Live and taped relaxation instructions: effects of procedural variables

Two experiments were designed to assess the effects of relaxation training, therapist presence or absence, live versus taped voice, and response-contingent versus noncontingent instructional progress on measures of subjective relaxation and frontal EMG. In the first experiment, it was found that subjects receiving taped instructions showed greater within-session subjective relaxation and lowering of within-session frontal EMG than subjects in a control condition. No differential training effects of therapist presence or absence was noted. In a second experiment, no significant differences in relaxation measures were found between subjects receiving live, response-contingent instructions and subjects receiving live, noncontingent instructions. Moreover, no meaningful differences in relaxation measures were found between subjects receiving live and taped instructions.     

Effects of noncontingent feedback on EMG training,EMG responses,and subjective experience

Various types of noncontingent feedback have been used as control procedures in EMG training; however, their effects on such training have received little attention. Experiment 1 in the present study examined the effects of noncontingent feedback on EMG training, and Experiment 2 assessed the effects of feedback characteristics on EMG responses. In Experiment 1, three noncontingent feedback groups (yoked control, randomly fluctuating tones, and decreasing tones) and one contingent group underwent 20 minutes of training for frontal EMG decreases. Procedures in Experiment 2 were identical to those in Experiment 1 except that subjects were instructed merely to listen to the feedback tones. Results of Experiment 1 indicated that contingent and noncontingent fluctuating feedback groups achieved significantly lower EMG levels than noncontingent decreasing and yoked control groups. In Experiment 2, however, no differences in EMG activity were found among groups. In both experiments, groups did not differ in terms of subjective variables such as frustration, suspiciousness about the tone, or length of time attending to the tone. Results of these two experiments suggest that differences in EMG responses to various types of noncontingent feedback result from interactions between characteristics of the feedback stimulus and instructions to decrease the stimulus.This research was supported by Ohio University Research Grants No. 9147 and No. 9155 to the first author.     

Effects of noncontingent feedback on EMG training, EMG responses, and subjective experience

Various types of noncontingent feedback have been used as control procedures in EMG training; however, their effects on such training have received little attention. Experiment 1 in the present study examined the effects of noncontingent feedback on EMG training, and Experiment 2 assessed the effects of feedback characteristics on EMG responses. In Experiment 1, three noncontingent feedback groups (yoked control, randomly fluctuating tones, and decreasing tones) and one contingent group underwent 20 minutes of training for frontal EMG decreases. Procedures in Experiment 2 were identical to those in Experiment 1 except that subjects were instructed merely to listen to the feedback tones. Results of Experiment 1 indicated that contingent and noncontingent fluctuating feedback groups achieved significantly lower EMG levels than noncontingent decreasing and yoked control groups. In Experiment 2, however, no differences in EMG activity were found among groups. In both experiments, groups did not differ in terms of subjective variables such as frustration, suspiciousness about the tone, or length of time attending to the tone. Results of these two experiments suggest that differences in EMG responses to various types of noncontingent feedback result from interactions between characteristics of the feedback stimulus and instructions to decrease the stimulus.     

Expectancy effects on relaxation instructions: Physiological and self-report indices

Two sessions of relaxation instructions were administered under high and low expectancy conditions. Fifty-four college students scoring high on a self-report measure of anxiety served as subjects. Live and taped abbreviated progressive muscle relaxation instructions and a self-relaxation condition were equally effective in reducing within-session self-report and physiological indices of anxiety. High expectancy instructions led to greater reductions in heart rate than did low expectancy instructions. Factors controlling anxiety reduction during relaxation therapies are discussed.This experiment was submitted by the first author in partial fulfillment for a master of science degree at VPI and SU. The authors would like to thank Jean Sales and Dan Fones for their help in this investigation. The First author is now at Johns Hopkins Hospital, Baltimore. The second author is currently at the Department of Neurology, University of Wisconsin-Madison.     

