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PubMed1985

Biofeedback and hypnosis in weaning from mechanical ventilators.

Weaning patients from mechanical ventilation can be hindered by both physical and psychologic factors. Biofeedback has been used successfully as an adjunct in difficult weaning problems. We have used a combination of hypnosis and biofeedback to wean a patient with neurologic disease who previously failed weaning by standard procedures. A 30-year-old woman with respiratory failure secondary to multiple sclerosis with transverse myelitis was given eight sessions of biofeedback over 12 days in which the movements of her chest wall, as monitored by magnetometers, were displayed on an oscilloscope. The patient was praised for targeted respiratory rate, amplitude, and rhythm. These sessions included hypnosis in which the patient was given suggestions of well-being and that she could breathe as she had five years earlier. In this manner the patient was successfully weaned. Respiratory biofeedback and hypnosis appear to be useful adjuncts in weaning patients from ventilators.

Adult↗
PubMedDate not supplied

Physiological problems of biofeedback control of the pulse rate.

Data are presented in this article on the voluntary control of the heart rate in man as a function of individual typological differences in adaptive attributes, in the ecological features of the milieu of habitation and work, as well as in the presence of deviations in the state of health (neuroses, vegetovascular dystonias, etc.). The key significance of training of the rhythmic regulatory processes in the course of biofeedback control is substantiated.

Adaptation, Psychological↗
PubMed2005

Rapid adaptation of torso pointing movements to perturbations of the base of support.

We investigated whether pointing movements made with the torso would adapt to movement-contingent augmentation or attenuation of their spatial amplitude. The pointing task required subjects standing on a platform in the dark to orient the mid-sagittal plane of their torso to the remembered locations of just extinguished platform-fixed visual targets without moving their feet. Subjects alternated pointing at two chest-high targets, 60 degrees apart, (1) in a baseline period with the stance platform stationary, (2) during exposure to concomitant contra or ipsiversive platform rotations that grew incrementally to 50% of the velocity of torso rotation, and (3) after return in one step to stationary platform conditions. The velocity and amplitude of torso movements relative to space decreased 25-50% during exposure to contraversive platform rotations and increased 20-50% during ipsiversive rotations. Torso rotation kinematics relative to the platform (as well as the platform-fixed targets and feet) remained virtually constant throughout the incremental exposure period. Subjects were unaware of the altered motion of their body in space imposed by the platform and did not perceive their motor adjustments. Upon return to stationary conditions, torso rotation movements were smaller and slower following adaptation to contraversive rotations and larger and faster after ipsiversive platform rotations. These results indicate a rapid sensory-motor recalibration to the altered relationship between spatial (inertial) torso motion and intended torso motion relative to the feet, and rapid re-adaptation to normal conditions. The adaptive system producing such robust torso regulation provides a critical basis for control of arm, head, and eye movements.

Adaptation, Psychological↗
PubMed1984

Behavioral and psychological approaches to the assessment and treatment of chronic pain.

This article briefly reviews behavioral and psychologic methods currently used to assess chronic pain patients. Assessment techniques designed to measure pain report, overt behavior patterns, and psychologic functioning are described. A variety of behavioral treatment procedures for chronic pain are also discussed. Treatment techniques can be grouped into two major categories: operant conditioning methods, and self-management strategies. Critical needs for future research are briefly identified.

Adaptation, Psychological↗
PubMed1996

Management of chronic pain. Part II.

Chronic pain is associated with substantial psychosocial and economic stress coupled with functional loss and various levels of vocational dysfunction. The role of a pain center is to focus on chronic pain in a multidisciplinary, comprehensive manner, providing the patient with the most effective opportunity to manage his or her chronic disease syndrome. This article focuses on methods to manage many types of chronic pain and describes a broad range of pharmacologic and non-pharmacologic interventions and options available to the patient. Part I of this two-part monograph described pharmacotherapeutic interventions and regional nerve blocks. Part II focuses on psychologic assessment and treatment and physical therapy. A multimodal management strategy offers patients the greatest improvement potential for specific chronic pain syndromes. Cognitive and behavioral therapies and physical therapies are described. This combination of therapies may provide patients with the skills and knowledge needed to increase their sense of control over pain. The integration of appropriate pharmacotherapeutic regimens, neural blockades, physical therapy, and psychologic techniques maximizes the patient's effectiveness in dealing with chronic pain. Three case studies are presented in Part II.

