title: Effect of thermal biofeedback-assisted relaxation training on blood circulation in the lower extremities of a population with diabetes.
abstract: OBJECTIVE
  Investigate the effect of relaxation training/thermal biofeedback on blood circulation in the lower extremities of diabetic subjects.
  
  
  METHODS
  Diabetic subjects (n = 40) aged 17-73 yr were volunteers recruited through the University of Wisconsin-La Crosse, the local ADA Chapter, and a medical clinic. A within-subjects experimental design was used. During phase 1, all subjects used a self-selected relaxation method and recorded toe temperatures daily. During phase 2, subjects were taught a biofeedback-assisted relaxation technique designed to elicit sensations of warmth in the lower extremities and increase circulation and temperature. Subjects relaxed at home with the use of a designated relaxation tape. They measured and recorded toe temperatures. Each phase lasted 4 wk.
  
  
  RESULTS
  Toe temperature and blood volume pulse (BVP) data were gathered at the beginning and end of phases 1 and 2. Paired t tests compared the means of temperature percent change scores between 1 and 2. Mean temperature change scores were 8.73% (phase 1) and 31.38% (phase 2) (t = -8.00, df = 39, P less than 0.001). Mean BVP change scores were 2.33% (phase 1) and 22.47% (phase 2) (t = -9.24, df = 35, P less than 0.001). Based on eta squared, 71% of the BVP increase in phase 2 was attributed to the relaxation technique. A multiple regression analysis indicated that none of the other examined variables affected by diabetes were significant predictors of BVP increase.
  
  
  CONCLUSIONS
  Data indicate that diabetic patients show significant increases in peripheral blood circulation with this technique. This noninvasive method could serve as an adjunct treatment for limited blood flow in some complications of diabetes.
authors.affiliation: Department of Health Education, University of Wisconsin-La Crosse.
authors.forename: B I
authors.initials: BI
authors.lastname: Rice
authors.forename: J V
authors.initials: JV
authors.lastname: Schindler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology / Q000502:physiology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D012044:Regression Analysis; D012064:Relaxation Therapy