Finger pulse amplitude and frontalis EMG biofeedback effects of single- and two-system training

The relationship between finger pulse amplitude (PA) and frontalis EMG was studied first by looking at general physiological changes accompanying successful bidirectional PA control. Seven successful subjects were then asked to produce two patterns of PA and EMG (PAincEMGdec and PAdecEMGdec) while receiving both PA and frontalis EMG biofeedback. Results indicate subjects can easily produce the differentiation pattern of PAdecEMGdec but cannot produce the integration pattern of PAincEMGdec. These rather paradoxical results may indicate subjects were using an attentional rather than arousal strategy for controlling PA and have implications for the use of peripheral vasomotor training as a general relaxation technique.     

EMG Reactivity and Oral Habits Among Young Adult Headache Sufferers and Painfree Controls in a Scheduled-Waiting Task

Previous research has shown that patients with facial pain exhibit a pattern of physiological and behavioral reactivity to scheduled-waiting tasks that may help account for the development of facial pain. The present study extended this line of research by examining the psychophysiological reactivity of headache sufferers in a similar task. A total of 34 frequent headache sufferers screened by International Headache Society (IHS) criteria and 13 painfree controls completed a psychophysiological assessment consisting of 4 phases (adaptation, free-play, scheduled-play, and recovery) that included a scheduled-waiting condition (scheduled-play) designed to produce adjunctive behavior. Masseter and frontalis EMG were measured continuously during each phase and self-reported oral habits and pain ratings were collected following each phase. A significant interaction and group effect was found on frontalis EMG, with the headache group exhibiting elevated EMG levels across the phases, whereas the control group exhibited increasing EMG levels that peaked during the scheduled-play phase. Only a significant phase effect was found on masseter EMG, with the highest EMG levels recorded during the scheduled-play phase for both groups. In addition, a significant phase effect was found on self-reported oral habits data. Overall, these results provide general support for the adjunctive behavior effect, but the predicted difference in magnitude between the groups was not found.     

Ocular and stabilization feedback: an evaluation of two EMG biofeedback control procedures

This study evaluated the adequacy of two novel EMG biofeedback control procedures. During a single training session, 36 subjects received either contingent EMG feedback from the frontal region (Veridical), contingent feedback for vertical eye movements (Ocular), or a feedback condition where the signal increased with deviations in any direction from baseline EMG levels (Stabilization). The results supported the use of Ocular but not Stabilization feedback as a control procedure in frontalis EMG biofeedback studies. Ocular feedback did not produce reductions in frontalis EMG but did lead to changes in subjective measures of nonspecific treatment effects that were at least comparable to those obtained with Veridical feedback. Stabilization subjects produced small but significant reductions in EMG, felt the most bored as a result of their feedback training, and were the most likely to rate themselves as having received false feedback. The implications of attribution theory and multiprocess relaxation theory for the evaluation of nonspecific treatment effects are discussed.     

Ocular and stabilization feedback: An evaluation of two EMG biofeedback control procedures

This study evaluated the adequacy of two novel EMG biofeedback control procedures. During a single training session, 36 subjects received either (1) contingent EMG feedback from the frontal region (Veridical), (2) contingent feedback for vertical eye movements (Ocular), or (3) a feedback condition where the signal increased with deviations in any direction from baseline EMG levels (Stabilization). The results supported the use of Ocular but not Stabilization feedback as a control procedure in frontalis EMG biofeedback studies. Ocular feedback did not produce reductions in frontalis EMG but did lead to changes in subjective measures of nonspecific treatment effects that were at least comparable to those obtained with Veridical feedback. Stabilization subjects produced small but significant reductions in EMG, felt the most bored as a result of their feedback training, and were the most likely to rate themselves as having received false feedback. The implications of attribution theory and multiprocess relaxation theory for the evaluation of nonspecific treatment effects are discussed.This research was supported in part by grants from the National Institutes of Health (AM31500) and the Robert Wood Johnson Foundation. Portions of this research were presented at the Sixth Annual Meeting of the Society of Behavioral Medicine, New Orleans, March 1985.     

Effectiveness of EMG biofeedback training for controlling arousal in subsequent stressful situations

Thirty-five subjects participated in (1) a pretreatment session during which arousal was measured while subjects anticipated and then viewed a stressful film; (2) four 20-min treatment sessions during which subjects received either contingent EMG biofeedback (biofeedback treatment), instructions to attend to a variable pitch tone (attention-placebo control), instructions to relax as much as possible (instructions-only control), or instructions to sit quietly (no-treatment control); and (3) a posttreatment session that was identical to the pretreatment session. Results indicate that when compared to the subjects in the control conditions, subjects who received EMG biofeedback were not effective in reducing frontalis EMG levels during treatment or while viewing the stressful film, but they were effective in reducing frontalis EMG levels while anticipating the stressful film. There was no evidence that EMG biofeedback influenced either skin conductance or self-reports of arousal.This research was supported in part by Bio-Medical and General Research Fund grants from the University of Kansas to David S. Holmes. Appreciation is due to B. Kent Houston, Edward F. Morrow, and Charles A. Hallenbeck for their contributions to the project.     

