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Progressive muscle relaxation as a supportive intervention for cancer patients undergoing chemotherapy: A systematic review

Published online by Cambridge University Press:  28 November 2016

Panagiotis Pelekasis ,
Ifigeneia Matsouka  and
Anna Koumarianou
Panagiotis Pelekasis*
Affiliation:
Hematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
Ifigeneia Matsouka
Affiliation:
Hematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
Anna Koumarianou
Affiliation:
Hematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
*
Address correspondence and reprint requests to: Panagiotis Pelekasis, Hematology/Oncology Unit, Fourth Department of Internal Medicine, Attikon Hospital, University of Athens, Rimini 1, 12462 Athens, Greece. E-mail: [email protected].
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Abstract

Background:

Many cancer patients use a wide variety of techniques to improve their physical and mental well-being, including relaxation therapy and, specifically, Progressive Muscle Relaxation (PMR). However, there is no strong evidence that supports the efficacy of this technique.

Objective:

Our aim was to review the evidence regarding the use of PMR as a supportive intervention for cancer patients undergoing chemotherapeutic treatment.

Method:

Six databases were electronically searched: AMED, the Cochrane Library, MEDLINE, PsychINFO, Scopus, and the Web of Science. After removing duplicates, 700 publications were screened and 57 identified as potentially relevant. The flow of information from record identification to study inclusion was conducted in accordance with the PRISMA statement. Original articles published in peer-reviewed journals that studied the use of PMR as an intervention, were randomized or included a matched control group, and that included patients receiving chemotherapy were included. Studies that combined PMR with other interventions were excluded. The methodological quality of included trials was assessed using the Jadad Scale and the CONSORT guidelines.

Results:

A total of 5 of the 57 papers fulfilled the preset criteria and were included in our systematic review. Our findings indicate that PMR might improve comfort and reduce the anxiety levels and side effects caused by chemotherapy, with the exception of vomiting. Nonetheless, the quality of all the included studies was extremely low.

Significance of results:

There is evidence that PMR might have a few benefits for patients undergoing chemotherapy. Still, the small number of studies included and their poor quality limit the significance of our results. Despite the fact that pharmaceutical approaches for controlling side effects might be reaching their full potential and that there might be further usefulness for such integrative treatments as PMR, the need to run more high-quality trials testing the efficacy of this technique is warranted before suggesting its adoption as part of standard cancer care.

Keywords

AnxietyCancerChemotherapyProgressive muscle relaxationSide effects
Type
Review Article
Information
Palliative & Supportive Care , Volume 15 , Issue 4 , August 2017 , pp. 465 - 473
Copyright
Copyright © Cambridge University Press 2016 

