Impact of Jacobson’s Progressive Muscle Relaxation on Stress Levels of Exam Going MBBS Students of a Medical College in South Gujarat, India

Abstract

Introduction: Academic examinations are a very stressful event for an Bachelor of Medicine and Bachelor of Surgery (MBBS) student. While many students learn to deal with it through the use of helpful or unhelpful coping skills, many still end up with considerable psychological morbidity in the form of anxiety and depression along with deterioration in overall health. Jacobson’s Progressive Muscle Relaxation (JPMR) causes deep muscle relaxation. Aim: To find out the prevalence of stress and exam anxiety in students of 1st year MBBS and to study the impact of JPMR. Materials and Methods: It was a quasi-experimental, pretest and post-test interventional study conducted amongst the first year MBBS students studying at the Government Medical College Surat, Gujarat, India, during March to May 2019. Two months before their internal exams, 114 1st year MBBS students were recruited for the study. They were given a pretest proforma which comprised of socio-demographic profile, Perceived Stress Scale (PSS), Test Anxiety Scale (TAS) and General Health Questionnaire (GHQ) 28. They were asked to attend JPMR sessions over the following month in batches of 30 each and asked to practise JPMR for one month leading up to their exams. Total 43 students attended these sessions while 71 did not. After one month, all 114 students were again given a post-test proforma comprising of the same scales. Paired t-test was applied to compare the pretest and post-test scores to see the impact of JPMR. Results: The mean age of participants was 19 years.The students who completed their schooling in Gujarati medium and those who reported to be staying at hostel experienced significantly more TAS scores at baseline evaluation as compared to their counterparts from English medium schools and those staying at home respectively. There was a statistically significant reduction in mean scores of PSS and TAS before and after practice of JPMR in the 43 students who attended and practiced JPMR (p-value=0.005 and p-value=0.002, respectively; p-value <0.05 was considered to be significant). Conclusion: One month practice of JPMR was found to be effective in reduction of stress and exam anxiety.

Efficacy of Progressive Muscle Relaxation in Adults for Stress, Anxiety, and Depression: A Systematic Review

“… High 13 Mustafa et al 51 (2021) Pakistan 4 sessions/ 4 weeks N/A 10 female nurses (PMR: 10) S: N/A DO: 0% QED / / DASS-21 N/A Stress (d=2.45), anxiety (d=0.53), depression (d=1.95) There is a significant decrease (↓) in stress and depression score but not in anxiety at post-test compared to pretest in IG. High 14 Palkar et al 52 (2021) India 45m at home/ 4 weeks + 3 sessions at seminar hall 7 days/ week 114 medical students (PMR: 43, CG: 71) S: Seminar Hall & at home DO: 0% QED / / PSS, TAS N/A Stress (d=0.45), Anxiety (d=0.35) There is a significant decrease (↓) in stress and anxiety score at post-test compared to pretest in IG. High 15 Prakash Jha et al 53 (2020) India 30m/ 2 weeks 7 days/ week 30 elderlies (PMR: 30) S: N/A DO: 0% QED / / (twice) GDS N/A Depression There is a significant decrease (↓) in depression score at post-test compared to pretest.…”

“…Next, when anxiety outcomes were analyzed, seven (7) studies 42 , 44 , 50 , 52 , 56 , 69 , 71 reported a significant decrease in levels of anxiety among university students, and nurses at posttest compared to pretest in the PMR group, highlighting the effective role of PMR in anxiety reduction. Besides, two (2) further studies 36 , 56 supported the discussion for PMR by demonstrating a substantial reduction in anxiety outcomes among athletes, and nursing students in the PMR group compared to the control group in the posttest phase.…”

“…Using the "Revised Checklist for Quasi-Experimental Studies", 28 the reviewers identified fifteen (15) studies of high quality, 34,36,38,[40][41][42][45][46][47][49][50][51][52][53]56 and six (6) studies of medium quality. 44,58,67,69,71,72 Following a thorough assessment, nine (9) studies 38,40,41,45,46,51,52,58,67 revealed noteworthy insights, indicating a discernable pattern of considerable drop in stress outcomes posttest in contrast to pretest within the PMR group among the female health care workers, nurses, university students and employees.…”

“…Using the "Revised Checklist for Quasi-Experimental Studies", 28 the reviewers identified fifteen (15) studies of high quality, 34,36,38,[40][41][42][45][46][47][49][50][51][52][53]56 and six (6) studies of medium quality. 44,58,67,69,71,72 Following a thorough assessment, nine (9) studies 38,40,41,45,46,51,52,58,67 revealed noteworthy insights, indicating a discernable pattern of considerable drop in stress outcomes posttest in contrast to pretest within the PMR group among the female health care workers, nurses, university students and employees. Moreover, two (2) more studies 36,72 reported a significant reduction in stress outcomes in the PMR group compared to the control group among the athletes and female clerical workers, adding weight to the information at hand.…”