PubMed Health⌕ Search

Biomedical subjects

H Kotses

Publications and source records attributed to H Kotses.

At least 19 recordsLinked to original sources
PubMed1992

EMG stability as a biofeedback control.

Factors that may confound comparisons between electromyographic (EMG) biofeedback training and its control conditions include feedback quality and experience of success. We investigated the usefulness of a control procedure designed to overcome these potential sources of confounding. The procedure consisted of training muscle tension stability. We used it as a control for frontal EMG relaxation training in children with asthma. To equate the groups for feedback quality and experience of success, we gave each child in the control condition audio feedback decreasing in pitch when muscle tension was at or near baseline levels, and feedback increasing in pitch when muscle tension was either substantially above or below baseline levels. Children in both groups were instructed to decrease the pitch of the tone. In comparison to children in the relaxation condition, the children in the control condition exhibited stable levels of muscle tension throughout eight training sessions. We concluded that feedback for stable muscle tension may be a useful control procedure for EMG biofeedback training whenever experimental and control procedures differ in either feedback quality of degree to which they permit subjects to experience success.

Adolescent↗
PubMed1992

A life activities questionnaire for adult asthma.

The development, testing, and applicability of an instrument, the Life Activities Questionnaire for Adult Asthma is described that can be used to assess activity restriction in adults with asthma. It explains how items for the instrument were selected to insure the validity of the developed instrument. The reliability of the questionnaire is also discussed. The result is a valid and reliable paper-and-pencil instrument that should have wide applicability as a component of quality of life measurement. This instrument has potential for functional use in clinical settings, research environments, and policy-making procedures.

Activities of Daily Living↗
PubMed1991

Long-term effects of biofeedback-induced facial relaxation on measures of asthma severity in children.

We studied the effects of electromyographic biofeedback on measures of asthma severity in children. Fifteen children received biofeedback training to reduce facial tension, and 14 children, who served as controls, received biofeedback training to maintain facial tension at a stable level. Assignment to experimental condition was random. As a result of training, electromyographic levels decreased in children trained in facial relaxation and remained fairly constant in children trained in facial tension stability. Biofeedback training was augmented for children in both groups by having them practice their facial exercises at home. Each child's condition was followed for a five-month period subsequent to biofeedback training. Throughout the experiment, the following measures of asthma severity were monitored: lung function, self-rated asthma severity, medication usage, and frequency of asthma attacks. In addition, standardized measures of attitudes toward asthma, self-concept, and chronic anxiety were recorded at regular intervals. As compared to the facial stability subjects, the facial relaxation subjects exhibited higher pulmonary scores, more positive attitudes toward asthma, and lower chronic anxiety during the follow-up period. Subjects in the two groups, however, did not differ on self-rated asthma severity, medication usage, frequency of asthma attacks, or self-concept. Based on the improvements we observed in pulmonary, attitude, and anxiety measures, we concluded that biofeedback training for facial relaxation contributes to the self-control of asthma and would be a valuable addition to asthma self-management programs.

Adolescent↗
PubMed1991

The COPD Self-Efficacy Scale.

Many individuals with COPD develop a lack of confidence regarding their ability to avoid breathing difficulty while participating in certain activities, however minimal the physical demands of the activity may be. This lack of confidence may be expressed as low self-efficacy. As a result of low self-efficacy, COPD patients may refrain from many routine activities of daily living. Identifying situations in which individuals with COPD experience low self-efficacy would allow the development of specific treatment interventions designed to increase the patient's self-efficacy in those situations and consequently increase activity. We developed a 34-item COPD Self-Efficacy Scale (CSES) to assess self-efficacy in individuals afflicted with COPD. The CSES has good test-retest reliability (r = .77), excellent internal consistency (Cronbach's alpha = .95), and a five-factor structure (negative affect, intense emotional arousal, physical exertion, weather/environmental, and behavioral risk factors.

