Is relaxation therapy effective for adults with intellectual disabilities?
Date of publication of the randomized controlled trial: September 2016
Design
Randomized controlled trial (RCT).
Participants
30 adults with mild or moderate intellectual disabilities (ID) (mean age: 40.37 years, male %: 47%). All the participants had an IQ below 70 as evaluated by the Wechsler Adult Intelligence Scale III.
Intervention
Relaxation therapy consisted of 60-minute classes was held once a week for 10 weeks.
Comparator
Comparison: Relaxation therapy versus wait-list controls.
Major Outcomes
Outcome 1: Self-esteem as assessed by French version (FV) of the Rosenberg Self-Esteem Scale (RSES) after 10 weeks. Higher scores indicated higher self-esteem.
Outcome 2: Emotional regulation as assessed by FV of the Emotion Regulation Questionnaire (ERQ) after 10 weeks. Higher scores indicated greater use of the emotion regulation strategy.
Outcome 3: Anxiety as assessed by State-Trait Anxiety Inventory form Y scale (STAI-Y) after 10 weeks. Higher scores indicated greater anxiety.
Settings
This study was performed in an outpatient setting.
Comparison    Relaxation therapy versus wait-list controls
Main Results
Compared to wait-list controls, relaxation therapy showed significant effects in improving self-esteem (Cohen’s d: 0.84, 95% CI: 2.42 to 4.30). Relaxation therapy also showed a higher use of cognitive reevaluation (Cohen’s d: 1.45, 95% CI: 0.27 to 0.81) and lower state anxiety (Cohen’s d: -0.93, 95% CI: -6.67 to -0.8). For all outcomes, the effect sizes were large or very large.
Comparison: Relaxation therapy versus wait-list controls in adults with ID
Outcomes Outcomes Mean score (SD) /No. of participants Heterogeneity test (I2) Cohen’s d (95% CI) Overall quality of evidence*
Intervention Comparator
1 1 (30) 35.40 (3.20)/15 32.30 (4.10)/15 Not applicable as there is only 1 study. 0.84 (2.42 to 4.30) Moderate
2 1 (30) 2.85 (0.39)/15 2.31 (0.35)/15 Not applicable as there is only 1 study. 1.45 (0.27 to 0.81) Moderate
3 1 (30) 51.30 (4.50)/15 55 (3.21)/15 Not applicable as there is only 1 study. -0.93 (-6.67 to -0.80) Moderate
Keys: SD: standard deviation; CI: confidence interval.
Comparison    Relaxation therapy versus wait-list controls
Main Results
Compared to wait-list controls, relaxation therapy showed significant effects in improving self-esteem (Cohen’s d: 0.84, 95% CI: 2.42 to 4.30). Relaxation therapy also showed a higher use of cognitive reevaluation (Cohen’s d: 1.45, 95% CI: 0.27 to 0.81) and lower state anxiety (Cohen’s d: -0.93, 95% CI: -6.67 to -0.8). For all outcomes, the effect sizes were large or very large.
Comparison: Relaxation therapy versus wait-list controls in adults with ID
Outcomes 1 2 3
Outcomes 1 (30) 1 (30) 1 (30)
Mean score (SD) /No. of participants Intervention 35.40 (3.20)/15 2.85 (0.39)/15 51.30 (4.50)/15
Comparator 32.30 (4.10)/15 2.31 (0.35)/15 55 (3.21)/15
Cohen’s d (95% CI) 0.84 (2.42 to 4.30) 1.45 (0.27 to 0.81) -0.93 (-6.67 to -0.80)
Overall quality of evidence* Moderate Moderate Moderate
Keys: SD: standard deviation; CI: confidence interval.
Conclusion
Benefits
Compared to wait-list controls, 10-session relaxation therapy may help adults with ID to improve their quality of life and life satisfaction by reducing state anxiety, improving self-esteem and improving cognitive reappraisal. For all outcomes, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were specifically associated with relaxation therapy.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/ 26420821
The synopsis is based on the following article:
Bouvet C, Coulet, A. Relaxation therapy and anxiety, self-esteem, and emotional regulation among adults with intellectual disabilities: A randomized controlled trial. Journal of Intellectual Disabilities. 2016 Sep; 20(3): 228-240.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.