Treatment of phantom limb pain with combined EMG and thermal biofeedback: a case report

Phantom pain is a frequent consequence of the amputation of an extremity and causes considerable discomfort and disruption of daily activities. This study describes a patient with extreme phantom limb pain following amputation of the right upper limb. The treatment consisted of 6 sessions of EMG biofeedback followed by 6 sessions of temperature biofeedback. The patient did not use a prosthesis and had not received previous treatment for chronic pain. Results demonstrated complete elimination of phantom limb pain after treatment, which was maintained at a 3- and 12-month follow-up. Pain relief covaried with increase in skin temperature at stump and perceptual telescoping (retraction of phantom limb into stump).     

Subjective experiences associated with thermal biofeedback treatment of hypertension

Reports of subjective experiences of 73 hypertensive patients who were treated with thermal biofeedback for hand warming were obtained over 16 treatment sessions. Most of the differential responding in subjective report occurred in the first 5 sessions. Differences in reports of throbbing were associated with medication status during treatment (presence of sympatholytic antihypertensive agent). From 4 to 9% of patients report negative subjective experiences at any one session. When short-term clinical successes (either elimination of medication or reduction of BP) were compared with short-term failures, it was found that successes reported more warmth, more likelihood of falling asleep, and more dreamlike experiences. The latter were more likely to occur suddenly for the successes. Correlational analyses revealed consistent positive associations between reports of warmth and relaxation with highest temperature achieved in the session and consistent negative associations between experiencing physical sensations and degree of temperature change within the session.This research was supported in part by grants from NHLBI, HL-27622 and HL-31189.     

Subjective experiences associated with thermal biofeedback treatment of hypertension

Reports of subjective experiences of 73 hypertensive patients who were treated with thermal biofeedback for hand warming were obtained over 16 treatment sessions. Most of the differential responding in subjective report occurred in the first 5 sessions. Differences in reports of throbbing were associated with medication status during treatment (presence of sympatholytic antihypertensive agent). From 4 to 9% of patients report negative subjective experiences at any one session. When short-term clinical successes (either elimination of medication or reduction of BP) were compared with short-term failures, it was found that successes reported more warmth, more likelihood of falling asleep, and more dreamlike experiences. The latter were more likely to occur suddenly for the successes. Correlational analyses revealed consistent positive associations between reports of warmth and relaxation with highest temperature achieved in the session and consistent negative associations between experiencing physical sensations and degree of temperature change within the session.     

Biochemical changes associated with thermal biofeedback treatment of hypertension

Fifty-two hypertensive patients whose blood pressure (BP) was controlled on two medications received either 16 sessions of thermal biofeedback (n = 30) for hand warming or 8 sessions of progressive muscle relaxation (n = 22) prior to medication withdrawal. A number of biochemical measures, including plasma norepinephrine (NEPI) (supine and standing), plasma renin activity, plasma aldosterone, and urinary sodium and potassium, were taken before treatment and after treatment while medication remained constant. Results for the biofeedback-treated patients showed significant reductions in mean arterial pressure as well as in both supine and standing NEPI, while the other biochemical measures were unchanged. There were no significant changes on any variable for the relaxation-treated patients. Although the group data support a reduction in peripheral sympathetic tone as associated with the decrease in BP for the thermal biofeedback condition, dose-response relations were not significant.     

Biochemical changes associated with thermal biofeedback treatment of hypertension

Fifty-two hypertensive patients whose blood pressure (BP) was controlled on two medications received either 16 sessions of thermal biofeedback (n=30) for hand warming or 8 sessions of progressive muscle relaxation (n=22) prior to medication withdrawal. A number of biochemical measures, including plasma norepinephrine (NEPI) (supine and standing), plasma renin activity, plasma aldosterone, and urinary sodium and potassium, were taken before treatment and after treatment while medication remained constant. Results for the biofeedback-treated patients showed significant reductions in mean arterial pressure as well as in both supine and standing NEPI, while the other biochemical measures were unchanged. There were no significant changes on any variable for the relaxation-treated patients. Although the group data support a reduction in peripheral sympathetic tone as associated with the decrease in BP for the thermal biofeedback condition, dose-response relations were not significant.This research was supported by a grant from NHLBI, HL-27622.     

