Throughout my research and compilation of this blog I have managed to further appreciate the benefits of progressive muscle relaxation. It is my understanding that the use of this relaxation method is continually expanding to many different settings, with most research having been done in the acute mental health area. This research strongly suggests it as an effective method to reduce anxiety, a common area of focus for us occupational therapists.
Having had two placements in mental health, it is an area of work that is close to my heart and with evidence to support my positive experiences of progressive muscle relaxation it is something I can see myself utilising as an occupational therapist in the future. Looking back to my facilitation of the progressive muscle relaxation sessions, it took me a couple of times at facilitating to feel I was reading the script at the right pace for the client. To help with this I would encourage you to perform the muscle actions as you read, to get an idea of how long to let the client tense before relaxing.I also found benefit or having soft, relaxing music in the background, to break the silence between my instructions.
I do however acknowledge that like most interventions, there are groups of people that might not be suited to progressive muscle relaxation, as touched on earlier but also the literature suggests it may put excess stress on the body for those with hypertension or cardiac disease (Neistadt & Crepeau, 1998). I therefore encourage a little research of your own if you plan to use progressive muscle relaxation with clients experiencing physical ailments.
I feel as though the population that benefit from use of relaxation techniques is endless, as I mentioned before, none of us can go without that feeling of stress when we experience change or difficult circumstances. Some of us can only imagine the stress of being diagnosed with a debilitating mental or physical illness, and even if our main priority for intervention is not an individual's stress or anxiety, we might just like to encourage the idea of relaxation techniques.
Thanks for reading my blog, I hope you feel informed and encouraged to explore progressive muscle relaxation in the future. If you still aren't convinced of the effectiveness of progressive muscle relaxation I encourage you to give it a go and feel the benefits yourself!
:)
Monday, 30 July 2012
So how can you perform or facilitate progressive muscle relaxation?
Progressive muscle relaxation can be performed as a group intervention or as one-on-one intervention, dependent on characteristics of the client and their potential risks to self and others. When utilising group intervention, it is best to ensure that participants are not likely to distract or influence others around them, and also that they feel comfortable enough around other people to fully participate in the progressive muscle exercises. If there is concern regarding a client's potential to be involved in group settings, then they may benefit from a one-on-one progressive muscle relaxation session. Sessions can be facilitated by the occupational therapist or by one of the many audio resources available for purchase.
As an occupational therapist you would generally get the client/s to lie down on soft but firm surface with their hands loosely at their sides or on top of their thighs. Some people might like to have a pillow under their head to feel comfortable. It is best to first get the client to focus on their breathing, encouraging them to slowly breath in through the nose, hold for a second and breath out through the mouth, ensuring breathing is done from the diaphragm. Deep breathing is a relaxation method often utilised on it's own, however during my placement experience it was encouraged throughout the progressive muscle relaxation sessions to further facilitate deep relaxation, a concept supported in many of the audio and script examples of progressive muscle relaxation (Leary, 1994).
As an occupational therapist you would generally get the client/s to lie down on soft but firm surface with their hands loosely at their sides or on top of their thighs. Some people might like to have a pillow under their head to feel comfortable. It is best to first get the client to focus on their breathing, encouraging them to slowly breath in through the nose, hold for a second and breath out through the mouth, ensuring breathing is done from the diaphragm. Deep breathing is a relaxation method often utilised on it's own, however during my placement experience it was encouraged throughout the progressive muscle relaxation sessions to further facilitate deep relaxation, a concept supported in many of the audio and script examples of progressive muscle relaxation (Leary, 1994).
The following clip is an example of a potential guide to progressive muscle relaxation, although some of the resources available for purchase are easier to listen to. And there are many other books which give a template for the professional to read from, should they choose to facilitate the session in that way. Audio CDs also work well; people can make their own with a timing and sequence to suit themselves (Leary, 1994).
http://www.youtube.com/watch?v=PYsuvRNZfxE&feature=related
Remember to reinforce that it is not expected for client's to feel completely relaxed after the first time they perform progressive muscle relaxation, it can take time and practice to fully reap the benefits and experience deep relaxation.
http://www.youtube.com/watch?v=PYsuvRNZfxE&feature=related
Sunday, 29 July 2012
Evidence-based Practice - Research on progressive muscle relaxation
As with many topics, progressive muscle relaxation could do with further research in many domains to establish where it is most effective and where perhaps other interventions would be more effective.
