The impact of sleep education, light intervention and relaxation on sleep and mood in the elderly.

Sleep and light education (SLE) combined with relaxation is a potential method of addressing sleep and affective problems in older people. 47 participants took part in a four-week sleep education program. SLE was conducted once a week for 60-90 minutes. Participants were instructed on sleep and light hygiene, sleep processes, and practiced relaxation techniques. Participants were wearing actigraphs for 6 weeks, completed daily sleep diaries, and wore blue light-blocking glasses 120 minutes before bedtime. Measures included scores of the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI) and actigraphy measurements of sleep latency, sleep efficiency, and sleep fragmentation. Sleep quality increased after SLE based on the subjective assessment and in the objective measurement with actigraphy. PSQI scores were statistically reduced indicating better sleep. Scores after the intervention significantly decreased in ESS and ISS. Sleep latency significantly decreased, whereas sleep efficiency and fragmentation index (%), did not improve. Mood significantly improved after SLE, with lower scores on the BDI-II and STAI. SLE combined with relaxation proved to be an effective method to reduce sleep problems and the incidence of depressive and anxiety symptoms.

The Effect of Progressive Muscle Relaxation Exercises on Sleep Quality in Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Study.

OBJECTIVES: This study aimed to evaluate the effect of progressive muscle relaxation exercises (PMRE) on sleep quality in patients undergoing chemotherapy treatment and experiencing disturbed sleep. METHODS: The prospective randomized controlled study was conducted between March and September 2022 with 69 patients (intervention group: 34 patients, control group: 35 patients) in a hospital chemotherapy unit. During the data collection process, the "Personal Information Form" and "Pittsburgh Sleep Quality Index (PSQI)" were utilized. Patients in the intervention group performed PMRE twice a day for 8 weeks. Patients in the control group received routine care at the clinic without additional intervention. For data analysis, Student's t-test, Mann-Whitney U test, Fisher's exact test, and chi-square test were used. RESULTS: The sociodemographic attributes of patients within both the intervention and control groups exhibited comparability. However, notable distinctions emerged in the PSQI Global sleep score and PSQI subdimension scores, encompassing sleep latency and duration, subjective sleep quality, habitual sleep efficiency, sleep disturbance, and daytime dysfunction between the two groups. The study found a notable difference in scores between the patients in the intervention group and those in the control group. The patients who received the intervention had significantly lower scores (P < .001). CONCLUSION: The study revealed that PMRE was beneficial in improving sleep quality in cancer patients undergoing chemotherapy who had poor sleep quality. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses may consider using PMRE to improve the sleep quality of cancer patients receiving chemotherapy.

The effects of web-based animation-supported progressive relaxation exercises applied to individuals with epilepsy on fatigue and sleep quality: A randomized controlled study.

PURPOSE: The study was conducted to determine the effects of Progressive Relaxation Exercise, supported by mobile-based animation, on fatigue and sleep quality of individuals with epilepsy. MATERIAL-METHOD: The study was conducted in a randomized controlled design with a pretest-posttest model on epileptic individuals who applied to Giresun University, Faculty of Medicine, Neurology Outpatient Clinic between February and December 2022. By using power analysis, the sample of the study was determined as 60 epilepsy patients (30 in the Control Group, 30 in the Experimental Group). The data were collected by face-to-face interview technique with the Personal Information Form, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Frequencies, percentages, arithmetic mean, standard deviations, Pearson Correlation Analysis, Paired t-Test, Student's t-Test, and Chi-Square Test were used in the evaluation of the study data. RESULTS: When the Control Group's mean scores in the pre-test and post-tests, which were performed with an interval of 6 weeks, were compared, a statistically significant difference was detected between the FSS and PSQI scores (p>0.05). The mean Fatigue Severity Scale score was found to be 5.24 ± 0.69 before the Progressive Relaxation Exercises and 3.82 ± 0.77 after the exercises. The mean scores of the individuals on the Fatigue Severity Scale after the relaxation exercises were found to be lower at a statistically significant level than the mean scores before the relaxation exercises (p<0.001). The differences between subjective sleep quality (p<0.001), sleep latency (p<0.001), daytime dysfunction (p<0.001), and total sleep quality (p<0.001) score averages after the Progressive Relaxation Exercises were statistically significant compared to the pre-exercises status. When the post-test scores of the participants in the Experimental Group was examined, significant, moderate, and positive differences were detected between the FSS and Total PSQI scores (r: 0.373-p: 0.042), Subjective Sleep Quality (r: 0.487-p: 0.006), which is one of the sub-dimensions of PSQI, Sleeping Pill Use (r: 0.531-p: 0.003), and Daytime Dysfunction (r: 0.461-p: 0.01) scores. CONCLUSION: It was determined that individuals with epilepsy experience fatigue and deterioration in sleep quality and there is a reciprocal relationship between the severity of fatigue and sleep quality in these individuals. Progressive Relaxation Exercises applied with the animation-supported web-based mobile intervention technique reduce the fatigue levels of individuals and increase sleep quality.