Feedback delays and relaxation expectancies in EMG biofeedback

The use of noncontingent feedback controls in studies of the efficacy and process of electromyographic (EMG) biofeedback may yield results confounded by differential expectancies for relaxation. Furthermore, the role of expectancies in producing psychological and physical relaxation as well as reducing muscle activity is unclear. This study investigated the effects of feedback delays and induced relaxation expectancies on EMG activity and experienced relaxation. One hundred four non-clinical subjects participated in one auditory frontal EMG biofeedback training session. Subjects were assigned to one of four computerized feedback delay conditions (0.0037, 0.7493, 2.2481, 6.7444 s) and to one of two relaxation expectancy conditions (positive or negative). During 20 minutes of biofeedback training, all groups decreased frontal activity. Feedback delays interacted with training epochs in affecting EMG; the longest delay group reduced frontal activity more slowly than the shortest delay group during training. Positive relaxation expectancies produced greater experienced relaxation than did negative relaxation expectancies. Instrumental and expectancy factors in EMG biofeedback appear to operate independently of each other by reducing physiological activity and producing psychological relaxation respectively.This study was completed by the first author under the direction of the second author in partial fulfillment of the requirements for the Master of Arts degree. We gratefully acknowledge the computerization advice and assistance provided by Larry Wheeler, and the assistance in data collection provided by Dawn Dexter and Michael Winstanley.     

Feedback delays and relaxation expectancies in EMG biofeedback

The use of noncontingent feedback controls in studies of the efficacy and process of electromyographic (EMG) biofeedback may yield results confounded by differential expectancies for relaxation. Furthermore, the role of expectancies in producing psychological and physical relaxation as well as reducing muscle activity is unclear. This study investigated the effects of feedback delays and induced relaxation expectancies on EMG activity and experienced relaxation. One hundred four non-clinical subjects participated in one auditory frontal EMG biofeedback training session. Subjects were assigned to one of four computerized feedback delay conditions (0.0037, 0.7493, 2.2481, 6.7444 s) and to one of two relaxation expectancy conditions (positive or negative). During 20 minutes of biofeedback training, all groups decreased frontal activity. Feedback delays interacted with training epochs in affecting EMG; the longest delay group reduced frontal activity more slowly than the shortest delay group during training. Positive relaxation expectancies produced greater experienced relaxation than did negative relaxation expectancies. Instrumental and expectancy factors in EMG biofeedback appear to operate independently of each other by reducing physiological activity and producing psychological relaxation respectively.     

Expectancy effects on relaxation instructions: physiological and self-report indices

Two sessions of relaxation instructions were administered under high and low expectancy conditions. Fifty-four college students scoring high on a self-report measure of anxiety served as subjects. Live and taped abbreviated progressive muscle relaxation instructions and a self-relaxation condition were equally effective in reducing within-session self-report and physiological indices of anxiety. High expectancy instructions led to greater reductions in heart rate than did low expectancy instructions. Factors controlling anxiety reduction during relaxation therapies are discussed.     

Effects of Relaxation Training on Glucose Tolerance and Diabetic Control in Type II Diabetes

The present study examined the effects of progressive relaxation training and EMG biofeedback on acute glucose disposal in diabetic subjects, as measured by glucose tolerance and three other measures of diabetic metabolic control. Twenty subjects with non-insulin-using Type II diabetes took part in progressive relaxation training and EMG biofeedback in a pre-post treatment versus wait-list experimental design. Treatment effects were assessed on glucose tolerance along with three measures of diabetic control: fasting blood glucose, two-hour postprandial blood glucose, and fructosamine. Stress reduction and relaxation was assessed with two physiological measures and two subjective questionnaires. The training program produced significant reductions in stress, as measured by State Anxiety, and significant changes in physiological measures of muscle activity and skin conductance compared to the control condition. However, no changes were found in glucose tolerance (while practicing relaxation) nor in any of the three measures of general diabetic metabolic control. The major implication of this study is that relaxation training does not appear to directly improve diabetic control in mildly stressed non-insulin-using Type II diabetic patients.     

EEG signature and phenomenology of alpha/theta neurofeedback training versus mock feedback

Alpha/theta (a/t) neurofeedback training has in the past successfully been used as a complementary therapeutic relaxation technique in the treatment of alcoholism. In spite of positive clinical outcomes, doubts have been cast on the protocol's specificity when compared to alternative relaxation regimes. This study investigated the basic tenet underlying the a/t training rationale, that accurate a/t feedback representation facilitates the generation of these frequency components. Two groups of healthy volunteers were randomly assigned to either (a) real contingent a/t feedback training or (b) a noncontingent mock feedback control condition. The groups were compared on measures of theta/alpha (t/a) ratios within and across training sessions, as well as activational self-report scales after each session. The contingent a/t feedback group displayed significant within-session t/a ratio increments not evident in the mock control group, as well as higher overall t/a ratios in some but not all of the training sessions. No differences were found between the groups in terms of subjective activational phenomenology, in that both groups reported significantly lower levels of activation after training sessions. The data demonstrate that irrespective of considerations of clinical relevance, accurate a/t neurofeedback effectively facilitates production of higher within-session t/a ratios than do noncontingent feedback relaxation.     