However, studies have been carried out which prove progressive muscle relaxation to be effective in reducing anxiety in a number of different psychiatric illnesses (Chen et al., 2009). Anxiety in patients with schizophrenia is commonly seen by occupational therapists in acute and community mental health settings. Chen et al. (2009) completed a randomised controlled trial on those with schizophrenia and experiencing anxiety, using the Beck Anxiety Inventory and finger temperature to measure the effectiveness of the technique. Finger temperature was used as it is proven that when someone is feeling anxious, the temperature of their extremities decreases, and increases when they feel comfortable. The results from the study demonstrated that progressive muscle relaxation can effectively alleviate anxiety in patients with schizophrenia.
This is reinforced by another study performed by Vancampfort et al. (2011) who also performed a randomised controlled trial which compared progressive muscle relaxation with resting, again in patients with schizophrenia and experiencing anxiety. Results from Vancampfort et al. (2011) provide evidence that progressive muscle relaxation not only reduces anxiety but increases subjective wellbeing in patients with schizophrenia. Vancampfort et al. (2011) conclude that they see benefit in progressive muscle relaxation being routine care to patients with schizophrenia in acute inpatient units.
However, studies have been carried out which prove progressive muscle relaxation to be effective in reducing anxiety in a number of different psychiatric illnesses (Chen et al., 2009). Anxiety in patients with schizophrenia is commonly seen by occupational therapists in acute and community mental health settings. Chen et al. (2009) completed a randomised controlled trial on those with schizophrenia and experiencing anxiety, using the Beck Anxiety Inventory and finger temperature to measure the effectiveness of the technique. Finger temperature was used as it is proven that when someone is feeling anxious, the temperature of their extremities decreases, and increases when they feel comfortable. The results from the study demonstrated that progressive muscle relaxation can effectively alleviate anxiety in patients with schizophrenia.
This is reinforced by another study performed by Vancampfort et al. (2011) who also performed a randomised controlled trial which compared progressive muscle relaxation with resting, again in patients with schizophrenia and experiencing anxiety. Results from Vancampfort et al. (2011) provide evidence that progressive muscle relaxation not only reduces anxiety but increases subjective wellbeing in patients with schizophrenia. Vancampfort et al. (2011) conclude that they see benefit in progressive muscle relaxation being routine care to patients with schizophrenia in acute inpatient units.
Client's voice on progressive muscle relaxation in mental health
In my opinion, it is important when implementing any intervention that you consider the client's perspective of their experience. Feedback from clients while on placement was invauable. I had clients express that they would continue to use progressive muscle relaxation in the future as they firmly believed it was helpful for them to reduce anger and anxiety which was great feedback to hear. However, I also had a client which had specific difficulty attending to tasks for a long period of time, and therefore struggled to attend to the task of tensing and releasing the muscles. I found this be extremely helpful information as it made me aware that the individual's ability to attend is something that I will need to consider in the future when identifying clients to participate in progressive muscle relaxation.
I also found information in other resources on client experience, such as the following quote:
“I thought I wouldn’t like this exercise. And the first few days were a bit uncomfortable. My arms hurt when I was done and I didn’t feel very relaxed. However, this is the fourth session and I’ve learned not to tense up so hard. If I squeeze very gently, and let go- and keep limp for about 30 seconds, the technique really works. I have to remember to go slow and go easy.” (Smith, 2005, p. 42).
I also found information in other resources on client experience, such as the following quote:
“I thought I wouldn’t like this exercise. And the first few days were a bit uncomfortable. My arms hurt when I was done and I didn’t feel very relaxed. However, this is the fourth session and I’ve learned not to tense up so hard. If I squeeze very gently, and let go- and keep limp for about 30 seconds, the technique really works. I have to remember to go slow and go easy.” (Smith, 2005, p. 42).
Why use relaxation techniques such as progressive muscle relaxation instead of other relaxation activities?
Relaxation techniques are an effective way to reduce stress, something we all experience, but for some, it begins to affect their ability to perform simple activities of daily living or reduces their ability to interact with the world around them. This can particularly be the case for those experiencing mental illness such as anxiety, depression or schizophrenia. Braga et al. (2005) state that those with increased anxiety levels also have a lower level of life satisfaction, something we would undoubtedly like to improve.
Relaxation techniques are not the only ways to relax, we often engage in activities which can induce relaxation for us, such as going for a walk or taking a hot bath. However, despite these being effective methods to relax us and calm us down, they are less likely to evoke the 'relaxation response' which is triggered by relaxation techniques such as progressive muscle relaxation (Alidina, 2012).
Our relaxation response is essentially the opposite of our stress response that prepares our body for 'fight or flight' when we are experiencing chronic stress. When our relaxation response is triggered, we can experience positive changes within the body and mind such as relaxed muscles, decreased blood pressure, slower breathing and less energy consumption along with increased ability to digest food and fight disease. We also feel very peaceful and at ease (Alidina, 2012).