The Effect of Benson's Relaxation Technique on Fatigue and Quality of Life of Patients Diagnosed With Heart Failure.

Patients with heart failure (HF) reported poor quality of life (QOL) due to different reasons among which fatigue is the most important. Improving QOL is a crucial objective for patients with HF and their primary health care providers. Managing fatigue with medication is not enough. Benson's relaxation technique (BRT) is a complementary therapy used to manage fatigue among different populations with limited studies checking its effect among patients diagnosed with HF. The purpose of this quasi-experimental study was to check the effect of BRT on fatigue and QOL among 140 (68 intervention and 72 control) patients diagnosed with HF. Intervention group performed BRT for 20 minutes twice a day for 2 months. Control group received regular care from their health care providers. At baseline, there were no differences between intervention and control groups regarding fatigue, physical component summary, and mental component summary. At follow-up, intervention group had higher scores in physical and mental component summaries than control group (45.48 ± 10.52 vs 37.97 ± 14.78) and (46.22 ± 8.39 vs 41.01 ± 10.36), respectively. Also, intervention group had lower levels of fatigue than control group (2.54 ± 0.87 vs 6.33 ± 0.61). In conclusion, the use of BRT as a complementary therapy for patients with HF might decrease fatigue level and improve QOL.

Biobehavioral treatments of migraine.

Pharmacotherapies are the mainstays of migraine management, though it is not uncommon for them to be poorly tolerated, contraindicated, or only modestly effective. There is a clear need for nonpharmacologic migraine therapies, either employed alone or in combination with pharmacotherapies. Behavioral and psychosocial factors known to contribute to the onset, exacerbation, and persistence of primary headache disorders (e.g., stress, sleep, diet) serve as targets within a self-management model for migraine-a model that features headache pharmacotherapies, behavioral skills training, medication adherence facilitation, relevant lifestyle changes, and techniques to limit headache-related impairment. Behavioral self-management interventions for migraine with the strongest empirical validation (e.g., relaxation training, biofeedback training, cognitive-behavior therapies) presently are available in specialty headache treatment centers and routinely show promise for reducing headache pain frequency/severity and related impairment, reducing reliance on pharmacotherapies, enhancing personal control over headache activity, and reducing headache-related distress and symptoms. These approaches may be particularly well-suited among patients for whom pharmacotherapies are unwanted, poorly tolerated, or contraindicated. Though underutilized, clinical trials indicate that new and well-established behavioral therapies are similarly effective to migraine medications for migraine prevention among adults and can be successfully employed in various settings.

A pilot trial of a brief intervention for cannabis use supplemented with a substance-free activity session or relaxation training.

