PROSPERO International prospective register of systematic reviews

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1 PROSPERO International prospective register of systematic reviews Effectiveness of progressive muscle relaxation training for adults diagnosed with schizophrenia: a systematic review protocol Carlos Melo-Dias, Joao Luis Alves Apóstolo, Daniela Filipa Batista Cardoso Citation Carlos Melo-Dias, Joao Luis Alves Apóstolo, Daniela Filipa Batista Cardoso. Effectiveness of progressive muscle relaxation training for adults diagnosed with schizophrenia: a systematic review protocol. PROSPERO 2014:CRD Available from Review question(s) The objective of this review is to systematically search, appraise and synthesize the best available evidence on the effectiveness of Progressive Muscle Relaxation (PMR) in the human responses of adults with schizophrenia and no positive symptoms of disease, in any setting, regarding anxiety, social isolation, personal and social functioning, cognition, sadness, conversation, and well-being. More specifically, the review will focus on the following question: What is the effectiveness of Progressive Muscle Relaxation training on anxiety, social isolation, personal and social functioning, cognition, conversation, and well-being in adults with schizophrenia? Searches The search strategy aims to find both published and unpublished studies. A three-step search strategy will be used in this review. An initial limited search of MEDLINE and CINAHL will be undertaken, followed by an analysis of the text words in the title and abstract and the index terms used to describe the article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Studies published in Portuguese, English, Spanish, Italian, French will be considered for inclusion in this review. All studies published with no time limits will be considered for inclusion in this review in order to cover all existing studies about this topic. The databases to be searched include: CINAHL (EBSCO) Directory of Open Access Journals (DOAJ) ERIC MEDLINE (EBSCO) PsycNET Scielo Citation Index The Cochrane Central Register of Controlled Trials (CENTRAL) EMBASE PEDro The search for unpublished studies will include: Page: 1 / 5

2 ProQuest Nursing and Allied Health Source Dissertations CAPES ( RCAAP Scientific Open Access Repository of Portugal ( The initial keywords to be used are: Schizophrenia Progressive Muscle Relaxation Types of study to be included This review will consider both experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case control studies, and analytical cross sectional studies for inclusion. This review will also consider descriptive epidemiological study designs including case series, individual case reports, and descriptive cross sectional studies for inclusion. Condition or domain being studied Schizophrenia is often characterized by a long prodromal phase and a gradual change in psychosocial functioning, with symptoms that could include changes in affect (such as anxiety, irritability and depression), cognition, thought content, and social withdrawal. Anxiety is a prominent symptom present early in the course of schizophrenia, and is viewed both as a co-morbidity and a clinical expression of schizophrenia. Progressive muscle relaxation is commonly used for alleviating anxiety in schizophrenic individuals, its training is consisted of successive tensing and relaxing of muscle groups. Although there already exists a systematic review on the effectiveness of this treatment, which only includes RCT design studies, and the outcomes of psychological distress and anxiety. This systematic review will go beyond and consider any quantitative study design, setting, and outcome that will include all scientific/standardized assessments (questionnaires or scales) of anxiety, social isolation, personal and social functioning, cognition, conversation, and well-being. Participants/ population This review will consider studies that include: 1) Adults (aged 18 and over), with no upper age limit. 2) Current DSM-IV Schizophrenia diagnosis, but excluding those with positive psychotic symptoms (namely delusional thinking and/or hallucinations). 3) Any setting where participants live (namely their own house, family house, psychiatric hospitals [acute units], day care hospitals, halfway houses, long-term care facilities, and forensic hospitals). Intervention(s), exposure(s) This review will consider studies that assess Progressive Muscle Relaxation (PMR) (Jacobson s Model) as an intervention (regardless of the number and duration of sessions, and of the participant s positioning model). Comparator(s)/ control A comparison will be made between patient group/individual PMR treatment versus no intervention, or another type of intervention referred to as relaxation intervention. Outcome(s) Primary outcomes This review will consider studies that include the following outcome measures (using any scientific/standardized measurement scales or questionnaires): Page: 2 / 5

3 Primary outcomes - anxiety, social isolation, personal and social functioning, cognition, sadness, conversation and well-being. Secondary outcomes Physiological measurement (respiratory rate, blood pressure, heart rate, skin temperature), self-rating (self-report from participants using preset descriptive phrases), and observation (structured observation of postures), and also attended training sessions. Data extraction, (selection and coding) Data will be extracted from papers included in the review using the standardized data extraction tool from JBI- MAStARI. The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives. The reviewers will extract data from studies independently. In order to find any missing data or information, the authors will be contacted. Risk of bias (quality) assessment Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta- Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Strategy for data synthesis Quantitative data will, where possible, be pooled in statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. Analysis of subgroups or subsets Heterogeneity will be assessed statistically using the standard Chi-square and explored using subgroup analyses based on the different study designs included in this review. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate. Dissemination plans If appropriate, the findings of this systematic review will inform Joanna Briggs Institute Best Practice Information Sheets, Evidence summaries and Consumer Information Sheets. Contact details for further information Joanna Briggs Institute Synthesis Science Unit (JBI SSU) Synthesis Science Unit (SSU) The Joanna Briggs Institute Faculty of Health Sciences The University of Adelaide SA 5005 AUSTRALIA jbiresearch@adelaide.edu.au Organisational affiliation of the review Health Sciences Research Unit: Nursing, Nursing School of Coimbra; The Portugal Centre for Evidence-Based Practice: an Affiliate Centre of the Joanna Briggs Institute, Portugal Page: 3 / 5

4 Review team Mr Carlos Melo-Dias, Health Sciences Research Unit: Nursing, Nursing School of Coimbra; The Portugal Centre for Evidence-Based Practice: an Affiliate Centre of the Joanna Briggs Institute, Portugal Mr Joao Luis Alves Apóstolo, Health Sciences Research Unit: Nursing, Nursing School of Coimbra; The Portugal Centre for Evidence-Based Practice: an Affiliate Centre of the Joanna Briggs Institute, Portugal Ms Daniela Filipa Batista Cardoso, Health Sciences Research Unit: Nursing, Nursing School of Coimbra; The Portugal Centre for Evidence-Based Practice: an Affiliate Centre of the Joanna Briggs Institute, Portugal Anticipated or actual start date 15 August 2014 Anticipated completion date 17 July 2015 Funding sources/sponsors none Conflicts of interest None known Other registration details The Joanna Briggs Institute PRO#1639 Language English Country Portugal Subject index terms status Subject indexing assigned by CRD Subject index terms Adult; Humans; Muscle Relaxation; Relaxation Therapy; Schizophrenia Reference and/or URL for protocol Stage of review Ongoing Date of registration in PROSPERO 27 November 2014 Date of publication of this revision 27 November 2014 Stage of review at time of this submission Started Completed Preliminary searches No Yes Piloting of the study selection process No Yes Formal screening of search results against eligibility criteria Yes Yes Data extraction No No Page: 4 / 5

5 Powered by TCPDF ( Risk of bias (quality) assessment No No Data analysis No No PROSPERO International prospective register of systematic reviews The information in this record has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Page: 5 / 5