It is virtually impossible for someone to consistently lead a balanced life and not experience stress, but we do have the control to address our stress when we feel it is getting too much, we can continue to use relaxation techniques to rebalance us.
The appreciation of these benefits appears to be increasing all the time, with relaxation techniques being used as intervention by occupational therapists in both acute and community settings.
Relaxation techniques are not the only ways to relax, we often engage in activities which can induce relaxation for us, such as going for a walk or taking a hot bath. However, despite these being effective methods to relax us and calm us down, they are less likely to evoke the 'relaxation response' which is triggered by relaxation techniques such as progressive muscle relaxation (Alidina, 2012).
Our relaxation response is essentially the opposite of our stress response that prepares our body for 'fight or flight' when we are experiencing chronic stress. When our relaxation response is triggered, we can experience positive changes within the body and mind such as relaxed muscles, decreased blood pressure, slower breathing and less energy consumption along with increased ability to digest food and fight disease. We also feel very peaceful and at ease (Alidina, 2012).
It is virtually impossible for someone to consistently lead a balanced life and not experience stress, but we do have the control to address our stress when we feel it is getting too much, we can continue to use relaxation techniques to rebalance us.
The appreciation of these benefits appears to be increasing all the time, with relaxation techniques being used as intervention by occupational therapists in both acute and community settings.
Friday, 27 July 2012
What is progressive muscle relaxation and where has it come from?
Progressive muscle relaxation is a relaxation method performed
through the use of voluntary skeletal muscles. This method of relaxation was
first developed in the 1930’s by Edmund Jacobson after he concluded that when
someone is anxious, they experience tension (or shortening of muscle fibres)
and that by reducing the tension they may in turn, reduce the anxiety. He then
developed a basic relaxation procedure using 15 muscle groups in 1962, a
procedure which lasted between one and nine hours at a time (Smith, 2005).
From this point, progressive muscle relaxation has been refined to take a much smaller amount of time and is known by two different methods, overt and covert progressive muscle relaxation (Smith, 2005).
From this point, progressive muscle relaxation has been refined to take a much smaller amount of time and is known by two different methods, overt and covert progressive muscle relaxation (Smith, 2005).
Overt Progressive Muscle Relaxation:
Overt progressive muscle relaxation is when the individual tenses a group of muscles for 5 to ten seconds and then attends to release of the tension for around 30 seconds. Many muscle groups can be systematically relaxed from one end of the body to the other, often up to sixteen.
Overt progressive muscle relaxation is when the individual tenses a group of muscles for 5 to ten seconds and then attends to release of the tension for around 30 seconds. Many muscle groups can be systematically relaxed from one end of the body to the other, often up to sixteen.
Covert Progressive Muscle Relaxation:
Covert progressive muscle relaxation is the “release” without first tensing the muscles as you would with the overt relaxation method. This method is often taught following weeks of training in overt relaxation. This method is less frequently used by occupational therapists, particularly in acute mental health settings where time is of the essence.
Covert progressive muscle relaxation is the “release” without first tensing the muscles as you would with the overt relaxation method. This method is often taught following weeks of training in overt relaxation. This method is less frequently used by occupational therapists, particularly in acute mental health settings where time is of the essence.
Throughout the blog when I mention progressive muscle
relaxation I am generally referring to overt progressive muscle relaxation.
Monday, 23 July 2012
Welcome
Hello, and welcome to my blog!
I have designed this blog as part of my Tranisiton to Practice course as a third year occupational therapy student. This course requires us to share some information on a topic we are passionate about that other people might be interested in, particularly occupational therapists.
My blog in particular is looking at progressive muscle relaxation. I was introduced to progressive muscle relaxation during an acute mental health placement at the beginning of the year.When I had clients telling me how much they enjoyed it, I really started to appreciate this method of relaxation and have since applied it to myself and found it is super effective. I decided it might be something useful for other people to know about, so here we are!
Please don't hesitate to comment on any of the content loaded to the blog or share your own experiences with progressive muscle relaxation, I would love to hear it :)
I have designed this blog as part of my Tranisiton to Practice course as a third year occupational therapy student. This course requires us to share some information on a topic we are passionate about that other people might be interested in, particularly occupational therapists.
My blog in particular is looking at progressive muscle relaxation. I was introduced to progressive muscle relaxation during an acute mental health placement at the beginning of the year.When I had clients telling me how much they enjoyed it, I really started to appreciate this method of relaxation and have since applied it to myself and found it is super effective. I decided it might be something useful for other people to know about, so here we are!
Please don't hesitate to comment on any of the content loaded to the blog or share your own experiences with progressive muscle relaxation, I would love to hear it :)
Image retrieved July 30, 2012 from http://www.funalso.com/PetLove/rel-anim/430
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