title: The Raynaud's Treatment Study: biofeedback protocols and acquisition of temperature biofeedback skills.
abstract: The Raynaud's Treatment Study (RTS) compared temperature biofeedback training and a behavioral control procedure (frontalis EMG biofeedback) with nifedipine-XL and a medication placebo for treatment of primary Raynaud's phenomenon (RP) in a large (N = 313) multicenter trial. The present study describes the RTS biofeedback protocols and presents data on the acquisition of digital skin temperature and frontalis EMG responses in the RTS. The findings point to substantial problems with acquisition of physiological self-regulation skills in the RTS. Only 34.6% of the Temperature Biofeedback group (N = 81) and 55.4% of the EMG Biofeedback group (N = 74) successfully learned the desired physiological response. In contrast, 67.4% of a Normal Temperature Biofeedback group (N = 46) learned hand warming. Multivariate analysis found that coping strategies, anxiety, gender, and clinic site predicted acquisition of hand-warming skills whereas variables related to RP disease severity did not. Physiological data showed vasoconstriction in response to the onset of biofeedback and also found that performance in the initial sessions was critical for successful acquisition. These findings indicate that attention to the emotional and cognitive aspects of biofeedback training, and a degree of success in the initial biofeedback sessions, are important for acquisition.
authors.affiliation: Department of Anesthesiology and Perioperative Surgery, Medical University of South Carolina, 165 Ashley Avenue, Suite 525, P.O. Box 250912, Charleston, South Carolina 29425, USA. middaugs@musc.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Middaugh
authors.forename: J A
authors.initials: JA
authors.lastname: Haythornthwaite
authors.forename: B
authors.initials: B
authors.lastname: Thompson
authors.forename: R
authors.initials: R
authors.lastname: Hill
authors.forename: K M
authors.initials: KM
authors.lastname: Brown
authors.forename: R R
authors.initials: RR
authors.lastname: Freedman
authors.forename: V
authors.initials: V
authors.lastname: Attanasio
authors.forename: R G
authors.initials: RG
authors.lastname: Jacob
authors.forename: M
authors.initials: M
authors.lastname: Scheier
authors.forename: E A
authors.initials: EA
authors.lastname: Smith
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology / Q000502:physiology; D004576:Electromyography; D005152:Facial Muscles / Q000503:physiopathology; D005260:Female; D005385:Fingers / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D011928:Raynaud Disease / Q000503:physiopathology / Q000628:therapy*; D012016:Reference Values; D012881:Skin Temperature / Q000502:physiology; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000502:physiology