Elsevier

Pain Management Nursing

Volume 5, Issue 3, September 2004, Pages 97-104
Pain Management Nursing

Original articles
A pilot study of the effectiveness of guided imagery with progressive muscle relaxation to reduce chronic pain and mobility difficulties of osteoarthritis

https://doi.org/10.1016/j.pmn.2004.01.003Get rights and content

Abstract

Osteoarthritis (OA) is a common, chronic condition that affects most older adults. Adults with OA must deal with pain that leads to limited mobility and may lead to disability and difficulty maintaining independence. A longitudinal, randomized clinical trial pilot study was conducted to determine whether Guided Imagery (GI) with Progressive Muscle Relaxation (PMR) would reduce pain and mobility difficulties of women with OA. Twenty-eight older women with OA were randomly assigned to either the treatment or the control group. The treatment consisted of listening twice a day to a 10-to-15-minute audiotaped script that guided the women in GI with PMR. Repeated-measures ANOVA revealed a significant difference between the two groups in the amount of change in pain and mobility difficulties they experienced over 12 weeks. The treatment group reported a significant reduction in pain and mobility difficulties at week 12 compared to the control group. Members of the control group reported no differences in pain and non-significant increases in mobility difficulties. The results of this pilot study justify further investigation of the effectiveness of GI with PMR as a self-management intervention to reduce pain and mobility difficulties associated with OA.

Section snippets

Chronic pain and decreased mobility in OA

Chronic pain and decreased mobility are cardinal symptoms of OA. As the disease progresses, the intensity and the severity of the pain increase. Among patients with OA, chronic pain is considered the primary cause of sedentary lifestyles (O’Reilly & Doherty, 1998), difficulties with activity (Yelin, 1998), and decreased quality of life (Affleck et al., 1999). Mobility difficulties, the other prime feature of OA, are associated with decreased physical activity (Felson, 2001) and an increased

Design

A 12-week longitudinal, randomized clinical trial pilot study was conducted to examine the effectiveness of GI with PMR to reduce pain and mobility difficulties in older women with OA.

Sample

Twenty-eight women over 65 years of age with a diagnosis of OA and joint pain participated in the study. Individuals with a history of dementia or cognitive impairment or who were unable to understand the study procedures and the consent form were excluded. Eighteen women were randomly assigned to the intervention

Demographics

The participants were 65 years to 93 years old. On the whole, they were highly educated (M ≥14 years of schooling), 53% were married; and 42% were widowed, divorced, or single. The participants in the experimental and the control groups were not significantly different in their age, years of schooling, marital status, presence of other rheumatologic conditions, or presence of other medical diseases (Table 1). In addition, no significant differences were found between the two groups in the

Discussion

Results from this pilot study, indicating that GI with PMR reduced pain in women with OA, support previous conclusions in other patient populations Arathuzik 1994, Creamer et al 2000, Graffam and Johnson 1987, Mannix et al 1999, Sloman 1995, Tusek et al 1997. In combination, these findings provide evidence that GI with PMR may be an effective self-management technique for coping with daily pain associated with OA.

These results also support conclusions from prior studies that GI with PMR

References (55)

  • G. Pfurtscheller et al.

    Visually guided motor imagery activates sensorimotor areas in humans

    Neuroscience Letters

    (1999)
  • L. Sebastiani et al.

    Autonomic and EEG correlates of emotional imagery in subjects with different hypnotic susceptibility

    Brain Research Bulletin

    (2003)
  • R. Sloman

    Relaxation and the relief of cancer pain

    Nursing Clinics of North America

    (1995)
  • D. Tusek et al.

    Guided imagery as a coping strategy for perioperative patients

    AORN Journal

    (1997)
  • GI focusThe effects of NSAIDs on the upper gastrointestinal tract

    (2003)
  • D. Arathuzik

    Effects of cognitive-behavioral strategies on pain in cancer patients

    Cancer Nursing

    (1994)
  • J.G. Arena et al.

    Biofeedback and relaxation therapy for chronic pain disorders

  • C.L. Baird

    Guided imagery script

    (2001)
  • H. Benson

    The relaxation response

    (1975)
  • H. Benson et al.

    The relaxation response

    Psychiatry

    (1974)
  • M. Bohan et al.

    When does imagery practice enhance performance on a motor task?

    Perceptual & Motor Skills

    (1999)
  • K.D. Brandt

    Epidemiology of osteoarthritis

  • K. Burks

    Health concerns of men with osteoarthritis of the knee

    Orthopaedic Nursing

    (2002)
  • P. Creamer et al.

    Sustained improvement produced by nonpharmacologic intervention in fibromyalgiaResults of a pilot study

    Arthritis Care and Research

    (2000)
  • G.L. Engel

    The need for a new medical modelA challenge for biomedicine

    Science

    (1977)
  • D.T. Felson

    Epidemiology of the rheumatic diseases

  • K.L. Fontaine
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