Biofeedback-assisted Relaxation Therapy Research Articles

Biofeedback-Assisted Relaxation Therapy on Women with Breast Cancer after Mastectomy: Effects of EMG-HRV Biofeedback on Psychological Symptoms

Abstract Introduction: Breast cancer patients usually react to mastectomy surgery by increased levels of stress, anxiety and depression which requires effective interventions. The aim of present research was to investigate the effects of an Electromyography (EMG) and heart rate variability (HRV) biofeedback-assisted relaxation training to alleviate the psychological symptoms of mastectomy breast cancer women. Method: In a randomized controlled trial design about 14 mastectomy women were randomly chosen and divided into two groups and measures of Depression Anxiety Stress Scale were gathered for them. The experimental group received biofeedback-assisted relaxation training, whereas no intervention administered on the control group. All subjects again completed the DASS scales afterwards. Indices of smooth artifact free surface Electromyography (sEMG) and HRV biofeedback recorded using a Biofeedback 2000 x-pert system Version 4. Data were analyzed by a General Linear Model: Multivariate Analysis of Variance statistical analysis. Results: Depression, anxiety, and stress average scores showed a significant difference after biofeedback intervention. Significant differences were observed in the sEMG and Heart Rate Variability-Index (HRV-Index) measures of the two groups with better results for the experimental subjects as well. Conclusion: The biofeedback-assisted relaxation training could effectively decrease negative psychological symptoms of the mastectomy breast cancer patients due to sEMG and HRV positive changes and is then recommended for these patients in the course of their treatment.

Systematic Review of Biofeedback Interventions for Addressing Anxiety and Depression in Children and Adolescents with Long-Term Physical Conditions.

Children and adolescents with long-term physical conditions are at increased risk of psychological problems, particularly anxiety and depression, and they have limited access to evidence-based treatment for these issues. Biofeedback interventions may be useful for treating symptoms of both psychological and physical conditions. A systematic review of studies of biofeedback interventions that addressed anxiety or depression in this population was undertaken via MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Central Register of Controlled Trials databases. Primary outcomes included changes in anxiety and depression symptoms and 'caseness'. Secondary outcomes included changes in symptoms of the associated physical condition and acceptability of the biofeedback intervention. Of 1876 identified citations, 9 studies (4 RCTs, 5 non-RCTs; of which all measured changes in anxiety and 3 of which measured changes in depression) were included in the final analysis and involved participants aged 8-25years with a range of long-term physical conditions. Due to the heterogeneity of study design and reporting, risk of bias was judged as unclear for all studies and meta-analysis of findings was not undertaken. Within the identified sample, multiple modalities of biofeedback including heart rate variability (HRV), biofeedback assisted relaxation therapy and electroencephalography were found to be effective in reducing symptoms of anxiety. HRV was also found to be effective in reducing symptoms of depression in two studies. A range of modalities was effective in improving symptoms of long-term physical conditions. Two studies that assessed acceptability provided generally positive feedback. There is currently limited evidence to support the use of biofeedback interventions for addressing anxiety and depression in children and adolescents with long-term physical conditions. Although promising, further research using more stringent methodology and reporting is required before biofeedback interventions can be recommended for clinical use instead or in addition to existing evidence-based modalities of treatment.

The Short-Term and Long-Term Effects of Biofeedback-Assisted Relaxation Therapy in Patients With Heart Failure

Background Relaxation techniques can reduce sympathetic nervous system activation and stress, potentially improving heart failure patients’ physical and psychological outcomes. Purpose To examine the effects of biofeedback-assisted relaxation (BFAR) therapy in patients with heart failure. Methods A prospective randomized control study was conducted. Participants in the treatment group received BFAR therapy, while participants in the control group received standard of care. Short-term outcomes were physical symptoms and psychosocial variables measured at baseline and 3 months; long-term outcomes were cardiac events and mortality assessed at 12 months. Results Fifty-two heart failure patients participated in the study: 23 (mean age 60.0 ± 13.7 years; 60.9% male; 39.1% New York Heart Association III/IV) in the treatment group and 29 (mean age 59.2 ± 12.2 years; 72.4% male; 48.3% New York Heart Association III/IV) in the control group. Short-term effects of BFAR on outcome variables were not significantly different between treatment and control groups. However, longer event-free survival was found in the treatment group compared with the control group ( p = .019). Conclusions/Implications for Practices BFAR therapy is effective to improve cardiac event-free survival of heart failure patients and can be applied to clinical setting.

