The effect of feedback on the control of cardiac rate

The role of biofeedback in Kegel exercise training for stress urinary incontinence

This study examined the effectiveness of teaching pelvic floor exercises with use of bladder-sphincter biofeedback compared to training with verbal feedback based on vaginal palpation in 24 women with stress urinary incontinence. Verbal feedback training consisted of instructing the patient to squeeze the vaginal muscles around the examiner's fingers and providing her with verbal performance feedback. Biofeedback patients received visual feedback of bladder pressure, abdominal (rectal) pressure, and external anal sphincter activity. The biofeedback group improved the strength and selective control of pelvic floor muscles; the verbal feedback group did not. Both groups significantly reduced the frequency of incontinence. The biofeedback group averaged 75.9% reduction in incontinence, significantly greater than the 51.0% reduction shown by the verbal feedback group. Twelve of 13 patients in the biofeedback group improved by 60% or better. Six patients in the verbal feedback group improved by 68% or better, and five were less than 30% improved.

Effects of alternative control procedures for electromyographic biofeedback relaxation training

Twenty-four college students participated in a single session of electromyographic (EMG) biofeedback in a comparison of three experimental control procedures commonly employed in biofeedback relaxation training research. One group received contingent EMG biofeedback from the forehead area, and each subject in this group served as his or her own control. Subjects in a second group received noncontingent EMG feedback from a tape recorder but were instructed to use the feedback signal to relax their forehead muscles (single blind). Subjects in a third group received the same auditory feedback as those in the second group but were not told the purpose or source of the feedback stimulus (yoked control). The contingent feedback group showed significantly less EMG activity when compared to the other two groups. However, this group did not exhibit significant EMG level decrements from the beginning to end of the session. This seemingly contradictory finding may have been due to statistically capitalizing on the artifactually high EMG level of the experimental and control groups, although the single-blind and yoked-control groups showed nonsignificant increases across the session. The single-blind group's data had a variance several times larger than the other two groups' variance. Findings are discussed with respect to a "probing" hypothesis as opposed to the previously offered frustration hypothesis. Of the three control procedures, the data suggest the yoked control as the procedure of choice for EMG biofeedback relaxation research.

Instrumental cardiovascular conditioning: a review

This paper reviews experiments, hypotheses, and current controversies about instrumental cardiovascular conditioning. Demonstrations of such conditioning in curarized animals challenged a differentiation between instrumental and classical learning on the basis of their respective effector systems but did not prove direct operant learning by the autonomic nervous system. In humans, ethical prohibition of curarization and lack of adequate controls for respiration and muscle tension have resulted in incomplete understanding of the roles of voluntary, somatic mediators. Despite a variety of potential clinical applications of biofeedback, the available literature lacks studies of its efficacy compared to more standard modes of therapy. The physiological mechanisms and central neural pathways involved in instrumental cardiovascular conditioning remain almost totally unknown.

The effect of chronic anxiety level upon self control of heart rate

A sample of 90 subjects were rated on the IPAT anxiety scale and 5 subjects (3 male and 2 female) per group were selected from each of the high and low anxiety categories. All subjects were naive participants in heart rate biofeedback sessions utilising analogue visual feedback. Following a heart rate baseline (no feedback) session, all subjects were required to raise their heart rate and lower their heart rate in two separate trials, a visual "target" criteria being provided. The data collected consisted of a resting baseline heart rate value, mean heart rate increase, and mean heart decrease values expressed as beats per minute. Results indicated a marked ability for highly anxious subjects to self-induce heart rate increases only and for low anxious subjects to decrease their heart rate only.

Control of cardiac response under aversive stimulation. Superiority of a heart-rate feedback condition

The relative heart rate effects of biofeedback training, deep muscle relaxation, and a no-feedback/music procedure were compared during two criterion situations. The first consisted of a 25-min training period during which subjects received the assigned treatments. The second consisted of the pre- to posttraining reductions in heart rate reactivity to a series of aversive tone-shock trials. On the first criterion, the heart rate decreases of the feedback and no-feedback/music groups were not clearly distinguishable; however, both groups fell significantly below the muscle-relaxation group. By contrast, on the second criterion, the three groups were clearly distinguishable, with feedback subjects evidencing the most heart rate "control", followed by the muscle-relaxation and no-feedback/music groups, respectively. On the segment of the posttraining aversive trials conducted in the absence of the feedback signal, transfer of heart rate control was incomplete for feedback subjects, but still remained below the level of the other two groups. Training effects were more pronounced on tonic than on phasic heart rate changes. The difference between the two criterion situations suggests the possible need for and feasibility of employing a situational arousal methodology in evaluating the extent and limitation of physiological training procedures.

The voluntary control of heart rate under differential somatic restraint

The purpose of this investigation was to test the hypothesis that subjects (Ss) can exert voluntary, bidirectional heart rate (HR) control in the absence of concomitant changes in respiration rate (RR) and muscle activity (chin EMG). Feedback-assisted HR control was studied under four experimental conditions involving increasing levels of somatic restraint: (a) No somatic controls, (b) RR pacing, (c) EMG feedback, to maintain constant muscle activity, and (d) RR pacing plus EMG feedback. Fifteen Ss, eight females and seven males, were assigned to each of these four conditions (N = 60). The HR control task involved ten increase and ten decrease trials in random order, each lasting 60 sec and preceded by a 60-sec resting baseline period. The results indicated that Ss produced significant HR increases (Xdelta = +3.4 bpm), but were unable to effect decreases (Xdelta = -.3 bpm). Furthermore, the magnitude of the obtained HR changes did not differ by experimental condition, i.e., by level of somatic restraint. While concomitant bidirectional RR changes were found, the pacing procedure effectively reduced, and on HR increase trials, nearly eliminated, RR involvement. No increases in EMG activity were found on HR increase trials for any of the four experimental conditions, whereas all groups showed some EMG decreases on HR deceleration trials. With respect to the question of somatic mediation of autonomic control, it is concluded that HR increases produced under paced respiration "favor" an interpretation of unmediated HR acceleration.