Progressive Muscle Relaxation (PMR) in Cancer Patients: A Scoping Review
DOI:
https://doi.org/10.71341/bmwj.v2i3.40Keywords:
Progressive muscle relaxation (PMR), Cancer, Physical symptoms, Psychological symptoms, Quality of lifeAbstract
Background: Cancer patients frequently endure a range of physical and psychological burdens during treatment. Progressive Muscle Relaxation (PMR) is utilized as a supportive intervention to address these symptoms, though its specific implementation and efficacy require synthesis.
Objective: This scoping review aims to investigate the implementation strategies and the effects of PMR on physical and psychological outcomes in patients diagnosed with cancer.
Methods: Following PRISMA and Joanna Briggs Institute (JBI) guidelines, a comprehensive literature search was conducted for articles published between 2019 and 2024. Inclusion criteria required studies to be in English or Indonesian and utilize specific designs, including quasi-experimental and randomized controlled trials (RCTs).
Results: From a total of 792 initial records, 15 studies met the inclusion criteria. These studies, conducted across various countries, typically utilized PMR interventions lasting 15–25 minutes. The analysis indicated that PMR was associated with reductions in physical symptoms, such as pain, fatigue, nausea, vomiting, and dyspnea. Furthermore, significant improvements were noted in psychological symptoms, including anxiety, stress, and emotional distress, alongside positive effects on sleep quality, functional well-being, coping mechanisms, and resilience.
Conclusion: PMR shows promise as a beneficial intervention for alleviating symptom burden in cancer patients. However, the limited number of studies and methodological heterogeneity suggest a need for further rigorous research to clarify the mechanisms of action and expand its clinical applications.
References
Anggraini, D., Rayasari, F., Fauziah, M., Jumaiyah, W., & Komalawati, D. (2023). Fatigue Reduction in Lung Cancer Patients with Progressive Muscle Relaxation. Journal of Telenursing (JOTING) , 5 (2), 2594–2602.
Anshasi, H., Saleh, M., Abdalrahim, M.S., & Shamieh, O. (2023). The effectiveness of progressive muscle relaxation technique in reducing cancer-related pain among palliative care patients: A randomized controlled trial. British Journal of Pain , 17 (5), 501–509. https://doi.org/10.1177/20494637231190191
Bhatia, M., Verma, M., & Kumar, R. (2020). Effectiveness of progressive muscle relaxation therapy on physical symptoms among cancer patients receiving chemotherapy admitted in Cancer Unit of Institute of Liver and Biliary Sciences, Delhi. International Journal of Science and Healthcare Research, 5(4), 221–232.
De Paolis, G., Naccarato, A., Cibelli, F., D’Alete, A., Mastroianni, C., Surdo, L., Casale, G., & Magnani, C. (2019). The effectiveness of progressive muscle relaxation and interactive guided imagery as a pain-reducing intervention in advanced cancer patients: A multicentre randomised controlled non-pharmacological trial. Complementary Therapies in Clinical Practice, 34, 280–287. https://doi.org/https://doi.org/10.1016/j.ctcp.2018.12.014
Fitria, NE, Hamdayani, D., & Arifin, Y. (2024). The Effect of Progressive Muscle Relaxation (PMR) on Reducing Anxiety in Children with Leukemia Undergoing Chemotherapy at the Cahaya Padang Community Shelter. Jurnal Kesehatan Saintika Meditory , 7 (1), 377–384. https://doi.org/http://dx.doi.org/10.30633/jsm.v7i1.2552
Gupta, B., Kumari, M., & Kaur, T. (2016). Effectiveness of progressive muscle relaxation technique on physical symptoms among patients receiving chemotherapy. Nursing & Midwifery Research Journal , 12 (1), 33–40. https://doi.org/10.1177/0974150X20160105
Jahn, F., Wörmann, B., Brandt, J., Freidank, A., Feyer, P., & Jordan, K. (2022). The Prevention and Treatment of Nausea and Vomiting During Tumor Therapy. Deutsches Arzteblatt International, 119(21), 382–392. https://doi.org/10.3238/arztebl.m2022.0093
