Effect of Progressive Muscle Relaxation on the outcomes of Multiple Sclerosis disease: A systematic review and meta-analysis

Introduction: Multiple sclerosis (MS) is an inflammatory disease, makes damage in central nervous system. Evidence showed Progressive Muscle Relaxation (PMR) technique is one of the non-pharmacological methods used to treat MS. The purpose of the study was to determining the effect of PMR on the MS's outcomes in published papers in the field.  Method: This systematic and meta-analysis study were conducted from the beginning to April 2018. English and Persian databases were searched until the February 2018. Studies that implement PMR in MS patients and had available data for analysis were included and irrelevant and duplicated studies were excluded.  To quality appraisal of articles, four scales JADAD, CONSORT, Newcastle-Ottawa and Cochran's risk of bias were used. Data analysis was carried out through the random-effects model, and heterogeneity was investigated by I2 index by using the STATA and SPSS software version 11.  Results: From 773-studies, 12-articles were selected that conducted between years 2008 to 2016. Studies have mentioned a positive and significant effect of PMR on reducing stress [-5.34(-8.18.-2.50) I2=75.7%], pain [-2.27(-4.17.-0.37) I2=96%], fatigue [-1.13 (-1.71.-0.55) I2=93%], depression [-3.76(-10.98.-3.46) I2=87.4%] and improving sleep quality [-5.34(-8.18.-2.50) I2=75.7%]. Spearman's correlation coefficient between scores of JADAD, CONSORT and Newcastle-Ottawa were significant.  Conclusion: PMR can be recommended as a nursing intervention, a suitable, inexpensive, and effective technique to reduce the outcomes of MS patients.