Activities of Daily Living↗
PubMed1991

Predicting asthma in individual patients.

The degree to which asthma attacks were related to seven environmental variables was determined for each of 17 individuals. Using stepwise regression procedures, cladosporium mold, ragweed pollen, and a change in temperature were significant predictors of asthma attacks in 5 of 17 individuals. The information provided by these analyses could prove useful in helping some individuals manage their asthma.

Adult↗
PubMed1991

Prediction of asthma episodes in children using peak expiratory flow rates, medication compliance, and exercise data.

Asthmatic patients demonstrate considerable variation in the extent to which their subjective evaluations and objective measures of airways obstruction correspond. The detection and prediction of asthma episodes have been improved through the use of objective pulmonary measures, such as peak expiratory flow rate (PEFR). Furthermore, information regarding adherence to medication regimens and specific asthma triggers (ie, exercise) may also improve the predictability of asthma in children. The utility of using PEFR values, medication compliance information, and exercise data for the prediction of asthma episodes in individual children was investigated in the present study. Individual logistic regression equations were calculated for ten asthmatic children. In predicting asthma episodes, PEFR was present in the model for nine out of ten subjects; exercise was included for two out of five subjects providing such data; whether an attack had occurred in the preceding 12-hour period was predictive for one out of ten participants; and whether an attack had been experienced in the previous 24 hours was present for four out of ten subjects. Hosmer-Lemeshow values indicated that the models fit the data well for nine subjects (alpha greater than .05). The mean model prediction rate (80.85%) was higher than the mean base rate (75.72%). The relative risk ratio values ranged from 0 to 5.72, with a mean of 3.50. These results suggest that the prediction of episodes may be enhanced by using PEFR, exercise, and time of day.

Adolescent↗
PubMed1990

Habituation of phasic total respiratory resistance responses.

We examined the effects of repetitious stimulation on phasic respiratory resistance responses of 30 healthy adult males. Individuals were told either that they would inhale a substance which would cause bronchoconstriction or that they would inhale a substance which would cause no breathing changes. All subjects completed four inhalation trials. During each trial a lamp was turned on to indicate the presence of the inhalant; in reality, the subjects inhaled no substances. Respiratory resistance and functional residual capacity were measured just before and during the time the lamp was on. Regardless of the type of instruction, the response to the inhalation task was predominantly an increase in respiratory resistance. During Trials 1, 2, and 3, the number of subjects who increased respiratory resistance was greater than the number of subjects who decreased respiratory resistance. The number of subjects who increased respiratory resistance was not different from the number of subjects who decreased respiratory resistance during Trial 4. Changes in functional residual capacity did not affect changes in respiratory resistance; functional residual capacity changed neither within nor between trials. Given a progressive decrease in the number of subjects who increased their respiratory resistance on successive trials, the results were consistent with a response habituation model.

Adolescent↗
PubMed1990

Environmental control of asthma self-management.

We describe a model of asthma self-management based on environmental control of behavior. The model emphasizes aspects of the environment that either prompt or strengthen asthma self-management behavior. In prompting behavior, environmental events function as behavioral cues; in strengthening behavior, they represent reinforcers. We describe concepts related to cueing and reinforcement, and how these operations might be incorporated in individualized self-management programs. Finally, we discuss evidence supporting asthma self-management programs based on environmental control behavior.

Asthma↗
PubMed1989

The Revised Asthma Problem Behavior Checklist.

The Asthma Problem Behavior Checklist (APBC) has proved to be an accurate and invaluable instrument for pinpointing potential behavioral problems in children with the disorder. This article presents the Revised Asthma Problem Behavior Checklist (RAPBC). The value of the RAPBC is that: (a) it has proven reliability when tested with asthmatic adults; (b) the change from a dichotomous yes/no format, used in the APBC, to a 5-point Likert-type answer format adds greater sensitivity to the instrument; and (c) data gathered with the RAPBC compare favorably to information gathered in two previous studies with the APBC. Considering the reliability and validity of the RAPBC, it should prove useful in both clinical and research settings.

