OBJECTIVE: This single-blind, randomized controlled study aimed to determine the effect of progressive muscle relaxation exercises on sleep quality and fatigue in the postmenopausal period. Progressive muscle relaxation aims to relax the muscles in the body and includes breathing techniques.
METHODS: This study was carried out between January 2022 and July 2022 with 63 postmenopausal women who applied to a district state hospital and had poor sleep quality. The women assigned to the experimental group (EG) (n = 31) applied progressive muscle relaxation exercises every day for 8 weeks. In contrast, the women in the control group (CG) (n = 32) continued their routine coping habits related to sleep problems and fatigue in the postmenopausal period. The EG and CG were reevaluated using the Piper Fatigue Scale and the Pittsburg Sleep Quality Index in the fourth and eighth weeks. The women applied progressive muscle relaxation exercises with a guide prepared by the researchers and the compact disc of the Turkish Psychologists Association. In the data analysis, the independent-samples t test, Fisher\'s exact test, and χ2 test were used to compare individual, obstetric, and medical characteristics between the groups. The difference between dependent groups at different times was evaluated by repeated-measures analysis of variance.
RESULTS: There was an improvement in fatigue symptoms in the progressive muscle relaxation exercises-performing EG at the end of 8 weeks compared with the CG, and fatigue symptoms increased in the CG (P < 0.001). There was a greater improvement in the sleep quality of the progressive muscle relaxation exercises-performing EG at the end of 8 weeks compared with the CG (P < 0.001).
CONCLUSIONS: In our study, it was determined that progressive muscle relaxation exercises had an improving effect on sleep quality and fatigue.

OBJECTIVE: This study was carried out to determine the effect of progressive muscle relaxation exercises (PMR) on premenstrual syndrome (PMS) symptoms.
METHODS: The study was designed in a single-blind randomized controlled type. The study was conducted in a hospital in Western Türkiye. Seventy-nine single women who experienced PMS who met the inclusion criteria were randomly assigned to the experimental group in which PMR would be applied, and the control group to continue their routine coping habits regarding PMS. PMR were applied to the experimental group every day for 8 weeks. At the end of 8 weeks, the experimental and control groups were re-evaluated with the Premenstrual Syndrome Scale (PMSS).
RESULTS: At the beginning of the study, it was observed that the individual, health characteristics and PMSS mean scores of the women in the experimental and control groups were similar (p > 0.05). At the end of eight weeks, it was seen that the mean PMSS score of the experimental group was lower than that of the control group, and the difference was statistically significant (p < 0.001). When in-group comparisons were made at the end of the exercise program, no significant difference was found in the mean PMSS score of the control group compared to the beginning (p > 0.05). The PMSS score of the experimental group decreased significantly and the difference was statistically significant (p < 0.001).
CONCLUSIONS: In this study, it was seen that PMR were effective in improving PMS.

BACKGROUND: This research was to determine the effect of neurolinguistic programming (NLP) and progressive muscle relaxation exercises (PMRE) on breastfeeding success and breastfeeding self-efficacy in primiparous women after cesarean section.
METHODS: This is a single-blind, three-arm, parallel-group, randomized controlled trial. Data were collected between 01 October 2023, and 18 December 2023. The sample of the study consisted of 99 primiparous women who gave birth by cesarean section (NLP=33, PMRE=33, and control=33). Women were randomly assigned to the groups. Starting from the first mobilization time after cesarean section, NLP was applied to the NLP group and PMRE was applied to the PMRE group every eight hours for 48 h. In the control group, NLP or PMRE was not applied and the women were allowed to rest on their backs. The primary outcomes of the study were breastfeeding success and breastfeeding self-efficacy.
RESULTS: The mean scores of breastfeeding success and breastfeeding self-efficacy measured over time were highest in the NLP group and lowest in the control group (p<.05). The mean scores of breastfeeding success and breastfeeding self-efficacy measured over time increased by 78.4 %, and 97.7 %, respectively, in the NLP group compared to the control group, 74.7 %, and 88.1 %, in the PMRE group compared to the control group, and 13.5 %, and 90.2 %, respectively, in the NLP group compared to the PMRE group (p<.05).
CONCLUSIONS: NLP intervention may have a more positive effect on breastfeeding success and breastfeeding self-efficacy than PMRE intervention.
UNASSIGNED: ClinicalTrials.gov, NCT06070792.

