Effects of Progressive Muscle Relaxation Training on Depression and Sleep in Fibromyalgic Patients
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Background: Fibromyalgia is a chronic multidimensional pain syndrome commonly associated with functional limitation, depressive symptoms, and disturbed sleep. Aerobic exercise is a core non-pharmacological intervention, but relaxation-based adjuncts may provide additional benefit by targeting muscular tension, autonomic arousal, and psychological distress. Objective: To compare the effects of progressive muscle relaxation combined with aerobic exercise versus aerobic exercise alone on fibromyalgia impact, depressive symptoms, and sleep quality in patients with fibromyalgia. Methods: This randomized controlled clinical intervention study enrolled 50 adults with fibromyalgia, mild depressive symptoms, and sleep disturbance from outpatient settings at Dow University of Health Sciences, Karachi. Participants were randomized to progressive muscle relaxation plus aerobic exercise or aerobic exercise alone. Thirty supervised sessions were completed over 8 weeks. FIQR and CES-D were assessed weekly, while PSQI was assessed at baseline, mid-intervention, and end intervention. Forty-two participants completed treatment and were included in the per-protocol analysis. Results: At week 8, the experimental group showed lower FIQR scores than the control group (44.70 ± 14.04 vs 56.47 ± 13.48, p < 0.01) and lower CES-D scores (31.45 ± 6.05 vs 37.68 ± 6.97, p < 0.01). End-intervention PSQI scores were also lower in the experimental group (13.10 ± 2.14 vs 14.77 ± 3.14, p = 0.05). Baseline-to-end reductions were greater in the experimental group for FIQR, CES-D, and PSQI. Conclusion: Progressive muscle relaxation combined with aerobic exercise produced greater short-term improvement in fibromyalgia impact, depressive symptoms, and sleep quality than aerobic exercise alone.
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