Treatment of psoriasis by using Hijamah: A case report

Hijamah (a well-known Prophetic complimentary treatment) has been used for centuries to treat various human diseases. It is considered that this traditional treatment (also known as wet cupping) has the potential to treat many kinds of diseases. It is performed by creating a vacuum on the skin by using a cup to collect the stagnant blood in that particular area. The vacuum at the end is released by removing the cup. Superficial skin scarification is then made to draw the blood stagnation out of the body. This technique needs to be performed in aseptic conditions by a well trained Hijamah-physician. Prophet Muhammad (PBUH) had described Hijamah as the best treatment humans can have. This novel treatment methodology has been successfully used as cure for numerous diseases including skin diseases. In this case report, we discuss about the application of this method in the treatment of psoriasis (an autoimmune skin disease). Results illustrated that with Hijamah, disease can not only be controlled but can be brought to a nearly complete remission.     

An hypothesis for explaining the mechanism of translocation in peptide chain synthesis

A mechanism is proposed for mRNA translocation during peptide chain synthesis, which involves a reciprocal rotation of the two ribosomal components on each other in such a way as to propel the mRNA along a string of ribosomes on an endoplasmic reticulum membrane or to propel a single ribosome along an mRNA molecule in a membrane-free system. Release of tRNA's is assumed to occur from only one of the two ribosomal components at a time, so that there is no danger of loss of the tRNA's during peptide chain synthesis. The mechanism would make the ribosome an active, dynamic structure in addition to being a platform with catalytic activity which holds the components of peptide chain synthesis in juxtaposition.     

Behavioral and biofeedback therapy for a functionally impaired musician: A case report

A performing musician with severe occupational palsy accompanied by obsessions and compulsions was treated by an in vivo temperature biofeedback exercise. The treatment appeared highly successful in removing both the palsy and the obsessions, with improvement seen after six 1/2-day sessions and persisting for 4 years after the termination of treatment. This is the second reported case of functional palsy in a performing musician successfully treated by applying feedback apparatus directly to the affected part of the body. Occupational palsy, traditionally thought to be highly resistant to treatment, seems surprisingly amendable to in vivo biofeedback.     

Isolated skeletal muscle metastasis following successful treatment of laryngeal cancer: case report

Skeletal muscle metastases from tumors are a rare occurrence and can present difficult management decisions. We report here on a patient that had been previously treated for squamous cell laryngeal cancer with surgical resection and adjuvant systemic chemotherapy that presented with a metastasis to the rectus abdominis muscle without evidence of recurrent disease at the primary site. After a metastatic workup with PET/CT scan suggested this to be an isolated lesion, surgical excision with negative margins was performed based upon limited treatment options secondary to the location of the tumor and his favorable prognosis suggested by his pathological staging at the time of the initial resection. Here we discuss the incidence of distant metastases from laryngeal cancer and appropriate screening methods. Additionally, skeletal muscle metastases and treatment considerations are discussed.     

Thermal biofeedback in the treatment of intermittent claudication in diabetes: A case study

The objective of the present case study was to examine the therapeutic effects of thermal biofeedback-assisted autogenic training on a patient with non-insulin-dependent diabetes mellitus (NIDDM), vascular disease, and symptoms of intermittent claudication. The patient received thermal biofeedback from the hand for five sessions, then from the foot for 16 sessions, while hand and foot skin temperature were monitored simultaneously. In addition, the patient was instructed in autogenic training and practiced daily at home. Follow-up measurements were taken at 12 and 48 months. Within-session foot temperature rose specifically in response to foot temperature biofeedback and starting foot temperature rose between sessions. Posttreatment blood pressure was reduced to a normal level. Attacks of intermittent claudication were reduced to zero after 12 sessions and walking distance increased by about a mile per day over the course of treatment. It would appear that thermal biofeedback and autogenic training are potentially promising therapies for persons with diabetes and peripheral vascular disease.Preparation of this article was supported in part by NIDDK grant No. R0128288 and the Commonwealth of Virginia Diabetes Clinical Research Institute.     

Continuous versus interrupted schedules of thermal biofeedback: An exploratory analysis with clinical subjects

Researchers administer thermal biofeedback in several different formats, although the most common are continuous administration and a series of brief trials separated by frequent rest breaks. The present study directly compared these two administration schedules with individuals suffering from migraine headache. Optimal training effects occurred for the continuous schedule of administration. Surprisingly, the interrupted schedule actually led to decreases in hand temperature over eight sessions. Possible reasons for this finding and its implications are discussed.This research was supported in part by grants from the National Institute of Neurological and Communicative Disorders and Stroke (NS-15235; NS-16891; NS-00818) and the Research Foundation of the State University of New York.     

A case report of the successful treatment of recurrent aphthous stomatitis with some preparations of orally administered transfer factor

A patient with severe disabling recurrent aphthous stomatitis (RAS) was treated with four different preparations of oral human transfer factor (TF), as well as placebo, following a double-blind protocol. Two of the TF preparations had a significant effect upon the course of the patient's illness by prolonging the interval between attacks and decreasing the severity of attacks. No side effects attributable to any of the preparations were noted by the patient. Thus, some but not all preparations of human transfer factor given orally are an effective therapy for RAS.     

