Progressive muscle relaxation therapy to relieve dental anxiety: a randomized controlled trial

Efficacy of progressive muscle relaxation technique in primary dysmenorrhea: A randomized controlled trial

OBJECTIVE

To examine the effects of Jacobson's Progressive Muscle Relaxation Technique (JPMRT) on menstrual pain and symptoms, anxiety, quality of life (QoL), social activity, and work/school performance in primary dysmenorrhea (PD).

MATERIALS AND METHODS

Women with PD were randomly divided into two groups as relaxation and control groups. JPMRT was applied three times a week from the estimated date of ovulation to the onset of the next menstruation. No treatment was performed in the control group. Pain intensity, menstrual symptoms, anxiety, impacts on QoL, social activity, and work/school performance were assessed before and after the interventions.

RESULTS

After the interventions, there was a further decrease in menstrual pain intensity, menstrual symptoms, anxiety level, the impact of QoL, and the work/school performance scores in the relaxation group than in the control group (p < 0.05).

CONCLUSION

JPMRT might be used as an alternative method in the treatment of PD.

Comparative Evaluation of the Effectiveness of Innovative Periorbital Eye Massager and Virtual Reality Eyeglasses for Reducing Dental Anxiety during Dental Restorative Procedures in Children

Background

Many behavior management techniques are employed to reduce the anxiety associated with dental procedures in children. One of the most commonly used methods comprises audiovisual distraction using virtual reality (VR) eyeglasses. In this study, an innovative device, a periorbital eye massager (PEM), is compared with VR to evaluate dental anxiety in children.

Materials and methods

in this study, 22 children were divided into two groups, that is, group I consisting of PEM and group II consisting of VR. The participants were instructed to wear the device and then subjected to dental restorative procedures. After completion of the procedure, anxiety was measured using a validated questionnaire by the children and by using the modified behavior pain scale by the second investigator. Also, physiological parameters like heart rate and oxygen saturation were evaluated before and after a dental procedure.

Results

The results were statistically insignificant for group I and group II when a validated questionnaire and modified behavior pain scale were used to measure the dental anxiety of children. Also, the data also shows no significant difference in heart rate and oxygen saturation between the two groups.

Conclusion

The innovative PEM can also be used as an effective behavior management tool in managing dental anxiety in children, as there was no statistically significant difference between PEM and VR.

Clinical significance

As a pediatric dentist, the methods for administering a patient present a novel challenge because behavior management varies from patient to patient. As a result, the prospects for augmenting various techniques of behavior therapy for pediatric patients are limitless.

How to cite this article

Gala UP, Kalaskar R. Comparative Evaluation of the Effectiveness of Innovative Periorbital Eye Massager and Virtual Reality Eyeglasses for Reducing Dental Anxiety during Dental Restorative Procedures in Children. Int J Clin Pediatr Dent 2024;17(1):48-53.

Effect of progressive muscle relaxation as an add-on to pulmonary telerehabilitation in discharged patients with COVID-19: A randomised controlled trial

BACKGROUND

and purpose: Most patients with coronavirus disease 2019 (COVID-19) experience persistent physical and psychological symptoms. This study aimed to investigate the effects of pulmonary telerehabilitation (PTR) combined with progressive muscle relaxation (PMR) on the physical and psychological outcomes of discharged patients with COVID-19.

MATERIALS AND METHODS

This randomised, assessor-blinded, parallel-group study was conducted in hospitals affiliated with Qom University of Medical Sciences between May and October 2021. Discharged COVID-19 patients aged 18-65 years were randomly assigned to two groups of 26 patients each. The experimental group underwent PTR and PMR for six weeks, while the comparison group received PTR alone. Primary (functional capacity) and secondary (dyspnoea, anxiety, depression, fatigue, sleep quality, and quality of life) outcomes were evaluated at baseline and after six weeks.

RESULTS

The experimental group showed significantly higher sleep quality (P = 0.001, 95% confidence interval [CI]: 1.20-4.09) and significantly lower fatigue (P = 0.041, 95% CI: 4.79-5.25) and anxiety (P = 0.001, 95% CI: 1.21-4.47) than the comparison group. No between-group differences were observed in terms of other outcomes (P > 0.05).

CONCLUSION

PTR coupled with PMR was more effective for promoting sleep quality and alleviating anxiety and fatigue than PTR alone.

Management strategies for adult patients with dental anxiety in the dental clinic: a systematic review

Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system. Dental anxiety is common and presents before, during or after dental treatment. The physiological response includes an increase in heart rate, blood pressure, respiratory rate, and cardiac output. Consequently, extensive distress leads to avoidance of dental treatment and multiple failed appointments, impacting both oral and general health. Dental anxiety can generate a variety of negative consequences for both the dentist and the patient. Evidence-based strategies are essential for mitigating and relieving anxiety in the dental clinic. Psychotherapeutic behavioural strategies can modify the patient's experience through a minimally invasive approach with nil or negligible side effects, depending on patient characteristics, anxiety level and clinical situations. These therapies involve muscle relaxation, guided imagery, physiological monitoring, utilizing biofeedback, hypnosis, acupuncture, distraction and desensitization. Pharmacological intervention utilizes either relative analgesia (nitrous oxide), conscious intravenous sedation or oral sedation, which can have undesirable side effects, risks and contraindications. These modalities increase the cost and availability of dental treatment.

