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StressNCT06028360

Progressive Muscle Relaxation (PMR) in Stress Management Among Physiotherapy Students

A study testing Progressive Muscle Relaxation and Virtual Reality Therapy in people with Stress, run by Shalamar Institute of Health Sciences at 1 site in Pakistan.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The objective of this clinical trial is to observe the effect of Virtual Reality (VR) and Progressive muscle relaxation (PMR) in stressed individuals. Procedure: Students will be invited verbally and procedure will be explained to them. 20 students will be recruited randomly into control and experimental group. Read more about this study

Who is it for?
Ages 18 to 24 yearsHealthy volunteers can take part
Conditions the study is for
Stress
What is being tested?
Progressive Muscle Relaxation and Virtual Reality Therapy
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 sitePakistan
Study dates
1 Oct 2023to 31 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 24 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Students of either sex, aged between 18-24 years
  • Students with Stress (through perceived stress scale PSS, any individual with a score above 14)

Who cannot join

  • Students more susceptible to motion sickness (Through VIMSSQ),
  • Students with in-corrected eye-sight,
  • Students with phobias relevant to landscapes/views of mountains, forests, beaches and night-skies.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site, 1 recruiting
  • Shalamar Medical and Dental College

    Lahore, Punjab Province, 46994

    Dr. Masooma Gull, MSc, masoomagull2@ymail.com

    Reema Khanam, DPT

    Recruiting

Other trials in Pakistan

About this study

Official title: The Effect of Virtual Reality (VR) and Progressive Muscle Relaxation (PMR) in Stress Management Among Physiotherapy Students

The objective of this clinical trial is to observe the effect of Virtual Reality (VR) and Progressive muscle relaxation (PMR) in stressed individuals.

Procedure:

Students will be invited verbally and procedure will be explained to them. 20 students will be recruited randomly into control and experimental group. Stress will be predicted using multiple questionnaires. Pss is given before and after the intervention. The students in control group will be given 10 mins session of PMR for 3 consecutive days and in intervention group will be given 10 mins session of PMR followed by 8 mins session of VR for 3 consecutive days in which specific landscapes i.e mountains, forests, nightskies and beaches.

Read the detailed description

Introduction:

As stress appears to be a natural human response to difficult situations prompting us to address challenges and threats in our lives, prolonged stress may cause the fight or flight response to over-ride body's normal physiology and produce multiple psychological and physiological symptoms resulting in various negative health conditions such as cardiovascular disorders, GIT disturbances, hypertension etc. Moreover, a global survey of adolescents in 72 countries found 66% of students reported feeling stressed about academics and 37% of students felt anxiety relating to schoolwork. Many stress reduction interventions such as Progressive Muscular Relaxation (PMR), mindfulness meditation, deep breathing exercises, and guided imagery have been shown to reduce stress levels among individuals and are being used as traditional relaxation interventions.

Progressive muscle relaxation (PMR) originally known as Jacobson Muscle Relaxation Technique, was developed by Edmund Jacobson in the 1934. It is an actively engaging technique guiding the patients to consciously contract muscles to create tension and release it progressively. This is repeated until patients acquire complete relaxation. Many studies on PMR have proven it to be beneficial in decreasing stress and anxiety levels in many adults as well as children worldwide.

With emerging technology, innovative ideas, such as the use of VR (Virtual Reality) for stress management, have also been considered and studied. According to Cruz-Neira (1993), Virtual reality refers to immersive, interactive, multisensory, viewer-centered, 3D computer generated environments and the combination of technologies required building environments. In the healthcare sector, VR has been proved beneficial for balance and cognition training in cerebral palsy and stroke, and also has been observed to mitigate acute and chronic pain. It can provide rehabilitation, motivation and entertainment all at once. Further studies on its immersive effect suggest it to be helpful in stress management. Natural environments (forests, beaches, mountains etc ) viewed through VR, have shown to help individuals reduce their stress levels, anxiety disorders, and phobias. However, there is little research on individual preferences of different VR landscapes.

In Asia, research relevant to VR has been shown to have a positive effect on stress management in individuals with high stress and mood disorders. Effect of forest and water landscapes on stress management has also been discussed earlier. However, area for more research still remains.

In Pakistan, multiple researches have been conducted on the use of VR in health care and as a rehabilitative intervention for diseases such as stroke, parkinsons, cerebral palsy and amblyopia, but very limited evidence is available on the effect of VR on stress management. No such research has been conducted in this region or in our institution prior to our study.

A study conducted in India showed that the PSS score decreased from mean 22.2 to 16.5 while another study conducted in India indicated that PMR and talk therapy in college students, reduced percieved stress from PSS score of 32.30 to 23.03.

The purpose of our research is to investigate the effect of VR in stress management, the individual preferences of landscapes and its comparison with traditional relaxation technique such as Progressive Muscle Relaxation (PMR). This will help health-care workers improve stress management in a technology driven community.

Statistical analysis:

data will be entered and analyzed using SPSS 25. Numerical data like age, PSS score will be presented in the form of mean ± S.D whereas qualitative data like gender, Pre/Post intervention stress etc. will be presented in the form of Frequency (Percentage). After fulfilling parametric assumptions, Repeated measure ANOVA will be applied.

Potential benefits:

  1. The subjects receiving the interventions will experience reduced stress and anxiety.
  2. The subjects will be introduced to an innovative and immersive technology i.e., VR.
  3. A step will be taken forward towards the use of technology in stress management, along with a traditional relaxation technique such as Progressive muscle relaxation (PMR).
  4. The use of VR for stress management is cost effective and time saving.

