Biofeedback - Biofeedback-Assisted Relaxation in Type 2...

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Biofeedback-Assisted Relaxation in Type 2 Diabetes Ronald A. McGinnis, MD, Angele McGrady, PHD, MED, LPCC, Stephen A. Cox, MD and Kimber A. Grower-Dowling, BA From the Department of Psychiatry, Medical University of Ohio, Toledo, Ohio Address correspondence and reprint requests to Ronald A. McGinnis, Medical University of Ohio, 3120 Glendale Ave., RHC-0079, Toledo, OH 43614-5809. E-mail: rmcginnis@meduohio.edu ABSTRACT OBJECTIVE —The objective of this randomized controlled study was to determine the effects of biofeedback and relaxation on blood glucose and HbA 1c (A1C) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS —Patients with type 2 diabetes were randomized to either 10 sessions of biofeedback (electromyograph and thermal) and relaxation or 3 sessions of education. All sessions were individual. A total of 39 participants were entered, and 30 completed the 3-month protocol. Average blood glucose, A1C, forehead muscle tension, and peripheral skin temperature were assessed, and inventories measuring depression and anxiety were administered prerandomization and after completion of treatment/control. RESULTS —Biofeedback and relaxation were associated with significant decreases in average blood glucose, A1C, and muscle tension compared with the control group. At 3- month follow-up, the treatment group continued to demonstrate lower blood glucose and A1C. Both groups decreased scores on the depression and anxiety inventories. Patients with depression had higher blood glucose levels and tended to drop out of the study. CONCLUSIONS —This study supports the use of biofeedback and relaxation in patients with type 2 diabetes for up to 3 months after treatment. Further research is necessary to determine the long-term effects of biofeedback and the effects of mood on patients’ responses to treatment. Abbreviations: BDI-II, Beck Depression Inventory II • BFRT, biofeedback-assisted relaxation therapy • EMG, electromyograph INTRODUCTION TOP ABSTRACT INTRODUCTION RESEARCH DESIGN AND METHODS RESULTS CONCLUSIONS References
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Management of type 2 diabetes requires continuous monitoring and multiple interventions to prevent long-term complications ( 1 ). One of the contributing factors in the etiology of glucose intolerance and poor glycemic control in individuals with diabetes is the stress response ( 2 , 3 ). Based on this premise, several studies have evaluated stress management techniques as adjunctive in the treatment of patients with diabetes. Stress management is a generic term that may encompass biofeedback, relaxation, cognitive behavioral therapy, and imagery. Biofeedback is a therapeutic technique involving an instrument that provides information about physiological activity, such as skin temperature or muscle tension, with the objective of learning control over maladaptive responses to stress. Biofeedback is commonly coupled with relaxation therapy, which can comprise deep breathing, progressive relaxation, or imagery ( 4 ). Jablon et al. (
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Biofeedback - Biofeedback-Assisted Relaxation in Type 2...

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