Progressive Muscle Relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients’ receiving radiotherapy.
Abstract
Background: Cancer patients’ face number of problems, among those pain and fatigue are common problems. To manage pain and fatigue among cancer patients, studies now a days are even focusing on use of non-pharmacological/ non invasive methods as exercises, imagery etc. But studies on effect of progressive muscle relaxation (PMR) exercises on pain and fatigue among admitted patients are scarce.
Objective: The study was done to evaluate effectiveness of PMR exercises on pain and fatigue among hospitalized cancer patients’ receiving radiotherapy.
Methods: The study design was quasi-experimental Pre test Post test control group design. Total of 100 participants, 50 in each intervention and control group were included. The subjects in the intervention group received four PMR exercise sessions in 4weeks along with routine standardized treatment while subjects in control group received treatment as usual with no added intervention.
Results: There was significant difference (p<0.01) in Pre NPRS (4.42±2.35) to post NPRS (3.44±2.05) scores among intervention group (PMR). Pre assessment mean fatigue scores (CFS) of subjects were 33.80±10.62 in intervention group (PMR) and 33.24±7.02 in controls where as post assessment CFS were 28.52±12.74 and 36.52±7.53 in intervention and control group respectively. There was significant (p<0.01) reduction in pre to post CFS in PMR group while fatigue increased significantly (p<0.01) in control group.
Conclusion: PMR along with routine standard treatment is effective in reducing pain and fatigue among hospitalized cancer patients receiving radiotherapy.
About this article
References
McMillan SC, Tittle M, Hagan S, et al. Management of pain and pain-related symptoms in hospitalized veterans with cancer. Cancer Nurs. 2000;23(5):327-336.
Portenoy RK, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer. Pain. 1999;81:129-134.
Wells N. Pain intensity and pain interference in hospitalized patients with cancer. Oncol Nurs Forum.2000;27:985-991.
McNeill JA, Sherwood GD, Starck PL, et al. Assessing clinical outcomes: patient satisfaction with pain management. J Pain Symptom Manage. 1998;16(1):29-40
Mularski RA, White-Chu F, Overbay D, et al. Measuring Pain as the 5th Vital Sign Does Not Improve Quality of Pain Management. J Gen Intern Med. 2006;21(6):607-612.
View more references (23)
Agasi-Idenburg C, Velthuis M, Wittink H. Quality criteria and user-friendliness in self-reported questionnaires on cancer-related fatigue: a review. J Clin Epidemiol. 2010;63(7):705-711.
Stone P. The measurement, causes and effective management of cancer-related fatigue. Int J Palliat Nurs. 2002;(3):120-128.
Jacobsen PB, Donovan KA, Vadaparampil ST, et al. Systematic Review and Meta-Analysis of Psychological and Activity-Based Interventions for Cancer-Related Fatigue. Health Psychol. 2007; 26(6):660–667.
Piper BF, Borneman T, Sun VC, et al. Cancer-related fatigue: role of oncology nurses in translating National Comprehensive Cancer Network assessment guidelines into practice. Clin J Oncol Nurs. 2008;12(5 Suppl):37-47.
National Comprehensive Cancer Network. (2009). NCCN Clinical Practice GuidelinesTM: Adult cancer pain [v.1.2009]. Retrieved January 7, 2012, from http://www.nccn.org/professionals/physician_gls/PDF/pain.pdf
Lolak S, Connors GL, Sheridan MJ, et al. Effects of progressive muscle relaxation training on anxiety and depression in patients enrolled in an outpatient pulmonary rehabilitation program. Psychother Psychosom. 2008;77(2):119-125.
Marcus AC, Garrett KM, Cella D, et al. Can telephone counseling post-treatment improve psychosocial outcomes among early stage breast cancer survivors? Psychooncology. 2010;19(9):923-932.
Gordon DB, Dahl JL, Miaskowski C, et al. American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force. Arch Intern Med. 2005;165(14):1574-1580.
Reeves K. A cancer pain primer. Medsurg Nurs. 2008;17(6):413-419; quiz 420.
Demiralp M, Oflaz F, Komurcu S. Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. J Clin Nurs. 2010;19(7-8):1073-1083.
De Nijs EJ, Ros W, Grijpdonck MH. Nursing intervention for fatigue during the treatment for cancer. Cancer Nurs. 2008;31(3):191-206.
Barbaric M, Brooks E, Moore L, et al. Effects of physical activity on cancer survival: a systematic review. Physiother Can. 2010;62(1):25-34.
Jacobsen PB, Donovan KA, Vadaparampil ST, et al. Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue. Health Psychol. 2007;26(6):660-667.
McCaffery M, Beebe A. Pain: Clinical Manual for Nursing Practice. Baltimore: V.V. Mosby Company; 1993.
Okuyama T, Akechi T, Kugaya A, et al. Development and validation of the cancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients. J Pain Symptom Manage. 2000;19(1):5-14.
Kwekkeboom KL, Wanta B, Bumpus M. Individual difference variables and the effects of progressive muscle relaxation and analgesic imagery interventions on cancer pain. J Pain Symptom Manage. 2008;36(6):604-615.
Jamadar KS. Effect of muscle relaxation on stress level on cancer breast patients. Nightingale Nursing Times. 2009; 5(5): 32-47.
Krajewski J, Wieland R, Sauerland M. Regulating strain states by using the recovery potential of lunch breaks. J Occup Health Psychol. 2010;15(2):131-139.
Sheu S, Irvin BL, Lin HS, et al. Effects of progressive muscle relaxation on blood pressure and psychosocial status for clients with essential hypertension in Taiwan. Holist Nurs Pract. 2003;17(1):41-47.
Campos de Carvalho E, Martins FT, dos Santos CB. A pilot study of relaxation technique for management of nausea and vomiting in patients receiving cancer chemotherapy. Cancer Nurs. 2007;30(2):163-167.
Wallace KG. Analysis of recent literature concerning relaxation and imagery interventions for cancer pain. Cancer Nurs. 1997;20(2):79-87.
Sabitha KE, Shyamaladevi CS. Oxidant and antioxidant activity changes in patients with oral cancer and treated with radiotherapy. Oral Oncol. 1999; 35: 273-277.
Kasapovic J, Pejic S, Todorovic A, et al. Antioxidant status in breast cancer patients of different ages after radiotherapy. Arch Biol Sci Belgrade 2009; 61: 23-28.