Cardiac Autonomic Function Associated with Treatment Adherence After a Brief Intervention in Patients with Chronic Pain

Abstract

The goal of this study was to investigate psychophysiological characteristics in chronic pain patients during a pain stressor (cold pressor test) and after a brief diaphragmatic breathing intervention. Laboratory procedures were designed to quantify the effects of diaphragmatic breathing training at six breaths per minute on cardiac autonomic reactivity as indexed by root mean square of successive differences (RMSSD) and sequential baroreflex sensitivity (sBRS). Participants (n = 22) completed an initial laboratory assessment including the diaphragmatic breathing training session and were instructed to practice the technique for three ten-minute sessions daily. Self-monitoring of the use of the technique along with daily pain and fatigue scores was accomplished with hand-held computers. Participants returned to the lab for a second assessment after two-weeks. Participants demonstrating improved resting physiological status as indexed by change in RMSSD and sBRS after training (improvers) were compared to those not demonstrating any change in these variables (non-improvers). After two weeks of training, the improvers showed higher tolerance (p < .05) and lower blood pressure reactivity to the cold pressor test (p < .05) compared to the non-improvers. Time spent practicing the breathing technique was significantly different between the groups with the improvers maintaining daily practice close to the intervention recommendations. These results suggest the potential for significant improvements in autonomic functioning and inhibitory response to stress after a single intervention session and two weeks of practice.

Perception of music-induced emotions in patients with somatoform disorders compared to healthy controls

“…This might lead to a hypothesis that, for example, a psychophysiological decoupling might exist at baseline and would be unset by TAU, eventually leading to a higher expression of psychophysiological answers. Previous studies on this topic could not be identified but, according to the literature available, a psychophysiological mismatch of patients with somatoform disorders is described in existing evidence (Evans et al, 2013;Pollatos et al, 2011;Rief & Auer, 2001;J. E. Schmidt, Joyner, Carlson, & Hooten, 2013).…”

The effects of slow-paced versus mechanically assisted breathing on autonomic function in fibromyalgia patients

“…In particular, previous studies have shown that sympathetic nervous system (SNS) activity decreases, as evidenced by changes in HR and blood pressure, while parasympathetic nervous system (PSNS) activity increases, as revealed by changes in HRV indices and sBRS. 24 , 30 , 37 , 40 These physiological changes have been associated with a reduction in symptoms of chronic pain syndromes, including fear, anxiety, and catastrophizing. 18 , 38 , 39 , 49 By understanding the mechanisms behind the therapeutic effects of slow-paced breathing, treatments can be refined and applied to other chronic pain conditions.…”

“… 3 Several recently published studies have demonstrated improvements in pain and other FM-related symptoms in patients after training in a breathing-focused intervention. 18 , 37 , 38 Specifically, heart rate variability (HRV) biofeedback paired with slow-paced breathing has demonstrated efficacy in the improvement of pain severity and functioning in FM. 18 However, the underlying physiological changes associated with the efficacy of these interventions are not well understood.…”