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References

REFERENCES

Arakawa, S. (1995). Use of relaxation to reduce side effects of chemotherapy in Japanese patients. Cancer Nursing, 18(1), 60–66.CrossRefGoogle ScholarPubMed
Arakawa, S. (1997). Relaxation to reduce nausea, vomiting, and anxiety induced by chemotherapy in Japanese patients. Cancer Nursing, 20(5), 342–349.CrossRefGoogle ScholarPubMed
Australian Institute of Health and Welfare (2013). Cancer in Australia: Actual incidence data from 1991 to 2009 and mortality data from 1991 to 2010 with projections to 2012. Asian Pacific Journal of Clinical Oncology, 9(3), 199–213. Available from http://onlinelibrary.wiley.com/doi/10.1111/ajco.12127/pdf.CrossRefGoogle Scholar
Bray, F., Jemal, A., Grey, N., et al. (2012). Global cancer transitions according to the Human Development Index (2008–2030): A population-based study. The Lancet. Oncology, 13(8), 790–801.CrossRefGoogle Scholar
Carpenter, J.S., Wells, N., Lambert, B., et al. (2002). A pilot study of magnetic therapy for hot flashes after breast cancer. Cancer Nursing, 25(2), 104–109.CrossRefGoogle ScholarPubMed
Demiralp, M., Oflaz, F. & Komurcu, S. (2010). Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. Journal of Clinical Nursing, 19(8), 1073–1083.CrossRefGoogle ScholarPubMed
DeVita, V.T. Jr. & Chu, E. (2008). A history of cancer chemotherapy. Cancer Research, 68(21), 8643–8653. Available from http://cancerres.aacrjournals.org/content/68/21/8643.long.CrossRefGoogle ScholarPubMed
Dickerson, S.S., Connors, L.M., Fayad, A., et al. (2014). Sleep–wake disturbances in cancer patients: Narrative review of literature focusing on improving quality of life outcomes. Nature and Science of Sleep, 6, 85–100. Epub ahead of print Jul 12. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103930/.CrossRefGoogle ScholarPubMed
Die Trill, M. (2013). Anxiety and sleep disorders in cancer patients. EJC Supplements, 11(2), 216–224. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041166/.CrossRefGoogle ScholarPubMed
Eguchi, K., Hyodo, I. & Saeki, H. (2000). Current status of cancer patients' perception of alternative medicine in Japan: A preliminary cross-sectional survey. Supportive Care in Cancer, 8(1), 28–32.CrossRefGoogle ScholarPubMed
Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., et al. (2013). Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer, 49(6), 1374–1403. Epub ahead of print Feb 26. Available from http://www.ejcancer.com/article/S0959-8049(13)00007-5/pdf.CrossRefGoogle ScholarPubMed
Garcia, M.K., McQuade, J., Haddad, R., et al. (2013). Systematic review of acupuncture in cancer care: A synthesis of the evidence. Journal of Clinical Oncology, 31(7), 952–960. Epub ahead of print Jan 22. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577953/.CrossRefGoogle Scholar
Glare, P., Miller, J., Nikolova, T., et al. (2011). Treating nausea and vomiting in palliative care: A review. Clinical Interventions in Aging, 6(), 243–259. Epub ahead of print Sep 12. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180521/.CrossRefGoogle ScholarPubMed
Holland, J.C., Morrow, G.R., Schmale, A., et al. (1991). A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms. Journal of Clinical Oncology, 9(6), 1004–1011.CrossRefGoogle ScholarPubMed
Huebner, J., Prott, F.J., Micke, O., et al. (2014). Online survey of cancer patients on complementary and alternative medicine. Oncology Research and Treatment, 37(6), 304–308. Epub ahead of print May 12. Available from http://www.karger.com/Article/FullText/362616.CrossRefGoogle ScholarPubMed
Hyodo, I., Amano, N., Eguchi, K., et al. (2005). Nationwide survey on complementary and alternative medicine in cancer patients in Japan. Journal of Clinical Oncology, 23(12), 2645–2654. Available from http://ascopubs.org/doi/pdf/10.1200/jco.2005.04.126.CrossRefGoogle ScholarPubMed
Jacobson, E. (1938). Progressive relaxation. Chicago: University of Chicago Press.Google Scholar
Jadad, A.R., Moore, R.A., Carroll, D., et al. (1996). Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Controlled Clinical Trials, 17(1), 1–12.CrossRefGoogle ScholarPubMed
