1. Relaxation
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2. 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 (relaxation training)
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3. Outlines 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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4. 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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5. Relaxation can be classified into:
Mental relaxation( reduce mental stress)
Physical relaxation ( reduce physical stress)
Also it can be classified into:
General relaxation
Local relaxation
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6. Factors Affecting Relaxation
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7. 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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8. 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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9. 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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10. 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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11. 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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12. Postural Tone. Cont.,
recumbent positions provide full support for all segments of the body general relaxation.
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13. (contraction=relaxation).
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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14. 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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15. 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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16. 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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17. Relaxation training
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18. 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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19. Common elements of relaxation training
Relaxation involves a reduction in muscle tension in the entire body or the region that is painful or restricted by conscious effort and thought.
Comfortable positions and support (Prone lying, Supine lying, Half lying, Side lying)
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20. When giving instructions the therapist uses a soft tone voice.
Training occurs in a quiet environment with low lighting and soothing music or an auditory cue on which the patient may focus.
The patient perform deep breathing exercises or visualizes a peaceful scene.
When giving instructions the therapist uses a soft tone voice.
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21. Lying supine
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22. 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 T- shaped footrest.
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23. Side lying
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24. Prone Lying
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25. Examples of approaches to relaxation training
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26. Autogenic training. It involves conscious relaxation through autosuggestion and a progression of exercises
Progressive relaxation. It uses systemic, distal to proximal progression of voluntary contraction and relaxation of muscles.
Awareness through the movement. It combines sensory awareness, movements of the limbs and trunk, deep breathing, conscious relaxation procedures, and self-massage to alter muscle imbalances and abnormal postural alignment to remediate muscle tension and pain.
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27. Sequence for progressive relaxation techniques
Place the patient in quiet area and in a comfortable position, and be sure that restrictive clothing is loosened.
Have the patient breath in a deep, relaxed manner.
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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28. Sequence for progressive relaxation techniques. Cont.,
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.
Progress to a more proximal area of the body and have the patient actively contract and actively relax the proximal musculature.
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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29. Local Relaxation
Preparatory to massage and passive movement. It can complement starching program
For relief of spasm.
To prevent adaptive shortening.
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30. Local relaxation is gained through
Heat: superficial or deep heat is applied to increase circulation to the soft tissue. (increase soft tissue extensibility prior stretching exercises)
Massage: superficial and deep massage can be used to increase local circulation and decrease muscle spasm.
Biofeedback: it reduce the amount of tension in a muscle (visual and /or auditory biofeedback).
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31. Joint traction or oscillation: slight manual distraction of joint surface can be used to decrease muscle spasm around the joint.
Contrast method
Reciprocal method
Suggestion method
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32. Contrast method Physiology
Strong contraction of the muscle is followed by an equal relaxation of the same muscle or
Excitation= inhibition
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33. Contrast method. Cont., 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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34. Contrast method. Cont., 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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35. Reciprocal method 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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36. Reciprocal method. cont.,
technique
The sequence used is more usually proximal to distal
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37. Suggestion method technique
In this technique the therapist provides comfortable relaxing conditions for patient:
A warm well-ventilated room
A comfortable support
Light covering
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38. Then by using quiet hypotonic mellow tones
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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39. Pendular swinging
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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40. Pendular swinging. Cont.,
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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41. Active inhibition techniques include: Contract- relax
Active inhibition techniques: are reflex relaxation procedures that therapist use to inhibit muscle prior to stretching or lengthening.
Active inhibition techniques include:
Contract- relax
Contract - relax –contract
Agonist contraction
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42. 1-Contract – relax (hold- relax):
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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43. 2- Contract – relax- contract (hold- relax- Contract):
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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44. 3-Agonist contraction
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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45. How to test relaxation:
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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46. Indicators of relaxation
Decrease in muscle tension
Lowered heart and respiratory rates and blood pressure
Increase skin temperature in the extremities associated with vasodilatation
Constricted pupils
Eyes closed and flat facial expression
Jaw and hands relaxed with palms open
Decreased distractibility.
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