OBJECTIVE: Cannabis use is increasing among college students and commonly co-occurs with anxiety symptoms in this age group. Interventions that reduce anxiety may also reduce cannabis use. Behavioral economic theory suggests that substance use reductions are most likely when there is an increase in substance-free reinforcement. This randomized pilot trial evaluated the efficacy of a brief motivational intervention (BMI) for cannabis supplemented by either a substance-free activity session (SFAS) or a relaxation training (RT) session for reducing cannabis use, problems, craving, and anxiety symptoms. METHOD: One hundred thirty-two college students (Mage = 19.9; 54% female; 67% White, 31% Black) who reported five or more past-month cannabis use days were randomized to: (a) assessment-only (AO); (b) BMI plus SFAS; or (c) BMI plus RT. Participants in the BMI conditions received two individual counselor-administered sessions plus a brief phone booster session. Outcomes were evaluated 1- and 6-months postintervention. RESULTS: Relative to assessment, both BMI + SFAS and BMI + RT were associated with significant reductions in cannabis problems and craving at 1-month follow-up, and significant reductions in anxiety at 6-month follow-up. Relative to AO, BMI + RT was associated with significant reductions in cannabis use at 1-month follow-up. There were no differences between BMI conditions. CONCLUSIONS: This pilot trial was not adequately powered to conclusively evaluate relative efficacy but provides preliminary support for the short-term efficacy of both two-session interventions for reducing anxiety and cannabis-related risk among nontreatment seeking emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of online health training/counseling and progressive muscle relaxation exercise on postpartum depression and maternal attachment: A randomized controlled trial.

OBJECTIVE: To evaluate the effect of online health training/counseling and a progressive muscle relaxation exercise (PMRE) program on postpartum depression and maternal attachment. METHODS: The present study was a randomized, controlled, experimental trial. Participants were asked to complete the Prenatal Attachment Inventory (PAI) and the Edinburgh Postpartum Depression Scale (EPDS) at 35 weeks of pregnancy. Group assignment was done by stratified block randomization according to EPDS score (0-9, 10-30) and parity. Women in the experimental group received training in progressive muscle relaxation, postpartum depression, and maternal attachment via online video calls twice a week starting at 36-37 weeks of pregnancy. They were asked to complete the PMRE program from 36 weeks of pregnancy until 6 months postpartum, and online counseling was provided throughout this period. Participants completed the Maternal Postpartum Attachment Scale (MPAS) and the EPDS at 6 weeks postpartum. RESULTS: Mean PAI score was 64.24 ± 9.61 in the experimental group before the intervention and 62.14 ± 10.13 in the control group. The mean EPDS score of the experimental group was 9.12 ± 5.05 and the mean score of the control group was 9.77 ± 6.30 (P > 0.05). The mean MPAS score after the intervention was 13.92 ± 5.54 in the experimental group and 17.51 ± 6.12 in the control group. The mean EPDS score of the experimental group was 3.40 ± 3.00 and the mean score of the control group was 11.40 ± 5.91 (P < 0.05). CONCLUSION: Online health training/counseling and PMRE reduce the risk of postpartum depression and increase maternal attachment.

Investigation of the effect of Jacobson's relaxation technique on the fatigue of family caregivers of hemodialysis patients: a single-blinded randomized controlled trial.

BACKGROUND: Caring for hemodialysis patients could be a heavy burden on family caregivers, causing them to become fatigued and decrease their quality of life. This study aimed to investigate whether Jacobson's relaxation can help alleviate the fatigue of family caregivers of hemodialysis patients. METHODS: This randomized controlled trial was conducted in 2021. Sixty-six family caregivers of hemodialysis patients were recruited by convenience sampling from a referral hospital in Tehran, Iran, and assigned randomly by coin toss to two groups of experimental (n = 32) and control (n = 34). Caregivers in the experimental group performed Jacobson's relaxation three times a week, each time for 30-45 min, for 30 days. The score and severity of fatigue before, 2 weeks after, and 1 month after the intervention were measured with the Fatigue Severity Scale. Data analysis was performed in the statistics software SPSS using descriptive statistics (frequency, percentage, mean, and standard deviation) and analytic statistics (Independent Samples t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and RM-ANOVA test). The significance level was less than 0.05. RESULTS: The fatigue scores of the experimental and control groups were not significantly different before the intervention (4.42 ± 0.42 vs. 4.38 ± 0.42, P = 0.696). However, the experimental group had significantly lower fatigue scores than the control group 2 weeks after the intervention (4.11 ± 0.63 vs. 4.39 ± 0.42, P = 0.036) and 1 month after the intervention (3.5 ± 0.71 vs. 4.4 ± 0.44, P = 0.001). The results also showed a significant drop in the fatigue score of the experimental group after the intervention (P < 0.0001), but no such change in the control group (P = 0.662). CONCLUSION: Jacobson's relaxation technique was effective in alleviating the fatigue of family caregivers of hemodialysis patients. Nurses are therefore recommended to promote the technique as a safe and easy method of fatigue management for family caregivers.

Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial.

PURPOSE: The present study aims to investigate the combined effect of slow breathing exercise (SBE) and progressive muscle relaxation (PMR) technique on blood pressure (BP), heart rate (HR), respiratory rate (RR), and anxiety in patients diagnosed with essential hypertension. TRIAL DESIGN: This study was based on a 4-arm parallel-group, randomized control design. METHODS: Sixty-four participants diagnosed with essential hypertension were randomly allocated into SBE, PMR, SBE-PMR, and Control groups, with 16 subjects each. All 3 groups received different treatments according to their name; however, the Control group received no treatment. Systolic and diastolic BP (SBP and DBP), HR, RR, and anxiety were all evaluated as the study outcomes using a digital sphygmomanometer and perceived stress scale (PSS) at baseline (pretest), 2nd week and 4th weeks post-intervention. A repeated measure analysis of variance test assessed intra-group comparison (overall) analyses across multiple time points. Bonferroni multiple comparison tests were used to analyze the mean differences between the groups. The confidence interval was kept at 95% for all the statistical analyses, that is, P < .05 is considered significant. RESULTS: There was a significant change in the HR (F = 239.04, P = .0001), RR (F = 167.74, P = .0001), SBP (F = 266.64, P = .0001), DSP (F = 279.80, P = .0001), and PSS (F = 473.42, P = .0001) as an outcome of baseline measurements versus (vs) the following weeks. There were significant (F = 48.57, P = .001) differences among different training on HR. The SBE vs SBE-PMR showed an insignificant difference (F = 48.54, P = 1.000). The RR showed significant differences (F = 32.05, 0.0001) between the SBE vs PMR, SBE vs Control, PMR vs Control, and SBE-PMR vs Control groups and insignificant differences for the SBE vs SBE-PMR and PMR vs SBE-PMR groups. The SBE vs SBE-PMR groups showed insignificant differences for DPP and SBP. However, PSS showed significant differences (F = 67.12, P = .0001) among the intervention groups except for the PMR and SBE-PMR groups. CONCLUSIONS: The combined interventions of SBEs and progressive muscle relaxation techniques can effectively reduce the heart rate, respiratory rate, BP, and anxiety in essential hypertensive patients compared to both techniques when given alone.

A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi- experimental study.

BACKGROUND: There is slight evidence on the effectiveness of relaxation techniques to improve quality of life of the old people, and no comparative studies have particularly investigated this population. Hence, the present study was conducted to examine the effect of Mitchell relaxation versus Benson relaxation technique to improve quality of life of the old people. METHODS: In the present quasi-experimental study, 96 eligible old people in a nursing home were selected by available sampling method. Afterwards, they were assigned to three groups: Mitchell's Relaxation Technique, Benson Relaxation Technique, and control (each of 32 participants) using the random block sampling method. The intervention groups received relaxation for 8 weeks and 3 sessions of 20 min each week. However, the control group did not receive any relaxation. Data was gathered by questionnaires (SF-36) and (CASP-19) before (week 0) and after the intervention (week 8) and were analyzed using the SPSS software version 26. RESULTS: The results indicated that both Benson and Mitchell relaxation had improved the quality of life (SF-36) and (CASP-19) and their sub-scales in the participants compare to the control group (P < 0.001). Accordingly, the median (quartile 25, 75) of the specific quality of life of the participants before the intervention was 21 (18.25, 25.75) in the Benson group, 20.5 (16, 24) in the Michel group, and 21 (16.25, 24) in the control group. However, after the intervention they reached 35(26.25, 38.75), 34.5(26.75, 42.25), and 17 (14, 21) respectively. There was no statistically significant difference between the Benson and Michel relaxation groups. CONCLUSIONS: Based on the results, Benson and Mitchell relaxation techniques improve the quality of life of the old people. If the results be confirmed in other studies, the education of each of them, especially for the old people living in nursing homes and their caregivers, is suggested as routine care.

