Efficacy of progressive muscle relaxation training in reducing anxiety in patients with acute schizophrenia

Optimising the efficacy of a stress-reducing psychological intervention using placebo mechanisms: A randomized controlled trial

This study examined whether i) brief videos aiming to optimise outcome expectations would augment the efficacy of progressive muscle relaxation (PMR) and ii) whether participants' characteristics would moderate these effects. Sixty-eight healthy subjects randomized to one of three experimental manipulations before undergoing a single PMR session either watched i) a video displaying a neutral expert, ii) a video with a warm expert, or iii) were part of an active control condition. Constrained linear mixed models indicated increased relaxation and decreased stress levels for all participants after the PMR session. The primary outcome was the change of perceived relaxation/stress from pre to post. Participants with high neuroticism and trait anxiety indicated an augmented PMR's efficacy and increased outcome expectations when watching the warm expert video compared to the control group or the less warm expert. Brief videos displaying an expert aiming to optimise outcome expectations regarding a brief stress-reducing psychological intervention may boost or decrease an intervention's efficacy. Effects may depend on the viewer's personality and the (video) expert's communication style. Trial Registration: The study protocol was approved by the local Ethics Committee of the University of Marburg, Germany. This study was registered at www.clinicaltrials.gov (NCT03330431).

Development and validation of audio-based guided imagery and progressive muscle relaxation tools for functional bloating

Mind-body techniques, including Guided Imagery (GI) or Progressive Muscle Relaxation (PMR), may effectively manage bloating. The current study aimed to develop and validate (psychometric and psychological responses) audio-based GI and PMR techniques for bloating. Audio scripts were first developed from literature reviews and in-depth interviews of participants with bloating diagnosed based on the Rome IV criteria. Scripts were validated using psychometric (content & face validity index) and physiological approaches (brain event-related potentials & heart rate variability). 45/63 participants completed the in-depth interview, and ‘balloon’ emerged as the synonymous imagery description for bloating, of which inflation correlated with a painful sensation. The final tools consisted of narrated audio scripts in the background of a validated choice of music. Overall, the content and face validity index for PMR and GI ranged from 0.92 to 1.00. For ERP and HRV, 17/20 participants were analyzed. For ERP, there was a significant difference between GI and PMR for alpha waves (p = 0.029), delta waves (p = 0.029), and between PMR and control for delta waves (p = 0.014). For HRV, GI and PMR exhibited similar autonomic responses over controls (overall p<0.05). The newly developed GI and PMR audio-based tools have been validated using psychometric and physiological approaches.

Voluntary Muscle Relaxation Can Mitigate Fatigue and Improve Countermovement Jump Performance

Pinto, BL and McGill, SM. Voluntary muscle relaxation can mitigate fatigue and improve countermovement jump performance. J Strength Cond Res 34(6): 1525-1529, 2020-When muscles contract, they create force and stiffness. Thus, muscle activation and relaxation must be strategically sequenced to coordinate and control movement, to enhance athletic variables such as speed and strength. However, research has favored investigation of muscle activation over relaxation. Athletes such as runners, swimmers, and boxers often shake their limbs to allow the muscle to oscillate freely, immediately before a bout. The purpose was to investigate whether shaking the lower limbs with the intention to voluntarily relax the muscles of the limb has an effect on countermovement jump (CMJ) performance. Subjects performed 10 maximal effort CMJs with 30 seconds of rest between each jump. During the rest period, they either performed the relaxation technique or control condition (standing still). Statistical significance was considered at p < 0.05. Subjects significantly improved jump height, compared with their first jump of the day, when performing the relaxation technique. To further investigate the mechanism of enhancement, subjects were grouped into responders and nonresponders. The responder group significantly decreased their jump height and concentric phase impulse (relative to the first jump) during the control condition compared with the nonresponder group, indicating fatigue. When performing the relaxation technique, the responder group improved their jump height and mitigated fatigue by significantly increasing their unweighting impulse and unweighting force. The relaxation technique improved CMJ performance, specifically in those that fatigue with consecutive bouts, by enhancing unweighting, that requires muscle relaxation, rather than propulsion that requires activation. This technique can be useful for training or competition.

