prevent subsequent stroke incident.

Effects of a progressive muscle relaxation intervention on dementia symptoms, activities of daily living, and immune function in group home residents with dementia in Japan

Aim

To evaluate the effects of progressive muscle relaxation on the behavioral and psychological symptoms of dementia, activities of daily living, and immune function of elderly patients with dementia in group homes.

Methods

The participants were ranked by their group home unit. Odd ranks were assigned to the intervention group and even ranks to the control group. The intervention group participated in progressive muscle relaxation for 15 min each day for 90 days in the group environment; the control group members continued with their normal routine. All the participants’ secretory immunoglobulin A was measured and they were assessed with the Neuropsychiatric Inventory‐Nursing Home version, Nishimura Mental State Scale for the Elderly, and Nishimura Activities of Daily Living Scale.

Results

The intervention group comprised 18 participants from six units and the control group comprised 19 participants from five units. After the intervention, the Neuropsychiatric Inventory scores were significantly better in the intervention group, particularly for Agitation and Anxiety. The intervention group also showed significantly lower Apathy and Irritability scores and significant improvement in the Interest, Volition, and Social relationships scores on the Mental State Scale, with improvement in the activities of daily living total. However, there was no difference in the secretory immunoglobulin A level between the groups.

Conclusion

The results suggest that progressive muscle relaxation improves the behavioral and psychological symptoms of dementia and activities of daily living in group home residents with dementia, but does not affect their immune function.

Anxiety and Anger Symptoms in Hwabyung Patients Improved More following 4 Weeks of the Emotional Freedom Technique Program Compared to the Progressive Muscle Relaxation Program: A Randomized Controlled Trial

Background. The Emotional Freedom Technique (EFT) is a meridian-based psychological therapy. The present clinical trial investigates the effectiveness of EFT as a new treatment option for Hwabyung (HB) patients experiencing anger and compares the efficacy to the Progressive Muscle Relaxation (PMR), the conventional meditation technique. Methods. The EFT and progressive muscle relaxation (PMR) methods were performed on 27 HB patients, and their capacities to alleviate anxiety, anger, and emotional status were compared. After a 4-week program, a survey was conducted; patients then completed a self-training program for 4 weeks, followed by a second survey. Results. During the initial 4 weeks, the EFT group experienced a significant decrease in the HB symptom scale, anger state, and paranoia ideation (p < 0.05). Over the entire 9-week interval, there were significant decreases in the HB symptom scale, anxiety state, anger state, anger trait, somatization, anxiety, hostility, and so on in EFT group (p < 0.05). Conclusion. The EFT group showed improved psychological symptoms and physical symptoms greater than those observed in the PMR group. EFT more effectively alleviated HB symptoms compared to PMR. EFT group showed better maintenance during self-training, suggesting good model of self-control treatment in HB patients.

Effect of progressive muscle relaxation in female health care professionals

BACKGROUND

Increasing population, fast paced industrialization, increased, competitiveness, unanticipated problems in the work place have increased the stress among the females working in health care in recent times.

AIM

The aim of the following study is to detect the stress levels among female health care professionals in the age group of 25-35 years and its impact on health.

SUBJECTS AND METHODS

A prospective cross-sectional pilot project was conducted in a tertiary care hospital in Eastern part of India, after receiving approval from the Institutional Ethics Committee and informed consent form was taken from the subjects. Stress level in the subjects was assessed according to the presumptive life event stress scale. Females with scores above 200 were selected. For these, initial assessment of anthropometric measurement, electrocardiogram and lipid profile analysis, resting pulse rate, blood pressure, physical fitness index (PFI), breath holding time (BHT), isometric hand grip (IHG) test results were evaluated and recorded. All subjects were given training of progressive muscle relaxation (PMR) for 3 months. After 3 months, the lipid profile and vital parameters, Perceived Stress Scale values were re-evaluated and subjects were asked to repeat the same exercises and data thus recorded were analyzed using Statistical Package for the Social Sciences (SPSS) version 16 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.).

RESULTS

Significant decrease in resting heart rate, blood pressure and Perceived Stress Scale levels was seen after PMR training in the subjects. Results of BHT, IHG tests and PFI were significantly increased after PMR training. There was a significant decrease in total cholesterol, triglyceride and low-density lipoprotein cholesterol in subjects after practicing PMR for 3 months.

CONCLUSIONS

Increasing stress among female health care professionals is a cause for concern and there is a need to adopt early life-style modification by practicing relaxation exercises to ameliorate stress and to improve not only their quality-of-life in general, but patient care in particular.

Breathing and relaxation training for patients with hypertension and stress

This study evaluated the effects of the relaxation and breathing training for hypertensive patients on the index, levels and symptoms of stress and blood pressure among hypertensive patients suffering from stress. Nineteen patients from a hypertension and diabetes program in Rio de Janeiro participated in the study that which used, as instruments, Lipp's inventory of stress symptoms for adults, the psychological interview for hypertensive patients, the relaxation and breathing training for hypertensive patients protocol, weekly registration form and blood pressure monitors. The experimental group received the relaxation and breathing training for hypertensive patients in 13 sessions of 60 minutes and had blood pressure monitored before and after each session. The control group had blood pressure monitored weekly. It was observed that the relaxation and breathing training for hypertensive patients reduced the stress index and symptoms in the experimental group in isolation, except when compared to the control group. However, it did not reduce the levels of blood pressure in the experimental group in comparison to the control group. The results report that, besides the relaxation and breathing training for hypertensive patients, other strategies are necessary to control stress and hypertension.

