App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial

Background Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. Conclusions The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques. Trial Registration ClinicalTrials.gov NCT02019134; https://clinicaltrials.gov/ct2/show/NCT02019134 International Registered Report Identifier (IRRID) RR2-10.1186/1745-6215-15-490

PENGELOAAN DIRI DI MASA PANDEMI PADA USAHA MIKRO, KECIL, DAN MENENGAH (UMKM)

The Covid-19 pandemic has caused various impacts on the community's economy, especially for Usaha Mikro, Kecil, dan Menengah (UMKM) owner. Various impacts felt by the UMKM owner have affected their psychological health such as the emergence of stress, anxiety, fear, and symptoms of depression. Therefore, this Pengabdian Kepada masyarakat (PKM) activity aims to help UMKM to be able to maintain psychological health in stressful situations during the pandemic. The implementation of this community service activity is carried out online. The implementation of PKM is held in the form of an interactive webinar through the presentation of material related to stress and its management. The activity was attended by a psychologist, accompanying students, and two owners of UMKM. Based on the implementation of community service activities, it can be concluded that providing education around stress-management could help participants gain new knowledge about stress and also able to experience the benefit of stress-management technique such as relaxation exercises that could manage the stress they experience.Pandemi Covid-19 telah menimbulkan berbagai dampak pada perekonomian masyarakat terutama pada pengusaha Usaha Mikro, Kecil, dan Menengah (UMKM). Beragam dampak yang dirasakan oleh pengusaha UMKM telah mempengaruhi kesehatan psikologis seperti timbulnya stres, cemas, rasa takut, dan gejala depresi. Oleh karena itu kegiatan Pengabdian Kepada Masyarakat (PKM) ini bertujuan untuk membantu pengusaha UMKM tetap dapat menjaga kesehatan psikologis dalam situasi stres di masa pandemi. Pelaksanaan kegiatan pengabdian kepada masyarakat ini dilaksanakan secara daring. Pelaksanaan PKM diselenggarakan dalam bentuk webinar secara interaktif melalui pemaparan materi terkait stres dan cara pengelolaannya. Kegiatan dihadiri oleh seorang psikolog, mahasiswa pendamping, dan dua pengusaha UMKM. Berdasarkan pelaksanaan dari kegiatan pengabdian kepada masyarakat, dapat disimpulkan bahwa pemaparan materi terkait stres membantu peserta memperoleh pengetahuan baru mengenai stres. Kemudian latihan relaksasi yang dilakukan pada saat webinar ditemukan bermanfaat untuk mengelola stres yang dialami oleh para peserta.

Breathing exercises for the treatment of anxiety symptoms

Breathing exercises have been used successfully to reduce the negative symptoms characterised anxiety and depression. One of the most effective methods of psychological counseling with students and other persons included in education sphere is breathing relaxation exercises, which can improve concentration, reduce anxiety, reduce heart rate, reduce muscle tension and improve sleep quality. The article presents the anatomical side of breathing exercises, physiological mechanisms and specific instructions for the practical use of the method.

Assessing Momentary States of Relaxation: The Relaxation State Questionnaire

Stress is ubiquitous in everyday life and hazardous for mental and physical health. To prevent or ameliorate stress-related disease, approaches such as relaxation exercises aim to counteract stress by inducing short-lasting states of relaxation. Critically, current assessments capture the mid- and long-term consequences of relaxation but are unable to quantify these states of relaxation. To address this problem, we developed the Relaxation State Questionnaire (RSQ). We assessed the item properties, reliability, and validity of the questionnaire in an online study. Construct validity was examined through correlations with the Perceived Stress Questionnaire (PSQ; Fliege et al., 2005). An exploratory factor analysis revealed four factors capturing the momentary state of muscle tension, sleepiness, cardiovascular activity, and general relaxation. The items had high loadings on their factors and the reliability and construct validity of the RSQ were both high. These findings establish the RSQ as a tool to measure states of relaxation. As such, the RSQ opens up investigations of the immediate effects and effectiveness of relaxation exercises.

Effects of Progressive Relaxation Exercises on Vital Signs and Fatigue in Liver Transplant Patients: A Randomized Controlled Trial

This randomized controlled study was conducted to evaluate the effects of progressive relaxation exercises on vital signs and fatigue level. Ninety patients with liver transplantation (experimental group = 45, control group = 45) were included in the study. The patients in the experimental group performed progressive relaxation exercises for 25 to 30 minutes every day for 4 weeks. Before the progressive relaxation exercises, the vital signs and fatigue level of the patients were recorded. Vital signs were recorded again immediately after the progressive relaxation exercises and at the end of the second week. At the end of the fourth week, the final measurement of vital signs was performed along with the second fatigue level assessment. In the experimental group, pulse and respiratory rates, systolic and diastolic blood pressure values, and fatigue severity mean scores were found to be lower and oxygen saturation level was higher than those of the control group. The improvement in vital signs in the experimental group was evident at week 3 ( p < .05).

PRENATAL MATERNAL SLEEP

Pregnancy affects women's sleep in many ways. Physical and emotional difficulties, especially towards the end of pregnancy, can lead to sleep disorders. Several studies suggest associations between sleep quality and high blood pressure, diabetes and depression. Sleep deprivation affect both mother and fetus. Sleep disorders are associated with low birth weight, intrauterine growth restriction, premature birth and cesarean births. This paper is a review based on information from the literature. The analysis was limited to articles and guidelines in English published between January 1, 2000 and May 1, 2020 on PubMed, ScienceDirect and Google Scholar using the following keywords: sleep, pregnancy, depression, anxiety, mental health, sleep disorders, pregnant women, interventions, treatment. In this review, we discuss the characteristics of prenatal maternal sleep, hormonal changes during pregnancy and their effects on sleep, the effects of changing sleep patterns on the pregnant woman, and the interventions needed to optimize sleep quality. According to the literature, sleep disorders are significant risk factors for mood disorders. Knowing sleep changes and their effects is useful for informing mothers. Consideration of non-pharmacological treatments and interventions such as cognitive-behavioral therapy, mindfulness therapy and relaxation exercises can be effective in optimizing the quality of sleep in pregnant women.

App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial (Preprint)

BACKGROUND Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. OBJECTIVE The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. METHODS Smartphone owners aged 18 to 65 years with chronic (&gt;12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. RESULTS We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; <i>P</i>=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. CONCLUSIONS The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques. CLINICALTRIAL ClinicalTrials.gov NCT02019134; https://clinicaltrials.gov/ct2/show/NCT02019134 INTERNATIONAL REGISTERED REPORT RR2-10.1186/1745-6215-15-490