Integrative Body-Mind-Spirit (I-BMS) Practices for Schizophrenia: An Outcome Literature Review on Randomized Controlled Trials

Prior reviews show that certain complementary and alternative practices are promising for patients with schizophrenia. The aim of this study is to review the outcome literature on intervention studies using integrative body-mind-spirit (I-BMS) practices on schizophrenia. This is an outcome literature review of randomized controlled trials (RCTs) on I-BMS practices from 2004 to 2016. The review used a modified Delphi List to assess methodological rigor and the California Evidence-Based Clearinghouse Scientific Rating Scale to evaluate the level of research support for each identified I-BMS practice. This review identified 13 RCTs of I-BMS practices, including mindfulness interventions (5), yoga (3), tai-chi (2), and relaxation (3). I-BMS practices were effective with medium to large effect sizes for alleviating symptoms, decreasing anxiety and stress, improving insight and mindfulness, subjective well-being and social/occupational functioning, as well as decreasing the frequency and duration of re-hospitalization. This review expands the knowledge base of treatment effectiveness pertaining to patients with schizophrenia.

Schizophrenia and Progressive Muscle Relaxation - A systematic review of effectiveness

Objective

We perform a systematically search, appraise and synthesize of the best available evidence on the effectiveness of Progressive Muscle Relaxation (PMR) in the adults with schizophrenia, in any setting, regarding anxiety, personal and social functioning, cognition, and well-being.

Method

Major databases were searched to find both published and unpublished studies from inception until April 2017, using Schizophren* AND Relax* as keywords, and studies published in Portuguese, English, Spanish, Italian, French were considered for inclusion in this review. Methodological quality was assessed by two independent reviewers using the Critical Appraisal Checklist for Randomized Controlled Trials from the Joanna Briggs Institute.

Results

From a total of 1172 studies, five studies, involving 216 adults with schizophrenia, met the inclusion criteria for this systematic review after assessment of their methodological quality. These studies reported benefits in experimental group participants after PMR intervention on anxiety (assessed with State anxiety inventory, Beck Anxiety Inventory and Spielberger Trait Anxiety Inventory), well-being (assessed with Subjective Exercise Experiences Scale) and personal and social functioning (assessed with Sheehan Disability Scale and Therapist Rating Scale).

Conclusions

Evidence suggests that PMR was effective in adults diagnosed with schizophrenia, except in one study where was only effective when combined with education. Thus, PMR may be useful to decrease state anxiety, improve well-being and social functioning in adults diagnosed with schizophrenia. However, due to the diversity of clinical intervention designs of PMR (different number and length of sessions) and outcome assessment scales, no strong evidence was found in this systematic review.

Does Jacobson's relaxation technique reduce consumption of psychotropic and analgesic drugs in cancer patients? A multicenter pre-post intervention study

Background

Cancer patients often suffer from emotional distress as a result of the oncological process. The purpose of our study was to determine whether practice of Jacobson’s relaxation technique reduced consumption of psychotropic and analgesic drugs in a sample of cancer patients.

Methods

This was a multicenter pre–post intervention design. Participants were 272 patients aged over 18 years attending 10 Spanish public hospitals with oncological pathologies and anxiety symptoms. The intervention consisted of a protocol of abbreviated progressive muscle relaxation training developed by Bernstein and Borkovec. This was followed up by telephone calls over a 1-month period. The intervention was performed between November 2014 and October 2015. Sociodemographic variables related to the oncological process, mental health variables, and intervention characteristics were measured.

Results

A reduction in the consumption of psychotropic and analgesic drugs was observed throughout the follow-up period. Improvement was observed throughout the 4-week follow-up for all the parameters assessed: anxiety, relaxation, concentration, and mastery of the relaxation technique.

Conclusions

The practice of abbreviated Jacobson’s relaxation technique can help to decrease the consumption of psychotropic and analgesic drugs. Patients experienced positive changes in all the evaluated parameters, at least during the 1-month follow-up. To confirm these findings, additional long-term studies are needed that include control groups.

Trial registration

ISRCTN 81335752, DOI 10.1186/ISRCTN81335752 17. Date of registration: 22/11/2016 (retrospectively registered).