Stress management for adult survivors of childhood sexual abuse: a holistic inquiry

Among the many sequelae of childhood sexual abuse is a maladaptive response to stress. Stress has been linked to a reduction in the immune system's ability to resist disease. The purpose of this exploratory mixed-method study is to examine the experience of stress management training for 35 adult survivors of childhood sexual abuse. Data gathered for analysis include pre- and postintervention saliva samples for sIgA, Ways of Coping Questionnaire, and a postintervention qualitative interview. Stress management strategies enhance immunity (increase in salivary immunoglobulin A, p < .05) and coping (less distancing, p < .001; less escape-avoidance, p < .001; more planful problem solving, p < .01; and more positive reappraisal, p < .001). Grounded theory analysis finds three themes emerging: hypervigilance , an outward-focused hyperawareness; somatic detachment, a lack of inward focus on self; and healing pathway, the process of healing from the abuse. Healing is possible.

The effects of strength training on central arterial compliance in middle-aged and older adults

BACKGROUND

Contrary to aerobic exercise, strength training (ST) is associated with decreased central arterial compliance in young men. It is unknown whether ST, with or without concurrent endurance training, would have a similar effect in older adults with reduced baseline arterial compliance.

OBJECTIVE

The primary aim of this study was to determine the effect of a ST program on central arterial compliance in middle-aged and older adults.

DESIGN

Randomized, controlled intervention study in which 37 healthy, sedentary men and women (52+/-2 years) performed 13 weeks of ST (n=13), ST+aerobic exercise (n=12) or stretching exercises as a control group (n=12).

METHODS

Participants were rigorously screened for cardiovascular disease and underwent pre-post testing for carotid arterial compliance (via simultaneous ultrasound and applanation tonometry), carotid-femoral pulse wave velocity, plasma endothelin-1 and angiotensin II concentrations and carotid artery vasoreactivity (cold pressor test).

RESULTS

ST performed alone, or in conjunction with aerobic exercise, improved maximal muscle strength and increased total lean body mass (both P<0.01). No significant changes were observed in carotid artery compliance or carotid-femoral pulse wave velocity following ST or ST+aerobic exercise. Carotid artery compliance increased significantly (23%) following stretching which may be attributed to a reduction in carotid pulse pressure. No significant changes were observed in plasma vasoconstrictor hormones or carotid artery vasoreactivity following the interventions.

CONCLUSION

Thirteen weeks of moderate ST two or three times per week does not reduce central arterial compliance in middle-aged and older adults.

Exploring nurses' perceived benefits of utilizing holistic modalities for self and clients

The purpose of this study was to describe the experience that holistic nurses have in incorporating complementary and alternative modalities in the care of their clients, as well as gain a deeper understanding of holistic nurses and the perceived benefit of utilizing a holistic modality with their clients and themselves concurrently as providers of these modalities. Purposeful samplings of holistic nurses' who include modalities in their healing process were the participants in this exploratory research, which entailed data collection through the use of critical incident reports and open-ended interviews.

Aromatherapy and massage for antenatal anxiety: Its effect on the fetus

Antenatal anxiety has been linked to maternal hypothalamic-pituitary-adrenal axis changes which can affect fetal development and may have lasting effects on the child's psychological development. Treatments for anxiety have hitherto focused on psychotherapy techniques or antidepressant drugs but these do not always effect long term improvement. Aromatherapy and massage have successfully been used to produce significantly greater improvement in reduction of anxiety. Midwives may highlight anxiety in some of the mothers in their care and can incorporate the holistic approach of aromatherapy and massage into their practice. However, further research is required to establish the efficacy and cost-effectiveness of aromatherapy and massage in the antenatal period.

A randomized controlled trial of stress reduction in African Americans treated for hypertension for over one year

BACKGROUND

Psychosocial stress has been implicated in the disproportionately higher rates of hypertension among African Americans. This randomized controlled trial compared the effects of two stress reduction techniques and a health education control program on hypertension during a period of 1 year in African-American men and women (N = 150, mean age 49 +/- 10 years, mean blood pressure (BP) = 142/95 mm Hg) at an urban community health center.

METHODS

Interventions included 20 min twice a day of Transcendental Meditation (TM) or progressive muscle relaxation (PMR), or participation in conventional health education (HE) classes. All subjects continued usual medical care. Outcomes assessed were systolic BP and diastolic BP at 3, 6, 9, and 12 months after treatment, analyzed by repeated measures ANCOVA.

RESULTS

The TM group showed decreases in systolic BP/diastolic BP of -3.1/-5.7 mm Hg compared to -0.5/-2.9 mm Hg for PMR or HE, (P = .12 to .17 for systolic BP, P = .01 for diastolic BP). In addition the TM group demonstrated reduced use of antihypertensive medication relative to increases for PMR (P = .001) and HE (P = .09) groups. Group analysis by gender showed that women practicing TM had decreased BP (-7.3/-6.9 mm Hg) significantly more than women practicing PMR (0.7/-2.7 mm Hg) or HE (-.07/-3.0 mm Hg) (P .01 to .03). The change in men praticing TM (0.2 /-4.7 mm Hg) was greater than men practicing HE (-0.9/-2.0 mm Hg) for diastolic BP only (P = .09,) and not different from PMR men (-2.0/-3.1).

CONCLUSIONS

A selected stress reduction approach, the Transcendental Meditation program, may be useful as an adjunct in the long-term treatment of hypertension in African Americans.