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Progressive Muscle Relaxation May Reduce Pain and Improve Sleep After Open Heart SurgeryRelaxation technique may help reduce pain and improve sleep after heart surgery

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Key Takeaway
Consider PMR as a potential non-pharmacological adjunct for pain and sleep after cardiac surgery, but recognize evidence is from a small single-center study.

A single-center, single-blind randomized controlled trial evaluated Progressive Muscle Relaxation (PMR) in 60 patients after open heart surgery. The intervention group received twice-daily PMR sessions on postoperative days 1, 2, and 3, while the control group received usual care. Pain was assessed using the Short-form McGill's Pain Questionnaire, and sleep quality was measured with the Richard-Campbell Sleep Questionnaire.

In the PMR group, pain scores decreased from 9.36 points on day 1 to 1.50 points on day 3, a change reported as statistically significant (p < .001). In the control group, pain scores decreased to 6.13 points on day 3. The study reported a significant difference in pain reduction between the two groups. For sleep quality, scores reached 545.83 points on day 3 in the PMR group, compared to 330.16 points in the control group, with a significant difference reported between groups.

Safety and tolerability data were not reported in the abstract. Key limitations include the small sample size (n=60), single-center design, and the lack of reported primary outcome, effect sizes, confidence intervals, and baseline characteristics. The authors recommend nurses consider including PMR in postoperative care protocols. While the RCT design supports causal inference within the study, the limited scope and unreported data mean these findings should be interpreted as preliminary evidence requiring confirmation in larger, more robust trials.

Researchers studied whether a relaxation technique could help patients after open heart surgery. They enrolled 60 patients who had just undergone heart surgery and randomly assigned half to practice progressive muscle relaxation twice a day for three days after their operation. The other half received standard hospital care without this specific relaxation training.

The study measured patients' pain levels and sleep quality over those three post-operative days. Patients who practiced the relaxation technique reported their pain decreasing more dramatically—from about 9 out of 10 on day one to about 1.5 by day three. Their sleep quality scores also improved more than those in the standard care group, who still reported moderate pain and poorer sleep by day three.

This was a small study at just one hospital, and the researchers did not report any safety concerns or side effects from the relaxation practice. Because the study was limited in size and location, we don't know if these results would apply to all heart surgery patients. The findings suggest this simple, drug-free technique might be a helpful addition to recovery, but larger studies are needed to be sure.

What this means for you:
A small study found relaxation exercises might help with pain and sleep after heart surgery, but more research is needed.

Study Details

Study typeRct
Sample sizen = 60
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
PURPOSE: This study aimed to evaluate the effectiveness of Progressive Muscle Relaxation (PMR) on postoperative pain level and sleep quality in patients undergoing open heart surgery. DESIGN: A single center, two-group, single-blind randomized controlled trial. METHODS: This study comprised 60 patients who were admitted to the cardiovascular surgery department and undergoing open heart surgery between January 2023 and April 2024. Patients were randomized into 30 in the experimental group and 30 in the control group. Data were collected using Patient Identification Form, Short-form of McGill's Pain Questionnaire (SF-MPQ) and Richard-Campbell Sleep Questionnaire (RCSQ). PMR were applied twice a day, morning and evening, on the post-operative days 1st, 2nd, and 3rd days to experimental group. Before and after PMR, the patients' pain level and sleep quality were evaluated. The control group received usual care and treatment. RESULTS: In the experimental group, pain level decreased significantly from 9.36 points on the 1st day to 1.50 points on the 3rd day in the post-operative service (p < .001). In the control group, pain level decreased only to 6.13 points on the 3rd day. It was determined that sleep quality gradually increased in the experimental group and reached 545.83 points on the 3rd day in the post-operative service. In the control group, it increased only to 330.16 points. A significant difference was found pain level and sleep quality in all measurements between the experimental and control groups. CONCLUSIONS: In this study, it was suggested that progressive muscle relaxation reduces pain and improves sleep quality in patients undergoing open heart surgery. It is recommended that nurses include progressive muscle relaxation in postoperative pain control and sleep management in usual care.
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