The Effect of Cognitive Behavioral Interventions on Depression and Anxiety Symptoms in Patients with Schizophrenia Spectrum Disorders: A Systematic Review

Depression and anxiety are prominent comorbid disorders in psychosis and relevant to psychotic symptom formation and maintenance. This poses the question of whether psychological interventions are effective in improving symptoms of depression and anxiety in patients with psychosis. A systematic review of the literature identified 14 studies evaluating a broad range of interventions targeting depression, anxiety, and posttraumatic stress disorder in patients with psychosis. The reviewed studies support the effectiveness of cognitive-behavioral interventions in improving the target symptoms. Further research is needed to examine whether the effects carry over to psychotic symptoms in the long term.

The impact of muscle relaxation techniques on the quality of life of cancer patients, as measured by the FACT-G questionnaire

INTRODUCTION

Patients with cancer frequently suffer from emotional distress, characterized by psychological symptoms such as anxiety or depression. The presence of psychological symptoms combined with the complex nature of oncology processes can negatively impact patients' quality of life. We aimed to determine the impact of a relaxation protocol on improving quality of life in a sample of oncological patients treated in the Spanish National Public Health System.

MATERIALS AND METHODS

We conducted a multicenter interventional study without a control group. In total, 272 patients with different oncologic pathologies and showing symptoms of anxiety were recruited from 10 Spanish public hospitals. The intervention comprised abbreviated progressive muscle relaxation training, according to Bernstein and Borkovec. This was followed by weekly telephone calls to each patient over a 1-month period. We collected sociodemographic variables related to the disease process, including information about mental health and the intervention. Patients' quality of life was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire. Bivariate and univariate analyses were performed, along with an analysis of multiple correspondences to identify subgroups of patients with similar variations on the FACT-G.

RESULTS

Patients showed statistically significant improvements on the FACT-G overall score (W = 16806; p<0.001), with an initial mean score of 55.33±10.42 and a final mean score of 64.49±7.70. We also found significant improvements for all subscales: emotional wellbeing (W = 13118; p<0.001), functional wellbeing (W = 16155.5; p<0.001), physical wellbeing (W = 8885.5; p<0.001), and social and family context (W = -1840; p = 0.037).

CONCLUSIONS

Patients with cancer who learned and practiced abbreviated progressive muscle relaxation experienced improvement in their perceived quality of life as measured by the FACT-G. Our findings support a previous assumption that complementary techniques (including relaxation techniques) are effective in improving the quality of life of patients with cancer.

Prevalence and Predictors of Metabolic Syndrome in People With Schizophrenia in Inpatient Rehabilitation Wards

BACKGROUND

Atypical antipsychotic medications increase the risk of developing metabolic syndrome (MetS) and cardiovascular diseases in people with schizophrenia.

AIM

To explore the prevalence of MetS and the predictors associated with the number of MetS components in people with chronic schizophrenia.

METHODS

We recruited 357 participants from 10 rehabilitation wards in northern Taiwan. The Beck Anxiety Inventory, Beck Depression Inventory-II, Health-Promoting Lifestyle Profile (HPLP), and modified Baecke physical activity questionnaire were used to evaluate the participants. MetS prevalence was calculated using the modified Adult Treatment Panel III criteria for Asians.

RESULTS

The prevalence of MetS in this sample was 37.8%. Multinomial logistic regression revealed that the HPLP-exercise score (odds ratio [OR] = 0.411, p = .002) and depressive symptoms (OR = 0.949, p = .040) were protective factors for ≥4 MetS components. The leisure physical activity level (OR = .536, p = .024) was a protective factor for three MetS components. Body mass index ≥24 kg/m(2) was the strongest risk factor for two MetS components (OR = 8.057, p < .001), three MetS components (OR = 11.287, p < .001), and ≥four MetS components (OR = 15.621, p < .001). Additionally, participants' age >40 (OR = 3.638, p = .012) was a risk factor for ≥four MetS components.

CONCLUSION

In this study, the prevalence of MetS was higher than that reported for patients utilizing community-based services in Taiwan. The important risk factors for MetS were being overweight and older than 40. The protective factors for MetS were a high HPLP-exercise score and leisure-based physical activities.

