COMMENTARY

Progressive Muscle Relaxation

A Cure for Cancer-Related Fatigue?

Laurie Scudder, DNP, NP

Disclosures

September 27, 2013

Progressive Muscle Relaxation: An Adjuvant Therapy for Reducing Pain and Fatigue Among Hospitalized Cancer Patients Receiving Radiotherapy

Pathak P, Mahal R, Kohli A, Nimbran V
Int J Adv Nurs Stud. 2013;2:58-65

Progressive Muscle Relaxation for Pain and Fatigue

Progressive muscle relaxation is a technique of sequential contraction and relaxation of the muscles of the body from head to toe. It is easy for patients to learn and can be an important adjunctive therapy.

Pain and fatigue are extremely common in cancer patients, both of which are reported in more than one half of all patients. Cancer-related fatigue, defined as a persistent sense of tiredness or exhaustion, occurs in almost all patients receiving radiation or chemotherapy.

Although many studies have examined a range of management methodologies for pain, few have examined pain and fatigue together and only a handful have studied the use of progressive muscle relaxation. The results of those trials have been ambiguous, and more research is needed.

Study Summary

This study was conducted in a single hospital in India. The participants were adults younger than 80 years, who were hospitalized to undergo radiation therapy for cancer and who verbalized that they were experiencing pain and fatigue. Patients who were terminally ill or experiencing cognitive or communication problems and those who had received chemotherapy or surgery in the previous month were excluded. The study used a quasi-experimental design, with pre- and post-intervention assessments of pain and fatigue in patients receiving progressive muscle relaxation and a control group of similarly matched patients who received usual care.

Pain was assessed with a numerical rating scale. Fatigue was measured with the Cancer Fatigue Scale, a brief, valid self-rating instrument consisting of 15 items measuring physical, affective, and cognitive fatigue on a Likert scale.

Patients in the intervention group were first trained in progressive muscle relaxation, which for most required 2-3 sessions. Training was provided by the researchers and through tape-recorded instructions. Patients then participated in weekly progressive muscle relaxation sessions, conducted with an audiotape with no music background. They were also instructed to perform the exercises daily for 15-20 minutes. A pain and fatigue scale was completed both before and at the conclusion of the intervention to assess the long-term results and durability of the intervention in ameliorating pain and fatigue.

Findings

The 100 patients who met inclusion criteria were enrolled and equally divided between the intervention and control groups. Most patients were 60-80 years of age, and about one half were men. There were no statistically significant differences in baseline or disease-related characteristics of the 2 groups. After the 4-week intervention, both pain and fatigue scores were significantly reduced in the intervention group. No significant change in pain was evident in the control group; the fatigue scores of these patients increased significantly.

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