Transcript Relaxation training

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Objectives of lecture:
After studying this lecture, the student will be able
to;
 Define the Relaxation
 Classify relaxation
 Enumerate the factors affecting relaxation
 Understand the benefit of relaxation
 Understand Common elements of relaxation
training
 Apply the different techniques of relaxation
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(relaxation training)
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Definition of Relaxation
 Classification of relaxation
 Test of relaxation
 Factors affecting relaxation
 Relaxation training
 How to gain relaxation
 How to test relaxation
 Indicators of relaxation

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Relaxation
It is a state in which muscle tension and
mental stress are reduced as much as
possible through conscious effort, or a
process that decreases the wear and
tear of life's challenges on your mind and
body
 It is a conscious effort to relieve tension in
muscles.
Interventions that promote general or local
relaxation can complement starching
program

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1.
2.
Mental relaxation( reduce mental stress)
Physical relaxation ( reduce physical
stress)
Also it can be classified into:
1. General relaxation
2. Local relaxation
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Factors Affecting Relaxation
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1- Muscle Tone
 Muscle
tone refers to the amount
of tension or resistance to
movement in a muscle even
during rest or relaxation.
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Muscle Tone. Cont.,
 Muscle
tone is maintained through the
activity of the muscle spindles circuit.
(Muscle spindles are modified muscle
fibers called intrafusal muscle fibers).
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2- Postural Tone
It is the muscle
contraction against
gravity to maintain
posture (it is
concerned mainly
about the anti-gravity
muscles).
 Postural tone is
maintained by a
reflex mechanism
called myotatic or
stretch reflex.

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2- Postural Tone. Cont.,
Any stretching of muscles by
an external force, such as the
force of gravity, stimulates
sensory receptors (muscle
spindles) situated within the
muscles giving rise to a
discharge of motor impulses
to the same muscles.
 These motor impulses will
cause stimulation of sufficient
numbers of motor units
leading to an increase tension
of the muscle.

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Postural Tone. Cont.,

The degree and location of postural tone
varies with any alteration in posture.

in upright positions, where the force of
gravity tends to stretch muscles more
strongly,

in recumbent positions, where the
effects of the force of gravity is
adequately counterbalanced by full
support of the body.
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Postural Tone. Cont.,
 recumbent
positions
provide full
support for all segments of the body
general relaxation.
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3- Voluntary Movement
 After
any muscle contraction and
completion of the movement, the
muscles come to rest and relax.
 There
is a recognized biological
principle that activity of living cells
tends to be followed by inhibition of
that activity
(contraction=relaxation).
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Voluntary Movement. Cont.,
 Contraction
in any one group of muscles
is accompanied by a reciprocal
relaxation of the antagonistic group to
allow movement to take place smoothly.
These facts are of importance during
consideration of methods designed to
obtain relaxation of a particular group of
muscles
(Reciprocal inhibition).
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4- Mental Attitude


Mental attitudes such as fear, anger and
exciting give rise of the muscle tension and
preparing the muscle for rapid or forceful
action.
Normally, this tension is reduced with
relaxation and when the need for it no
longer exist, but in some cases it may
become habitual and lead to change of
normal posture.
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5- Pathological Tension in Muscle
The tension of higher motor centers (upper
motor neuron lesions) leads to increase
tension of relaxed muscles which varies from
hyper tonicity to spasticity or rigidity.

A temporary reduction in this tension in the
affected area can be achieved in some
cases by suitable means which promote
relaxation, and this allows re-education of
any functional activity which remains to take
place.
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Relaxation training
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Relaxation training
Relaxation training, using methods of
general relaxation (total body
relaxation), has been used by a variety of
practitioners to help patient to
 Relieve pain
 Relieve muscle tension, anxiety or stress
 Relieve associated physical and mental
dysfunctions, including tension
headaches, high blood pressure, and
respiratory distress
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Common elements of relaxation
training
1. Relaxation involves a reduction in muscle
tension in the entire body or the region that
is painful or restricted by conscious effort
and thought.
2. Comfortable positions and support (Prone
lying, Supine lying, Half lying, Side lying)
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3. Training occurs in a quiet environment with
low lighting and soothing music or an
auditory cue on which the patient may
focus.
4. The patient perform deep breathing
exercises or visualizes a peaceful scene.
5. When giving instructions the therapist uses
a soft tone voice.
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Lying supine
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Half Lying
This is similar to the previous
position but breathing is easier
as there is less weight on the
back and abdominal pressure
on the under surface of the
diaphragm is reduced.
 An armchair makes quite a
good substitute for a plinth or
bed, the things are fully
supported and the feet rest on
the floor, or a footstool, or a Tshaped footrest.

