Rheumatoid arthritis: A study of relaxation and temperature biofeedback training as an adjunctive therapy

Abstract

Rheumatoid arthritis (RA) is a painful systemic disease and is believed to be exacerbated by stress. Relaxation and biofeedback strategies have demonstrated utility in alleviating both pain and stress-related symptomatology, and therefore were tested for efficacy with this disease in a two-phase study. First, 24 patients were taught a relaxation technique and then trained in either temperature elevation or reduction. Second, a group of 15 patients thus trained was compared with 8 others who received traditional physiotherapy modalities. Psychological tests, functional/physical evaluations, as well as measurements related to pain, sleep, and other activities were carried out. Results of the first study revealed significant and positive changes following treatment that were primarily related to pain, tension, and sleep patterns for both groups, but no differential effects were noted between temperature elevation or reduction conditions. This was attributed to both groups having maintained temperature above baseline during biofeedback training. The results of the second study consistently favored the relaxation and biofeedback over the physiotherapy group on the physical/functional indices. The psychological measures tended to remain constant throughout both studies, leading to the conclusion that the effectiveness of treatment was specific to physical functioning rather than to a psychological enhancement of well-being.

Stress, Inflammation and Pain: A Potential Role for Monocytes in Fibromyalgia-related Symptom Severity

“…The General Sleep Disturbance Scale (GSDS) measures frequency of subjective sleep disturbances and problems over the past 7 days using an eight‐point Likert scale with a range from 0 to 7 (0 = never, 7 = every day), with a higher total score indicating a greater degree of sleep disturbance. Reliability and validity of the GSDS have been established in healthy persons and those diagnosed with chronic pain conditions, HIV or cancer (Achterberg, McGraw, & Lawlis, ; Aouizerat et al, ; Gay, Lee, & Lee, ; Lee, ). Cronbach's alpha coefficients ranging from 0.79 to 0.88 have been reported for the GSDS (Lee, ; Seib, Anderson, & Lee, ); in the study sample being reported on in this article, Cronbach's alpha for the GSDS was 0.765.…”

Coping with arthritis pain. A review of the literature

“…Biofeedback training is the use of electromechanical monitoring devices to provide feedback for the purpose of altering physiological activity. Achterberg et al [56] reported that skin temperature training resulted in higher peripheral temperature and lower EMG levels among RA patients. The skin temperature training also resulted in improved mood, pain, activities of daily living, and sleep.…”

Temperature biofeedback and sleep: limited findings and methodological challenges

“…[23][24][25][26][27][28][29] By contrast, less is known about the effectiveness of thermal biofeedback as a treatment for insomnia. Two case studies report that hand temperature biofeedback was successful in normalizing sleep onset in a middle-aged patient with sleep-onset insomnia, 25 and that foot warming improved sleep quality in a 21-year-old good sleeper.…”