Baseline levels in muscle relaxation training

Variations in the baseline levels of physiological measures, a familiar problem in psychophysiological research, can affect the results of clinical applications and research in the self-control of bodily processes. In this presentation, the problem is illustrated within the context of skeletal muscle relaxation training using continuous biofeedback(BF) based on surface electromyographic(EMG) activity. In terms of the Law of Initial Values(LIV), higher EMG levels are expected to be associated with greater decreases during training. The combined results of two studies documented an LIV-like effect for pretraining baseline levels with greater EMG decreases after training for subjects with the higher pretraining baselines. Left uncorrected, such baseline differences were shown to lead to discrepant results between two identical studies, and therefore to conflicting conclusions about the effectiveness of these procedures. The available methods suggested to correct for the biasing effect of baseline differences in research are described, with particular emphasis on the analysis of covariance.This research was supported in part by NIH Grants MH24222 and AI-10398. The authors would like to thank Miss Sharon Robinson for supervising the collection of data and for her constructive comments regarding the training procedures of the studies described.     

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.     

Variations in digital temperature during frontal EMG biofeedback training in normal subjects

During frontal EMG biofeedback training, the relationship between frontal EMG and digital skin temperature was investigated in two experiments, which varied the number of baseline and feedback sessions. The results of Experiment 1 suggested a "general relaxation effect," where digital temperature increased as frontal EMG decreased, especially for subjects with initially low hand temperature. Experiment 2 extended the number of baseline and feedback sessions and qualified the results of Experiment 1. EMG and digital temperature did not simultaneously converge toward general relaxation over the extended baseline or feedback sessions in Experiment 2. Furthermore, when the feedback signal was introduced, digital temperature dropped quickly but recovered to baseline levels within three feedback sessions; this drop in digital temperature was interpreted within the context of attentional demands of the biofeedback task. The results appeared consistent with the view that frontal biofeedback training teaches a discriminative skill of lower frontal EMG, and that this skill does not readily generalize to digital skin temperature.     

Differential shaping of EEG theta rhythms

Heart rate, EEG, frontal EMG, and forearm EMG were recorded in 20 subjects for 3 baseline, 8 feedback, and 2 postbaseline sessions in order to compare two biofeedback methods of teaching subjects to increase theta EEG activity. Subjects were divided into high- and low-EMG groups. Five high-EMG subjects, and 5 low-EMG subjects then received 8 sessions of strictly theta feedback. The remaining 10 subjects, 5 from the high-EMG group, and 5 from the low-EMG group, received a “graduated” training which involved shaping the target response. This procedure consisted of 4 initial sessions of EMG feedback, followed by a second phase consisting of 4 sessions of theta feedback. Results showed a clear relationship between subjects' baseline frontal EMG levels and the effect of the training methods. Although subjects with high-EMG baseline increased their theta output only with the two-phase training, subjects with low-EMG baseline levels performed better when given theta feedback only. This result shows not only that amounts of theta can be reliably increased, but that training techniques should be adapted to the physiological characteristics of the individual—in this case, baseline levels of frontal EMG levels.     

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.     

Variations in digital temperature during frontal EMG biofeedback training in normal subjects

During frontal EMG biofeedback training, the relationship between frontal EMG and digital skin temperature was investigated in two experiments, which varied the number of baseline and feedback sessions. The results of Experiment 1 suggested a general relaxation effect, where digital temperature increased as frontal EMG decreased, especially for subjects with initially low hand temperature. Experiment 2 extended the number of baseline and feedback sessions and qualified the results of Experiment 1. EMG and digital temperature did not simultaneously converge toward general relaxation over the extended baseline or feedback sessions in Experiment 2. Furthermore, when the feedback signal was introduced, digital temperature dropped quickly but recovered to baseline levels within three feedback sessions; this drop in digital temperature was interpreted within the context of attentional demands of the biofeedback task. The results appeared consistent with the view that frontal biofeedback training teaches a discriminative skill of lower frontal EMG, and that this skill does not readily generalize to digital skin temperature.This research was supported by Grant 2 S06RR08038-17 funded by the National Institutes of Mental Health.     

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.     

Hypnotizability and response to EMG relaxation training

This study examines the relationship between Spiegel's Hypnotic Induction profile (HIP) and ability to perform EMG relaxation under conditions of self-induced and audio-assisted biofeedback training. One hundred women volunteered for screening with Spiegel's test for hypnotizability. Thirty students were then selected from the top, middle, and bottom of the HIP scoring distribution for EMG biofeedback training in relaxation. Three treatment trials included baseline, EMG biofeedback with self-induced relaxation, and EMG biofeedback with audio relaxation instructions. Contrary to predictions, high HIPs were not significantly different from low HIPs on any of the treatment measures, although all students showed a training effect. The middle HIPs demonstrated significantly higher levels of EMG activity than the extreme groups.     

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.     

