• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.1
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• pp.109-121
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• 2000

Increasingly nursing science is embracing the concepts and methodology derived from psycho-neuroimmunology. It has been previously shown that stress increases and immune function declines in students undergoing examinations. To date, however, no many studies have been reported on stress levels, immune function and interventions in Korean students undergoing their first clinical nursing rotation. It was proposed that nursing students during their first clinical rotation experience increase in stress because of the novelty of the situation and their lack of clinical knowledge. It was also hypothesized that biofeedback and progressive relaxation, methods of self-regulation of involuntary autonomic nervous system responses, would reduce the stress response. The purpose of this study is to test the effectiveness of progressive muscle laxation using biofeedback The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS) and the values of ephinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were thirty nursing students divided into two groups: experimental group was progressive muscle relaxation group using biofeedback and control group. This study was conducted for 8 weeks of clinical practice. Biofeedback training was done by software developed by J&J company (1-410 form for progressive muscle training). Progressive muscle relaxation training according to Jacobson's Theory was done by messaged word from biofeedback. The data was analyzed using Chronbach' ${\alpha}$ and t-test of the SPSS program and the significance level of statistics was 5%. The results of the study were : 1) The progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress(t=-4.248, p<.001) under clinical practice stress conditions. 2) The progressive muscle relaxation training using biofeedback was not effective for the values of epinephrine(t=-1.294, p=.206). 3) The progressive muscle relaxation training using biofeedback was effective for the reduction of systolic blood pressure (t=-2.757, p=.01). 4) The progressive muscle relaxation training using biofeedback was effective for the reduction of diastolic blood pressure (p=-2.032, 0=.05). 5) The progressive muscle relaxation training using biofeedback was not effective for the reduction of pulse rate(t=-15, p=.988). 6) The progressive muscle relaxation training using biofeedback was effective for the maintenance of natural killer cells (t=2.381, p=02). The first clinical rotation for student nurses is a stressful experience as seen by the rise in the SOS in the control group. Biofeedback using progressive muscle relaxation were effective in preventing the rise of symptoms of stress and the blood pressure means when comparing the pre to post clinical experience, The mean natural killer cell count was depressed in the control group but not significantly different in the experimental groups, It is proposed here that stress via the hypothalamic - pituitary - adrenal axis suppressed the NK cell count whereas the relaxation methods prevented the rise in stress and the resulting immune depression. We recommend relaxation techniques using biofeedback as a health promotion technique to reduce psychological stress. In summary. the progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress under clinical practice stress conditions.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.855-869
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• 1999

The purpose of this study was to test the effectiveness of self-management relaxation training through biofeedback and progressive muscle relaxation methods. The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS), the McNair's profile of Mood States (POMS), the levels of ephinephrine, norepinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were sixty six nursing students divided into four groups : two groups were the biofeedback and progressive muscle relaxation groups, the other two groups served as control groups. One was a group of sophomores with no experience at all, the other a junior group without self -management or relaxation training. This study was conducted for eight weeks of clinical practice from April, 26th 1998 to June, 20th 1998. Biofeedback training was done with software developed by J&J company (1-410 form for abdominal respiration training). Progressive muscle relaxation training was done with u audiotape recorded according to Jacobson's Theory. The data were analyzed with frequencies, means, and analysis of covariance using the SPSS program and the significance level of statistics was 5%. The results of the study are : 1) The importance of clinical practice stress reduction is shown in that the level of symptoms of stress in the experimental groups in clinical practice was higher than in the group receiving only a lecture. 2) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing the symptoms of stress under the clinical practice stress conditions. 3) The effectiveness of the biofeedback training relaxation method to reduce symptoms of stress was higher than that of progressive muscle relaxation. 4) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing stressful mood states. 5) The relaxation training methods of biofeedback and progressive muscle relaxation were not effective in reducing epinephrine and norepinephrine levels. 6) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in increaing the number of natural killer cells. 7) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in decreasing high systolic and diastolic values of blood pressure and high pulse rates. In summary, the relaxation methods of biofeedback and progressive muscle relaxation in reducing clinical practice stress were effective in lowering the level of symptoms of stress and the profile of stressful mood states. They were also effective in lowering high blood pressure and pulse rates. The relaxation methods were effective in increasing the number of natural killer cells as part of the immune function. However, relaxation methods were not effective in reducing the catecholamine level. The biofeedback training method for reduction of symptoms of stress was more effective than the progressive muscle relaxation method.