A biomechanical hypothesis explaining upstream movements by the freshwater snail Elimia

1. Many taxa of freshwater invertebrates show active upstream movements, particularly the snails. Hypotheses explaining this behaviour invoke the search for food or space, compensation for drift, avoidance of predation and hydrodynamic effects. The pervasiveness of upstream movements among remote lineages of snails (two subclasses, three orders, 10 families), however, suggests that snails may move upstream for mechanical rather than adaptive reasons.
2. It is proposed that upstream movements by snails are a function of torque on the snail's foot generated by hydrodynamic drag on the shell. When subject to high broadside drag-forces on their shells, snails are able to reduce torque and stabilize orientation only by directing their anterior aspect upstream.
3. Movements of the freshwater pleurocerid snail Elimia were studied by following marked free-ranging individuals in six streams in Alabama, USA (four species, eight populations).
4. Populations showed either no net movement (two streams) or significant upstream movements ranging to a mean of ≈40 m over a 3-month period (four streams). Movement patterns were stream specific rather than species or population specific. Within populations showing significant upstream movements, snails with shell lengths ≤10 mm showed little net movement. Larger snails showed movements from 0 to >200 m upstream.
5. A torque-constrained random walk model was used to perform a post hoc test of the hypothesis that upstream movements were a function of torque on the snail's foot generated by hydrodynamic drag on the shell. The model predicted upstream and size-dependent movement patterns that approximated those observed for snails in the field.     

Response to the challenge: Effective treatment of the elderly through thermal biofeedback combined with progression relaxation

This notes pursues the theme introduced in the first Notes and Observations publication: the effectiveness of biofeedback in treatment of the elderly. Current clinical results in progress are reported for a 76-year-old female hypertensive whose blood pressure has to date been lowered from 190/90 to 160/82 by means of thermal biofeedback in conjunction with progressive relaxation. These results are contrasted with reported failures in the headache study of elderly patients (Blanchard, Andrasik, Evans, & Hillhouse 1985). Results of this study are reinterpreted in terms of biofeedback modality rather than age of subjects.     

Response to the challenge: effective treatment of the elderly through thermal biofeedback combined with progression relaxation

This notes pursues the theme introduced in the first "Notes and Observations" publication: the effectiveness of biofeedback in treatment of the elderly. Current clinical results in progress are reported for a 76-year-old female hypertensive whose blood pressure has to date been lowered from 190/90 to 160/82 by means of thermal biofeedback in conjunction with progressive relaxation. These results are contrasted with reported failures in the headache study of elderly patients (Blanchard, Andrasik, Evans, & Hillhouse 1985). Results of this study are reinterpreted in terms of biofeedback modality rather than age of subjects.     

Self-control procedures in biofeedback: A review of temperature biofeedback in the treatment of migraine

It is argued that in order to optimize the achievement of self-control and to evaluate the clinical effects of biofeedback three skills should be included in training and assessment, namely: (1) the ability of voluntary control with external feedback, (2) the ability of voluntary controlwithout external feedback, and (3) the ability toapply the self-control skill in critical situations in everyday life. A review of the literature concerning temperature-biofeedback in the treatment of migraine headaches shows that the research from this point of view is in a rather poor state of affairs and that no definite conclusion can in fact be drawn about the degree of self-control which has been achieved and hence of the ultimate clinical value of biofeedback.This study was supported by grant no. 80/66 from the Bank of Sweden Tercentenary Foundation.     

Evaluation of home-based thermal biofeedback treatment of pediatric migraine headache

Sixteen children and adolescents with migraine headache were treated with thermal biofeedback. Seven were seen individually in the clinic while the other nine participated in a limited-contact, partly home-based regimen. Evaluation of headache diary data from 4-week monitoring periods before and after treatment showed significant (p<.01) reduction in headaches, with no significant difference in efficacy between the two conditions.This research was supported in part by grants from NIMH, MH-41341, and NINCDS, NS-23440.     

Evaluation of home-based thermal biofeedback treatment of pediatric migraine headache

Sixteen children and adolescents with migraine headache were treated with thermal biofeedback. Seven were seen individually in the clinic while the other nine participated in a limited-contact, partly home-based regimen. Evaluation of headache diary data from 4-week monitoring periods before and after treatment showed significant (p less than .01) reduction in headaches, with no significant difference in efficacy between the two conditions.