A Pilot Study of Brief Heart Rate Variability Biofeedback to Reduce Craving in Young Adult Men Receiving Inpatient Treatment for Substance Use Disorders

The present pilot study investigated the implementation feasibility, and efficacy for reducing alcohol and drug craving, of a brief, 3-session heart rate variability biofeedback (HRV BFB) intervention added to a traditional 28-day substance abuse disorder inpatient treatment program. Forty-eight young adult men received either treatment as usual (TAU) plus three sessions of HRV BFB training over 3 weeks, or TAU only. Participants receiving HRV BFB training were instructed to practice daily using a hand-held HRV BFB device. HRV BFB training was well tolerated by participants and supported by treatment staff. Men receiving TAU + HRV BFB demonstrated a greater, medium effect size reduction in alcohol and drug craving compared to those receiving TAU only, although this difference did not reach statistical significance. In addition, an interaction effect was observed in analyses that accounted for baseline craving levels, wherein heart rate variability (HRV) levels at treatment entry were predictive of changes in craving in the TAU group only. Low baseline levels of HRV were associated with increases in craving, whereas higher baseline HRV levels were associated with greater decreases in craving from start to end of treatment. In the TAU + HRV BFB group, however, there was no such association. That is, HRV BFB appeared to dissociate individual differences in baseline HRV levels from changes in craving. Given that alcohol and drug craving often precipitates relapse, HRV BFB merits further study as an adjunct treatment to ameliorate craving experienced by persons with substance use disorders.     

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.     

Effects of creatine supplementation and three days of resistance training on muscle strength, power output, and neuromuscular function

Previous studies have demonstrated increases in peak torque (PT) and decreases in acceleration time (ACC) after only 2 days of resistance training, and other studies have reported improvements in isokinetic performance after 5 days of creatine supplementation. Consequently, there may be a combined benefit of creatine supplementation and short-term resistance training for eliciting rapid increases in muscle strength, which may be important for short-term rehabilitation and return-to-play for previously injured athletes. The purpose of this study, therefore, was to examine the effects of 3 days of isokinetic resistance training combined with 8 days of creatine monohydrate supplementation on PT, mean power output (MP), ACC, surface electromyography (EMG), and mechanomyography (MMG) of the vastus lateralis muscle during maximal concentric isokinetic leg extension muscle actions. Twenty-five men (mean age +/- SD = 21 +/- 3 years, stature = 177 +/- 6 cm, and body mass = 80 +/- 12 kg) volunteered to participate in this 9-day, double-blind, placebo-controlled study and were randomly assigned to either the creatine (CRE; n = 13) or placebo (PLA; n = 12) group. The CRE group ingested the treatment drink (280 kcal; 68 g carbohydrate; 10.5 g creatine), whereas the PLA group received an isocaloric placebo (70 g carbohydrate). Two servings per day (morning and afternoon) were administered in the laboratory on days 1-6, with only 1 serving on days 7-8. Before (pre; day 1) and after (post; day 9) the resistance training, maximal voluntary concentric isokinetic leg extensions at 30, 150, and 270 degrees x s(-1) were performed on a calibrated Biodex System 3 dynamometer. Three sets of 10 repetitions at 150 degrees x s(-1) were performed on days 3, 5, and 7. Peak torque increased (p = 0.005; eta(2) = 0.296), whereas ACC decreased (p < 0.001; eta(2) = 0.620), from pretraining to posttraining for both the CRE and PLA groups at each velocity (30, 150, and 270 degrees x s(-1)). Peak torque increased by 13% and 6%, whereas ACC decreased by 42% and 34% for the CRE and PLA groups, respectively, but these differences were not statistically significant (p > 0.05). There were no changes in MP, EMG, or MMG amplitude; however, EMG median frequency (MDF) increased, and MMG MDF increased at 30 degrees x s(-1), from pretraining to posttraining for both the CRE and PLA groups. These results indicated that 3 days of isokinetic resistance training was sufficient to elicit small, but significant, improvements in peak strength (PT) and ACC for both the CRE and PLA groups. Although the greater relative improvements in PT and ACC for the CRE group were not statistically significant, these findings may be useful for rehabilitation or strength and conditioning professionals who may need to rapidly increase the strength of a patient or athlete within 9 days.     

Biofeedback as a means to alter electromyographic activity in a total knee replacement patient

This paper presents a single case controlled study of a 75-year-old male having bilateral total knee replacement. Baseline EMG recordings demonstrated differential levels of vastus medialis and vastus lateralis muscle activity in both knees during exercise, with increased vastus lateralis activity compared to vastus medialis activity. The purpose of the study was to use electromyographic (EMG) biofeedback training to train the patient to equalize vastus medialis and vastus lateralis EMG activity during exercise. After 11 and 13 training sessions for the left and right knees, respectively, differences between vastus medialis and vastus lateralis activity had markedly decreased. Following the termination of biofeedback training, EMG activity during exercise showed a return toward baseline levels. Several concomitant changes in psychological and physical function were noted. These results suggested that EMG biofeedback can be used to train vastus medialis and vastus lateralis activity in total knee replacement patients, and that biofeedback training may produce positive benefits in other functional areas.     

