Thermal Biofeedback for Primary Raynaud’s Phenomenon: A Review of the Literature

University of Nevada, Las Vegas, Las Vegas, Nevada, United States
Applied Psychophysiology and Biofeedback (Impact Factor: 1.13). 10/2006; 31(3):203-16. DOI: 10.1007/s10484-006-9018-2
Source: PubMed


The clinical presentation of primary Raynaud's phenomenon (RP) derives from various pathogenic triggers. The use of thermal biofeedback (TBF) may be of benefit in reducing the severity and frequency of attacks. This article summarizes the relevant research regarding the pathophysiology of primary RP and mechanism of TBF for RP. Systematic reviews of the efficacy of TBF for RP and treatment guidelines for clinicians are provided. The panel concludes that the level of evidence for TBF efficacy is categorized as Level IV: efficacious. The rationale, based on three randomized controlled trials conducted in independent laboratories, demonstrated "superiority or equivalence" of treatments that include TBF. However, randomly controlled trials (RCT) with positive clinical outcomes tended to be small. A large RCT with negative results did not effectively teach handwarming skills. Procedures for reviewing and rating of the levels of evidence of efficacy of studies was based on the Template for Developing Guidelines for the Evaluation of the Clinical Efficacy of Psychophysiological Interventions developed by the joint task force of the AAPB and the Society for Neuronal Regulation (SNR).

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    • "Inoltre rende possibile discriminare l'andamento dell'arousal a riposo, in risposta allo stress e in condizioni di recupero. Questo tipo d'informazione è particolarmente importante per indirizzare la scelta dell'intervento nei seguenti casi: 1. qualora lo stress risulti una componente importante nell'eziologia del disturbo (si veda, ad esempio, Chang, 2011); 2 quando vi è un'alterata funzionalità fisiologica alla base del disturbo (ad esempio, per la fenomenologia di Raynaud; si vedano Karavidas et al., 2006); 3. nel trattamento dei medical unexplained physical symptoms (MUPS) o «disturbi funzionali» (si vedano, ad esempio, Ryan e Gevirtz, 2004; Peper, Harvey e Takabayashi, 2009); 4. in tutte quelle condizioni in cui un arousal eccessivo contribuisca a mantenere o aggravare i sintomi (Arena e Schwartz, 2003). "
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    ABSTRACT: Chronic diseases falling under the category of functional or stress-related diseases are a relevant part of today pathologies and therapies currently offered are only partially effective. Scientific literature supports the integration of the psychophysiological approach in the multidisciplinary interventions aiming to manage such disorders. In this article we present some theoretical principles and methodological indications about the recording and the interpretation of a psychophysiological assessment in order to give practical guidance to those who want to integrate the psychophysiological approach in their practice. We especially focus on how this tool can be applied to choose an individualized biofeedback protocol. Una parte rilevante delle patologie odierne è costituita da alcune patologie croniche che possono essere classificate come disturbi funzionali e stress-correlati, le terapie offerte correntemente risultano solo parzialmente efficaci. I dati forniti dalla letteratura scientifica danno supporto all’integrazione dell’approccio psicofisiologico negli interventi terapeutici multidisciplinari, sempre più indicati nella gestione di tali condizioni patologiche. In questo articolo presentiamo alcuni riferimenti teorici e indicazioni metodologiche sulla conduzione e l’interpretazione dell’assessment psicofisiologico, al fine di fornire riferimenti concreti a coloro che vogliono utilizzare questo strumento nella loro pratica professionale. Una particolare attenzione è data all’utilizzo dell’assessment psicofisiologico nella scelta di un protocollo di biofeedback individualizzato.
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    • "The term " biofeedback " is used when the information provided concerns physiological parameters such as body temperature, breathing rhythm and heart rate. Biofeedback has been used for treating migraines (Nestoriuc, & Martin, 2007), Raynaud's disease (Katsamanis Karavidas, Tsai, Yucha, McGrady, & Lehrer, 2006) and urinary incontinence (Glazer & Laine, 2006). Neurofeedback training (NFB) or electroencephalographic biofeedback (EEG) involves providing the subject in real time with information relating to the rhythmic cortical electrical activities that reflect the electrical activity of specific cortical areas and functions (Evans, & Abarbanel, 1999; Masterpasqua, & Healey, 2003). "
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    ABSTRACT: Neurofeedback or electroencephalographic operant conditioning (EEG-OC) is an EEG biofeedback technique used to train individuals to control or modify their cortical activity through learned self-regulation. Initially used for treating a variety of pathologies, neurofeedback has been employed more recently to improve the physical or cognitive performance of human beings. The purpose of this study is to assess the hypothesis of the effect of neurofeedback (the 'awakened mind' model) on the memory performance of subjects aged over 65. 30 partici-pants were shared equally between 3 groups: an experimental group that underwent 4 neurofeedback training sessions; a non-neurofeedback group trained at relaxation; and a 'waiting list' control group. Results showed that the members of the Neurofeedback group learned to increase the spectral power of the alpha frequency range as well as the alpha/thêta ratio, and that compared with the members of the two other groups, neurofeed-back training resulted in a more pronounced decrease, albeit without any relation to changes in EEG activity and the level of stress and anxiety of participants undergoing such training. Yet contrary to expectations, no im-provement of memory performance (differed recall of words and learning of lists of words) was observed. These mixed results, which suggest a wide range of applications, underline the need for a more systematic assessment of the potential applications of NFB training in elderly humans in order to be better able to specify the effects of the retained protocol on cognitive performance.
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