Jemal, A., Center, M.M., DeSantis, C., et al. (2010). Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiology, Biomarkers & Prevention, 19(8), 1893–1907. Epub ahead of print Jul 20. Available from http://cebp.aacrjournals.org/content/19/8/1893.long.CrossRefGoogle ScholarPubMed
Jorm, A.F., Morgan, A.J. & Hetrick, S.E. (2008). Relaxation for depression. The Cochrane Database of Systematic Reviews, (4), CD007142.CrossRefGoogle ScholarPubMed
Kachuri, L., De, P., Ellison, L.F., et al. (2013). Cancer incidence, mortality and survival trends in Canada, 1970–2007. Chronic Diseases and Injuries in Canada, 33(2), 69–80. Available from http://www.phac-aspc.gc.ca/publicat/hpcdp-pspmc/33-2/ar-03-eng.php.CrossRefGoogle ScholarPubMed
Kamen, C., Tejani, M.A., Chandwani, K., et al. (2014). Anticipatory nausea and vomiting due to chemotherapy. European Journal of Pharmacology, 722, 172–179. Epub ahead of print Oct 21, 2013. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880638/.CrossRefGoogle ScholarPubMed
Katanoda, K., Hori, M., Matsuda, T., et al. (2015). An updated report on the trends in cancer incidence and mortality in Japan, 1958–2013. Japanese Journal of Clinical Oncology, 45(4), 390–401. Epub ahead of print Jan 30. Available from http://jjco.oxfordjournals.org/content/45/4/390.full.pdf+html.CrossRefGoogle ScholarPubMed
Koumarianou, A., Pelekasis, P., Kontogoni, M., et al. (2015). How to encounter the development of panic disorder during adjuvant breast cancer chemotherapy: A case study. Journal of Clinical Case Reports, 4, 475. Available from http://www.omicsgroup.org/journals/how-to-encounter-the-development-of-panic-disorder-during-adjuvant-breast-cancer-2165-7920.1000475.pdf.php?aid=40666.Google Scholar
Lee, E.J., Bhattacharya, J., Sohn, C., et al. (2012). Monochord sounds and progressive muscle relaxation reduce anxiety and improve relaxation during chemotherapy: A pilot EEG study. Complementary Therapies in Medicine, 20(6), 409–416. Epub ahead of print 2012 Aug 23. Available from http://www.complementarytherapiesinmedicine.com/article/S0965-2299(12)00088-X/pdf.CrossRefGoogle ScholarPubMed
Lewith, G.T. (2002). Clinical research in complementary therapies: Principles, problems and solutions. Edinburgh: Churchill Livingstone.Google Scholar
Mahendran, R., Lim, H.A., Tan, J.Y., et al. (2015). Efficacy of a brief nurse-led pilot psychosocial intervention for newly diagnosed Asian cancer patients. Supportive Care in Cancer, 23(8), 2203–2206. Epub ahead of print May 23.CrossRefGoogle ScholarPubMed
Maizes, V., Rakel, D. & Niemiec, C. (2009). Integrative medicine and patient-centered care. Explore (New York, N.Y.), 5(5), 277–289.CrossRefGoogle ScholarPubMed
Manzoni, G.M., Pagnini, F., Castelnuovo, G., et al. (2008). Relaxation training for anxiety: A ten-years systematic review with meta-analysis. BMC Psychiatry, 8, 41. Available from https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC2427027/.CrossRefGoogle ScholarPubMed
Moher, D., Liberati, A., Tetzlaff, J., et al. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6, e1000097. Epub ahead of print Jul 21. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2707599/.CrossRefGoogle ScholarPubMed
Molassiotis, A., Fernandez-Ortega, P., Pud, D., et al. (2005). Use of complementary and alternative medicine in cancer patients: A European survey. Annals of Oncology, 16(4), 655–663. Epub ahead of print Feb 2. Available from http://annonc.oxfordjournals.org/content/16/4/655.full.pdf+html.CrossRefGoogle ScholarPubMed
Moore, H.C. (2014). An overview of chemotherapy-related cognitive dysfunction, or “chemobrain.” Oncology (Williston Park, N.Y.), 28(9), 797–804. Available from http://www.cancernetwork.com/oncology-journal/overview-chemotherapy-related-cognitive-dysfunction-or-chemobrain.Google ScholarPubMed
Morone, N.E. & Greco, C.M. (2007). Mind–body interventions for chronic pain in older adults: A structured review. Pain Medicine (Malden, Mass.), 8(4), 359–375. Available from http://painmedicine.oxfordjournals.org/content/8/4/359.long.CrossRefGoogle ScholarPubMed