Potential risks:

  1. Motion Sickness It will be tried to minimize by excluding the susceptible subjects, using Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ). Also subjects with any psychological or in-corrected eye sight will not be included in the study. In case the above mentioned risk develops during the intervention, the subject will be given rest.
  2. Increased Drop Out Rate If the required sample size is not met due to high drop out rate, new participants will be recruited and the procedure will be repeated until required amount of data is available.
Conditions
Stress
Being tested
Progressive Muscle Relaxation, Virtual Reality Therapy
Keywords
Psychological stress, progressive muscle relaxation (PMR)
Medical subject headings
Stress, Psychological

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Progressive Muscle RelaxationOther

    Also called PMR

    Intervention will be applied for 15-20 minutes 3 consecutive days a week for 1 week

  • Virtual Reality TherapyDevice

    Also called VR Therapy

    Therapy through VR will be given for 8 minutes 3 times a week on consecutively for 1 week

Study groups in NCT06028360
Study groupRoleWhat they receive
Progressive Muscle RelaxationActive comparatorProgressive muscle relaxation will be applied for 15-20 minutes for 3 consecutive days for 1 week.
Receives: Other: Progressive Muscle Relaxation
Virtual RealityExperimentalVirtual reality session will be given for 8 mins for 3 consecutive days for 1 week.
Receives: Other: Progressive Muscle Relaxation; Device: Virtual Reality Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Stress Reduction

    Reduction in Perceived Stress scale(PSS) from the previous reading will be considered as stress reduction. information will be collected before and after the treatment on each day. The scoring of Perceived Stress scale(PSS) ranges between 0-40, where 0-13 means low stress, 14-26 means moderate stress and 27-40 would be considered as high perceived stress

    Measured: the outcome will be determine at the base line of the treatment and at the 3rd day after initiation oftreatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Sep 2023
  2. Study start1 Oct 2023 (estimated)
  3. Primary completion10 Nov 2023 (estimated)
  4. Study completion31 Dec 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
A Randomized Control Trial with a Control and an Experimental group that will be given intervention 3 consecutive days.
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06028360
Sponsor's protocol ID
SSAHS 2023/02
Status last verified
Sep 2023
First submitted
31 Aug 2023
Last updated
28 Sep 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Gao T, Zhang T, Zhu L, Gao Y, Qiu L. Exploring Psychophysiological Restoration and Individual Preference in the Different Environments Based on Virtual Reality. Int J Environ Res Public Health. 2019 Aug 26;16(17):3102. doi: 10.3390/ijerph16173102.

    PubMed 31455015
  • Wang X, Shi Y, Zhang B, Chiang Y. The Influence of Forest Resting Environments on Stress Using Virtual Reality. Int J Environ Res Public Health. 2019 Sep 5;16(18):3263. doi: 10.3390/ijerph16183263.

    PubMed 31491931
  • Allison S, Irwin Hamilton K, Yuan Y, Wallis Hague G. Assessment of Progressive Muscle Relaxation (PMR) as a Stress-Reducing Technique for First-Year Veterinary Students. J Vet Med Educ. 2020 Dec;47(6):737-744. doi: 10.3138/jvme.2018-0013. Epub 2019 Nov 15.

    PubMed 31738679
  • Ruotolo I, Berardi A, Sellitto G, Panuccio F, Polimeni A, Valente D, Galeoto G. Criterion Validity and Reliability of SF-12 Health Survey Version 2 (SF-12v2) in a Student Population during COVID-19 Pandemic: A Cross-Sectional Study. Depress Res Treat. 2021 Aug 4;2021:6624378. doi: 10.1155/2021/6624378. eCollection 2021.

    PubMed 34394986
  • Levenstein S, Prantera C, Varvo V, Scribano ML, Berto E, Luzi C, Andreoli A. Development of the Perceived Stress Questionnaire: a new tool for psychosomatic research. J Psychosom Res. 1993 Jan;37(1):19-32. doi: 10.1016/0022-3999(93)90120-5.

    PubMed 8421257
  • Keshavarz B, Murovec B, Mohanathas N, Golding JF. The Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ): Estimating Individual Susceptibility to Motion Sickness-Like Symptoms When Using Visual Devices. Hum Factors. 2023 Feb;65(1):107-124. doi: 10.1177/00187208211008687. Epub 2021 Apr 19.

    PubMed 33874752
  • Ahmadpour N, Randall H, Choksi H, Gao A, Vaughan C, Poronnik P. Virtual Reality interventions for acute and chronic pain management. Int J Biochem Cell Biol. 2019 Sep;114:105568. doi: 10.1016/j.biocel.2019.105568. Epub 2019 Jul 12.

    PubMed 31306747
  • Browning MHEM, Shin S, Drong G, McAnirlin O, Gagnon RJ, Ranganathan S, Sindelar K, Hoptman D, Bratman GN, Yuan S, Prabhu VG, Heller W. Daily exposure to virtual nature reduces symptoms of anxiety in college students. Sci Rep. 2023 Jan 23;13(1):1239. doi: 10.1038/s41598-023-28070-9.

    PubMed 36690698
  • Kashif M, Ahmad A, Bandpei MAM, Farooq M, Iram H, E Fatima R. Systematic review of the application of virtual reality to improve balance, gait and motor function in patients with Parkinson's disease. Medicine (Baltimore). 2022 Aug 5;101(31):e29212. doi: 10.1097/MD.0000000000029212.

    PubMed 35945738

Questions about this trial

What is this clinical trial studying?

A study testing Progressive Muscle Relaxation and Virtual Reality Therapy in people with Stress, run by Shalamar Institute of Health Sciences at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Masooma Gull, M.S. (+92-42-111-205-205 ext. 528, masooma.gull@sihs.org.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Stress Reduction (time frame: the outcome will be determine at the base line of the treatment and at the 3rd day after initiation oftreatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06028360, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Sep 2023.

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