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Side lying
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Prone Lying
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Examples of approaches to
relaxation training
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1.
Autogenic training. It involves conscious
relaxation through autosuggestion and a
progression of exercises
2.
Progressive relaxation. It uses systemic, distal
to proximal progression of voluntary
contraction and relaxation of muscles.
3.
Awareness through the movement. It
combines sensory awareness, movements of
the limbs and trunk, deep breathing,
conscious relaxation procedures, and selfmassage to alter muscle imbalances and
abnormal postural alignment to remediate
muscle tension and pain.
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Sequence for progressive
relaxation techniques
1. Place the patient in quiet area and in a
comfortable position, and be sure that
restrictive clothing is loosened.
2. Have the patient breath in a deep,
relaxed manner.
3. Ask the patient to contract the distal
musculature in the hands or feet
voluntarily for several (5 to 7) seconds
and then consciously relax those
muscles for 20 to 30 seconds.
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Sequence for progressive
relaxation techniques.
Cont.,
4. Suggest that the patient try to feel a sense of
heaviness in the hands or feet and a sense of
warmth in the muscle just relaxed.
5. Progress to a more proximal area of the body
and have the patient actively contract and
actively relax the proximal musculature.
6. Suggest to the patient that he or she should
feel a sense of relaxation and warmth
throughout the entire limb and eventually
throughout the whole body.
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Local Relaxation
1.
2.
3.
Preparatory to massage and passive
movement. It can complement
starching program
For relief of spasm.
To prevent adaptive shortening.
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Local relaxation is gained
through
1. Heat: superficial or deep heat is
applied to increase circulation to the
soft tissue. (increase soft tissue
extensibility prior stretching exercises)
2. Massage: superficial and deep
massage can be used to increase
local circulation and decrease
muscle spasm.
3. Biofeedback: it reduce the amount of
tension in a muscle (visual and /or
auditory biofeedback).
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4. Joint traction or oscillation: slight
manual distraction of joint surface
can be used to decrease muscle
spasm around the joint.
5. Contrast method
6. Reciprocal method
7. Suggestion method
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 Physiology
Strong contraction of the muscle is
followed by an equal relaxation of the
same muscle or
Excitation= inhibition
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technique
The technique consists of
 sequence of contractions of the muscles
performed, usually, in a distal to proximal
sequence in each limb or pair of limbs in
turn followed by letting go or relaxation for
an equal or longer period of time
 Then the contractions for each limb part
are usually added to one another so that
tension in the limb is total and relaxation
should be controlled in reverse sequence
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Value
It can be used for a limited part of
the body, for example,
for relaxation of the hand or of the
shoulder girdle or of the hip
adductors and lateral rotators.
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 physiology
The antagonistic groups of the
muscles always relax reciprocally
and to equally to the contraction
of the agonist group of muscles.
Tension will be relieved by
contraction of the antagonistic
muscles.
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technique
1.
The sequence used is more
usually proximal to distal
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technique
1. In this technique the therapist
provides comfortable relaxing
conditions for patient:
2. A warm well-ventilated room
3. A comfortable support
4. Light covering
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5. Then by using quiet hypotonic
mellow tones
6. The patient is told to think about
each part of the body in turn. To
think that it is very heavy and this
suggestion is repeated several times
until the limb gives the appearance
of relaxation, e.g. until the lower limb
is rolled out
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The technique
This is used for relaxation of the limbs. The
arm/s or leg/s may be swung back and
forward until they feel numb. . The
sensory receptors have
accommodated to the constant
movement. This type of swinging may
be aided by adding from a 1/2 to 1 kg
weight to the limb
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Value
This type of swinging is of particular value
to reduce the rigidity of Parkinsonism, but
is also used for shorter periods of time to
mobilize joints by patient activity. It is the
most suitable for the shoulder, hips, knee
and lumbar spine
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9. Active inhibition techniques: are reflex
relaxation procedures that therapist use
to inhibit muscle prior to stretching or
lengthening.
Active inhibition techniques include:
1. Contract- relax
2. Contract - relax –contract
3. Agonist contraction
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Start with the tight muscle in comfortably
lengthened position
 Ask the patient to isometrically contract
the tight muscle against resistance for 5
to10 seconds, then relax.
 Repeat the procedure several times.

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
Follow the same procedure as done for
contract- relax, then ask the patient to
perform concentric contraction of the
muscle opposite to the tight muscle.
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Passively lengthen the tight muscle to a
comfortable position.
 The patient perform a dynamic
contraction of the muscle opposite the
tight muscle.
 Apply mild resistance to the contracting
muscle, but allow joint movement to
occur.
 The tight muscle will relax as a result of
reciprocal inhibition.

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By sight
 By palpation
 By passive movement
 By shacking the limb
 By raising the limb and sudden fall down
 By EMG

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1. Decrease in muscle tension
2. Lowered heart and respiratory rates
and blood pressure
3. Increase skin temperature in the
extremities associated with
vasodilatation
4. Constricted pupils
5. Eyes closed and flat facial expression
6. Jaw and hands relaxed with palms
open
7. Decreased distractibility.
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