Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD

Abstract

Acute effects of music and relaxation have not been evaluated in hospitalized subjects with chronic obstructive pulmonary disease (COPD). This study aims to evaluate the acute effects of music and progressive muscle relaxation (PMR) in hospitalized COPD subjects after a recent episode of exacerbation. A Randomized controlled study was performed of pre-test post-test design after recruiting 82 COPD subjects from K.M.C hospitals. All patients were admitted for acute exacerbation and were medically stabilized. After being screened for the inclusion and exclusion criteria, 72 subjects were selected for the study. Demographic and baseline data was taken on the day subjects were screened. Music group listened to a self selected music of 60-80 beats per minute for 30 minutes. PMR group practiced relaxation through a pre-recorded audio of instructions of 16 muscle groups. Outcome variables were Spielberger’s state anxiety inventory (SSAI), Spielberger’s trait anxiety inventory (STAI), dyspnea, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR) and respiratory rate (RR). There was statistically significant main effect across the sessions for state anxiety (F = 62.621, p = 0.000), trait anxiety (F = 19.528, p = 0.000), dyspnea (F = 122.227, p = 0.000), SBP (F = 63.885, p = 0.000), PR (F = 115.780, p = 0.000) and RR (F = 202.977, p = 0.000). There was statistically significant interaction effect between the two groups for state anxiety (F = 6.024, p = 0.003), trait anxiety (F = 8.222, p = 0.000), dyspnea (F = 10.659, p = 0.000), SBP (F = 12.889, p = 0.000), PR (F = 4.746, p = 0.008) and RR (F = 12.078, p = 0.000). There were greater changes observed after the second session in both groups however, change in DBP was not significant in either group. Music and PMR are effective in reducing anxiety and dyspnoea along with physiologic measures such as SBP, PR and RR in two sessions in COPD patients hospitalized with exacerbation. However, reductions in the music group were greater compared to the PMR group.

Keywords

COPD music progressive muscle relaxation anxiety dyspnoea relaxation

References

World Health Organization. World Health Report 2002. Geneva: World Health Organization , www.who/int/whr/2002/en/ ( 2002 ) (accessed 7th January 2006).

Nishimura K. , Izumi T. , Tsukino M. , Oga T. Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD . Chest 2002; 121: 1434-1440.

Brenes GA Anxiety and chronic obstructive pulmonary disease: prevalence, impact, and treatment. Psychosom Med 2003; 65: 963-970.

American Thoracic Society. Panic anxiety, dyspnea and respiratory disease: theoretical and clinical considerations. Am J Respir Crit Care Med 1996; 154: 6-17.

Gift AG , Moore T. , Soeken K. Relaxation to reduce dyspnea and anxiety in COPD patients. Nurs Res 1992; 41: 242-246.

Renfroe KL Effect of progressive relaxation on dyspnea and state anxiety in patients with chronic obstructive pulmonary disease. Heart Lung 1988; 17: 408-413.

McBride S. , Graydon J. , Sidani S. , Hall L. The therapeutic use of music for dyspnea and anxiety in patients with COPD who live at home. J Holist Nurs 1999; 17: 229-234.

Bauldoff GS , Hauffman LA , Zullo TG , Sciurba FC Exercise maintenance following pulmonary rehabilitation: effect of distractive stimuli. Chest 2002; 122: 948-954.

Thornby MA , Haas F. , Axen K. Effect of distractive auditory stimuli on exercise tolerance in patients with COPD. Chest 1995; 107: 1213-1217.

10.

Lehrer PM , Hochron SM , Mayne T. , et al. Relaxation and music therapies for asthma among patients prestabilized on asthma medication. J Behav Med 1994; 17: 1-24.

11.

Chlan L. Effectiveness of music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung 1998; 27: 169-176.

12.

Brooks D. , Sidani S. , Graydon J. , McBride S. , Hall L. , Weinacht K. Evaluating the effects of music on dyspnea during exercise in individuals with chronic obstructive pulmonary disease: a pilot study. Rehabil Nurs 2003; 28: 192-196.

13.

Zimmerman LM , Pierson MA , Marker J. Effects of music on patient anxiety in coronary care units. Heart Lung 1988; 17: 560-566.

14.

Poppen R. Behavioral relaxation training and assessment. 2nd ed. Thousand Oaks, CA: SAGE Publications, 1998.

15.

Bernstein DA , Borkovec TD Progressive relaxation training: a manual for the helping professions. Champaign, IL: Research Press, 1973 .

16.

Gold Workshop Report. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease, www.gold.copd.org (2005) (accessed 7th January 2006).

17.

Bonny H. Music and healing. Music Ther 1986 ; 6: 3-12.

18.

Merit S. Mind, music and imagery. Boulder: Asian publishing, 1990.

19.

Bunt L. Music therapy: an art beyond words. London: Routledge, 1994.

20.

Gift AG validation of vertical visual analogue scale as a measure of clinical dyspnea . Rehabil Nurs 1989; 14: 323-325.

21.

Gift AG Visual analogue scales: measurement of subjective phenomena. Nurs Res 1989; 38: 286-288.

22.

Spielberger CD , Gorsuch RL , Lushene RE STAI manual for the state-trait anxiety inventory . Palo Alto, CA: Consulting Psychologists , 1983.

23.

http://hyper.ahajournals.org/cgi/content/full/45/1/142 (accessed 14th February 2006).

24.

Portney LG , Watkins MP Foundations of clinical research. Norwalk, CT: Appleton & Lange, 1993.

25.

Benson H. The relaxation response. New York: Avon Books, 1975.

26.

Bolwerk CA Effects of relaxing music on state anxiety in myocardial infarction patients . Crit Care Nurs Q 1990; 13: 63-72.

27.

White JM Music therapy: an intervention to reduce anxiety in the myocardial infarction patient. Clin Nurse Spec 1992; 6: 58-63.

28.

Leventhal H. , Everhart D. Emotion, pain and physical illness. In: Izard CE (ed.) Emotions in personality and psychopathology. New York: Plenum Press, 1979, p.263-298.

29.

Campbell, D. Music physician for times to come. Wheaton, IL : Quest Books, 1991.

30.

Cook JD The therapeutic use of music: a literature review. Nurs Forum 1981; 20: 252-266.

31.

Nickel C. , Kettler C. , Muehlbacher M. , et al. Effect of progressive muscle relaxation in adolescent female bronchial asthma patients: a randomized, double blind, controlled study. J Psychosom Res 2005; 59: 393-398.

32.

McCance K. , Huether S. Pathophysiology: the biologic basis for disease in adults and children . 3rd ed. St. Louis: Mosby, 1998.

Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD—A randomized controlled pilot study

Abstract

Keywords

References