Adaptation, Psychological↗
PubMed1996

Pre- and post-stimulus processes in affective task and event-related desynchronization (ERD): do they discriminate anxiety coping styles?

The present investigation was designed to study whether pre-stimulus (as measured by EEG power in the time interval before the stimulus presentation) and post-stimulus (as measured by event-related desynchronization (ERD)) processes of alpha components in two frequency bands (8-10 and 10-12 Hz) and their scalp distribution discriminate among anxiety coping styles in an affective task. We investigated this question by using a sample of 30 college students who were split into three groups consisting of 10 low-anxious (LA) and 10 high-anxious (HA) subjects, and 10 repressors (RE). In the present study, positive and negative emotions were operationalized by winning and losing certain amounts of money in gambling situation while measuring ERD to positive and negative feedback stimuli. The main findings of the prestimulus data analyses suggest that the prestimulus level of alpha power is sensitive to the anxiety coping styles. In terms of ERD effects, HA individuals were marked by relatively larger left-hemisphere activation compared to low-anxious subjects and repressors. Further, in contrast to LA and RE, the phenomena observed in our experiment of increased and extended ERD over time in HA in response to negative feedback stimulation implies that threatening information (loss of money) is more persistently activated in subjects with high anxiety. Although preliminary, the reported findings are of potential importance because they could lead to the development of a new psychophysiological measure of relevance to personality.

Adaptation, Psychological↗
PubMedDate not supplied

Presentation and response of patients with upper extremity repetitive use syndrome to a multidisciplinary rehabilitation program: a retrospective review of 24 cases.

OBJECTIVE: To analyze retrospectively a group of patients presenting to an outpatient hand rehabilitation clinic with complaints related to repetitive tasks of the upper extremity. DESIGN: Retrospective case study reviewing 24 consecutive cases for presenting symptoms and response of patients to a multidisciplinary rehabilitation approach. SETTING: An outpatient hand rehabilitation clinic in a tertiary referral center offering simultaneous medical, psychological, and occupational evaluations. PATIENTS: Twenty-four patients with upper extremity symptoms related to repetitive use, who had all failed various prior therapeutic interventions. Fifty percent of the patients were receiving medical disability compensation because of their symptoms. Sixty-two percent had filed a worker's compensation claim. INTERVENTIONS: Treatment consisted of medical management with pharmacologic interventions, occupational therapy with workplace simulation and job-site evaluations, and psychological treatment with pain management and biofeedback training. Treatments were individualized to meet each patient's needs. OUTCOME MEASURES: Reduction in symptom intensity or frequency, increase in work and performance of activities of daily living, and termination of medical disability with return to work. RESULTS: Most cases (83%) were found to be related to occupational computer keyboard use. Bilateral hand and forearm pain were the major symptoms. A unique physical finding was diffuse tendon tenderness and tightness of the long flexor and extensor muscles of the forearm. Carpal tunnel syndrome was found in only one patient. Twenty-five percent of patients achieved resolution of most symptoms, although on a modified and often reduced activity level; 54% had moderate improvement; and 13% had only minimal or no improvement. Of the patients receiving medical disability compensation, 58% returned to their previous jobs. CONCLUSIONS: Patients with upper extremity symptoms related to repetitive use often have unique physical findings, distinct from those of carpal tunnel syndrome. Resulting work disability is high. Patients who have not responded to conventional interventions within a reasonable time may benefit from a multidisciplinary treatment approach. Most patients improve with this treatment but do not fully recover.

Adult↗
PubMed1995

Anxiety levels of pregnant women during ultrasound examination: coping styles, amount of feedback and learned resourcefulness.

Anxiety levels were measured before and after ultrasound examination in 183 women who underwent the procedure as part of their routine prenatal care. Women were classified according to their preferred mode of information gathering, their amount of available cognitive resources and predetermined feedback conditions. The results indicated significant reductions in state or situational anxiety levels for all subjects while trait anxiety was unaffected. In addition, the results suggested a correspondence between learned resourcefulness and informational coping styles. Women who had higher levels of cognitive resources and actively sought out information showed significantly greater decreases in state anxiety levels. This finding was also true for women who had lower levels of cognitive resources and tended to block out information. The impact of the scan was more profoundly affected by personality repertoires and informational coping styles than by either of the feedback conditions.