Regulation of mental states and biofeedback techniques: Effects on breathing pattern

The purpose of the present study was to examine whether breathing pattern may be used as a reliable index for the effectiveness of techniques applied for the regulation of mental states. Heart rate (HR), breathing pattern, galvanic skin response (GSR), and electromyogram (EMG) of the frontalis muscle were measured in 39 male and female subjects aged 18–25 years during 10-minute treatment with relaxation technique (autogenic training and/or music) followed by 10 minutes of imagery training. In the first 7 sessions biofeedback (BFB) was not included, while during the last 6 sessions BFB was introduced and utilized by the subjects. Relaxation (music or autogenic training) led to a decrease in breathing frequency, attributed to lengthening of expiration time, as well as reduced HR, GSR, and frontalis EMG response. In most instances imagery training was related to an increase in these indices. Specifically, significant tachypnea was observed during imagery of sprint running. In most cases BFB substantially augmented the physiological responses. In conclusion, our data suggest that, compared with HR, GSR, and EMG responses, the breathing pattern is at least as sensitive to the mental techniques employed, and may be useful as a psychophysiological index for diagnosis and testing, especially in sport practice.     

A comparison of EMG feedback and alternative anxiety treatment programs

Four cohorts of 40 subjects each were randomly assigned to 1 of 10 treatment conditions utilizing EMG feedback, cognitive monitoring training, systematic desensitization, high expectancy discussion group, or waiting list controls either in isolation or in various combinations. A three-way ANOVA for repeated measures indicated that significant anxiety reductions were experienced in all noncontrol treatment conditions. Treatment groups employing EMG feedback demonstrated significantly greater anxiety decrements on Cattell's IPAT Self-Analysis Form, and baseline frontalis EMG. Adding desensitization or cognitive monitoring to EMG feedback did not produce a more powerful effect than using EMG feedback alone. Sex and age differences were also observed. Some implications are discussed.     

The effect of electrode placement on frontalis EMG measurement in headache patients

Comparisons were made between frontalis EMG surface recordings concurrently taken from horizontal, right vertical, and left vertical electrode placement configurations. Six migraine and seven tension headache patients were used as subjects. Results showed that, in general, a positive correlation existed between recordings from the three placements for both migraine and tension subjects as a group. However, marked individual differences were noted. It was concluded that electrode placement can be quite important in measuring changes in frontalis muscle tension for headache patients.     

A comparison of EMG feedback and alternative anxiety treatment programs

Four cohorts of 40 subjects each were randomly assigned to 1 of 10 treatment conditions utilizing EMG feedback, cognitive monitoring training, systematic desensitization, high expectancy discussion group, or waiting list controls either in isolation or in various combinations. A three-way ANOVA for repeated measures indicated that significant anxiety reductions were experienced in all noncontrol treatment conditions. Treatment groups employing EMG feedback demonstrated significantly greater anxiety decrements on Cattell's IPAT Self-Analysis Form, and baseline frontalis EMG. Adding desensitization or cognitive monitoring to EMG feedback did not produce a more powerful effect than using EMG feedback alone. Sex and age differences were also observed. Some implications are discussed.This research was supported in part by a grant from the Medical Services Research Foundation of Alberta.     

Stress reduction treatment of severe recurrent genital herpes virus

Four individuals with high-frequency recurrences of genital herpes virus of at least 2 years' duration were treated with two behavioral stress-reduction treatments. Subjects were given 10 weekly sessions of frontalis EMG biofeedback (2 subjects) or progressive muscle relaxation treatment (2 subjects). Presession and postsession frontalis EMG measures were recorded for all subjects across treatment. Outcome was measured by daily and weekly symptom charting mailed in weekly over 6 months, or by telephone interview after 6 months. Results demonstrated substantial improvement in reported symptoms with both treatments. Relaxation treatment resulted in a 66% and 100% reduction in frequency of recurrences. Frontalis EMG biofeedback resulted in a 72% and 7% reduction in frequency of recurrences. Follow-up at 1-year posttreatment showed that treatment effects were maintained by one subject, partially maintained by two, and reversed in one subject. The need for controlled investigation is emphasized.     

