Recent studies focusing on autonomic nervous system (ANS) dysfunctions, together with theoretical pathophysiological models of musculoskeletal disorders, indicate the involvement of ANS regulation in development and maintenance of chronic muscle pain. Research has demonstrated the effectiveness of heart rate variability (HRV) biofeedback (BF) in increasing HRV and reducing the symptoms of different disorders characterized by ANS aberration. The study investigated the effects of resonance frequency HRV BF on autonomic regulation and perceived health, pain, stress and disability in 24 subjects with stress-related chronic neckshoulder pain. Twelve subjects participated in 10 weekly sessions of resonant HRV BF and were compared to a control group. Subjective reports and HRV measures during relaxation and in response to a standardized stress protocol were assessed for both groups pre-and postintervention. Group X time interactions revealed a significantly stronger increase over time in perceived health (SF-36) for the treatment group, including vitality, bodily pain and social functioning. Interactions were also seen for HRV during relaxation and reactivity to stress.The present pilot study indicates improvement in perceived health over a 10 week intervention with HRV-biofeedback in subjects with chronic neck-pain. Increased resting HRV as well as enhanced reactivity to hand grip and cold pressor tests might reflect beneficial effects on ANS regulation, and suggest that this intervention protocol is suitable for a larger controlled trial.

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The aim of the study was to assess the efficacy of the standardised extract SHR-5 of roots of Rhodiola Rosea L. in the treatment of individuals suffering from stress-related fatigue. The phase III clinical trial took the form of a randomised, double-blind, placebo-controlled study with parallel groups. Participants, males and females aged between 20 and 55 years, were selected according to the Swedish National Board of Health and Welfare diagnostic criteria for fatigue syndrome. A total of 60 individuals were randomised into two groups, one ( N = 30) of which received four tablets daily of SHR-5 extract (576 mg extract/day), while a second ( N = 30) received four placebo tablets daily. The effects of the extract with respect to quality of life (SF-36 questionnaire), symptoms of fatigue (Pines' burnout scale), depression (Montgomery -Asberg depression rating scale - MADRS), attention (Conners' computerised continuous performance test II - CCPT II), and saliva cortisol response to awakening were assessed on day 1 and after 28 days of medication. Data were analysed by between-within analyses of variance. No serious side effects that could be attributed to the extract were reported. Significant post-treatment improvements were observed for both groups (placebo effect) in Pines' burnout scale, mental health (SF-36), and MADRS and in several CCPT II indices of attention, namely, omissions, commissions, and Hit RT SE. When the two groups were compared, however, significant effects of the SHR-5 extract in comparison with the placebo were observed in Pines' burnout scale and the CCPT II indices omissions, Hit RT SE, and variability. Pre- VERSUS post-treatment cortisol responses to awakening stress were significantly different in the treatment group compared with the control group. It is concluded that repeated administration of R. ROSEA extract SHR-5 exerts an anti-fatigue effect that increases mental performance, particularly the ability to concentrate, and decreases cortisol response to awakening stress in burnout patients with fatigue syndrome.

Stress diagnosis based on finger temperature (FT) signals is receiving increasing interest in the psychophysiological domain. However, in practice, it is difficult and tedious for a clinician and particularly less experienced clinicians to understand, interpret, and analyze complex, lengthy sequential measurements to make a diagnosis and treatment plan. The paper presents a case-based decision support system to assist clinicians in performing such tasks. Case-based reasoning (CBR) is applied as the main methodology to facilitate experience reuse and decision explanation by retrieving previous similar temperature profiles. Further fuzzy techniques are also employed and incorporated into the CBR system to handle vagueness, uncertainty inherently existing in clinicians reasoning as well as imprecision of feature values. Thirty-nine time series from 24 patients have been used to evaluate the approach (matching algorithms) and an expert has ranked and estimated similarity. On average goodness-of-fit for the fuzzy matching algorithm is 90% in ranking and 81% in similarity estimation that shows a level of performance close to an experienced expert. Therefore, we have suggested that a fuzzy matching algorithm in combination with CBR is a valuable approach in domains, where the fuzzy matching model similarity and case preference is consistent with the views of domain expert. This combination is also valuable, where domain experts are aware that the crisp values they use have a possibility distribution that can be estimated by the expert and is used when experienced experts reason about similarity. This is the case in the psycho-physiological domain and experienced experts can estimate this distribution of feature values and use them in their reasoning and explanation process.

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Healthy participants habituated to the induced pain on the BN and were able to subjectively relax. When on a BN, signs of both sympathetic and parasympathetic nervous system activity were observed. The pain may hypothetically have triggered a parasympathetic response.

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