Kindergarten-Based Progressive Muscle Relaxation Training Enhances Attention and Executive Functioning in 5-6-year-old Children: A Randomized Controlled Trial

In the present study we assessed the impact of kindergarten-based progressive muscle relaxation (PMR) on attention and executive functioning of 5-6-year-old children. In this randomized-controlled trial, 52 children (26 female; 26 male; M age = 5.4, SD = 0.2 years) from two private Tunisian kindergartens were randomly assigned to experimental and control groups. Over 12 weeks, 18 children performed PMR in two 30-minute sessions/week, another 17 children performed generic physical education (PE) for two 30-minute sessions/week, and 17 children in a control group (CG) had no systematically guided physical activity and engaged in usual self-chosen activities like free play or artisanal activities during Kindergarten hours. Prior to (T0) and after (T1) the 12-week PMR intervention, all participants completed the Visuomotor Precision and Statue subtests of the Neuropsychological Evaluation Battery (NEPSY-2), the Teddy Bear Cancellation Test, and the Rey Simple Figure Test. While there were no significant group differences at T0, repeated measures analysis of variance revealed higher scores for the PMR group relative to both the PE and CG groups on measures of attention, visuomotor precision, memory, and motor inhibition. PMR provided an effective relaxation technique and enhanced attention and executive functioning of these 5-6-year-old children, with important implications for assisting learning and academic achievement among young children.

How Can We Reduce Dental Fear in Children? The Importance of the First Dental Visit

Dental fear is a common problem amongst children. It can affect children’s psychological well-being, quality of life, and oral and systemic health. The aim of this study was to identify whether the patients’ age at which visits to the paediatric dentist begin as well as the periodicity of these visits are factors that can prevent dental fear. This observational transversal study was conducted on 575 school children (average age 6.85 ± 0.78) and their mother/father/guardian. Parents completed a survey on the characteristics of dental visits and the child completed the index of dental anxiety and fear (IDAF-4C) to assess dental fear. The correlation between dental fear and age at first visit (r = −0.36 p < 0.01) and dental fear and frequency of visit (r = −0.65 p < 0.01) were statistically significant. The regression analysis performed showed that both variables predicted 44.4% of the dental fear in the child. In conclusion, the age of initiation to the paediatric dentist (before 2 years) and the periodic revisions (every 6 months or every year) could protect the child from dental fear.

Role of Hypnosis in Dental Treatment: A Narrative Review

Aim

This narrative aims to outline the use of hypnosis in managing dental anxiety in during dental treatment. The PICO used to answer the objectives are (P) dental patients, (I) hypnosis, (C) conventional behaviour management techniques & (O) reduced pain/anxiety.

Materials and Methods

An electronic search of three databases; PubMed, Scopus and EBSCOhost was conducted using the keywords "hypnosis or hypnotherapy" AND "dentistry or dental" between the year 2000 and 2020. A total of 19 studies were selected based on eligibility. Data extracted were study subject, design of study, parameters used to assess, type of hypnosis script used and the study outcome.

Results

The studies show that hypnosis is effective in pain management and dental anxiety. It can also be used for improving compliance in patients who are wearing orthodontic appliances (Trakyali et al, 2008) and reducing salivary flow during dental treatment (Satlz et al, 2014).

Conclusion

Hypnosis has the potential to be a useful tool in the management of children and adults.

Relationship between subjective and objective measures of anticipatory anxiety prior to extraction procedures in 8- to 12-year-old children

Background

This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated.

Methods

An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child's temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as "easy," "slow to warm-up," and "difficult." The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO₂], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated.

Results

The study included 60 children aged 8-12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety. A significant positive correlation was noted between anxiety levels and HR (r_s = 0.477, P < 0.001^*) and systolic BP (r_s = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO₂ (r_s = -0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety.

Conclusion

A high percentage (70%) of children aged 8-12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO₂ were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.

Hypnosis and progressive muscle relaxation for anxiolysis and pain control during extraction procedure in 8-12-year-old children: a randomized control trial

Introduction

Hypnosis (H) and Progressive Muscle Relaxation (PMR) have proven to be effective in a variety of medical settings; there is a paucity of their practical application in paediatric dentistry. The study aimed to comparatively evaluate the role of H and PMR on anxiety, heart rate (HR), oxygen saturation (SPO₂), blood pressure (BP), pain, and analgesic requirement during extraction in children.

Materials and methods

Sixty children aged 8–12 years undergoing primary molar extractions were randomly allocated to three groups—H, PMR, and control (C). The anxiety (proposed Visual Facial Anxiety scale), HR, and SPO₂ were measured pre/post-operatively with/without interventions (H, PMR, C) at 4 intervals. The BP and pain (Wong-Baker faces pain scale) were recorded pre- and post-operatively. Need for analgesic post-operatively was assessed.

