Middaugh S J, Woods S E, Kee W G, Harden R N, Peters J R
Department of Physical Medicine and Rehabilitation, Medical University of South Carolina, Charleston 29425-2254.
Biofeedback Self Regul. 1991 Dec;16(4):361-77. doi: 10.1007/BF00999990.
The older segments of the U.S. population are expanding rapidly and account for a disproportionate amount of health care, including treatment for pain-related musculoskeletal disorders. In a prospective study with objective measures and one-year follow-up, Middaugh et al. (1988) found that older patients (55-78 yr; N = 17, 76% success) treated in a multidisciplinary chronic pain rehabilitation program enjoyed a success rate equal to that of younger patients (29-48 yr, N = 20, 70% success). The current study presents additional data on these two groups of patients to compare their ability to learn the physiological self-regulation skills taught in the biofeedback/relaxation component of the multimodal program. This component included progressive muscle relaxation training, diaphragmatic breathing instruction, and EMG biofeedback. Repeated measures ANOVA showed significant increases in digital skin temperature (peripheral vasodilation) and decreases in respiration rate both within and across training sessions (p values = .04 to .0001) with no differences between age groups (p greater than .05). EMG measures for the upper trapezius ms in patients with cervical pain showed similar deficits in muscle control at evaluation and similar improvements with biofeedback training for the two age groups. These findings indicate that older pain patients responded well to the biofeedback/relaxation training component of the multimodal pain program.
美国老年人口数量正在迅速增长,他们在医疗保健方面所占份额过高,其中包括与疼痛相关的肌肉骨骼疾病的治疗。在一项采用客观测量方法并进行了一年随访的前瞻性研究中,米多等人(1988年)发现,在多学科慢性疼痛康复项目中接受治疗的老年患者(55 - 78岁;N = 17,成功率76%)与年轻患者(29 - 48岁,N = 20,成功率70%)的成功率相当。本研究提供了关于这两组患者的更多数据,以比较他们学习多模式项目生物反馈/放松部分所教授的生理自我调节技能的能力。该部分包括渐进性肌肉放松训练、横膈膜呼吸指导和肌电图生物反馈。重复测量方差分析显示,在训练期间内及不同训练阶段,指端皮肤温度(外周血管舒张)显著升高,呼吸频率显著降低(p值 = 0.04至0.0001),且年龄组间无差异(p大于0.05)。颈部疼痛患者上斜方肌的肌电图测量结果显示,在评估时两组患者的肌肉控制能力存在相似的缺陷,且在生物反馈训练后均有相似程度的改善。这些发现表明,老年疼痛患者对多模式疼痛项目的生物反馈/放松训练部分反应良好。