Postoperative Progressive Relaxation Exercises for Pain and Anxiety After Emergency Surgery

NCT07301073 | Completed

• 1 other identifier: PRE-EMERGENCY-2021
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial investigated the effectiveness of postoperative progressive relaxation exercises (PRE) on pain, anxiety, and physiological parameters among adult patients undergoing emergency general surgery. Seventy patients were randomized to either a PRE intervention delivered at postoperative hour 6, postoperative day 1, and postoperative day 2, or to routine postoperative care. Pain (SF-MPQ), anxiety (STAI), and vital signs were measured. The trial demonstrated that PRE significantly reduced multidimensional pain and anxiety and improved heart rate, respiratory rate, and oxygen saturation. The study provides novel evidence that PRE is feasible and effective when implemented exclusively in the postoperative period among emergency surgical patients.

Conditions

Emergency Surgical Procedures; Postoperative Pain; Postoperative Anxiety

Keywords

Progressive Relaxation; Emergency Surgery; Postoperative Pain; Anxiety; Physiological Parameters

Outcome Measures

Primary Outcomes (2)

• Change in Postoperative Pain Score (SF-MPQ Total Score)

  Postoperative pain will be assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ), which includes sensory and affective descriptors, the Present Pain Intensity (PPI) index, and a Visual Analogue Scale (VAS). Total Score Range: 0 to 45. Higher scores indicate greater pain severity.

  Postoperative hour 6 and postoperative day 2.

• Change in State Anxiety Score (STAI-State, TX-L1)

  SSituational anxiety will be assessed using the State Anxiety Inventory (STAI-State). Score Range: 20 to 80. Higher scores indicate greater state anxiety.

  Postoperative hour 6 and postoperative day 2.

Secondary Outcomes (8)

• Change in Trait Anxiety Score (STAI-Trait, TX-L2)

  Postoperative hour 6 and postoperative day 2.

• Change in Systolic Blood Pressure

  Postoperative hour 6, postoperative day 1, postoperative day 2.

• Change in Diastolic Blood Pressure

  Postoperative hour 6, postoperative day 1, and postoperative day 2.

• Change in Heart Rate

  Postoperative hour 6, postoperative day 1, and postoperative day 2.

• Change in Respiratory Rate

  Postoperative hour 6, postoperative day 1, and postoperative day 2.

Study Arms (2)

Progressive Relaxation Exercises (PRE) Intervention

EXPERIMENTAL

Participants assigned to this arm received standardized Progressive Relaxation Exercises (PRE) consisting of three postoperative sessions (each 30 minutes in duration). Sessions were administered at postoperative hour 6, postoperative day 1, and postoperative day 2 by a nurse trained in PRE. The protocol included diaphragmatic breathing, sequential contraction-relaxation of major muscle groups, and a final integration phase. PRE was delivered in addition to routine postoperative care.

Behavioral: Progressive Relaxation Exercises (PRE)

Routine Postoperative Care Only

NO INTERVENTION

Participants in this arm received routine postoperative care according to institutional protocols, including physician-prescribed analgesics, vital sign monitoring, mobilization, wound care, and standard nursing follow-up. No relaxation-based or behavioral intervention was provided. Pain, anxiety, and physiological parameters were assessed at the same scheduled postoperative time points as in the intervention arm.

Interventions

Progressive Relaxation Exercises (PRE) BEHAVIORAL

This intervention consists of structured Progressive Relaxation Exercises (PRE) delivered exclusively in the postoperative period. PRE involves diaphragmatic breathing, awareness of muscle tension, and sequential contraction-relaxation of major muscle groups (hands, arms, shoulders, neck, chest, abdomen, back, hips, legs, and feet). Each session lasts 30 minutes and is administered at the bedside by a nurse trained in PRE. The protocol includes a preparation phase (2-3 min), a muscle relaxation sequence (20-22 min), and an integration phase (3-5 min). PRE is delivered at postoperative hour 6, postoperative day 1, and postoperative day 2, in addition to routine care, and does not include any pharmacological components

Progressive Relaxation Exercises (PRE) Intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 18 years or older.
• Undergoing an emergency surgical procedure requiring postoperative hospitalization.
• Conscious, oriented, and hemodynamically stable by postoperative hour 6.
• Able to communicate and follow verbal instructions.
• No psychiatric, neurological, cognitive, or auditory impairment that would prevent participation.
• No chronic pain disorder and not using long-term opioids, sedatives, or anxiolytics before admission.
• Provided written informed consent.

