The Effects of a Brief Relaxation Program on Symptom Distress and Heart Rate Variability in Cancer Patients

Asher, Arash; Palmer, J. Lynn; Yadav, Rajesh R.; Yusuf, Syed W.; Konzen, Benedict; Bruera, Eduardo; Guo, Ying

doi:10.1016/j.pmrj.2010.04.026

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Volume 2, Issue 7 , Pages 636-641, July 2010

The Effects of a Brief Relaxation Program on Symptom Distress and Heart Rate Variability in Cancer Patients

Portions of this work presented at the AAPM&R Annual Assembly in October 2009

Arash Asher, MD
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, C-2000, Los Angeles, CA 90048^⁎
- Address correspondence to: A.A.
J. Lynn Palmer, PhD
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX^†
Rajesh R. Yadav, MD
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX^‡
Syed W. Yusuf, MD
- Department of Cardiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX^§
Benedict Konzen, MD
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX^∥
Eduardo Bruera, MD
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX^¶
Ying Guo, MD
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX^#

Received 30 October 2009; accepted 27 April 2010.

Objectives

To determine whether a 15-minute, one-time guided relaxation program for cancer patients could improve symptom distress as measured by the Edmonton Symptom Assessment System (ESAS). In addition, we were interested in characterizing the changes of the autonomic nervous system, as demonstrated by heart rate variability (HRV) high-frequency (HF) spectral analysis, before and after this relaxation program.

Design

Nonrandomized pilot study.

Setting

Comprehensive cancer center.

Methods

Twenty cancer patients underwent a 15-minute relaxation program. The ESAS and a 5-minute HRV recording were completed before and after the relaxation program.

Main Outcome Measures

The differences between the pre- and post-summed ESAS score and HRV values were compared by a paired t-test.

Results

The summed ESAS scores were significantly lower after the relaxation program (P < .01), with an average 31% decrease in total score. However, no differences were found in HRV HF power. There was no correlation between the change in HRV HF and change in symptom distress, as measured by ESAS.

Conclusions

A brief guided relaxation program can significantly improve symptoms as measured by ESAS. More research is required to understand the effects of relaxation on HF HRV power.