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.     

Simultaneous biofeedback of heart rate and frontal EMG as a pretraining for the control of EEG theta activity

Following one base-line session, 20 normal subjects received four half hour sessions consisting of simultaneous feedback of heart rate and frontalis muscle (pretraining). Ten subjects received contingent (CF), the other ten noncontingent feedback (NCF). Subjects were asked to lower heart rate and frontal muscle tension (EMG). Heart rate within sessions decreased up to 19 bpm, with a mean of 4 bpm for the CF group. There was only a weak decrease over sessions, however, because of the strong habituation effect. The following events accompanied the heart rate decrease: (1) an increase of the variability of the heart rate, (2) a decrease of the variance of the EMG, (3) an increased correlation between heart rate slowing and EMG decrease, and (4) an increasing subjective experience of control of heart rate and EMG. After pretraining, subjects received eight sessions of auditory feedback of their frontal EEG theta activity (four sessions with CF and four sessions with NCF in balanced order). There was a weak increase of theta for the CF condition over sessions, but a decrease within the sessions. Pretraining on heart rate and frontal EMG control had no influence on the performance during theta training. It was hypothesized that control of heart rate slowing and theta control involve different mechanisms.     

A comparison of direct blood pressure feedback and electromyographic feedback on the blood pressure of normotensives

Groups of 20 normotensive subjects were assigned to one of three conditions to help them lower their blood pressure: (1) intermittent visual feedback of blood pressure; (2) continuous analogue auditory feedback of frontal EMG; (3) an instructed, no-feedback condition. Both groups receiving feedback showed greater within-session lowering of systolic blood pressure than the no-feedback control group. Although the group receiving intermittent visual feedback of blood pressure lowered blood pressure more than the EMG feedback group at the first session, in three subsequent sessions, the two feedback groups did not differ.     

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.     

A comparison of frontal EMG biofeedback and neck EMG biofeedback in the treatment of muscle-contraction headache

EMG biofeedback from the frontal area (FFB) was compared to EMG biofeedback from the neck (NFB) in the treatment of chronic muscle-contraction headache. Both treatment groups (N=10) evidenced significant decreases in reported headache activity, with the NFB group also significantly reducing medication consumption. An analysis of EMG changes suggested that subjects were able to produce large within-session changes in EMG activity during initial sessions, with the major effect of additional training being an increase in speed with which these changes occurred. In neither group, however, did changes in EMG activity correspond closely to changes in reported headache activity.     

Frontal electromyographic feedback

This study evaluated the effects of one session of frontal electromyographic (EMG) feedback on (1) frontal EMG, (2) frontal EMG response to stress, (3) cardiovascular variables, and (4) cardiovascular responses to stress. Eighteen male and female undergraduate volunteers received either frontal EMG feedback or a relaxation instructions control procedure and were then exposed to a fear stimulus (visualization of a feared situation) and a post-stress adaptation period while several cardiovascular measures were monitored. In comparison to the control group, frontal EMG feedback significantly reduced resting levels of frontal EMG and frontal EMG response to stress but had no significant effect on cardiovascular measures. The results of this study suggest that one session of frontal EMG feedback may attenuate response to stress but, within the paradigm utilized, may be confined to the specific muscle groups monitored. Additional areas of needed research were noted including individual differences in generalization, the effects of EMG feedback from multiple sites sequentially and concomitantly, and the generalized effects from symptom-specific sites.     

Frontal electromyographic feedback. Stress attenuation and generalization.

This study evaluated the effects of one session of frontal electromyographic (EMG) feedback on (1) frontal EMG, (2) frontal EMG response to stress, (3) cardiovascular variables, and (4) cardiovascular responses to stress. Eighteen male and female undergraduate volunteers received either frontal EMG feedback or a relaxation instructions control procedure and were then exposed to a fear stimulus (visualization of a feared situation) and a post-stress adaptation period while several cardiovascular measures were monitored. In comparison to the control group, frontal EMG feedback significantly reduced resting levels of frontal EMG and frontal EMG response to stress but had no significant effect on cardiovascular measures. The results of this study suggest that one session of frontal EMG feedback may attenuate response to stress but, within the paradigm utilized, may be confined to the specific muscle groups monitored. Additional areas of needed research were noted including individual differences in generalization, the effects of EMG feedback from multiple sites sequentially and concomitantly, and the generalized effects from symptom-specific sites.     

