Effects of a progressive muscle relaxation intervention on dementia symptoms, activities of daily living, and immune function in group home residents with dementia in Japan.

Only 18 people in the relaxation group and 19 in the control group were analysed, after exclusions for medication changes or fractures after falls. The paper describes assignment as random, but the method shown is ranking by unit and assigning odd and even ranks, which may not be equivalent to concealed random allocation. Group home staff who helped deliver the intervention also rated behaviour, mental status and daily living, so expectations or extra attention could have affected the scores. The relaxation group had more contact with researchers and staff than controls, so the added interaction may explain some improvements. Participants had to be able to sit and take part in recreational activities, so results may not apply to residents with more severe dementia or higher care needs. The saliva immune measure had large individual variation and baseline differences between groups, so it did not provide clear evidence of immune effects.

The paper states that no potential conflict of interest was disclosed.

Do not conclude that relaxation improves immune function or that daily living gains are independent of extra staff contact. The saliva immune measure did not show a clear between-group change, and staff who delivered the intervention also rated the behaviour and daily living outcomes, so unblinding and added attention may have influenced the positive scores.