title: Effects of progressive muscle relaxation training on anxiety and depression in patients enrolled in an outpatient pulmonary rehabilitation program.
abstract: BACKGROUND
  This prospective, randomized controlled trial examined the effect of progressive muscle relaxation (PMR) training on anxiety and depression in patients with chronic breathing disorders receiving pulmonary rehabilitation (PR).
  
  
  METHODS
  Eighty-three subjects with chronic breathing disorders entering the 8-week PR program were randomly assigned to a standard care or intervention group. The standard program included 2 days per week of exercise, education and psychosocial support delivered by a multidisciplinary team. The intervention group received additional sessions of PMR training using a prerecorded tape for 25 min/week during weeks 2-8. Primary outcome measures were levels of anxiety and depression evaluated by the Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  For anxiety, there was an overall significant improvement within each group over time (p < 0.0001). There was no statistically significant group-time interaction (p = 0.17) and no statistically significant difference between the groups (p = 0.22), despite lower scores for every time point in the PMR group. For depression, there was an overall significant improvement within each group over time (p < 0.0001). Although the difference between the groups (p = 0.09) and group-time interaction (p = 0.07) did not reach statistical significance, the results again favored the PMR group for weeks 5-8. Depression scores were lower for the PMR throughout weeks 1-8.
  
  
  CONCLUSIONS
  PR is effective in reducing anxiety and depressive level in chronic lung patients. Our findings suggest that adding structured PMR training to a well-established PR program may not confer additional benefit in the further reduction of anxiety and depression in patients receiving PR.
authors.affiliation: Department of Psychiatry, Inova Fairfax Hospital, Falls Church, VA, USA. slolak@gmail.com
authors.forename: Sermsak
authors.initials: S
authors.lastname: Lolak
authors.forename: Gerilynn L
authors.initials: GL
authors.lastname: Connors
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sheridan
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Wise
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000554:Ambulatory Care Facilities; D001007:Anxiety / Q000517:prevention & control*; D001008:Anxiety Disorders / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000517:prevention & control*; D003866:Depressive Disorder / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation; D010348:Patient Care Team; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D013315:Stress, Psychological / Q000517:prevention & control