Cardiac Coherence Training to Reduce Anxiety in Remitted Schizophrenia, a Pilot Study

Health care that addresses the emotional regulation capacity of patients with schizophrenia confronted with daily stress may contribute to a less anxious life. A psycho-physiological training [cardiac coherence training (CCT)] focusing on emotion regulation is known to decrease anxiety for healthy individuals. We performed a pilot cross sectional survey to explore the benefits of CCT for clinically stable patients with schizophrenia. Ten patients were enrolled in the program consisting of twelve weekly 1-h session programs monitored over a 2-month period. Standardised questionnaires were used before and after the intervention to assess anxiety, well-being outcomes, and how patients deal with stress and stressors. Results showed that this quite-well accepted intervention improved (or tended to improve) well-being outcomes, state-anxiety, and emotional stressors evaluation. The successful transformations were higher for patients with the highest clinical and emotional suffering. Thus, this pilot study revealed that CCT may help patients with schizophrenia to deal with anxiety in daily life.

The effect of progressive muscle relaxation on pregnant women's general health

Background:

Pregnancy may be accompanied by serious physiological and psychological changes as it is a stressful period in a woman's life. So, this study was conducted to determine the effect of progressive muscle relaxation on pregnant women's general health.

Materials and Methods:

In this clinical trial, 60 primigravida women admitted to the prenatal clinic of selected hospitals in Iran constituted the study population. Using purposive sampling method, the level of general health of the women was measured with General Health Questionnaire-28 (GHQ-28). Then, the samples were randomly divided into control and experimental groups. Three 1.5–2 h relaxation training sessions were held for the experimental group. After 8 weeks, the level of general health of both groups was measured again. Finally, the collected data were analyzed using Chi-square and paired t-test (P < 0.05).

Results:

Total mean score of general health of the experimental group and the control group before the intervention was 35.83 (6.92) and 29.46 (8.3), respectively, and after the intervention, the respective scores were 20.2 (5.61) and 27.85 (8.24). Although after the intervention both groups showed an increased level of general health, the difference in general health between before and after intervention was significant in the experimental group (P < 0.001). Furthermore, comparison of variations in mean scores of general health level before and after intervention in the two groups showed a significant difference (P < 0.001).

Conclusions:

Given that the results showed the effectiveness of progressive muscle relaxation on pregnant women's general health, the prenatal clinics can include a training program for progressive muscle relaxation in the routine training programs for pregnant women.

Effects of a Stress-Management Program for Inpatients With Mental Disorders: A Feasibility Study

Stress-management interventions have been integrated into treatments for people with mental disorders. Nevertheless, most studies on these interventions have been conducted on patients with schizophrenia in Western countries, and limited studies have used objective measurements of stress. We developed a group-based, four-session stress-management (S-Manage) program for people with mental disorders, consisting of two major components: psychoeducation and relaxation practice. This single-group, pretest-posttest, quasi-experimental study was undertaken to test the initial effects and determine the effect sizes of the program. A convenience sample of 55 inpatients were recruited from a mental health ward at a tertiary hospital in Singapore. Self-report questionnaires and physiological measures of stress (skin temperature and salivary immunoglobulin A [SIgA]) were used for data collection. Data were analyzed by descriptive statistics and repeated-measures analysis of variance. Most participants were Singaporean, female, single, and employed. Diagnoses included schizophrenia, depression, bipolar disorder, anxiety disorder, and mixed diagnoses. All received standard care provided by the hospital. Participants had significant reductions in objective stress, measured by skin temperature (effect size = 0.54) and SIgA (effect size = 0.16), and subjective stress (effect size = 0.16) as well as improved psychological health (effect size = 0.40) in response to the intervention. This study provides preliminary evidence to support the positive effects of the S-Manage program on people with mental disorders. Future studies should further test the efficacy of the program using more rigorous methods such as randomized controlled trial and multicenter study.