Adolescent↗
PubMed1989

Living with asthma: Part II. Beyond CARIH.

This article focuses on the evolution and assessment of additional self-management programs and strategies following the original development and evaluation of Living with Asthma. In particular, it describes the basis and philosophy underlying a self-management program for adults with asthma. In doing so, it introduces strategies that can be used by adults to process and evaluate the information they gather, and to make decisions as to what steps to take to predict and prevent asthma attacks. These strategies rely upon techniques ranging from the use of decision-making trees to the calculation of conditional probabilities to enhance the patients' knowledge that an attack is apt to occur within a prescribed period. It is hoped that further refinement of these procedures will not only provide greater control over asthma, but may help reverse the recent trend of increased mortality due to the disorder.

Adult↗
PubMed1989

A reinterpretation of psychologically induced airways changes.

Psychologically induced airways changes in asthmatic individuals may be a function of variation in general activation level, not variation in asthma severity. The evidence for this hypothesis derives from work showing that healthy individuals exhibit psychologically induced airways changes similar to those exhibited by asthmatics. Individuals from both normal and healthy populations display increases in bronchomotor tone in response to stress and decreases in bronchomotor tone in response to relaxing stimulation. Although these responses are not limited to asthmatics, they are not irrelevant to asthma. Knowledge of specific relationships between airways changes and psychological factors is helpful in the management of asthma.

Asthma↗
PubMed1988

The effects of suggestion on the total respiratory resistance of nonasthmatic female subjects.

Bronchodilation suggestion, bronchoconstriction suggestion, or neutral suggestion was given to thirty nonasthmatic female subjects; the effect of the suggestion on the total respiratory resistance (Rt) of the subjects was examined. Subjects were told either (a) that they would inhale a substance which would make their breathing better, (b) that they would inhale a substance which would make their breathing worse, or (c) that they would inhale a substance which would have no effect on their breathing. In actuality, no subject inhaled any substance. Those subjects who were told that their breathing would worsen exhibited a reliable increase in R1, whereas those subjects who were told that their breathing would become better or that their breathing would not be affected exhibited no reliable change in Rt. This study confirmed earlier work, showing that bronchoconstriction suggestion increases Rt in healthy individuals. Furthermore, this study showed that bronchodilation suggestion alone is not sufficient to produce a decrease in Rt.

Adult↗
PubMed1988

Measures of asthma severity recorded by patients.

Twenty-nine children with asthma made daily recordings of the severity of their asthma for 8 months. Each child recorded four measures of severity: a medication usage score, a morning peak expiratory flow rate (PEFR), an evening PEFR, and a subjective rating of overall severity. We determined the relationships between the four measures. Except for the morning and evening PEFRs, the relationships between the measures were weak; the PEFR measures were highly related to one another. The relationship between PEFR scores and medication usage scores increased following biofeedback relaxation training.

Adolescent↗
PubMed1987

The effect of changes in facial muscle tension on respiratory resistance.

The relationship between changes in facial electromyographic (EMG) levels and respiratory resistance was examined. Thirty adult males were assigned equally to 1 of 3 groups; a facial muscle tension increase group (EMG increase), a facial tension decrease group (EMG decrease), and a noncontingent group (EMG noncontingent). Biofeedback procedures, based on EMG recordings made form electrodes positioned over the frontalis muscles, were used to effect muscle tension changes. Individuals in the EMG increase group exhibited increases in facial tension, but individuals in the EMG decrease group failed to show muscle tension changes. Respiratory resistance increased in individuals in the EMG increase group but did not change in individuals in the EMG decrease group. Like the EMG decrease group subjects, EMG noncontingent group subjects changed neither in facial tension nor in respiratory resistance. The results provided some support for a hypothesis linking facial muscle tension and respiratory resistance.

Adolescent↗