Jaya, P., & Thakur, A. (2020). Effect of Progressive Muscle Relaxation Therapy on Fatigue and Psychological Distress of Cancer Patients during Radiotherapy: A Randomized Controlled Trial. Indian Journal of Palliative Care, 26(4), 428–432. https://doi.org/10.4103/IJPC.IJPC_236_19
Kartika, D. E., Sabri, Y. S., & Gusty, R. P. (2022). The Effect of Progressive Muscle Relaxation (PMR) in Lowering The Pain Scale in Lung Cancer Patients Who Get Chemotherapy Treatment. Jurnal Kesehatan Komunitas (Journal of Community Health), 8(1 SE-Articles), 27–31. https://doi.org/10.25311/keskom.Vol8.Iss1.1094
Kugali, S., Deelip S, N., & Mahesh, W. (2023). ‘“Effectiveness Of Progressive Muscle Relaxation Therapy And Guided Imagery On Functional Well Being, Selected Physical And Psychological Parameters Among Cancer Patients Receiving Chemotherapy”’. Evaluation Of Pilot Study. Journal of Pharmaceutical Negative Results, 575–584. https://doi.org/10.47750/pnr.2023.14.S01.71
Larasati, AD, & Noni, IB (2022). Complementary Interventions to Reduce Fatigue and Improve Quality of Life in Cancer Patients : A Systematic Review. ASJN (Aisyiyah Surakarta Journal of Nursing) , 3 (1 SE-Articles), 34–42. https://doi.org/10.30787/asjn.v3i1.838
Loh, E.-W., Shih, H.-F., Lin, C.-K., & Huang, T.-W. (2022). Effect of progressive muscle relaxation on postoperative pain, fatigue, and vital signs in patients with head and neck cancer: A randomized controlled trial. Patient Education and Counseling , 105 (7), 2151–2157. https://doi.org/https://doi.org/10.1016/j.pec.2021.10.034
Mardiana, M., Fitriani, F., Ricky, Z., & Yusnaeni, Y. (2020). The effectiveness of progressive muscle relaxation (PMR) on pain in breast cancer patients. Jurnal Berita Kesehatan , 13 (1 SE-Artikel). https://doi.org/10.58294/jbk.v13i1.38
Miltenburg, N.C., & Boogerd, W. (2014). Chemotherapy-induced neuropathy: A comprehensive survey. Cancer Treatment Reviews , 40 (7), 872–882. https://doi.org/https://doi.org/10.1016/j.ctrv.2014.04.004
Mochamat, Cuhls, H., Sellin, J., Conrad, R., Radbruch, L., & Mücke, M. (2021). Fatigue in advanced disease associated with palliative care: A systematic review of non-pharmacological treatments. Palliative Medicine, 35(4), 697–709. https://doi.org/10.1177/02692163211000628
Muhammad Khir, S., Wan Mohd Yunus, W. M. A., Mahmud, N., Wang, R., Panatik, S. A., Mohd Sukor, M. S., & Nordin, N. A. (2024). Efficacy of Progressive Muscle Relaxation in Adults for Stress, Anxiety, and Depression: A Systematic Review. Psychology Research and Behavior Management, 17(null), 345–365. https://doi.org/10.2147/PRBM.S437277
Nguyen, K. T., Hoang, H. T. X., Bui, Q. V, Chan, D. N. S., Choi, K. C., & Chan, C. W. H. (2023). Effects of music intervention combined with progressive muscle relaxation on anxiety, depression, stress and quality of life among women with cancer receiving chemotherapy: A pilot randomized controlled trial. PLOS ONE, 18(11), e0293060. https://doi.org/10.1371/journal.pone.0293060
Nur, H. A., & Anggraini, S. (2022). Pemberian Progressive Muscle Relaxation terhadap stres dan penurunan gula darah pada pasien diabetes mellitus tipe 2. Jurnal Manajemen Asuhan Keperawatan, 6(1), 25–34. https://doi.org/https://doi.org/https://doi.org/10.33655/mak.v6i1.127
Nurkayatun, D., & Fitriani, DR (2021). The Effect of Progressive Muscle Relaxation (PMR) Therapy on Anxiety Levels in Cancer Patients at the Samarinda Cancer Shelter. Borneo Studies and Research , 3 (1), 474–482. https://journals.umkt.ac.id/index.php/bsr/article/view/2341
Pelekasis, P., Matsouka, I., & Koumarianou, A. (2017). Progressive muscle relaxation as a supportive intervention for cancer patients undergoing chemotherapy: A systematic review. Palliative and Supportive Care , 15 (4), 465–473. https://doi.org/DOI:10.1017/S1478951516000870
