The Effect of Progressive Muscle Relaxation on Fatigue, Functional Ability, and Health Anxiety in Hospitalized Patients after Ischemic Stroke

To determine and compare the mean fatigue,functional ability,health anxiety scores of patients with ischemic stroke at three stages (pre, post-test, and 4-week follow-up) between the intervention and control groups .

study is a randomized, controlled, single-blind clinical trial with two parallel groups and a 4-week follow-up period, conducted on 120 patients. For randomization, a set of sealed envelopes containing predetermined numbers will be placed in a bag. A staff member will randomly select one envelope for each patient. Based on the assigned number, patients with even numbers will be allocated to the control group (receiving routine care), whereas those with odd numbers will be assigned to the intervention group (receiving progressive muscle relaxation).

The training sessions will be delivered individually, face-to-face, once daily during the morning shift, and will last approximately 20–30 minutes at the patient’s bedside in the neurology ward of Ali ibn Abi Talib and Khatam al-Anbia Hospitals in Zahedan. Each session involves the sequential tensing and relaxing of different muscle groups.This group will receive only routine ward care and no additional interventions.

First occurrence of ischemic stroke Age range between 20 and 80 years NIHSS score < 12 Ability to read and write No history of central nervous system disorders such as dementia, Parkinson’s disease, or seizures prior to the stroke No history of psychiatric disorders Accessibility and availability of the patient throughout the study period

The intervention group will undergo progressive muscle relaxation training conducted by a trained researcher for five consecutive days. control group will receive only routine ward care and no additional interventions.

Fatigue, Functional Ability, Health Anxiety

In this study, patients diagnosed with ischemic stroke who meet the inclusion criteria will be selected using a convenience sampling method upon admission to the ward. After obtaining written informed consent, each eligible patient will be enrolled as a participant in the study. The allocation of patients into the intervention and control groups will be performed randomly and immediately after admission. To achieve this, a number of sealed envelopes containing pre-assigned numbers will be placed in a bag, and one of the ward staff members will randomly draw an envelope for each patient. Based on the assigned number, patients with even numbers will be allocated to the control group (receiving routine care), while those with odd numbers will be allocated to the intervention group (receiving progressive muscle relaxation training). The randomization process will be conducted at the time of hospitalization and prior to the initiation of any intervention to prevent allocation bias and ensure baseline balance between the study groups.

In this study, the functional ability of patients in both the intervention and control groups will be assessed on the first day of hospitalization, on the fifth day of hospitalization at the time of discharge, and again four weeks after discharge. Functional status will be measured using the Barthel Index through direct observation or patient interview (and when communication difficulties are present, through an informed caregiver). All assessments will be conducted by an independent evaluator, selected from among master's-level nursing students, who will be blinded to the study details (Blinded Assessor) in order to minimize bias in data collection.