Progressive muscle relaxation improves anxiety and depression of pulmonary arterial hypertension patients

We explored the effects of progressive muscle relaxation (PMR) on anxiety, depression, and quality of life (QOL) in patients with pulmonary arterial hypertension (PAH). One hundred and thirty Han Chinese patients with PAH were randomly assigned to a PMR group (n = 65) and a control group (n = 65). In a 12-week study duration, the PMR group received hospital-based group and in-home PMR practice, while the control group received hospital-based mild group stretching and balance exercises. The control group and the PMR group were comparable at baseline. After 12 weeks of intervention, the PMR group showed significant improvement in anxiety, depression, overall QOL, and the mental component summary score of QOL (P < 0.05) but not the physical component summary score of QOL or the 6-minute walking distance. In contrast, the control group showed no significant improvement in any of the variables. Moreover, the PMR group showed significant improvement in all QOL mental health domains (P < 0.05) but not the physical health domains. In contrast, the control group showed no significant improvement in any QOL domain. In conclusion, this study suggests that PMR practice is effective in improving anxiety, depression, and the mental health components of QOL in patients with PAH.

Combined intervention with education and progressive muscle relaxation on quality of life, functional disability, and positive symptoms in patients with acute schizophrenia

OBJECTIVES

To explore the effects of combined intervention with education and progressive muscle relaxation (PMR) on quality of life (QoL), functional disability, and positive symptoms of patients with acute schizophrenia.

METHODS

This randomized controlled study took place in an acute schizophrenia ward in Changsha, China. Sixty-four patients with acute schizophrenia were randomly assigned to four groups: control, education, PMR, and education plus PMR. QoL was assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form. Functional disability was assessed with the Sheehan Disability Scale. Severity of positive schizophrenia symptoms was assessed with the Scale for the Assessment of Positive Symptoms. All patients were evaluated at baseline (within 72 hours before the interventions) and at the end of weeks 5 (when the interventions ended) and week 15 (a 10-week follow-up after the interventions).

RESULTS

The sociodemographic and clinical characteristics of all four study groups were similar at baseline. Repeated-measures analysis of variance showed significant differences among the interventions in improving QoL, functional disability, and positive symptoms over time in the patients. Education and PMR alone resulted in sustained improvement of QoL during the intervention period and a 10-week follow-up but had no significant effects on functional disability or positive schizophrenia symptoms. In contrast, combined intervention with education and PMR showed better effects on improving QoL than did education or PMR alone throughout the 15-week study. It also statistically significantly improved functional disability and positive schizophrenia symptoms during the intervention period and led to sustained improvement of functional disability during the 10-week follow-up.

CONCLUSIONS

A combined intervention with education and PMR is effective in improving QoL, functional disability, and positive symptoms in patients with acute schizophrenia. The combined intervention model could be a new paradigm of adjunctive treatment for acute schizophrenia.

Efficacy of the virtual reality-based stress management program on stress-related variables in people with mood disorders: the feasibility study

This study aimed to investigate the effect of a VR-based stress management program on people with mood disorders. A quasi-experimental study was conducted in a tertiary hospital in Singapore, and a convenience sample of 22 was recruited. The program comprised three daily 1-hour sessions incorporating psychoeducation and VR-based relaxation practice. Participants who completed the program had significantly lowered subjective stress (t=6.91, p<0.001), depression (t=5.62, p<0.001), and anxiety (t=5.54, p<0.001); and increased skin temperature (F=17.71, p<0.001), perceived relaxation (F=26.20, p<0.001) and knowledge (F=13.77, p<0.001). Participants' feedback on the program was positive. Findings from this study contribute to improving clinical practice and serve as preliminary data to conduct more rigorous research in the future.

Efficacy of psychoeducation and relaxation interventions on stress-related variables in people with mental disorders: a literature review

This paper aimed to critically review and summarize empirical evidence concerning the efficacy of psychoeducation or relaxation-based stress management interventions on stress-related variables in people with mental disorders. Electronic databases were used during the literature search. Thirteen articles that fulfilled the preset eligible criteria were included in the review. Findings indicated that psychoeducation and relaxation-based interventions mitigated stress and depression; and enhanced relaxation intensity and knowledge on stress management. However, mixed results were obtained on anxiety. In addition, interventions using virtual reality technology revealed positive effects on depression, relaxation intensity and anxiety. Limitations and recommendations for future research are discussed.

