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. 2021 Jan;63(1):e12243.
doi: 10.1002/1348-9585.12243.

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

Michael Zhang  1 , Brittany Murphy  2 , Abegail Cabanilla  3 , Christina Yidi  4
Affiliations

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

Michael Zhang et al. J Occup Health. 2021 Jan.

Abstract

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.

Keywords: burnout; healthcare workers; occupational medicine; stress.

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Conflict of interest statement

Approval of the research protocol: N/A. Informed Consent: N/A. Registry and the Registration No. of the study/trial: N/A. Animal Studies: N/A.

Authors declare no Conflict of Interests for this article.

Figures

FIGURE 1
FIGURE 1
PRISMA study selection flowchart
FIGURE 2
FIGURE 2
Meta‐analysis of all physical relaxation methods vs no intervention on occupational stress reduction at the longest duration of follow‐up from baseline. A negative SMD indicates a reduction in stress measures vs baseline
FIGURE 3
FIGURE 3
Meta‐analysis of physical relaxation methods vs no intervention on physical health (top) and mental health (bottom) at the longest duration of follow‐up from baseline
FIGURE 4
FIGURE 4
Network plot of physical relaxation trials. The size of each node is proportional to the sample size, and line thickness is proportional to the number of trials
See this image and copyright information in PMC

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