The Effects of Progressive Relaxation and Myoelectric Feedback on Respiratory Resistance in Bronchial Asthmatics
For the individual with bronchial asthma, an asthmatic attack can be a life threatening experience. A theory of bronchial asthma as a conditioned response has been recently proposed by several investigators. It was suggested that this conditioned response may be modified by lowering the arousal level, and as a result, decreasing the asthmatic response. The problem identified in this exploratory study was to measure the effects of relaxation on the smaller or peripheral airways of a convenience sample of six asthmatic subjects fourteen to seventy years of age. It was hypothesized that an increased degree of total body relaxation would result in a decrease in airway resistance as would be evidenced by the changes in certain pulmonary function tests performed. The six asthmatic subjects participated in the study after referrals by their physicians. At a pre-study session the subjects were introduced to the objectives of the study. Identifying information was recorded, and after the base line physiological measurements were taken, details of the relaxation training program were explained to each subject. The base line measurements consisted of the subjects’ tension levels recorded with an electromyograph, with the surface electrodes on the skin over the frontalis muscle. The base line also consisted of the following pulmonary function tests: closing capacity and closing volume, forced expiratory volume, forced vital capacity, maximal mid-expiratory flow rate, residual volume and total lung capacity. The subjects were introduced to the intervention of purposeful relaxation training using an electromyograph biofeedback unit. They were to practice the relaxation exercises at home at least twice each day of the four week study. Each of the six subjects attended eight relaxation training sessions using the biofeedback techniques. The investigator was present at all of the laboratory sessions, and recorded integrated electromyographic values during two-minute periods. Each of the eight relaxation training sessions lasted twenty-four minutes, and the means of the electromyographic values were reported in microvolts. The tension levels measured during the sessions for each subject fluctuated within the sessions, generally showing a decrease within the sessions. This decrease was not continuously progressive over the eight sessions. The short term evaluation of the relaxation intervention was determined by performing the pulmonary function tests before and after each of the last two sessions. The long term evaluation was made by repeating the tests at the end of the study. The results of the pulmonary function tests did not indicate that an increase in total body relaxation resulted in a decrease in airway resistance of the six asthmatic subjects studied. Subjective findings reported at the end of the study did indicate that the subjects were able to relax and to decrease the frequency and intensity of their asthmatic symptoms. It was concluded that the hypothesis was not supported by the findings of the study, even though the subjective findings indicated that this might be possible. It was further concluded that there were some uncontrolled factors present in the study which might have affected the pulmonary function tests. These factors included cold air, exposure to certain pollens and smog, some emotional factors, and the stressful effects of taking several pulmonary function tests which required forced breathing. It was recommended that further studies dealing with this subject should consider certain changes in the areas of sampling and methodology. These changes should allow for a larger sample which would be more representative of the population. The changes in methodology would include the use of a control group, having the subjects in closer proximity to the laboratory, and allowing the investigator to supervise the subjects' practice of the relaxation exercises. It was also recommended that further nursing studies be done to explore the feasibility of teaching asthmatic patients systematic relaxation techniques during incidental nursing encounters.
Nursing, Pulmonology, Asthma; Relaxation; Biofeedback (Psychology)
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