Effectiveness of Progressive Muscle Relaxation for Psychological Outcomes in Older Adults: A Systematic Review and Meta-Analysis

Progressive muscle relaxation (PMR) is a non-pharmacological intervention increasingly applied in geriatric settings; however, its effectiveness for psychological outcomes and adaptation difficulty in older adults remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of PMR for depressive symptoms, anxiety symptoms, and adaptation difficulty among the elderly. PubMed, Embase, Web of Science, and the Cochrane Library were searched. Randomized and controlled trials evaluating PMR as the primary intervention in adults aged ≥60 years were eligible for quantitative synthesis. Outcomes were assessed using validated psychological instruments and risk of bias was assessed using the Cochrane tool. Overall, 2209 records were identified, and five RCTs involving 390 participants were included in the meta-analysis. PMR was associated with a significant reduction in depressive symptoms compared with control conditions (4 studies; n = 336), although substantial heterogeneity was observed. PMR also significantly improved anxiety symptoms (2 studies; n = 202), although the low observed heterogeneity should be interpreted cautiously because only two studies contributed to the analysis. No significant effect was found for adaptation difficulty (2 studies; n = 112). PMR appears to be a potentially beneficial intervention for reducing anxiety and depressive symptoms in older adults, but evidence remains limited by small samples, predominantly high risk of bias including concerns regarding randomization, blinding, and self-reported outcomes, and geographic concentration in Asian populations, which limits generalizability to other cultural and healthcare settings. Larger, high-quality trials are needed to confirm these findings and clarify the broader psychosocial effects of PMR.