Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta‐analysis of randomized controlled trials

• Published in: Journal of occupational health Vol. 63; no. 1; pp. e12243 - n/a
• Main Authors: Zhang, Michael, Murphy, Brittany, Cabanilla, Abegail, Yidi, Christina
• Format: Journal Article
• Language: English
• Published: Australia Oxford University Press 01.01.2021; John Wiley and Sons Inc
• Subjects: Bias; Burnout; Cardiovascular disease; Clinical trials; Coronaviruses; COVID-19; COVID-19 - psychology; Exercise; Health care; Health Personnel - psychology; Health promotion; healthcare workers; Humans; Intervention; Massage; Medical personnel; Mental disorders; Mental health; Mental health care; Meta-analysis; Muscle contraction; Muscles; Music therapy; Occupational Health; occupational medicine; Occupational stress; Occupational Stress - psychology; Psychological stress; Randomized Controlled Trials as Topic; Relaxation method (mathematics); Relaxation Therapy - psychology; Review; Standard deviation; Stress; Systematic review; Therapy; Workers; Workplace - psychology; Yoga; Yoga - psychology; stress; burnout; occupational medicine; healthcare workers
• ISSN: 1348-9585; 1341-9145; 1348-9585
• DOI: 10.1002/1348-9585.12243

Objectives Work related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID‐19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta‐analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers. Methods Databases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow‐up. Meta‐analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non‐intervention controls. Network meta‐analysis was conducted to determine the best relaxation method. Results Fifteen trials representing 688 healthcare workers were identified. Random‐effects meta‐analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow‐up vs baseline compared to non‐intervention controls (SMD −0.53; 95% CI [−0.74 to −0.33]; p < .00001). On network meta‐analysis, only yoga alone (SMD −0.71; 95% CI [−1.01 to −0.41]) and massage therapy alone (SMD −0.43; 95% CI [−0.72 to −0.14]) were more effective than control, with yoga identified as the best method (p‐score = .89). Conclusion Physical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.