Jacobson's Progressive Muscle Relaxation for Fatigue and Kinesiophobia in Multiple Sclerosis

NCT07854691 | Completed DMC

• 1 other identifier: ERCNMA 1000/7/5/112/25
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

Multiple sclerosis (MS) is a chronic neurological condition that can cause fatigue and fear of movement (kinesiophobia), which may interfere with daily activities and participation in rehabilitation. Jacobson's Progressive Muscle Relaxation Technique (JPMRT) is a structured relaxation technique involving the sequential contraction and relaxation of different muscle groups. This study examined the association between participation in an eight-week JPMRT program and changes in fatigue impact and kinesiophobia among patients with MS. A quasi-experimental, two-group pretest-posttest design was conducted at the Neurological Clinic and Neurological Department of Menoufia University Hospital, Egypt. A total of 70 patients with MS participated in the study. Thirty-five patients were assigned to the control group and 35 to the JPMRT study group using a non-random sequential allocation procedure. The control group was recruited and assessed first, followed by recruitment and intervention of the study group, to reduce the possibility of sharing intervention-related information between participants. Patients in the study group received a structured JPMRT program over eight weeks. The program included four supervised sessions during the first two weeks, followed by six weeks of daily home practice. Each supervised session lasted approximately 30-45 minutes. Participants were taught the correct sequence of contracting and relaxing major muscle groups through demonstration, redemonstration, feedback, educational materials, and instructions for home practice. Home practice was performed once daily for 10-15 minutes. The control group continued to receive routine neurological care without the JPMRT program during the study period. Fatigue impact and kinesiophobia were assessed before and after the eight-week study period using the Modified Fatigue Impact Scale (MFIS) and the Tampa Scale of Kinesiophobia (TSK), respectively. Performance of the relaxation technique was also assessed in the JPMRT group using a performance checklist. The study examined changes in fatigue impact and kinesiophobia within and between the two groups and the relationship between these outcomes after the intervention. Because participants were not randomly allocated and the groups were recruited during different periods, the findings were interpreted as an association rather than definitive evidence of a causal effect of JPMRT.

Conditions

Multiple Sclerosis

Keywords

Multiple Sclerosis; Jacobson's Progressive Muscle Relaxation Technique; Kinesiophobia; Fatigue; Progressive Muscle Relaxation; Neurological Rehabilitation

Outcome Measures

Primary Outcomes (1)

• Change in Kinesiophobia

  Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK), a 17-item instrument measuring fear of movement and re-injury. Each item is scored from 1 (strongly disagree) to 4 (strongly agree), with total scores ranging from 17 to 68. Higher scores indicate greater kinesiophobia. Kinesiophobia was assessed at baseline and after completion of the 8-week intervention.

  Baseline (Week 0) to post-intervention (Week 8)

Study Arms (2)

Jacobson's Progressive Muscle Relaxation Technique (JPMRT) Group

EXPERIMENTAL

Participants received a structured 8-week Jacobson's Progressive Muscle Relaxation Technique (JPMRT) program. The intervention consisted of four supervised sessions delivered over 2 weeks (two sessions per week), with each session lasting approximately 30-45 minutes. Participants were instructed to practice JPMRT independently at home once daily for 10-15 minutes for 6 consecutive weeks. The intervention included demonstration, redemonstration, corrective feedback, educational materials, and weekly telephone/WhatsApp follow-up to support adherence.

Behavioral: Jacobson's Progressive Muscle Relaxation Technique (JPMRT)

Routine Care Control Group

ACTIVE COMPARATOR

Participants continued to receive routine care provided by the neurology clinic, including their prescribed medical treatment and usual follow-up according to their clinical needs. They did not receive JPMRT training or the home-practice program during the study period. After completion of the study and data collection, participants in the control group were provided with educational materials and instructions regarding JPMRT.

Other: Routine Care

Interventions

Jacobson's Progressive Muscle Relaxation Technique (JPMRT) BEHAVIORAL

A structured 8-week Jacobson's Progressive Muscle Relaxation Technique (JPMRT) program. Participants received four supervised sessions over 2 weeks, with two sessions per week and each session lasting approximately 30-45 minutes. The program included instruction, demonstration, redemonstration, corrective feedback, and educational materials. Participants subsequently practiced JPMRT independently at home once daily for 10-15 minutes for 6 consecutive weeks. Adherence was supported through weekly telephone calls and WhatsApp reminders. The technique involved sequential contraction of major muscle groups for approximately 5-10 seconds followed by relaxation for 20-30 seconds while focusing on relaxation and deep breathing.

Jacobson's Progressive Muscle Relaxation Technique (JPMRT) Group

Routine Care OTHER

Participants continued to receive routine care provided by the neurology clinic, including their prescribed medical treatment and usual follow-up according to their clinical needs. They did not receive Jacobson's Progressive Muscle Relaxation Technique (JPMRT) training or the associated home-practice program during the 8-week study period. After completion of the study and data collection, control-group participants were provided with educational materials and instructions regarding JPMRT.

Routine Care Control Group

Eligibility Criteria

• Age: 20 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants were eligible if they had a diagnosis of multiple sclerosis for at least six months, were aged 20-60 years, and were able to communicate and comprehend the study instructions.

You may not qualify if:

• Patients with a documented psychotic disorder that could impair their ability to understand the study instructions, those who had received psychotherapy during the previous six months, or those who had participated in any program targeting physical health and/or fatigue during the previous six months were excluded.

Sponsors & Collaborators

• Al-Zaytoonah University of Jordan: lead

Study Sites (1)

Menoufia university

Cairo, Menoufia Governorate, Egypt

Location

MeSH Terms

Conditions

Multiple Sclerosis; Kinesiophobia; Fatigue

Condition Hierarchy (Ancestors)

Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Nervous System Diseases; Demyelinating Diseases; Autoimmune Diseases; Immune System Diseases; Phobic Disorders; Anxiety Disorders; Mental Disorders; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Faten Nouh, Assistant Professor

  Al- Zaytouna University of Jordan, Amman, Jordan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcome assessor was blinded to participants' group allocation. The researcher responsible for delivering the JPMRT intervention did not participate in outcome assessment. Participants and intervention providers were not blinded because of the nature of the behavioral intervention. Statistical analyses were performed using coded group identifiers, with group allocation revealed after completion of the primary analyses.
• Purpose: SUPPORTIVE CARE
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Faten Mabrouk Nouh

Model Details: A two-group, non-randomized, parallel-assignment, pretest-posttest design in which participants were allocated sequentially to either a routine-care control group or a Jacobson's Progressive Muscle Relaxation Technique (JPMRT) intervention group. The control group was recruited and assessed first, followed by recruitment and intervention of the study group to minimize potential contamination between groups.

Study Record Dates

• First Submitted: September 27, 2026
• First Posted: October 2, 2026
• Study Start: August 1, 2025
• Primary Completion: December 30, 2025
• Study Completion: December 30, 2025
• Last Updated: October 2, 2026

Record last verified: 2026-09

Locations

EG (1)