Self-relaxation training can improve sleep quality and cognitive functions in the older: a one-year randomised controlled trial

AIMS AND OBJECTIVE

To evaluate the effects of self-relaxation training on sleep quality and cognitive functions in the older.

BACKGROUND

Ageing causes declines in sleep quality and cognitive functions in older adults, and decreased sleep quality also accelerates declines in cognitive functions. Therefore, it is necessary to find cost-effective interventions to enhance sleep quality in the older, thereby improving their cognitive functions or delaying cognitive decline.

DESIGN

Randomised controlled study.

METHODS

The study was conducted between July 2010 and June 2011 at Wangyuehu Community in Changsha, China. Eighty older adults with reduced sleep quality were selected and randomly assigned to experimental (n = 40) or control (n = 40) group. Subjects in the experimental group received self-relaxation training including progressive muscle relaxation and meditation based on sleep hygiene education, while the control group received sleep hygiene education only. Sleep quality and cognitive functions of the two groups were measured prior to training and at the end of the 3rd, 6th and 12th months using four reliable and valid questionnaires.

RESULTS

Repeated measures anova revealed that the self-relaxation training had significant main effect as well as interaction effect with time on sleep quality and cognitive functions. Except for scores of Epworth Sleepiness Scale, Mini-Mental State Examination and number memory, time had significant main effect on scores of Pittsburgh Sleep Quality Index, picture memory, associative memory and understanding memory.

CONCLUSION

Self-relaxation training can improve sleep quality and cognitive functions in the older.

RELEVANCE TO CLINICAL PRACTICE

Self-relaxation training is a non-invasive, simple and inexpensive therapeutic method of improving sleep quality and cognitive functions in community-dwelling older people.

Anxiety comorbidity in schizophrenia

Diagnostic and treatment hierarchical reductionisms have led to an oversight of anxiety syndromes in schizophrenia. Nevertheless, recent data have indicated that anxiety can be a significant source of morbidity in this patient group. This paper reviews current knowledge concerning anxiety comorbidity in schizophrenia, its epidemiology, course, and treatment. A computerized search of the literature published from 1966 to July 2012 was conducted on Medline. Comorbid anxiety disorders are present in 38.3% of subjects with schizophrenia spectrum disorders. The most common anxiety disorder is social phobia followed by post-traumatic stress disorder and obsessive compulsive disorder. The presence and severity of symptoms of anxiety are associated with more severe clinical features and poorer outcomes. Available literature on the treatment consists primarily of case reports and open trials. Fragments of data support the notion of treating these anxiety states and syndromes as co-occurring clinical conditions with adjunctive medications and psychosocial interventions. However, additional work remains to be done on this issue before firm conclusions can be drawn.

Impact of applied progressive deep muscle relaxation training on the level of depression, anxiety and stress among prostate cancer patients: a quasi-experimental study

BACKGROUND

The aim of this study was to determine the impact of applied progressive muscle relaxation training on the levels of depression, anxiety and stress among prostate cancer patients.

MATERIALS AND METHODS

A quasi-experimental study was conducted at the University Malaya Medical Centre (UMMC) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over six months. Prostate cancer patients from UMMC received the intervention and patients from UKMMC were taken as controls. The level of depression, anxiety and stress were measured using Depression, Anxiety Stress Scales - 21 (DASS-21).

RESULTS

A total of 77 patients from the UMMC and 78 patients from the UKMMC participated. At the end of the study, 90.9% and 87.2% of patients from the UMMC and UKMMC groups completed the study respectively. There were significant improvements in anxiety (p<0.001, partial ?2=0.198) and stress (p<0.001, partial ?2=0.103) at the end of the study in those receiving muscle training. However, there was no improvement in depression (p=0.956).

CONCLUSIONS

The improvement in anxiety and stress showed the potential of APMRT in the management of prostate cancer patients. Future studies should be carried out over a longer duration to provide stronger evidence for the introduction of relaxation therapy among prostate cancer patients as a coping strategy to improve their anxiety and stress.

Progressive muscle relaxation in persons with schizophrenia: a systematic review of randomized controlled trials

Objective:

The aim of this systematic review was to assess the effectiveness of progressive muscle relaxation on psychological distress and anxiety symptoms and on response/remission for people with schizophrenia.