Stress reduction treatment of severe recurrent genital herpes virus

Four individuals with high-frequency recurrences of genital herpes virus of at least 2 years' duration were treated with two behavioral stress-reduction treatments. Subjects were given 10 weekly sessions of frontalis EMG biofeedback (2 subjects) or progressive muscle relaxation treatment (2 subjects). Presession and postsession frontalis EMG measures were recorded for all subjects across treatment. Outcome was measured by daily and weekly symptom charting mailed in weekly over 6 months, or by telephone interview after 6 months. Results demonstrated substantial improvement in reported symptoms with both treatments. Relaxation treatment resulted in a 66% and 100% reduction in frequency of recurrences. Frontalis EMG biofeedback resulted in a 72% and 7% reduction in frequency of recurrences. Follow-up at 1-year posttreatment showed that treatment effects were maintained by one subject, partially maintained by two, and reversed in one subject. The need for controlled investigation is emphasized.The authors thank Stephen Ritz for his contribution to this study.     

Biofeedback training in frontalis muscle relaxation and enhancement of belief in personal control

The hypothesis that biofeedback training in frontalis muscle relaxation increases beliefs in internal (personal) locus of control was tested. Subjects were divided into two groups (internals and externals) based on Mirels' (1970) factor analyzedpersonal control subscale of Rotter's (1966) I-E Scale. Internal and external subjects were assigned randomly to one of three conditions: biofeedback (BF), false feedback (FF), or no feedback (NF). All subjects were measured on frontalis electromyographic (EMG) activity. Training consisted of three sessions spaced 1 week apart. Each session was comprised of a 5-minute baseline (nonfeedback) trial followed by a 20-minute experimental session. After each experimental session, subjects completed a questionnaire which assessed the extent to which they attributed their EMG performance to personal and environmental sources. After three sessions, subjects were posttested on the I-E Scale. Results indicated that subjects receiving BF reduced their EMG activity more than did subjects in either the FF or NF conditions, and this effect was maintained across all three sessions. Subjects who received BF shifted toward internal personal locus of control from pre- to posttesting, whereas no such change was found for either FF or NF subjects. Also, the relationship between BF training and change in personal locus of control was mediated by subjects attributing their EMG reduction more to personal effort than to properties of the task. Results are discussed in terms of the importance of contingent feedback as a determinant of cognitions of control.     

Treatment of spastic dysphonia by EMG biofedback

Two middle-aged subjects, a male and female, with spastic dysphonia (hoarseness, stammering) were treated with both frontalis and throat muscle electromyographic (EMG) biofeedback. Both subjects reported no noticeable improvement in their voice qualities. Results of a battery of psychological tests provided some insight into the inability of EMG treatment, as well as other therapeutic approaches, to alleviate the pathology.     

Cephalic vasomotor feedback in the modification of migraine headache

The effect of cephalic vasomotor response (CVMR) and frontalis electromyographic (EMG) feedback on control of temporal arterial vasoconstriction and frontalis muscle activity in migraine and muscle contraction headache patients was investigated. A single subject multiple baseline design (across subjects and responses) was introduced to evaluate (1) patterning in the two physiological systems and (2) the effects of CVMR and EMG feedback on headache activity. The data indicated that (a) all four patients demonstrated an ability to control CVMR activity during CVMR feedback and EMG during EMG feedback, (b) idiosyncratic patterns of physiological activity emerge during feedback training, and (c) learned control of the pain mechanism for muscle contraction and migraine headaches was related to reduced frequency and duration of these headaches.Portions of this paper were presented at the Ninth Annual Convention of the Association for Advancement of Behavior Therapy, San Francisco, 1975.     

The effects of EMG-assisted relaxation training on the academic performance, locus of control, and self-esteem of hyperactive boys

This study investigated effects of EMG-assisted relaxation training on the academic performance, locus of control, and self-esteem of hyperactive junior high school-age boys. Twenty-four subjects each were randomly assigned to the treatment and control condition. Treatment consisted of six 20 to 25-minute sessions conducted biweekly. Pretreatment frontalis EMG, math, reading, and language performance, locus of control, and self-esteem were assessed for both groups. Outcome measures were again obtained on these dependent variables 2 weeks after the last treatment session. Experimental subjects demonstrated significantly higher posttreatment reading and language performance. Math performance gain did not reach statistical significance. A significant internal shift in locus of control was observed; however, self-esteem did not improve to that level. These outcomes correlated with significantly lower posttreatment frontalis EMG in the experimental group. EMG level did not change during the course of this study for control subjects. Implications of these findings are discussed in terms of existent research.     

