Effect of Progressive Muscle Relaxation on Anxiety Among Patients Undergoing Haemodialysis

Abstract

Anxiety is common among people who receive maintenance haemodialysis, yet it is often unrecognised and rarely treated with anything other than reassurance or sedative medicines. Progressive muscle relaxation, a structured routine of tensing and releasing muscle groups in sequence, is cheap, can be taught by nurses and can be practised during a dialysis session, which makes it an obvious candidate for supportive care. This narrative review asks what the published literature allows us to say about its effect on anxiety in this population. It draws on work about the burden and causes of anxiety in kidney failure, the physiology of stress, the evidence for relaxation training in other groups, and psychosocial trials carried out in dialysis units, and it reports no new data. The indirect evidence makes a modest benefit plausible, and the safety of the technique is not in doubt. Direct evidence in haemodialysis is thin: trials tend to be small, unblinded and short, measures of anxiety overlap with symptoms of kidney failure, and attention from staff is seldom separated from the technique itself. The review concludes that the practice is reasonable to offer as a supplement to usual care, that the size of its effect is not established, and it sets out what a convincing trial would need to include.