Methods:

Randomized controlled trials were considered if they investigated progressive muscle relaxation in patients with schizophrenia. EMBASE, PsycINFO, PubMed, ISI Web of Science, CINAHL, PEDro and Cochrane Library were searched. The selection of studies, data extraction and quality assessment were performed independently by two reviewers.

Results:

Three randomized controlled trials involving 146 patients met the inclusion criteria. Progressive muscle relaxation can acutely reduce state anxiety and psychological distress and improve subjective well-being. No studies investigated the evidence for progressive muscle relaxation as an add-on treatment for general psychopathology and for positive or negative symptoms. Also, no studies assessed the value of progressive muscle relaxation in longer-term treatment and for relapse prevention. There were no data to draw any conclusions about progressive muscle relaxation in comparison with other treatment modalities. None of the studies encountered adverse events. Dose-response relationships could not be determined.

Conclusion:

Progressive muscle relaxation might be a useful add-on treatment to reduce state anxiety and psychological distress and improve subjective well-being in persons with schizophrenia.

Systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia

BACKGROUND

Although schizophrenia is the fifth leading cause of disability-adjusted life years worldwide in people aged 15 to 44 years, the clinical evidence of physical therapy as a complementary treatment remains largely unknown.

PURPOSE

The purpose of this study was to systematically review randomized controlled trials (RCTs) evaluating the effectiveness of physical therapy for people with schizophrenia.

DATA SOURCES

EMBASE, PsycINFO, PubMed, ISI Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and the Cochrane Library were searched from their inception until July 1, 2011, for relevant RCTs. In addition, manual search strategies were used.

STUDY SELECTION

Two reviewers independently determined study eligibility on the basis of inclusion criteria.

DATA EXTRACTION

Reviewers rated study quality and extracted information about study methods, design, intervention, and results.

DATA SYNTHESIS

Ten RCTs met all selection criteria; 6 of these studies addressed the use of aerobic and strength exercises. In 2 of these studies, yoga techniques also were investigated. Four studies addressed the use of progressive muscle relaxation. There is evidence that aerobic and strength exercises and yoga reduce psychiatric symptoms, state anxiety, and psychological distress and improve health-related quality of life, that aerobic exercise improves short-term memory, and that progressive muscle relaxation reduces state anxiety and psychological distress.

LIMITATIONS

The heterogeneity of the interventions and the small sample sizes of the included studies limit overall conclusions and highlight the need for further research.

CONCLUSIONS

Physical therapy offers added value in the multidisciplinary care of people with schizophrenia.

Immediate Effects of Reiki on Heart Rate Variability, Cortisol Levels, and Body Temperature in Health Care Professionals With Burnout

Burnout is a work-related mental health impairment comprising three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Reiki aims to help replenish and rebalance the body’s energetic system, thus stimulating the healing process. The objective of this placebo-controlled, repeated measures, crossover, single-blind, randomized trial was to analyze the immediate effects of Reiki on heart rate variability (HRV), body temperature, and salivary flow rate and cortisol level in health care professionals with burnout syndrome (BS). Participants included 21 health care professionals with BS, who were asked to complete two visits to the laboratory with a 1-week interval between sessions. They were randomly assigned the order in which they would receive a Reiki session applied by an experienced therapist and a placebo treatment applied by a therapist with no knowledge of Reiki, who mimicked the Reiki treatment. Temperature, Holter ECG recordings (standard deviation of the normal-to-normal interval [SDNN], square root of mean squared differences of successive NN intervals [RMSSD], HRV index, low frequency component [LF], and high frequency component [HF]), salivary flow rate and cortisol levels were measured at baseline and postintervention by an assessor blinded to allocation group. SDNN and body temperature were significantly higher after the Reiki treatment than after the placebo. LF was significantly lower after the Reiki treatment. The decrease in the LF domain was associated with the increase in body temperature. These results suggest that Reiki has an effect on the parasympathetic nervous system when applied to health care professionals with BS.