Effect of Benson's relaxation technique versus music intervention on physiological parameters and stress of children with thalassemia during blood transfusions: A randomized controlled trial.

BACKGROUND: Children with thalassemia are generally dependent on blood transfusions and face a lot of stress and alteration in their physiological parameters through the procedure. AIM: This study aimed to investigate the effect of Benson's relaxation technique versus music intervention on physiological parameters and stress of children with thalassemia during blood transfusions. DESIGN: A randomized, controlled trial with three parallel groups. METHODS: One hundred and twenty preschool-age children with thalassemia who underwent blood transfusions were randomly assigned to three groups. Children of the control group received only routine hospital care through blood transfusions. Music intervention group children listened to recorded Mozart's music and children of Benson's relaxation group received relaxation intervention before and during the blood transfusions. Outcome measures were physiological parameters and behavioral distress levels. SETTING: Hematology outpatient clinic of the Children's University Hospital at El-Shatby in Alexandria from October 2022 to February 2023. RESULTS: The mean total score of children's behavioral responses to stress before the blood transfusions procedure was 19.32 ± 4.08, 14.20 ± 0.93, and 16.92 ± 4.74 in the control, music, and Benson groups, respectively. Beyond that, there was a decline in their physiological parameters and behavioral stress response during and after procedure among groups of study (P = 0.005 & <0.001, respectively). CONCLUSION: Music and Benson's relaxation interventions had a helpful effect on stabilizing the physiological parameters and reducing behavioral distress levels in children with thalassemia undergoing blood transfusions. PRACTICE IMPLICATIONS: This study directs paediatric nurses to apply Benson's relaxation and music interventions for children with thalassemia to enhance their responses.

Cognitive Behavioral Therapy for the Management of Episodic Migraine.

PURPOSE OF REVIEW: This article provides an overview of the application of CBT in the management of episodic migraine while also providing context and insight into the underlying neurophysiological mechanisms of therapeutic change. It discusses the theoretical foundations of CBT and highlights key components including education, cognitive restructuring, behavioral interventions, relaxation techniques, and lifestyle changes. RECENT FINDINGS: Cognitive behavioral therapy (CBT) is an empirically based treatment that is well suited for the management of episodic migraine. Although first-line treatments of migraine are typically pharmacological, a review of empirical literature suggests growing evidence for the use of CBT as a standard non-pharmacological treatment of headache conditions. In summary, this article explores evidence supporting the efficacy of CBT in reducing the frequency, intensity, and duration of migraine attacks as well as improving the quality of life and psychological well-being of those with episodic migraine.

Comparison of the effects of Benson relaxation technique and nature sounds on pain, anxiety, and body image in burn-injured patients admitted to the burn ICU: A single-blind randomized clinical trial.