Mustian, K.M., Devine, K., Ryan, J.L., et al. (2011). Treatment of nausea and vomiting during chemotherapy. U.S. Oncology & Hematology, 7(2), 91–97. Available from https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3898599/.Google ScholarPubMed
Nakash, O., Levav, I., Aguilar-Gaxiola, S., et al. (2014). Comorbidity of common mental disorders with cancer and their treatment gap: Findings from the World Mental Health Surveys. Psycho-Oncology, 23(1), 40–51. Epub ahead of print Aug 27, 2013. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992888/.CrossRefGoogle ScholarPubMed
Park, C. (2013). Mind–body CAM interventions: Current status and considerations for integration into clinical health psychology. Journal of Clinical Psychology, 69(1), 45–63. Epub ahead of print Aug 30, 2012.CrossRefGoogle ScholarPubMed
Pelekasis, P., Zisi, G., Koumarianou, A., et al. (2016). Forming a stress management and health promotion program for women undergoing chemotherapy for breast cancer: A pilot randomized controlled trial. Integrative Cancer Therapies, 15(2), 165–174. Epub ahead of print Aug 4, 2015. Available from http://ict.sagepub.com/content/15/2/165.long.CrossRefGoogle ScholarPubMed
Rainforth, M.V., Schneider, R.H., Nidich, S.I., et al. (2007). Stress reduction programs in patients with elevated blood pressure: A systematic review and meta-analysis. Current Hypertension Reports, 9(6), 520–528. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268875/.CrossRefGoogle ScholarPubMed
Robson, C. (2002). Real-world research: A resource for social scientists and practitioner-researchers, 2nd ed. Malden, MA: Blackwell Publishing.Google Scholar
Roscoe, J.A., Morrow, G.R., Hickok, J.T., et al. (2003). The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting: A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. Journal of Pain and Symptom Management, 26(2), 731–742. Available from http://www.jpsmjournal.com/article/S0885-3924(03)00254-9/pdf.CrossRefGoogle ScholarPubMed
Schulz, K.F., Altman, D.G., Moher, D., et al. (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine, 152(11), 726–732. Epub ahead of print Mar 24. Available from http://annals.org/aim/article/745807/consort-2010-statement-updated-guidelines-reporting-parallel-group-randomized-trials.CrossRefGoogle ScholarPubMed
Siegel, R.L., Miller, K.D. & Jemal, A. (2016). Cancer statistics, 2016. CA: A Cancer Journal for Clinicians, 66, 7–30. Epub ahead of print Jan 7. Available from http://onlinelibrary.wiley.com/doi/10.3322/caac.21332/full.Google Scholar
Song, Q.H., Xu, R.M., Zhang, Q.H., et al. (2013). Relaxation training during chemotherapy for breast cancer improves mental health and lessens adverse events. International Journal of Clinical and Experimental Medicine, 6(10), 979–984. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832338/.Google ScholarPubMed
Streitberger, K. & Kleinhenz, J. (1998). Introducing a placebo needle into acupuncture research. Lancet, 352(9125), 364–365.CrossRefGoogle ScholarPubMed
Thompson, B.T. & Schoenfeld, D. (2007). Usual care as the control group in clinical trials of nonpharmacologic interventions. Proceedings of the American Thoracic Society, 4(7), 577–582. Available from https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC2647648/.CrossRefGoogle Scholar
Vancampfort, D., Correll, C.U. & Scheewe, T.W. (2013). Progressive muscle relaxation in persons with schizophrenia: A systematic review of randomized controlled trials. Clinical Rehabilitation, 27(4), 291–298. Epub ahead of print Jul 27, 2012.CrossRefGoogle ScholarPubMed
Yilmaz, S.G. & Arslan, S. (2015). Effects of progressive relaxation exercises on anxiety and comfort of Turkish breast cancer patients receiving chemotherapy. Asian-Pacific Journal of Cancer Prevention, 16(1), 217–220. Available from http://journal.waocp.org/article_30416_298f0f99a9d472a5672cfad505f03a6e.pdf.CrossRefGoogle ScholarPubMed
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