Affective psychotherapy in post-traumatic reactions guided by affective neuroscience: memory reconsolidation and play

This paper reviews the affective neuroscience dealing with the effects of traumatic events. We give an overview of the normal fear reactions, the pathological fear reaction, and the character of emotional episodic memories. We find that both emotions and emotional memories are a tripartite unit of sensory information, autonomic reaction, and motor impulse (the PRM complex). We propose that emotions and movements are part and parcel of the same complex. This is our main finding from the review of affective neuroscience, and from here we focus on psychotherapy with post-trauma reactions. The finding of the process of memory reconsolidation opens up a new treatment approach: affective psychotherapy focused on reconsolidation. The meaning of reconsolidation is that an emotional memory, when retrieved and being active, will rest in a labile form, amenable to change, for a brief period of time, until it reconsolidates in the memory. This leads us to the conclusion that emotions, affects, must be evoked during the treatment session and that positive emotion must come first, because safety must be part of the new memories. In the proposed protocol of affective psychotherapy based on reconsolidation the emotional episodic memory is relived in a safe and positive setting, focused in turn on the sensory experience, the autonomic reaction, and the motor impulse. Then it is followed by a fantasy of a different positive version of the same event. All in all treatment should provide a series of new memories without fear related to the original event. With the focus on the motor program, and the actions, there is a natural link to art therapy and to the mode of play, which can rehearse and fantasize new positive actions.

The Effect of Music Therapy on Hospitalized Psychiatric Patients’ Anxiety, Finger Temperature, and Electroencephalography

Purpose: This study aimed to explore the effectiveness of music therapy in reducing anxiety in hospitalized psychiatric patients.

Methodology: The authors used a randomized clinical trial design and randomly allocated the 24 enrolled participants to the experimental or the control group. Patients in the experimental group received music therapy in a therapy room at a set time for 30 min each morning for 11 days. The authors administered the Beck Anxiety Inventory (BAI) and measured skin temperature and brain waves to determine anxiety level before, during, and after music therapy. Results: Experimental group participants had lower scores on the BAI than control participants, after the music therapy ( z = −2.0, p < .05) and at 1-week follow-up ( z = −2.2, p < .05), indicating that they were experiencing significantly less anxiety. The mean BAI anxiety score fell in the experimental group from 23.9 ( SD = 9.9) at baseline to 13.9 ( SD = 8.8), after music therapy, and 12.7. ( SD = 10.5) at follow-up. The experimental group demonstrated a significant elevation in the average alpha electroencephalographic (EEG) percentage (from 38.1% to 46.7%) and a reduction in the average beta EEG percentage (from 61.9% to 53.4%) after the music therapy. After adjusting for change in patient finger temperature on the first day, mean change in finger temperature did not differ significantly between the experimental and control groups. Conclusions: Music therapy can relieve anxiety in hospitalized psychiatric patients and help them achieve a state of relaxation.

Effects of progressive muscle relaxation on state anxiety and subjective well-being in people with schizophrenia: a randomized controlled trial

Objective: To examine the efficacy of a single progressive muscle relaxation session compared with a control condition on state anxiety, psychological stress, fatigue and subjective well-being in patients with schizophrenia.

Design: Randomized controlled trial.

Setting: An acute inpatient care unit of an University Psychiatric Centre.

Subjects: Sixty-four out of 88 eligible patients with schizophrenia.

Interventions: Patients were randomly assigned to either a single progressive muscle relaxation session during 25 minutes or a resting control condition with the opportunity to read for an equal amount of time.

Main outcome measures: Before and after the single interventions the State anxiety inventory and the Subjective exercise experiences scale were completed. Effect sizes were calculated.

Results: Only within progressive muscle relaxation, participants (n=27) showed decreased state anxiety, psychological stress and fatigue and increased subjective well-being. Between-group differences in post scores were found for state anxiety, subjective well-being and psychological stress, but not for fatigue. The effect size favouring progressive muscle relaxation was 1.26 for subjective well-being and −1.25 and −1.02 for respectively state anxiety and psychological stress.

Conclusions: Progressive muscle relaxation is highly effective in reducing acute feelings of stress and anxiety in patients with schizophrenia. A reduction in stress and state anxiety is associated with an increase in subjective well-being.