Table I.

Characteristics of the included studies.

			No. of participants
Author/(Ref.), year	Relaxation technique	Surgery type	R	C	Age group	Sex	Relaxation protocol	Time interval between post-test and relaxation	Study conclusion
Flaherty and Fitzpatrick (27), 1978a	Jaw relaxation	Cholecystectomy, herniorrhaphy, haemorrhoidectomy	21	21	18–65	M: 23 F: 19	6–8 h after surgery, relaxation started just before patient ambulation (30 ft), continued during and after ambulation.	Immediately	Significantly less incisional pain, body distress and respiratory rate in relaxation group. No difference in blood pressure and pulse rates.
Wilson (26), 1981	Systematic relaxation	Cholecystectomy, hysterectomy	17	18	42.3 10.7	NS	Relaxation therapy used by patients as and when desired for post-operative days 1, 2 and 3.	NS	Significantly better hospital recovery in relaxation group
							Data of 3 days averaged and compared.	NS	Significantly less pain in relaxation group.
Levin et al (20), 1987	Benson's relaxation	Cholecystectomy	9	10	21–65	F: 19	Relaxation therapy used by patients as and when desired. Data collected evening of surgery and then twice daily for 2 days.		No difference in number of analgesics consumed and length of hospital stay between 2 groups.
Good et al (9), 1999a	Jaw relaxation	Gastro-intestinal, gynaecological, exploratory, urinary	130	120	20–70	NS	On 1st post-operative day, relaxation started 5 min prior to ambulation, continued during and after ambulation for 10 min. One half tested after ambulation other half tested at rest. Order reversed on 2nd day.	10 min	Significantly less pain and distress in relaxationgroup. Reduced pulse rates and respiratory rates in treatment group.
Roykulcharoen and Good (2), 2004a	Systematic relaxation	Gastrointestinal, gynaecological, exploratory	51	51	21–65	M:18 F: 84	Post-ambulation on 1st post-operative day, relaxation therapy given for 15 min.	Immediately	Significantly less pain sensation and distress of pain in relaxation group. No change in anxiety levels between the 2 groups and no difference in 6-h opioid intake
Chandrababu (25), 2012	Progressive muscle relaxation	NS	20	20	18–60	NS	On 1st post-operative day, relaxation therapy performed for 20 min. Repeated twice daily for 3 days.	5 min	Significantly less pain in relaxation group. No difference in respiration rate, systolic blood pressure and diastolic blood pressure between the 2 groups.
Topcu and Findik (4), 2012	NS	NS	60	60	48.38 NS	NS	On post-operative days 1–4, relaxation therapy performed for 20 min.	Immediately	Significantly less pain in relaxation group.
Rejeh et al (7), 2013a	Systematic relaxation	NS	62	62	65–92	M: 32 F: 92	Relaxation therapy repeated 3 times. Post-test measured after 15 min recovery following ambulation.	15 min, 1 h and 12 h	Significantly less pain, anxiety and analgesic use in relaxation group.
Solehati and Rustina (24), 2015	Benson's relaxation	Caesarean	30	30	NS	F: 60	Relaxation therapy performed 2 h after the operation, continued twice daily for 4 days.	Immediately	Significant pain reduction seen in both relaxation and control groups
Devi and Saharia (23), 2017a	Progressive muscle relaxation	Appendicectomy, cholecystectomy, hernioplasty, gastrectomy, gastro-jejunostomy	20	20	20–40	M: 20 F: 20	For 3 post-operative days, relaxation therapy performed for 15 min.	1h	Significantly less pain in relaxation group
Devmurari and Nagrale (22), 2018	Progressive muscle relaxation	Caesarean	17	17	18–30	F: 34	Relaxation therapy performed 10 times per session. One session performed each day from post-operative days 3–7.	After completing 5 days of therapy	Greater pain reduction in relaxation group. No statistical analysis done.
Ismail and Elgzar (21), 2018a	Progressive muscle relaxation	Caesarean	40	40	20–35	F: 80	Relaxation therapy performed thrice daily for 30 min on post-operative days 0 and 1.	After completing 2 days of therapy	Significantly less pain, improved physical activity and better quality of sleep in relaxation group.

^aStudies included in the meta-analysis. R, relaxation group; C, control group; M, male; F, female; NS, not specified.