The Effect of Progressive Muscle Relaxation Exercises on Depression and Fatigue in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial

Hemodialysis is a vital treatment modality for patients with kidney failure, extending life expectancy and reducing associated symptoms. However, it also introduces significant physical, psychological, and social challenges for patients. Fatigue, one of the most frequently reported symptoms among hemodialysis patients, substantially impairs daily functioning and quality of life, with studies indicating that 42% to 89% of these individuals experience clinically relevant fatigue levels.

In addition to physical symptoms, anxiety and depression are common psychological problems among hemodialysis patients. These symptoms are closely linked to fatigue and sleep disturbances. Depression often presents with persistent fatigue and low energy, whereas insomnia can contribute to the onset or exacerbation of fatigue, anxiety, and depressive symptoms. Globally, approximately 280 million people are affected by depression, with significant prevalence among adults and older adults. Depression is a major contributor to disability worldwide and is projected to become the leading cause of disease burden by 2030. In a study involving 55,982 patients with chronic kidney disease, nearly one-quarter were found to experience depression, with even higher rates reported among those receiving maintenance hemodialysis. Current evidence indicates that the prevalence of depression in this population ranges from 20% to 47%.

Progressive Muscle Relaxation (PMR), first introduced by Jacobson in 1924, is a technique aimed at achieving physical and mental relaxation through systematic tensing and releasing of muscle groups. Research has shown that relaxation practices reduce oxygen consumption, heart rate, respiratory rate, and muscle tension while alleviating pain perception and lowering stress responses through increased endorphin production. Ortega et al. (2021) highlighted that PMR enhances awareness of bodily sensations and reduces tension, while Ramaiah and Albokhary (2021) demonstrated that progressive relaxation and similar home-based practices significantly decreased menstrual pain severity through increased blood flow and suppression of sympathetic nervous system activity. These findings suggest that PMR can serve as an effective complementary approach for both physical and psychological symptoms.

The present study aims to evaluate the effects of progressive muscle relaxation exercises on depression and fatigue levels in patients undergoing hemodialysis. Specifically, it investigates whether this individualized intervention contributes to improved psychological well-being among hemodialysis patients.