• Journal of muscle and joint health
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• v.17 no.2
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• pp.132-141
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• 2010

Purpose: This study was to examine the effect of Progressive Muscle Relaxation Therapy on stress and anxiety of traffic accident patients. Method: Subjects of this study were 39 hospitalized patients at orthopedic ward. An experimental group received Progressive Muscle Relaxation Therapy five times each week for four weeks beginning from the fourth day following the injury, whereas a control group received regular care. A tape of Jacobson's Progressive Muscle Relaxation Therapy recorded in Korean by the Rheumatoid Health Academic Society was used for relaxation therapy. Data were analyzed using SPSS 13.0 for Windows. Results: Patients who received Progressive Muscle Relaxation Therapy experienced lower level of stress (t=-9.829, p<.001) and anxiety (t=-15.303, p<.001) than those who did not. Conclusion: Progressive Muscle Relaxation Therapy may be an effective nursing intervention to reduce levels of stress and anxiety of traffic accident patients.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.1
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• pp.125-140
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• 2008

Objectives : The purpose of this study was to investigate the effect of Progressive Muscle Relaxation(PMR) on stress and muscle relaxation in healthy people. Methods : Sample group of 14 healthy subjects had been treated by progressive muscle relaxation for 10 days. Control group of 14 healthy subjects were not treated during the same period. Outcomes were assessed by Meridian-Electromyograph(MEMG), Heart Rate Variability(HRV), Stress Reaction Inventory(SRI). Results : The contraction and fatigue of erector spinae muscle by MEMG had decreased significantly in Sample group. There was no significant difference between two groups in the HRV and SRI. Conclusions : Further studies analysing PMR effect on stress and muscle relaxation are needed.

• Child Health Nursing Research
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• v.7 no.3
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• pp.383-396
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• 2001

This study was designed to investigate the effects of the progressive muscle relaxation on behavioral states and emotional reactions of adolescent athletes. The participants were 167 adolescent male soccer players aged between 12 and 18 who were junior or high school students in Seoul. Ninety-three of them were assigned to the experimental group, while seventy-four to the control group. The experimental group was treated by 10 sessions (20 min./session) of Jacobson's progressive muscle relaxation for two weeks, while the control group was not treated. The self and observer reported behavioral states, general stress by visual analogue scale, physical symptoms of stress, athletic stress, state anxiety, depression, self-esteem were measured before and after two weeks of the progressive muscle relaxation. The results were as follows ; 1. The self and observer reported behavioral states were significantly decreased in the experimental group compared with the control group. 2. The general stress and the gastrointestinal symptoms of stress were significantly decreased in the experimental group compared with the control group. No significant difference on athletic stress was found between the two groups. The depression and the state anxiety were significantly decreased in the experimental group compared with the control group. The self-esteem was significantly increased in the experimental group compared with the control group. 3. The influential factors on behavioral state of adolescent male athlete were depression and state anxiety. The accelerating factor on behavioral state change after the progressive muscle relaxation was state anxiety. These results are suggested that the progressive muscle relaxation could be effective in stabilizing behavioral state, decreasing general stress, gastrointestinal symptoms of stress, depression, state anxiety, in increasing self-esteem of adolescent male athletes. And the behavioral state change after the progressive muscle relaxation was influenced by state anxiety.

• Journal of Oriental Neuropsychiatry
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• v.20 no.4
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• pp.173-183
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• 2009

Objectives : This study was designed to report the effect of Korean traditional treatment and progressive muscle relaxation for insomnia. Methods : We treated two patients scored more than 15 point at insomnia severity index by korean traditional treatment and progressive muscle relaxation. Results : After treatment, sleep duration and sleep quality was improved. Insomnia Severity Index, Pittsburgh Sleep Quality Index score were decreased. Conclusions : We may conclude that korean traditional treatment and progressive muscle relaxation is effective in patients with insomnia.

