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Thyroid cancer patients often experience pain and reduced quality of life during chemotherapy. This randomized controlled trial will evaluate whether Progressive Muscle Relaxation (PMR) exercises, added to routine range-of-motion exercises, reduce pain and improve quality of life compared to range-of-motion exercises alone. Thirty-two thyroid cancer patients randomly assigned to either the PMR group or the control group. Pain measured by using the Numeric Pain Rating Scale (NPRS) and quality of life using the FACT-G questionnaire before and after a 4-5 day intervention. The study compared changes between groups.
This is a single-center, parallel-group, randomized controlled trial to be conducted at PINUM Cancer Hospital, Faisalabad, Pakistan. A total of 32 patients with histologically confirmed thyroid cancer (Stage I-III) undergoing chemotherapy (1-3 sessions) will be enrolled. Inclusion criteria: age 30-50 years, moderate pain (NPRS 3-7), baseline FACT-G score ≥80%, history of lobectomy or thyroidectomy. Exclusion criteria: comorbidities (cardiomyopathy, respiratory disorders, severe mental illness), recent fractures or surgeries, inability to follow instructions, current practice of relaxation therapies. Participants will be randomly allocated 1:1 using an online random number generator into two groups. Experimental group (n=16): Progressive Muscle Relaxation Technique (PMRT) once daily for 4-5 consecutive days, each session 20-40 minutes, targeting head/neck, shoulders, arms/hands, lower back/hips, calves/thighs, and feet/toes. Each movement involves deep inhalation, tensing for 10-20 seconds, then exhalation with relaxation. Control group (n=16): gentle range-of-motion and stretching exercises of same frequency and duration. Outcomes: pain (NPRS, 0-10) and quality of life (FACT-G, 4 subscales) measured at baseline and post-intervention. Normality of data assessed by using Shapiro-Wilk test. Between-group comparisons is performed by using Mann-Whitney U test, and within-group pre-post comparisons using Wilcoxon signed-rank test. No adverse events are anticipated. After study completion, results will be submitted separately in the Results Module.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PMR + ROM | Experimental | Participants received once-daily Progressive Muscle Relaxation Technique (PMRT) plus range-of-motion (ROM) exercises for 4-5 consecutive days, 20-40 minutes per session. |
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| ROM | Active Comparator | Participants received only gentle range-of-motion (ROM) and stretching exercises, once daily for 4-5 consecutive days, 20-40 minutes per session. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Progressive Muscle Relaxation Technique | Behavioral | Participants were guided through sequential tensing and relaxing of six muscle groups: head/neck, shoulders/upper back, arms/hands, lower back/hips, calves/thighs, and feet/toes. For each group, they inhaled deeply and tensed muscles for 10-20 seconds, then exhaled slowly while relaxing completely. Each session lasted 20-40 minutes, once daily for 4-5 consecutive days. Sessions were conducted by a trained physiotherapist in a quiet hospital room. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Pain Intensity | Pain intensity measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale from 0 (no pain) to 10 (worst possible pain). Higher scores indicate worse pain. | Baseline (day 1) and post-intervention (day 4-5) |
| Change in Quality of Life | Quality of life measured using the Functional Assessment of Cancer Therapy - General (FACT-G), a 27-item questionnaire covering physical, social/family, emotional, and functional well-being. Higher scores indicate better quality of life. | Baseline (day 1) and post-intervention (day 4-5) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Faisalabad | Faisalābad | Punjab Province | 3800 | Pakistan |
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| ID | Term |
|---|---|
| D013964 | Thyroid Neoplasms |
| D010146 | Pain |
| ID | Term |
|---|---|
| D004701 | Endocrine Gland Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D006258 | Head and Neck Neoplasms |
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| ID | Term |
|---|---|
| D016059 | Range of Motion, Articular |
| ID | Term |
|---|---|
| D010808 | Physical Examination |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D009142 | Musculoskeletal Physiological Phenomena |
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| Range of Motion and Stretching Exercises | Other | Participants performed gentle range-of-motion (ROM) and stretching exercises for the same muscle groups (head/neck, shoulders, arms, lower back, legs, feet), without the tensing-relaxation component of PMR. Each session lasted 20-40 minutes, once daily for 4-5 consecutive days, supervised by the same physiotherapist. |
|
| D004700 |
| Endocrine System Diseases |
| D013959 | Thyroid Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |