Efficacy of progressive muscle relaxation training in post-traumatic stress disorder after the Kahramanmaraş earthquake: a randomized controlled trial

The February 6, 2023 Kahramanmaraş earthquake was one of Turkey’s most devastating natural disasters, causing serious psychological issues, especially Post-Traumatic Stress Disorder (PTSD). Although various treatments exist for PTSD, they can be costly and sometimes ineffective. Progressive Muscle Relaxation Training (PMRT) is a low‑cost, self‑administered technique with no side effects, but randomized controlled trials on its effectiveness for post‑earthquake PTSD remain very limited. This randomized trial examined whether PMRT effectively treats PTSD in individuals after the Kahramanmaraş earthquake. The study included 44 earthquake-affected individuals aged 18–65 who met at least one of the following criteria: formal DSM-5 PTSD diagnosis by a psychiatrist, or a PCL-5 score of 47 or higher (indicating clinically significant PTSD symptoms). Based on power analysis, 22 participants were assigned to each group via block randomization: PMRT and control. All received PTSD and healthy lifestyle information; those on ongoing treatment continued. The PMRT group additionally received 6 weeks (twice/week, 20–30 min/session) of telerehabilitation-based PMRT. Assessments (PCL-5, DASS-21, PSQI, FSS, SF-36) were conducted pre- and post-intervention. Time-group interactions were analyzed with two-way mixed ANOVA ( p < 0.05). In the PMRT group, PTSD symptom severity significantly decreased after the intervention ( p < 0.001; η² p = 0.735). Significant improvements were also observed in depression (η² p = 0.435), anxiety (η² p = 0.521), stress (η² p = 0.504), sleep quality (η² p = 0.632), fatigue (η² p = 0.477), and both physical (η² p = 0.727) and mental (η² p = 0.630) components of quality of life compared to the control group ( p < 0.001). In the control group, no significant changes were observed in these parameters, while sleep quality and physical health deteriorated in the control group. PMRT was associated with greater improvements in PTSD symptoms, psychological well-being, sleep quality, fatigue, and quality of life compared to an education-only control group. Telerehabilitation may offer a practical advantage when face-to-face care is limited, although this remains speculative. NCT07164261-02.09.2025.