Results

Statistically significant reduction in anxiety was noted post-extraction in H (0.30 ± 0.80), PMR (0.50 ± 0.69) (p < 0.001*). HR showed a statistically significant drop after H, PMR application. (p < 0.001*) No significant difference in SPO₂ was noted in the three groups (p > 0.05). Pain control was well achieved using H (85%), PMR (70%); BP was well-regulated in the H, PMR compared to C group (p < 0.001*). Need for analgesics was reduced in H (45%), PMR (50%) versus C (100%). Both techniques H, PMR were comparable in all measures.

Conclusion

Hypnosis and PMR are effective techniques for anxiolysis and pain control in paediatric dental patients.

Effects of progressive muscle relaxation training on negative emotions and sleep quality in COVID-19 patients: A clinical observational study

This study investigates the effect of progressive muscle relaxation training on negative mood and sleep quality in Coronavirus Pneumonia (COVID-19) patients.COVID-19 is an emerging infectious disease, and there is still uncertainty about when the outbreak will be contained and the effectiveness of treatments. Considering that this disease is highly contagious, patients need to be treated in isolation. This may lead to psychological symptoms such as anxiety and depression, and even sleep problems.This study is a clinical observation study.Participants included 79 COVID-19 patients admitted to a designated hospital for COVID-19 patients in Wuhan from February to March, 2020. Patients were selected and assigned to the control group and the observation group according to their wishes, with 40 and 39 cases in each group, respectively. The control group received routine treatment and nursing, and the observation group received progressive muscle relaxation training, in addition to the routine treatment and nursing. We compared scores of the Pittsburgh Sleep Quality Index Scale (PSQI), the Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaire (PHQ-9) before and after the intervention.There was no significant difference in PSQI, GAD-7, and PHQ-9 scores between the control group and the observation group before the intervention (P > .05). After the intervention, the difference in scores of PSQI, GAD-7, and PHQ-9 in the 2 groups were statistically significant (P < .05).Progressive muscle relaxation training can significantly reduce anxiety and depression and improve sleep quality in COVID-19 patients during isolation treatment.Progressive muscle relaxation training was shown to improve the treatment effect of patients and is worthy of clinical promotion.

How we assess the perioperative anxiety of surgical patients with pulmonary nodules: the revision of state-trait anxiety inventory

PURPOSE

The aim of the study was to develop a short form of State-Trait Anxiety Inventory (STAI) and calculate the norms for the assessment of anxiety in surgical patients in mainland China.

METHODS

Patients who were scheduled to carry out pulmonary surgery in our department were included. The sinicized 40-item STAI Form-Y was used to assess the anxiety on the surgery eve. Then the coefficient of variation, coefficient of correlation, stepwise regression analysis, principal component analysis, and structural equation model were successively to filter the items. The reliability and validity of the revised STAI was estimated and the norms were computed.

RESULTS

445 intact replies were collected. A 13-item STAI with 6 items in state subscale and 7 items in trait subscale produced similar scores with the full version of STAI. The Cronbach alpha coefficients for the state and trait subscales were 0.924 and 0.936, respectively. The determinant coefficients were 0.781 and 0.822, respectively. Moreover, the norms of both state subscale and trait subscale are provided according to the age and gender.

CONCLUSIONS

The revised short form of STAI has good reliability and validity. It is likely to be more acceptable by reducing the fatigue effects, and is suitable for follow-up study on the assessment and intervention of perioperative anxiety of surgical patients with pulmonary nodules.

The effect of progressive muscle relaxation on anxiety and sleep quality in burn patients: A randomized clinical trial

BACKGROUND AND OBJECTIVES

Burn patients experience a high level of anxiety and poor sleep quality due to their special physical and psychological conditions. The present study aimed to investigate the effect of progressive muscle relaxation on anxiety and sleep quality in burn patients.

METHODOLOGY AND PARTICIPANTS

In this randomized controlled clinical trial, a total of 80 patients admitted to burn ward were enrolled using convenient sampling and randomly assigned to one of the experimental or control groups. In the experimental group, patients were intervened using Jacobson's relaxation technique 20-30min daily for three consecutive days. During this period, the control group received only routine care and treatment. Patients' anxiety and their sleep quality were measured and recorded before and after the intervention using the Spielberger State-Trait Anxiety Inventory (STAI) and St Mary's Hospital Sleep Quality Questionnaire (SMHSQ) respectively. Eventually, data analysis was conducted using SPSS version 20.0 software (IBM Corp., Armonk, N.Y., USA).

RESULTS

The findings of the present study showed a statistically significant decrease in anxiety and improvement in sleep quality in the experimental group compared to the control group (P<0.05).

CONCLUSION

Relaxation as a complementary method can be used along with modern medicine to reduce anxiety and improve sleep quality in burn patients.