Biofeedback Study

Few biofeedback studies few used double blind, randomized, placebo control designs. To investigation the effect of respiratory feedback on chronic pain, Kapitza, Passle, Bernatck, and Karst (2010) used the above design. Relaxation procedures have been shown as a useful method in reducing psychophysiological symptoms associated with chronic pain. Conscious breathing and the affect this has on heart rate variability are thought to be a mechanism that makes these effects possible. This connection is the reason Kapitz et al. (2010) decided to investigate respiratory biofeedback. Respiratory feedback (RFB) is considered a useful method for calming down and developing a relaxed stated (Kapitz et al., 2010).

In this study 42 patients with moderate chronic lower back pain were used. The inclusion criteria was 18-70 years of age, chronic lower back pain of myofascial origin for at least 3 months, but not fully explained by either structural or functional deficits alone (Kapitz et al., 2010). Both the invention and the control group performed daily 30-minutes breathing exercises with a portable RFB machine for 15 consecutive days. The intervention group received ordinary, synchronized feedback of their own breathing and the control group received no feedback, but a constant proxy signal corresponding to a breathing rate of ~8 breaths per minute. Both groups received the exact same instruction.

Each patient received a baseline clinical assessment that comprised of a detailed medical history. Afterwards they were assigned to an experimental group. The following measurements were obtained: relaxation index, pain diary, quantitative sensory testing, symptom checklist, pain disability index, and a Tellegen Absorption Scale. T-tests were used to examine between groups and within group differences.

Compared to the placebo RFB, actual RFB induced a higher relaxation index, higher reductions in pain at rest and during activity, and in psychopathological symptoms. The results did not reach significance at between group comparisons. Although, pre-post changes within the RFB group more often showed significant symptom reductions (Kapitz et al., 2010). This study demonstrated less pronounced effects then previous research, but did use the double blind, randomized, placebo controlled design.

The study was limited by the use of participants that started with relatively low pain scores. This resulted in small to moderate pain reduction. Second the researchers did not test whether muscle tension was related to stress responses. Further research could explore effects of longer periods of training and consider longer follow-up intervals, as well as including a waiting list group. Nevertheless, this study supports RFB as a useful method in the multimodal treatment of pain.

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