Clinical evaluation of a respiratory resistance biofeedback training

Abstract

This study evaluated the effectiveness of a respiratory resistance biofeedback training. Fifteen adult asthmatic subjects participated in a feedback training program including twelve feedback sessions (three sessions weekly). Respiratory resistance (Ros) was measured using the forced oscillation method; to prevent subjects from lung hyperinflation, feedback was interrupted when functional residual capacity increased. One-second forced expiratory volume (FEV1), usage of self-administered medication, degree of asthmatic dyspnoea, and general activity were daily recorded in symptom diaries for at least three months, starting four weeks before the first feedback session. Seven subjects showed significant average Ros decreases within the sessions, while mean Ros in two subjects was increased. However, these direct feedback effects were not related to transfer effects outside the laboratory: e.g., not one of the seven successful subjects showed FEV1 improvements, and only in one of them were within-session Ros reductions accompanied by a decreased frequency of self-administered medication during the training period. These results lead to the conclusion that Ros feedback may not be an effective technique for the treatment of bronchial asthma in adults.

Psychological aspects of asthma.

“…Mass and his colleagues (1991) attempted to directly train participants to decrease respiratory resistance by providing continuous biofeedback of this measure, using the forced oscillation method. In an uncontrolled trial, this feedback technique decreased average respiratory resistance within sessions but not between sessions (Mass, Dahme, & Richter, 1993), and it did not increase FEV 1 (Mass, Richter, & Dahme, 1996). They concluded that this type of biofeedback might not be an effective treatment component against bronchial asthma in adults.…”

Psychosocial factors and behavioral medicine interventions in asthma.

“…Each of these approaches has its own specific set-up of sensors and follows a different psychophysiological rationale. Findings with direct feedback of respiratory resistance (controlled for hyperinflation of the lungs, which can reduce resistance), one of the most relevant parameters of asthma pathophysiology, were disappointing (Mass, Dahme & Richter, 1993). Similarly, electromyography-supported facial muscle relaxation that has been promoted in earlier research has been found questionable in its rationale and empirical outcome (Ritz, 2004).…”

Effects of static forehead and forearm muscle tension on total respiratory resistance in healthy and asthmatic participants

“…In particular, skeletal muscle activity is an integral part of the behavioral process itself and an essential component of many psychological phenomena~Cacioppo, Tassinary, & Fridlund, 1990!. With a growing number of studies investigating the psychophysiology of respiratory resistance~Butler & Steptoe, 1986;Carr, Lehrer, Jackson, & Hochron, 1996;Dahme, Richter, & Masz, 1996;Kotses, Westlund, & Creer, 1987;Masz, Richter, & Dahme, 1993;Wigal, Kotses, Rawson, & Creer, 1988!, it is thus critical to explore the potential role of skeletal muscle activation on this parameter.…”