The study, conducted by Tuğba Karadaşlı of Tatvan State Hospital and Mesut Arslan of Bitlis Eren University, enrolled 44 earthquake-affected adults aged between 18 and 65. To enter the trial, participants had to meet rigorous clinical thresholds: either a formal DSM-5 diagnosis of PTSD made by a psychiatrist, or a score of 47 or higher on the Post-Traumatic Stress Disorder Checklist for DSM-5, widely known as the PCL-5, which indicates clinically significant symptom burden. The researchers used block randomization to allocate 22 participants to an intervention group and 22 to a control group, a method that helps ensure balanced group sizes and reduces the risk of selection bias. Everyone in the trial received standard psychoeducation about PTSD and healthy lifestyle habits, and those already receiving ongoing treatment were permitted to continue it unchanged.

The intervention itself was elegantly straightforward. Participants in the experimental group underwent six weeks of Progressive Muscle Relaxation Training, delivered through telerehabilitation in twice-weekly sessions lasting 20 to 30 minutes each. The technique, first developed in the early twentieth century, is grounded in a simple physiological principle: by systematically tensing and then releasing specific muscle groups throughout the body, individuals learn to recognize and deliberately reduce physical tension. Because heightened muscle tension is closely intertwined with the autonomic arousal that sustains PTSD symptoms, the repeated practice of releasing that tension is thought to dampen the body’s chronic stress response, indirectly easing the intrusive thoughts, sleep disturbance, and emotional volatility that characterize the disorder. Crucially, the technique requires no medication, produces no pharmacological side effects, and can be self-administered once learned, making it an unusually practical tool for disaster settings where clinical resources are stretched thin.

To capture the full spectrum of trauma’s impact, the researchers assessed participants before and after the intervention using a battery of validated instruments. The PCL-5 measured PTSD symptom severity; the Depression Anxiety Stress Scale-21, or DASS-21, quantified three distinct dimensions of psychological distress; the Pittsburgh Sleep Quality Index tracked sleep disturbance, one of the most debilitating and persistent consequences of trauma; the Fatigue Severity Scale gauged exhaustion, which frequently accompanies chronic hyperarousal; and the Short Form-36 health survey assessed both physical and mental components of quality of life. Statistical analysis relied on two-way mixed analysis of variance to examine time-by-group interactions, with significance set at a threshold of p less than 0.05.

The results were unambiguous and, in places, dramatic. Among participants who received the relaxation training, PTSD symptom severity fell significantly after the intervention, with a time-group interaction yielding p less than 0.001 and a partial eta squared of 0.735, an effect size indicating that the intervention accounted for the overwhelming majority of the variance in symptom change between groups. For context, in behavioral intervention research, partial eta squared values above 0.14 are conventionally considered large; a value approaching 0.74 is exceptional. But the benefits did not stop at PTSD symptoms. Compared with controls, the trained group showed significant improvements in depression, with an effect size of 0.435; anxiety, at 0.521; stress, at 0.504; sleep quality, at 0.632; fatigue, at 0.477; and both the physical and mental components of quality of life, at 0.727 and 0.630 respectively, all with p values below 0.001.

Equally instructive was what happened to the control group. Participants who received only psychoeducation and standard care showed no significant improvement on any of the measured parameters over the six-week period. More sobering still, their sleep quality and physical health actually deteriorated during the study window, a pattern consistent with the natural history of untreated post-disaster PTSD, in which symptoms tend to persist or worsen without targeted intervention. This divergence between the two groups strengthens the causal interpretation of the findings, because both groups had equal access to general health information and continued treatment, meaning the relaxation training itself, delivered remotely, stands out as the active ingredient driving recovery.

The telerehabilitation delivery model deserves particular attention. By conducting sessions remotely, the researchers sidestepped one of the most persistent barriers to mental health care in disaster zones: the sheer difficulty of transporting survivors, many of them displaced, injured, or caregiving for children, to clinical facilities. Remote delivery also multiplied the reach of a limited number of trained providers across geographically dispersed populations. The authors note that telerehabilitation may offer a practical advantage when face-to-face care is limited, while appropriately characterizing this interpretation as speculative pending further research. Even so, the model aligns with a growing international literature showing that structured psychological interventions can be effectively delivered at a distance, and the trial’s registration on ClinicalTrials.gov under identifier NCT07164261 signals a commitment to prospective transparency.

The scientific rationale for why muscle relaxation should help trauma survivors is worth unpacking. PTSD is increasingly understood not merely as a psychological condition but as a disorder of physiological regulation, in which the sympathetic nervous system remains locked in a threat-detection mode long after danger has passed. Elevated resting muscle tension, altered heart rate variability, exaggerated startle responses, and fragmented sleep all reflect this persistent arousal state. Progressive Muscle Relaxation interrupts the loop from the bottom up: the deliberate contrast between tension and release trains interoceptive awareness, giving individuals a felt sense of what relaxation actually is and a reproducible method for achieving it. Over repeated sessions, this practiced downregulation of somatic arousal appears to generalize, reducing the baseline hyperarousal that fuels re-experiencing symptoms and avoidance behaviors. The trial’s broad improvements across depression, anxiety, stress, sleep, fatigue, and quality of life fit neatly with this mechanism, since these outcomes all share hyperarousal as a common physiological substrate.

Caveats remain. The trial involved 44 participants, a sample size determined by power analysis but still modest by the standards of multi-site trials, and the study was conducted at a single institution in a specific disaster context. The comparison group received education rather than an active alternative therapy, so the findings cannot yet speak to how Progressive Muscle Relaxation compares with first-line treatments such as trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing. Longer follow-up is needed to determine whether the gains persist after training ends, and the mechanisms mediating the improvements were not directly measured. Nevertheless, the combination of large effect sizes, a rigorous randomized design, objective validated outcome measures, and a delivery model suited to resource-constrained settings makes this one of the more compelling demonstrations of a minimal-intervention approach to disaster-related PTSD.

The implications reach well beyond Turkey. Earthquakes, floods, wildfires, and conflicts displace tens of millions of people each year, and post-disaster mental health need consistently outstrips the available supply of psychiatrists, psychologists, and therapists. An intervention that is free of side effects, costs almost nothing, requires no medication, and can be taught remotely in twelve short sessions represents exactly the kind of scalable tool the field has been searching for. If future studies replicate and extend these findings, Progressive Muscle Relaxation Training could become a standard component of disaster response protocols worldwide, offered alongside shelter, food, and medical care as a first line of defense for traumatized minds. For the survivors of Kahramanmaraş, the message from this research is quietly revolutionary: healing may not always require what victims lack, but can begin with something as simple, and as universally available, as learning to let go.

Subject of Research: Progressive Muscle Relaxation Training as a treatment for post-traumatic stress disorder in survivors of the Kahramanmaraş earthquake

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

Article References: Karadaşlı, T., & Arslan, M. (2026). Efficacy of progressive muscle relaxation training in post-traumatic stress disorder after the Kahramanmaraş earthquake: a randomized controlled trial. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08676-9

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08676-9

Keywords: PTSD, progressive muscle relaxation, Kahramanmaraş earthquake, telerehabilitation, randomized controlled trial, sleep quality, mental health, disaster psychology, anxiety, depression, quality of life, BMC Psychiatry