A Cognitive-Behavioral, Biofeedback-Assisted Relaxation Treatment for Panic Disorder With Agoraphobia

A 39-year-old man diagnosed with panic disorder with agoraphobia, comorbid with depression, was treated successfully with cognitive-behavioral, biofeedback-assisted relaxation therapy. Treatment consisted of 22 individual sessions over the course of 10 months. Of those, 18 sessions included biofeedback with electrodermal response as the primarymodality and finger temperature monitored as a general index of relaxation. The core interventions utilized during treatment included psychophysiological monitoring, relaxation techniques, cognitive restructuring, and exposure to feared cues. Results were cessation of panic attacks, full remission of agoraphobia, and alleviation of depressive symptoms. Assessments used during the course of treatment included the Beck Anxiety Inventory, State-Trait Anxiety Inventory Form Y-2, Agoraphobic Cognitions and Body Sensations Questionnaires, and the Beck Depression Inventory-II. A treatment formulation that combined the most effective interventions with cognitive-behavioral underpinnings is discussed along with recommendations for practice.

A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with posttraumatic headache.

Although biofeedback in the treatment of migraine and tension-type headache has been widely researched, there is little research examining biofeedback therapy in posttraumatic headache (PTH). In this retrospective study, 40 subjects with PTH who had received biofeedback-assisted relaxation at our headache clinic were questioned at least 3 months following the completion of therapy. Subjects were queried about improvements in headache, increases in ability to relax and cope with pain, and overall benefits, lasting effectiveness, and continued use of biofeedback in daily life. Results indicate 53% reported at least moderate improvement in headaches; 80% reported at least moderate improvement in ability to relax and cope with pain; 93% found biofeedback helpful to some degree; 85% felt headache relief achieved through biofeedback had continued at least somewhat; and 95% stated they were continuing to use biofeedback skills in daily life. A correlation analysis revealed a negative relationship between response to biofeedback and increased chronicity of the disorder. In other words, the more chronic the disorder, the poorer the response to treatment. A stepwise regression analysis found that chronicity of the disorder and number of treatment sessions significantly affected response to treatment. Data suggest that biofeedback-assisted relaxation should at least be considered when planning treatment strategies for posttraumatic headache.

Evaluating the response of mild hypertensives to biofeedback-assisted relaxation using a mental stress test

The objective of this study was to evaluate the long term effect of a program of biofeedback-assisted relaxation on hypertensive patients by mental stress test reactivity. Twenty mild hypertensive patients were subjected to a mental arithmetic stress test before and six months after completing biofeedback-assisted relaxation therapy. The therapy consisted of 10 sessions of biofeedback-assisted relaxation instruction and continuous home practise. The study group was compared to a control group. The biofeedback-assisted relaxation treatment produced a mild improvement in blood pressure control and decreased the dose of drugs used as well as a decrease in state-anxiety ( p<0.05). The stress-induced increases in systolic blood pressure, diastolic blood pressure, heart rate, galvanic skin response and skin temperature were all significantly attenuated six months after completion of biofeedback-assisted relaxation treatment.

Changes in Cerebral Blood Flow Velocity Associated With Biofeedback‐Assisted Relaxation Treatment of Migraine Headaches are Specific for the Middle Cerebral Artery

Twenty-five patients with diagnosed migraine headaches were randomly assigned to a biofeedback-assisted relaxation therapy group or to a group who relaxed on their own. This study confirmed that the biofeedback trained group significantly decreased pain and medication more than the self-relax group. The best responders were those with the more elevated initial cerebral blood flow values and the changes in cerebral blood flow were specific for the middle cerebral artery.

Sustained effects of biofeedback-assisted relaxation therapy in essential hypertension

The usefulness of biofeedback-assisted relaxation as an adjunct or substitute for pharmacotherapy in essential hypertension can be enhanced if the effects are shown to persist after formal treatment has ended. Patients with essential hypertension successfully treated with biofeedback-assisted relaxation were recalled for follow-up yearly after the termination of treatment. Twenty-six of 40 patients met the BP criterion for success. At one-, two-, and three-year follow-up, 31%, 38%, and 27% of the successful completers continued to meet the criterion for success. The pretreatment-posttreatment decreases in BP were accompanied by decreases in forehead muscle tension and urinary cortisol. Forehead muscle tension, urinary cortisol, and anxiety levels were significantly lower than pretreatment one year after the end of treatment. Self-report data were used to assess continued relaxation practice. No relationship was found between practice and any other dependent measure. It appears that some patients trained in biofeedback-assisted relaxation can maintain lowered blood pressure, muscle tension, anxiety, and cortisol levels over the long term; however, the role of relaxation practice in maintaining these lowered levels remains unclear.

A semi-automated system for biofeedback-assisted relaxation therapy

A semi-automated system is described for use in research in biofeedback-assisted muscular relaxation therapy. The system employs a cassette tape recorder for presentation of instructions and for program control signals, programming modules for timing and gating EMG feedback and EMG recording intervals, a Kodak Carousel programmer to interface the cassette recorder with the programming system, and an EMG processor wired for external timing of feedback and counting of averaged EMG activity. A description of the current functioning of the system is presented, along with possible extensions.