EMG stability as a biofeedback control

Factors that may confound comparisons between electromyographic (EMG) biofeedback training and its control conditions include feedback quality and experience of success. We investigated the usefulness of a control procedure designed to overcome these potential sources of confounding. The procedure consisted of training muscle tension stability. We used it as a control for frontal EMG relaxation training in children with asthma. To equate the groups for feedback quality and experience of success, we gave each child in the control condition audio feedback decreasing in pitch when muscle tension was at or near baseline levels, and feedback increasing in pitch when muscle tension was either substantially above or below baseline levels. Children in both groups were instructed to decrease the pitch of the tone. In comparison to children in the relaxation condition, the children in the control condition exhibited stable levels of muscle tension throughout eight training sessions. We concluded that feedback for stable muscle tension may be a useful control procedure for EMG biofeedback training whenever experimental and control procedures differ in either feedback quality of degree to which they permit subjects to experience success.This research was supported by NIH-Grant HL 27402. We are grateful to Paul Schnitter who constructed the EMG stability feedback device.     

Crosscultural differences in frontalis muscle tension levels: An exploratory study comparing Japanese and Westerners

This paper describes a comparison between Japanese (N=20) and Westerners (N=20) in their respective frontal EMG levels and their ability to relax during one 5-minute biofeedback training session. The data indicated a significantly lower baseline muscle tension level in Japanese than in Westerners. After EMG biofeedback, however, no significant difference was found between the two groups. Japanese females showed significantly higher tension levels both during baseline and biofeedback phases than did Japanese males.     

Contingently faded heart rate biofeedback: Attempted replication of large-magnitude decreases

McKinney et al. (1980) reported large-magnitude reductions in heart rate (HR) from resting baseline levels, employing shaping and fading techniques and a reinforcement program in which a secondary reinforcer was awarded both contingently and immediately during training. The four male subjects in this group showed significantly greater HR decreases than a group of four males receiving beat-by-beat analogue HR feedback. The present study compared decreases in HR in 20 male subjects receiving the contingently faded biofeedback procedure to those shown by 10 male subjects for whom reinforcement was contingent on vigilant observation of a visual display, and independent of HR. The former group showed significantly greater decreases in HR that could not be attributed to elevated baseline levels. However, the decreases in HR were not as large as those reported by McKinney et al. (1980). It is argued that future research should assess variables contributing to individual differences in performance.This research was supported by Ontario Heart Foundation Research Grant 15–37 to R. Pavloski.     

Crosscultural differences in frontalis muscle tension levels: an exploratory study comparing Japanese and Westerners

This paper describes a comparison between Japanese (N = 20) and Westerners (N = 20) in their respective frontal EMG levels and their ability to relax during one 5-minute biofeedback training session. The data indicated a significantly lower baseline muscle tension level in Japanese than in Westerners. After EMG biofeedback, however, no significant difference was found between the two groups. Japanese females showed significantly higher tension levels both during baseline and biofeedback phases than did japanese males.     

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 effects of EMG feedback training during problem solving

The present case study investigated the effects of competing task demands on biofeedback training to reduce frontalis muscle tension. Baseline levels of frontalis muscle tension were recorded for relaxation and problem solving. The subject was trained to decrease muscle tension with biofeedback for the problem-solving task alone. The results indicated that EMG training during problem solving was successfully accomplished. Frontalis muscle tension during relaxation baseline did not change as a result of reductions in muscle tension during problem-solving feedback training. This suggests that the decrease of muscle tension cannot be attributed to reductions in overall muscle tension levels. Instead, training was specific to the problem-solving feedback phases. Additionally, it was found that accuracy in problem-solving did not decline as a result of simultaneous feedback training. Thus EMG biofeedback training can be accomplished and exercised without disruption of ongoing mental activity.     

Frontal EMG-biofeedback training of athetoid cerebral palsy patients

Six athetoid cerebral palsy patients participated in the following: speech and motor prebiofeedback training evaluation; frontal EMG biofeedback training, 6 wk; speech and motor postbiofeedback training evaluation, Frontal pretraining levels for the subjects averaged 28.9 µV p-p. Subjects' feedback consisted of an auditory signal(clicks) varying proportionately with frontal EMG activity. A visual meter display of the integrated EMG was also provided. Self-regulation of frontal EMG was evident for all subjects within session 1. Throughout all sessions, EMG levels of 2–4 µV were often attained. Trend analysis of EMG acquisition curves showed significant reduction in frontal tension across sessions for all but one subject. Frontal posttraining levels averaged 13.0 µV p-p. Parents or subjects, or both, reported subtle improvements in various speech and motor functions, a finding confirmed by objective postbiofeedback training evaluation. Only the 2 most severely impaired subjects, JA and DS, failed to improve significantly on the speech measures. All subjects improved significantly on those measures that tapped fine and gross motor skills. Collectively, these results indicate that EMG biofeedback training shows promise as an additional treatment modality in the habilitation of cerebral palsy patients.