Samami, E., Shahhosseini, Z., Hamzehgardeshi, Z., & Elyasi, F. (2022). Psychological Interventions in Chemotherapy-Induced Nausea and Vomiting in Women with Breast Cancer: A Systematic Review. Iranian Journal of Medical Sciences, 47(2), 95–106. https://doi.org/10.30476/ijms.2020.86657.1660
Sarı, E., Gündogdu, F., & Semerci, R. (2024). The Effect of Progressive Muscle Relaxation Exercises on Sleep Quality in Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Study. Seminars in Oncology Nursing, 40(2), 151620. https://doi.org/https://doi.org/10.1016/j.soncn.2024.151620
Sinha, M. K., Barman, A., Goyal, M., & Patra, S. (2021). Progressive Muscle Relaxation and Guided Imagery in Breast Cancer: A Systematic Review and Meta-analysis of Randomised Controlled Trials. Indian Journal of Palliative Care, 27(2), 336–344. https://doi.org/10.25259/IJPC_136_21
Sulistyawati, E., Allenidekania, A., & Gayatri, D. (2021). Effect of Progressive Muscle Relaxation on Sleep Quality and Side Effects of Chemotherapy in Children with Cancer: Randomized Clinical Trial. Open Access Macedonian Journal of Medical Sciences, 9(T4 SE-Oncology), 300–308. https://doi.org/10.3889/oamjms.2021.5774
Suryani, D., Nuraini, T., & Gayatri, D. (2022). Progressive Muscle Relaxation Intervention in Cancer Patients Experiencing Fatigue. Journal of Telenursing , 4 (2), 668–674. https://doi.org/https://doi.org/10.31539/joting.v4i2.4247
Sutinah, Maulani, Azhari, R., & Harkomah, I. (2021). Progressive Muscle Relaxation, Spiritual Guided Imagery, Music on Coping and Resilience among Cancer Patients who Undergo Chemotherapy. KnE Life Sciences , 6 (1 SE-Articles). https://doi.org/10.18502/kls.v6i1.8623
Tan, L., Fang, P., Cui, J., Yu, H., & Yu, L. (2022). Effects of progressive muscle relaxation on health-related outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Clinical Practice, 49, 101676. https://doi.org/https://doi.org/10.1016/j.ctcp.2022.101676
Tian, X., Tang, R.-Y., Xu, L.-L., Xie, W., Chen, H., Pi, Y.-P., & Chen, W.-Q. (2020). Progressive muscle relaxation is effective in preventing and alleviating of chemotherapy-induced nausea and vomiting among cancer patients: a systematic review of six randomized controlled trials. Supportive Care in Cancer, 28(9), 4051–4058. https://doi.org/10.1007/s00520-020-05481-2
Toussaint, L., Nguyen, Q. A., Roettger, C., Dixon, K., Offenbächer, M., Kohls, N., Hirsch, J., & Sirois, F. (2021). Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation. Evidence-Based Complementary and Alternative Medicine, 2021(1), 5924040. https://doi.org/https://doi.org/10.1155/2021/5924040
Turan, G. B., Özer, Z., & Sariköse, A. (2024). The effects of progressive muscle relaxation exercise applied to lung cancer patients receiving chemotherapy on dyspnea, pain and sleep quality: A randomized controlled trial. European Journal of Oncology Nursing, 70, 102580. https://doi.org/https://doi.org/10.1016/j.ejon.2024.102580
Vuttanon, N., Finnegan, L., Lojanapiwat, B., Sittisombut, S., Meechamnan, C., & Dhatsuwan, J. (2019). Effect of progressive muscle relaxation on symptom clusters in breast cancer patients receiving chemotherapy: A quasi-experimental controlled trial. Complementary Therapies in Clinical Practice, 37, 27–31. https://doi.org/https://doi.org/10.1016/j.ctcp.2019.08.004
Z, R. (2022). The Effectiveness of Progressive Muscle Relaxation (PMR) Against Anxiety in Breast Cancer Patients Undergoing Chemotherapy at Dr Wahidin Sudirohusodo Hospital Makassar. Jurnal Perilaku Kesehatan Terpadu, 1(2 SE-Articles), 41–48. https://doi.org/10.61963/jpkt.v1i2.71
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Made Satya Nugraha Gautama, Kadek Dwi Pitriyani, Made Deisyana Winaryanta , Luh Mutiara Widiarini, Ni Kadek Mawar Aries Sunday, Komang Agus Jerry Widyanata, Gaviota Khalish
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
License
This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercial purposes.
- Adaptation — mixing, changing, and developing materials for any purpose, even commercial ones.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