Cognitive and physiologic responses to EMG biofeedback and three types of pseudofeedback during a muscular relaxation task

Four groups of normal human subjects were tested for their ability to reduce frontal muscle tension levels during presentation of veridical auditory biofeedback or auditory pseudofeedback. A double-blind methodology was used. Three groups of subjects assigned to the pseudofeedback conditions received a feedback signal that was not contingent on EMG activity but that followed one of three different patterns. One group received a truly random signal, the second received a signal that gradually increased in frequency (apparent failure), and the third received a signal that gradually decreased in frequency (apparent success). Dependent measures included both physiologic (frontal and neck EMG) and subjective reactions to the relaxation task. The different patterns of pseudofeedback did produce reliably different subjective responses, suggesting that the manipulations succeeded in producing unequal nonspecific effects that were unrelated to the feedback contingency specifically. However, these differential subjective effects were not strongly reflected in the physiologic responses since the differences in EMG levels among the four groups did not differ significantly at any stage of training. An analysis of the integrity of the double-blind procedure showed that although experimenters were effectively kept blind to group assignment, subjects' responding suggested a response bias as well as the possibility that the double-blind was breached. The utility of the double-blind methodology in biofeedback experiments is discussed and suggestions for future research are offered.     

The response of manual motor functioning in Parkinsonians to frontal EMG biofeedback and progressive relaxation

The purpose of the current investigation was to determine the effects of frontal EMG biofeedback and progressive relaxation training on manual motor functioning in Parkinsonians. Twenty patients were matched and randomly assigned to two groups. All subjects were administered a brief manual motor assessment. The experimental group then underwent weekly sessions of frontal EMG and relaxation training for a period of 15 weeks. At the conclusion of the training period, both experimental and control groups were again administered the manual motor tasks. The results indicated that Parkinsonian patients are capable of significantly lowering frontal EMG activity levels. The motor task results, however, yielded no statistically significant differences between the two groups as a result of the biofeedback training.     

Relationship Between Changes in EMG and Respiratory Sinus Arrhythmia in a Study of Relaxation Therapy for Asthma

This paper reports the relationships among changes in cardiovagal activity, surface EMG, and measures of pulmonary function in a study of relaxation therapy for asthma. Changes in FEV ₁ /FVC were negatively correlated with those in cardiac interbeat interval, consistent with the hypothesis that relaxation-induced changes in airway function are mediated autonomically, with increased vagal tone and/or decreased sympathetic arousal producing bronchoconstriction. Contrary to Kotses's theory of a vagal-trigeminal reflex as mediator for relaxation-induced improvement in asthma, decreases in pulmonary function occurred during relaxation sessions, accompanied by increases in cardiovagal activity, and within-session changes in frontal EMG in the first session of training were positively associated with changes in a measure of pulmonary function (FEV1/FVC). However, consistent with this hypothesis, first-session frontalis EMG changes were positively associated with changes in respiratory sinus arrhythmia, and last-session changes in cardiac interbeat interval were positively associated with changes in FEV1/FVC. The results suggest that the immediate effects of generalized relaxation instruction can be associated with a parasympathetic rebound, which, in turn, may induce countertherapeutic changes in asthma. However, the effects of specific facial muscle relaxation remain uncelar.     

Locus of control and frontal electromyographic response training

Forty-eight normal subjects from a college population, representing extreme internal and external orientations on a locus of control scale, were provided an auditory signal in a laboratory relaxation setting. For one group (feedback) the pitch of the signal varied as a function of frontal electromyographic (EMG) levels, while for another group (control) the pitch was constant. The feedback subjects acquired lower EMG potentials than did the control subjects, and the internal subjects in the feedback condition acquired lower levels than did the external subjects. In the control condition, no consistent differences in EMG levels between internal and external subjects were obtained. These results were stable across two replications, three ethnically distinct groups, and both sexes. Additional measures designed to reflect the effects of the frontal EMG training as a generalized relaxation technique for this population, including finger temperatures and a variety of postexperiment questionnaire ratings of relaxation, yielded negative results. Tests of other predictions from the locus of control construct are also discussed.This research was supported by NIMH Special Postdoctoral Fellowship No. MH58202-01.