You may not qualify if:

• Postoperative admission to the intensive care unit (ICU).
• Development of postoperative complications preventing participation (e.g., severe bleeding, respiratory distress, infection).
• Inability to complete all three scheduled PRE sessions.
• Postoperative confusion, delirium, or any condition limiting communication.

Sponsors & Collaborators

• Agri Ibrahim Cecen University: lead

Study Sites (1)

Ağrı Training and Research Hospital

Ağrı, Merkez, 04100, Turkey (Türkiye)

Location

Related Publications (6)

• Loh EW, Shih HF, Lin CK, Huang TW. Effect of progressive muscle relaxation on postoperative pain, fatigue, and vital signs in patients with head and neck cancers: A randomized controlled trial. Patient Educ Couns. 2022 Jul;105(7):2151-2157. doi: 10.1016/j.pec.2021.10.034. Epub 2021 Nov 3.

  PMID: 34785078 BACKGROUND

• Akinci N. Effect of progressive muscle relaxation on postoperative pain in laparoscopic living kidney donors: a randomized controlled trial. BMC Surg. 2025 Sep 24;25(1):410. doi: 10.1186/s12893-025-03187-y.

  PMID: 40993691 BACKGROUND

• Kisaarslan M, Aksoy N. Effect of Progressive Muscle Relaxation Exercise on Postoperative Pain Level in Patients Undergoing Open Renal Surgery: A Nonrandomized Evaluation. J Perianesth Nurs. 2020 Aug;35(4):389-396. doi: 10.1016/j.jopan.2019.12.003. Epub 2020 Mar 24.

  PMID: 32220520 BACKGROUND

• Ju W, Ren L, Chen J, Du Y. Efficacy of relaxation therapy as an effective nursing intervention for post-operative pain relief in patients undergoing abdominal surgery: A systematic review and meta-analysis. Exp Ther Med. 2019 Oct;18(4):2909-2916. doi: 10.3892/etm.2019.7915. Epub 2019 Aug 19.

  PMID: 31555379 BACKGROUND

• Aslan, F. E. (2006). Ağrı değerlendirilmesi ve ölçümü. In F. E. Aslan (Ed.), Ağrı: Doğası ve Kontrolü (pp. 68-99). İstanbul Tıp Kitabevleri

  BACKGROUND

• Abbasi, A., Naderi, Z., & Zakerimoghadam, M. (2018). The effect of progressive muscle relaxation on postoperative pain and physiological parameters in patients undergoing abdominal surgery. Journal of PeriAnesthesia Nursing, 33(5), 512-520. https://doi.org/10.1016/j.jopan.2017.11.010

  BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative; Anxiety Disorders

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Mental Disorders

Study Officials

• VOLKAN GÖKMEN, Doctorate

  Agri ibrahim Cecen Univercity

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Outcome assessors who collected pain, anxiety, and physiological measurements were masked to group assignment throughout the study. Data analysts were also blinded by using coded datasets without group identifiers. Participants and care providers could not be masked due to the behavioral nature of the intervention, but standard postoperative care protocols were applied equally to minimize performance bias.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asisstant Professor

Model Details: The study used simple computer-generated randomization to allocate participants in a 1:1 ratio to the intervention or control arm. Participants remained in their assigned arm throughout the study.

Study Record Dates

• First Submitted: November 28, 2025
• First Posted: December 24, 2025
• Study Start: May 1, 2021
• Primary Completion: November 30, 2021
• Study Completion: November 30, 2021
• Last Updated: December 24, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)