The purpose of this research was to ascertain how progressive muscle relaxation (PMR) technique affected hip fracture patients\' anxiety, sleep quality, and post-operative pain. This parallel randomized controlled trial was conducted on 100 patients with hip fracture hospitalized in one of the reference orthopedic hospitals in Tehran, Iran who were selected using convenience sampling and randomly were placed in two PMR group (n = 50) and control group (n = 50). Data were collected by Demographic information questionnaire, Visual analogue scale for pain rating, Pittsburgh Sleep Quality Index and State-Trait Anxiety Inventory. The PMR technique was the progressive muscle relaxation technique, which was started the night after the surgery for three nights before going to bed. Data were collected on two occasions, including before the PMR technique and the day after the last stage of the PMR technique. The data were analyzed by SPSS software using descriptive and inferential statistics. The results revealed significant within-group changes in both groups\' post-operative pain, sleep quality, and anxiety scores (P < 0.001). The progressive muscle relaxation group experienced decreased post-operative pain and anxiety scores and increased sleep quality scores (P < 0.001). The linear mixed model showed that the absolute changes in the follow-up post-operative pain, sleep quality, and anxiety scores were 1.19 and 7.94 units, significantly lower than the baseline, respectively. The results revealed significant within-group changes in both groups\' post-operative pain, sleep quality, and anxiety scores (P < 0.001). The progressive muscle relaxation group experienced decreased post-operative pain and anxiety scores and increased sleep quality scores (P < 0.001). The study\'s findings demonstrated the beneficial effects of progressive muscle relaxation on hip fracture patients\' outcomes, such as their level of anxiety, sleep quality, and post-operative pain. The study\'s findings can be applied by medical professionals to improve patient satisfaction and care quality.This clinical trial has been registered with the Iranian Registry of Clinical Trials under the code IRCT20231120060119N1, which was approved on 7/12/2023.

OBJECTIVE: To examine the effects of Jacobson\'s Progressive Muscle Relaxation Technique (JPMRT) on menstrual pain and symptoms, anxiety, quality of life (QoL), social activity, and work/school performance in primary dysmenorrhea (PD).
METHODS: Women with PD were randomly divided into two groups as relaxation and control groups. JPMRT was applied three times a week from the estimated date of ovulation to the onset of the next menstruation. No treatment was performed in the control group. Pain intensity, menstrual symptoms, anxiety, impacts on QoL, social activity, and work/school performance were assessed before and after the interventions.
RESULTS: After the interventions, there was a further decrease in menstrual pain intensity, menstrual symptoms, anxiety level, the impact of QoL, and the work/school performance scores in the relaxation group than in the control group (p < 0.05).
CONCLUSIONS: JPMRT might be used as an alternative method in the treatment of PD.

Movement and muscle control are crucial for the survival of all free-living organisms. This study aimed to explore differential patterns of cortical and subcortical activation across different stages of muscle control using functional magnetic resonance imaging (fMRI). An event-related design was employed. In each trial, participants (n = 10) were instructed to gently press a button with their right index finger, hold it naturally for several seconds, and then relax the finger. Neural activation in these temporally separated stages was analyzed using a General Linear Model. Our findings revealed that a widely distributed cortical network, including the supplementary motor area and insula, was implicated not only in the pressing stage, but also in the relaxation stage, while only parts of the network were involved in the steady holding stage. Moreover, supporting the direct/indirect pathway model of the subcortical basal ganglia, their substructures played distinct roles in different stages of muscle control. The caudate nucleus exhibited greater involvement in muscle contraction, whereas the putamen demonstrated a stronger association with muscle relaxation; both structures were implicated in the pressing stage. Furthermore, the subthalamic nucleus was exclusively engaged during the muscle relaxation stage. We conclude that even the control of simple muscle movements involves intricate automatic higher sensory-motor integration at a neural level, particularly when coordinating relative muscle movements, including both muscle contraction and muscle relaxation; the cortical and subcortical regions assume distinct yet coordinated roles across different stages of muscle control.