BACKGROUND: Burn patients feel a lot of physiological and mental stress during treatment and rehabilitation which often cause anxiety and body image dissatisfaction. This study aimed to compare the effects of the Benson relaxation technique and nature sounds on pain anxiety and body image in burn-injured patients admitted to a burn intensive care unit (BICU). METHODS: This single-blind randomized clinical trial studied 60 burn patients allocated into three groups (Benson relaxation, nature sounds, and control) from September 2021 to February 2022. The patients received the intervention for seven consecutive days in person. Burn Specific Pain Anxiety Scale (BSPAS), was completed on the 1st, 4th, and 7th days. The intervention continued for four weeks measuring body image using the Satisfaction with Appearance Scale (SWAP) at the end of the 1st, 3rd, and 5th weeks. Finally, the data were statistically analyzed using the Shapiro-Wilk test, chi-square test, Fisher's exact test, Bonferroni post hoc test, repeated measures ANOVA, Kruskal Wallis test, and Generalize Estimating Equations (GEE). RESULTS: The mean pain anxiety and dissatisfaction with the appearance were high in the three groups in the pretest. On the 7th day after the intervention, the ANOVA showed that the mean pain anxiety decreased significantly in Benson's relaxation and nature sounds groups in three stages (before intervention (S1), after intervention (S2) and immediately after dressing change (S3) (P < 0.001). Correspondingly, the Kruskal Wallis test revealed that the body image dissatisfaction decreased significantly in the three groups at the end of the 3rd and 5th weeks (P < 0.001). The mean scores of pain anxiety showed that the nature sounds group proved more effective than the Benson relaxation technique. Also, the means scores of body image satisfaction showed that the Benson relaxation technique proved more effective than nature sounds. CONCLUSION: The study findings suggested that the Benson relaxation technique and nature sounds effectively reduces pain, anxiety, and improves body image satisfaction in patients with burn injuries.

The Effectiveness of Benson's Relaxation Technique on Pain and Perceived Stress Among Patients Undergoing Hemodialysis: A Double-Blind, Cluster-Randomized, Active Control Clinical Trial.

Benson's relaxation affects many symptoms among hemodialysis patients. A cluster-randomized active control clinical trial with three repeated measures; pre, 1-week, and 1-month post-intervention sought to evaluate the effectiveness of Benson's Relaxation on pain and perceived stress (P&PS) among hemodialysis patients. Two governmental hospitals were randomly assigned to intervention and control. Thirty-six participants were randomly selected; 18 were intervention, and 18 were controlled. The intervention group performed Benson's Relaxation twice a day for 10 minutes for 8 weeks after a training session. The control group received an educational session about Progressive Relaxation. Findings revealed a statistically significant reduction in the PSS-10 and PRI scores between pre-intervention and 1 month after-intervention (p < .001) and at 1 week after intervention and 1 month after-intervention (p < .001). A non-statistically significant reduction between pre-intervention and 1 week after-intervention (p > .05). Benson's Relaxation significantly relieved P&PS among hemodialysis patients but not after only 1 week of practicing.

Application of Noise Control Combined with Relaxation Training in Patients with Skin Laser Cosmetology: A Single-center Retrospective Study.

Objective: Noise pollution has been listed as one of the three major types of pollution, along with air and water pollution. Hospitals should pay attention to noise control, which is of great importance for the treatment and rehabilitation of patients. This study focuses on the application value of noise control and relaxation training. Methods: This study retrospectively collected and analyzed the clinical data of 184 patients who underwent skin laser cosmetology in Ningbo Yinzhou No. 2 Hospital from January 2021 to December 2022. Twelve patients who did not meet the criteria were excluded, and the remaining 172 patients were divided based on the type of intervention into the control group (CG, n = 82) and the study group (SG, n = 90). The CG received relaxation training and routine noise management, while the SG received noise control combined with relaxation training. The intervention effect was discussed from the aspects of noise, psychology, and satisfaction. Results: After the intervention, the SG had overtly lower noise levels and lower scores of anxiety and depression compared to the CG (all P < 0.001). Correlation analysis showed that noise levels were positively correlated with scores of anxiety and depression (r = 0.553, r = 0.592, P < 0.001). The two groups had no significant difference in total satisfaction (P > 0.05). Conclusion: Noise poses a significant threat to the human body. Strengthening noise control in hospitals is beneficial for patients' recovery. Combining noise control with relaxation training is an intervention method worthy of clinical application. It can improve the hospitalization environment and reduce the noise levels to a great extent, thereby improving the psychological state of patients and enhancing the medical satisfaction.

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.

The Role of Personalization in the User Experience, Preferences and Engagement with Virtual Reality Environments for Relaxation.