The Raynaud's Treatment Study: Biofeedback Protocols and Acquisition of Temperature Biofeedback Skills

The Raynaud's Treatment Study (RTS) compared temperature biofeedback training and a behavioral control procedure (frontalis EMG biofeedback) with nifedipine-XL and a medication placebo for treatment of primary Raynaud's phenomenon (RP) in a large (N = 313) multicenter trial. The present study describes the RTS biofeedback protocols and presents data on the acquisition of digital skin temperature and frontalis EMG responses in the RTS. The findings point to substantial problems with acquisition of physiological self-regulation skills in the RTS. Only 34.6% of the Temperature Biofeedback group (N = 81) and 55.4% of the EMG Biofeedback group (N = 74) successfully learned the desired physiological response. In contrast, 67.4% of a Normal Temperature Biofeedback group (N = 46) learned hand warming. Multivariate analysis found that coping strategies, anxiety, gender, and clinic site predicted acquisition of hand-warming skills whereas variables related to RP disease severity did not. Physiological data showed vasoconstriction in response to the onset of biofeedback and also found that performance in the initial sessions was critical for successful acquisition. These findings indicate that attention to the emotional and cognitive aspects of biofeedback training, and a degree of success in the initial biofeedback sessions, are important for acquisition.     

Relaxation and subjective estimates of muscle tension: Implications for a central efferent theory of muscle control

The relationship of “awareness of muscle tension” to depth of relaxation was explored. In one experiment, accuracy of forearm flexor control was assessed using the psychophysical method of magnitude production, and depth of flexor relaxation was measured using the integrated EMG before and after EMG biofeedback training. No consistent relationship between motor-control accuracy and depth of relaxation was found. A second, similar experiment with frontalis showed increased accuracy of frontalis control with deeper relaxation. Accuracy of passive, verbal judgments of spontaneous frontalis tension fluctuation exhibited no clear relationship with depth of relaxation. It was concluded that forearm flexor and frontalis may be under the control of distinct mechanisms, and that afferent information probably contributes to the control of neither muscle. Three structural theories of the control mechanisms were considered, and one depending on the central monitoring of efferent outflow(rather than afferent inflow) seemed most compatible with the frontalis data. Both flexor and frontalis data could be accounted for by a two-phase scheme combining central outflow monitoring with the monitoring of mental contents for arousal value at very low muscle tension levels.     

A meta-analysis of frontalis EMG levels with biofeedback and alternative procedures

The lack of comparative reviews of the efficacy of EMG frontalis biofeedback versus alternative procedures for reduction of muscle tension prompted the present meta-analytic treatment of literature previously concluded to be equivocal. Twenty studies comparing EMG frontalis biofeedback with other tension-reduction procedures produced a total of 68 separate effect sizes suitable for meta-analysis. Differences between clinical and normal samples were nonsignificant, and data analyses revealed that EMG frontalis biofeedback was significantly superior to control (p<.05) but that alternative forms of muscle relaxation, while effective, did not reach statistical significance.     

Biofeedback,relaxation training,and music: Homeostasis for coping with stress

This study compared the efficacy of five relaxation training procedures, four of which employed EMG auditory feedback: (1) biofeedback only (BF), (2) autogenic training phrases (ATP), (3) music (MU), (4) autogenic training phrases and music (ATP & MU), and (5) a control group, in developing self-regulation of a cultivated low arousal state as a countermeasure to tensed muscular reaction to stressful imagery. Twenty subjects established a pre- and posttraining frontalis region EMG biofeedback baseline measurement. Sixteen subjects were assigned at random to the 25-minute taped relaxation training procedure. After eight training sessions (4 weeks), MU and ATP & MU groups achieved highly significant differences when compared with the control group. The ATP & MU group attained the lowest postbaseline arousal level measured by the EMG. EMG as a physiological measure for transfer of training functioned well in detecting the psychophysiological affect of stressful imagery.This report is based on a thesis submitted in partial fulfillment of the requirements for the Master of Arts in Psychology degree by the author. The author extends his gratitude to Dr. Theodore Steiner, Dr. Paul Eskildsen, and Dr. Frank Hovell, who served on the committee, and to Rosemary Kolentus, for her help with this article.     

The effect of stress imagery on arousal and its implications for biofeedback of the frontalis muscles

The purpose of this study was to determine whether the frontal muscles of the forehead during the imagination of an individualized stress situation reflect general arousal. Physiological arousal and subjective feelings of tension were measured during a stress and a relaxing imaginative situation, utilizing a counterbalanced design. Frontalis EMG during stress imagination was raised and was paralleled by more reported tension, elevated skin conductance, and trends toward increments in heart rate and respiration rate. The raised frontalis EMG can be seen as a consequence of the greater effort spent in the stress imaginative situation than in the relaxing one. This experiment supports an important assumption of the clinical application of frontalis EMG biofeedback to stress-related disorders. Other assumptions still remain to be examined.