• Asian Oncology Nursing
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• v.10 no.2
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• pp.171-179
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• 2010

Purpose: The purpose of this study was to evaluate the effects of progressive muscle relaxation on nausea, vomiting, fatigue, anxiety, and depression in cancer patients undergoing chemotherapy. Methods: This study was a quasi-experimental research using non-equivalent control group pretest-posttest design. Data were collected from outpatients in a university hospital from April to August, 2009. There were 74 participants, 39 in the experimental group and 35 in the control group. The experimental group was given daily the progressive muscle relaxation for 20 min during three weeks. The structured questionnaire was used to measure nausea, vomiting, fatigue, anxiety, and depression. Data were analyzed using the SPSS/WIN 12.0 program, $x^2$-test, Fisher's exact test, t-test and ANCOVA were conducted to examine the homogeneity and the research hypotheses. Results: There were statistically significant decreases in anxiety and depression in the experimental group compared to the control group. However, there were no significant differences in nausea, vomiting, and fatigue between the groups. Conclusion: In this study, progressive muscle relaxation was effective in alleviating anxiety and depression of cancer patients undergoing chemotherapy. Therefore, progressive muscle relaxation can be usefully utilized as a nursing intervention that enhances psychological function of cancer patients.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.289-302
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• 1997

The main purpose of this study was to identify the effects of integrated stress management program on the stress symptoms of psychophysiological patients. especially patients with peptic ulcer. The study employed a quasi-experimental design using two different experimental groups. The samples in the integrated stress management program participated in autogenic training with biofeedback. discussions on effective coping method. cognitive. behavioral, and emotional management. They were also provided with an educational booklet on stress management and an tape on progressive muscie relaxation. Each session lasted one hour and the program consisted of seven sessions over four weeks. The other group was only given an tape on progressive muscle relaxation. The data were collected from May 20 to september 25, 1996. A total 47 patients from one university hospital located in Seoul participated, experiment group 1(integrated stress management training) had 23 subjects and experiment group 2(progressive muscle relaxation training) had 24 subjects. The effects of these programs were measured by the stress symptom scale developed by Kogan(1991) which was translated by Lee(1992) and the healing status of the ulcer evaluated by a physician. The data were analyzed using Chi-square test, t- test, ANOVA, repeated measure ANOVA. The result are as follows : 1. The integrated stress management group reported a significantly lower stress symptom score than the group given the progressive muscle relaxation only. 2. The integrated stress management group showed a significantly improved ulcer status as compared to the group given a progressive muscle relaxation only. In conclusion, it was found that the integrated stress management program was more effective in decreasing self-reported stress and physiological symptoms among patients with peptic ulcer as compared to the progressive muscle relaxation group. Based on this finding, the following suggestions can be made. 1. It is necessary to broaden the scope of nursing practice for psychophysiological patients so nurses can include stress management as part of patient care. 2. It is necessary to develop stress management program for other patients whose symptoms are known to be related to stress. 3. It is necessary to replicated this study with a larger sample in different settings.

• Journal of Oriental Neuropsychiatry
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• v.18 no.1
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• pp.111-122
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• 2007

Objective : Progressive muscle relaxation(PMR) therapy is the way of mind and body self-regulation which makes major muscles tension to be comfortable condition. It was considered to be important to check the level of relaxation in objective validity. Therefore, Heart rate variability(HRV) is the valuable measurement to investigate the effect of progressive muscle relaxation therapy on autonomic nerve system. Method : I studied 38 subjects. The subjects were measured HRV at first. And then, Using a CD player, the subjects listened to recorded PMR program for 15 minutes. After this progress, I rechecked HRV. Results : heart rate item of HRV was significantly decreased. Also, the numerical value of SDNN(standard deviation of all NN intervals) and SDSD(standard deviation of differences between adjacent NN intervals) items of HRV were showed significantly increased in all subjects after PMR. Conclusion : It indicated that PMR is efficient for inspiring resistance of the stress and a sense of stability, and PMR is a valuable method to reduce the mind stress and stiffness of body muscle.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.31-38
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• 2019

Background: The purpose of this study was to investigate the effects of Progressive muscle relaxation training on pain, Korean version of Oswestry disability index (ODI) and psychological level in chronic low back pain patients with somatization. Methods: A total of 30 subjects were treated with the experimental group (n=15) and conservative physical therapy (n=15). The experimental group was trained with progressive muscle relaxation (PMR), and the control group was treated with conservative physical therapy. Physical factor treatment was applied for 60 minutes by hot pack, electrotherapy and ultrasound. Both groups performed three times a week for six weeks. VAS, ODI, psychological level measurements were taken before and after intervention. Results: There was a significant difference in VAS (p<.05) and ODI (p<.01) between experimental and control group. At the psychological level, there were significant differences in somatization (p<0.01) and depression scales (p<.01), but not in anxiety. Conclusion: As a result of this study, the degree of pain was decreased, the level of back pain dysfunction was improved, and the somatization scale and depression scale were decreased by gradual muscle relaxation therapy.