Virtual Reality Environments (VREs) are widely deployed in mental health treatments, often associated with relaxation techniques. The personalization of natural VR-based scenarios is a key element that can further facilitate users' sense of presence and relaxation. This study explored the role of VREs' personalization in the user experience with an environment supporting relaxation, by deploying mixed methods. METHODS: A non-clinical sample of 20 individuals participated in exposure to a supportive body-scan-guided relaxation VRE. In the personalized conditions, the participants had the option of choosing the context (e.g., sea, mountain, or countryside) and including in the scenario different types of sounds, visual elements, and changing the time of day and weather. In the standard conditions, individuals were exposed to a relaxing VRE, but they could choose neither the context nor the auditory and visual elements. The order of presentation of the personalized vs non-personalized environments was randomized. Measures regarding relaxation, state-anxiety perceived levels, VRE-related symptoms, the usability of the Virtual Reality (VR) setting, sense of presence, pleasure, activation, engagement, and level of immersion experienced were collected before and after exposure to the VR environments. RESULTS: Findings showed that personalized VREs were preferred by users. Participants generally preferred to experience a greater immersivity, pleasure, engagement, and relaxation in the personalized virtual settings. CONCLUSION: The study further confirms the role of personalization as a component positively contributing to relaxation and engagement. Future research may further assess this effect in the context of large-scale controlled studies involving clinical and non-clinical populations.

The Effects of Relaxation Techniques on Pain, Fatigue, and Kinesiophobia in Multiple Sclerosis Patients: A 3-Arm Randomized Trial.

ABSTRACT: BACKGROUND: In addition to the available medical treatment options, multiple sclerosis (MS) patients may tend toward complementary and integrative therapies. Relaxation techniques are a nonpharmacological and side-effect-free therapy option currently available to alleviate the symptoms of many different chronic diseases. The aim of this study was to examine and compare the effects of relaxation techniques on the pain, fatigue, and kinesiophobia in MS patients. METHODS: This 3-arm randomized controlled trial consisted of 80 MS patients. Relaxation techniques, progressive muscle relaxation and Benson relaxation technique were applied to 2 intervention groups, the third was the control group. The study lasted 12 weeks, and the patient information form, visual analog scale, Fatigue Severity Scale, and Tampa Scale for Kinesiophobia were used for data collection. RESULTS: There was a statistically significant decrease in pain, fatigue, and kinesiophobia levels in the intervention groups compared with the control group (P < .05). Progressive muscle relaxation was more effective than Benson relaxation technique (P < .05). CONCLUSION: Relaxation techniques are recommended for the management of symptoms of pain, fatigue, and kinesiophobia, which can often cause disability in MS patients, because they have no side effects and are practical administrations. These exercises are also promising in the rehabilitation process of MS patients.

Effectiveness of progressive muscle relaxation technique on anxiety caused by Covid-19 in pregnant women: A randomized clinical trial.

AIM: To determine the effectiveness of the progressive muscle relaxation (PMR) technique on anxiety caused by Covid-19 in pregnant women under the auspices of comprehensive health service centers in the nineteenth district of Tehran University of Medical Sciences. METHOD: This study is a randomized clinical trial. A total of 126 pregnant women were randomly allocated to the intervention group (N = 63) and control group (N = 63). All participants completed demographic questionnaires and the Corona Disease Anxiety Scale electronically. The intervention was held in six sessions through Sky Room (three times a week). It consisted of training and practicing the PMR. The intervention group was re-evaluated with the related questionnaires immediately after the intervention and 2 weeks later, and the control group 2 and 4 weeks after the baseline. RESULTS: There was a significant difference between the control and intervention groups at the baseline (P = .05). Nevertheless, analysis of variance test results showed that the difference between the intervention and control groups was found to be significantly different statistically; (22.92 ± 6.07) for intervention versus (28.13 ± 6.93) for control, with the second follow up (P = .01). CONCLUSIONS: Progressive muscle relaxation is used as a useful intervention to reduce anxiety in pregnant women during coronavirus pandemics educated and recommended with more emphasis and sensitivity in pregnancy care by healthcare providers.