Adaptation, Psychological↗
PubMed1999

Posttraumatic headache: neuropsychological and psychological effects and treatment implications.

Posttraumatic headache (PTHA) is a frequent occurrence following trauma to the head, brain, and/or neck. Estimates of persistence for 6 months are as high as 44%. Review of available studies examining the effect of headache on neuropsychological test findings reveals that chronic headache pain, and chronic pain generally, exerts a significant and negative effect that poses a challenge to differential diagnostic efforts in the evaluation of mild brain injury. Given that PTHA is the most common postconcussive symptom and most frequent type of posttraumatic pain associated with mild traumatic brain injury (TBI), it follows that resolution of the postconcussion syndrome, and successful posttraumatic adaptation, may frequently rely on success in coping with PTHA symptomatology. Viewing PTHA from a biopsychosocial perspective, a general outline is offered for improving both assessment and treatment of PTHA. In addition, the most promising psychology-based treatment interventions are reviewed.

Adaptation, Psychological↗
PubMed1980

Anxiety reduction in asthma: four catches to general application.

Anxiety reduction procedures as adjuncts to medical treatment have almost invariably been reported to benefit asthmatic patients in individual case studies. However, the results of more systematically controlled studied are clearly inconsistent. This discrepancy is understandable in view of what is now known about anxiety in asthma. Four catches, each based on what has been reported about the roles and forms of anxiety in asthma, are presented. Each catch argues against general, across-the-board application of anxiety reduction procedures in asthma. Careful evaluation leading to more problem-oriented treatment is needed in view of the different roles of anxiety in asthma.

Adaptation, Psychological↗
PubMed2003

Learning to control brain rhythms: making a brain-computer interface possible.

The ability to control electroencephalographic rhythms and to map those changes to the actuation of mechanical devices provides the basis for an assistive brain-computer interface (BCI). In this study, we investigate the ability of subjects to manipulate the sensorimotor mu rhythm (8-12-Hz oscillations recorded over the motor cortex) in the context of a rich visual representation of the feedback signal. Four subjects were trained for approximately 10 h over the course of five weeks to produce similar or differential mu activity over the two hemispheres in order to control left or right movement in a three-dimensional video game. Analysis of the data showed a steep learning curve for producing differential mu activity during the first six training sessions and leveling off during the final four sessions. In contrast, similar mu activity was easily obtained and maintained throughout all the training sessions. The results suggest that an intentional BCI based on a binary signal is possible. During a realistic, interactive, and motivationally engaging task, subjects learned to control levels of mu activity faster when it involves similar activity in both hemispheres. This suggests that while individual control of each hemisphere is possible, it requires more learning time.

Adaptation, Psychological↗
PubMed1994

Migraine headaches: coping efficacy of guided imagery training.

This study compares the effectiveness of guided imagery, (psychosynthetic approach), and biofeedback in the treatment of migraine headache. Specifically, the volunteer's subjective perception of the efficacy of the treatments is assessed. The subjects were 40 male and female volunteers presenting with migraine headache diagnosis at Sunnybrook Health Sciences Centre in Toronto, Canada. Subjects were randomly assigned to one of the three treatment conditions or to a control group. All subjects attended six sessions of training. Measures were completed pre- and post-treatment. The results did not reveal significant reduction in migraine activity in any of the treatment groups. There were no differences among the groups regarding the intake of medication. Nevertheless the implementation of guided imagery training resulted in subjective reports of improved capacity to cope with the pain and in subjective reports of a reduced perception of the pain itself, although objective measures did not indicate an appreciable change in migraine activity. Findings from the present study do not support either feedback or guided imagery training as more effective in counteracting migraines although subjective reports do favor guided imagery as having a positive influence on the perception of migraine pain. These findings are discussed from the perspective of empowering the sufferers by providing them with a more active role in dealing with the migraine triggering physiology, abandoning the "learned helplessness" typical of chronic pain syndromes. The issue of cost effectiveness is raised and it supports the use of guided imagery versus biofeedback training given the lack of theoretical agreement in the current literature.

Adaptation, Psychological↗