OBJECTIVE: Multiple effective nursing interventions are needed to manage deviations from normal vital signs and fatigue experienced by kidney transplant patients. In this study, we investigated the effect of progressive muscle relaxation (PMR) exercises on vital signs and fatigue in kidney transplant patients.
METHODS: We conducted a randomized controlled experimental study with 52 patients (intervention = 26, control = 26) who underwent kidney transplantation at a university hospital in Turkey and met the inclusion criteria. The \"Descriptive Characteristics Form\", \"Vital Signs Monitoring Form\", and \"Fatigue Severity Scale\" were used to record data on the patients. Then, the patients in the intervention group (baseline assessment) were trained to perform PMR exercises, asked to practice, and followed up (first follow-up). Patients were recommended to perform PMR exercises for 20 min every day for four weeks. The second follow-up in the second week after discharge and the third follow-up at the end of the fourth week were performed in the outpatient clinic.
RESULTS: We found that the pulse rate, body temperature, and arterial blood pressure decreased over time and oxygen saturation increased in the patients of the intervention group. The PMR exercises decreased fatigue in these patients. The arterial blood pressure and oxygen saturation values differed significantly across different time points among the patients in the control group. The difference in the scores of fatigue severity between the pre-follow-up and the third follow-up in the control group was not significant.
CONCLUSIONS: PMR exercises were found to be an effective nursing intervention in regulating vital signs and reducing fatigue in renal transplant patients.

OBJECTIVE: The aim of the present study is the analysis of how progressive muscle relaxation exercise affects dyspnea, pain and sleep quality in patients with lung cancer receiving chemotherapy.
METHODS: Seventy-four patients diagnosed with lung cancer were included in this randomized controlled study. A total of 16 sessions of progressive muscle relaxation exercises were applied to the patients in the intervention group for a duration of 30 min, 2 days a week for 8 weeks. Patient Information Form, Medical Research Council Dyspnea Scale (MRC dyspnea scale), Pitssburg Sleep Quality Index (PSQI), Visual Analog Scale- Pain (VAS-P) were used to collect data.
RESULTS: Socio-demographic and disease characteristics were found to be similar in control and intervention groups. Final scores indicated significant differences between the experimental and control groups in all variables. The experimental group showed significantly more favorable results in dyspnea (p < 0.001), pain (p < 0.003) and sleep (p < 0.001) symptoms. When the effect size values (Cohen\'s d) of these findings were analyzed, PMR exercise was found to have a moderate effect on mean VAS-P scores (0.548) and a large effect on mean MRC dyspnea scale (1.073) and PSQI (0.970) scores. These results indicated significant differences in pre and post intervention mean scores.
CONCLUSIONS: Progressive muscle relaxation exercise applied to lung cancer patients receiving chemotherapy was found to be effective in reducing dyspnea and pain severity and improving sleep quality. Clinical trial registration at ClinicalTrials.gov. NCT04978805.

OBJECTIVE: 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).
CONCLUSIONS: The study revealed that PMRE was beneficial in improving sleep quality in cancer patients undergoing chemotherapy who had poor sleep quality.
CONCLUSIONS: Oncology nurses may consider using PMRE to improve the sleep quality of cancer patients receiving chemotherapy.

The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides quantitative information on the elasticity of soft tissue. However, the universal velocity scale for quantification has not been developed. The aim of the study is to determine the shear wave velocities of abdominal muscle during anesthetic induction and to identify methods to cancel the effects of confounders for future development in the quantitative assessment of muscle tone using the universal scale.
We enrolled 75 adult patients undergoing elective surgery with ASA-PS I - III in the period between December 2018 and March 2021. We measured and calculated the shear wave velocity (SWV) before and after opioid administration (i.e., the baseline at rest and opioid-induced rigidity condition), and after muscle relaxant administration (i.e., zero reference condition). The SWV value was adjusted for the subcutaneous fat thickness by our proposed corrections. The SWVs after the adjustment were compared among the values in baseline, rigidity, and relaxation using one-way repeated-measures ANOVA and post hoc Tukey-Kramer test. A p-value of < 0.05 was considered to be statistically significant. UMIN Clinical Trials Registry identifier UMIN000034692, registered on October 30, 2018.
The SWVs in the baseline, opioid-induced rigidity, and muscle relaxation conditions after the adjustment were 2.08 ± 0.48, 2.41 ± 0.60, and 1.79 ± 0.30 m/s, respectively (p < 0.001 at all comparisons).
The present study suggested that the SWV as reference was 1.79 m/s and that the SWVs at rest and opioid-induced rigidity were ~ 10% and ~ 30% increase from the reference, respectively. The SWV adjusted for the subcutaneous fat thickness may be scale points for the assessment of muscle tone.