2007 Volume 34 Issue 2 Pages 23-30
It is possible that a combination of biofeedback (BF) and psychotherapy is effective in the treatment of muscle tension. Several studies have reported that EMG-BF combined with Autogenic training (AT) was effective for spasmodic torticollis. AT is a method of concentrating on proprioception through self-hypnotic suggestion (formula). Ishida et al. (2000) explored the effect of EMG-BF while concentrating on trapezius muscle relaxation. In this study, participants were randomly assigned to EMG-BF, concentration, and EMG-BF combined with concentration conditions. Results indicated that there was a significant decrease in muscle tension as indicated by the EMG in the EMG-BF with concentration condition, compared with the other two conditions. Although combining EMG-BF and AT might be useful for muscle relaxation, other relaxation techniques must be combined with EMG-BF for patients who are unable to learn AT. Sakakibara et al. (1993) in a study of two patients with spasmodic torticollis has reported that breathing exercises with prolonged respiratory exhalation was useful as a strategy for muscle relaxation. In this study, the treatment to reduce the tension of sternocleidomastoid muscle consisted of (1) an EMG-BF session (2) an EMG-BF with breathing exercise session, and (3) a breathing exercise session, in this order. Results indicated that the average tension of the sternocleidomastoid muscles was reduced during each session as indicated by the EMG. After the first and second session, however, the patients could suppress muscle tension using only the breathing exercise, and moreover, their complaints improved following treatment. Sakakibara et al. (2002) has reported that although muscle tension was reduced through relaxation training (EMG-BF and AT) everyday symptoms remained unchanged in patients with spasmodic torticollis. Thus, Solution-focused therapy (SFT) was used for muscle control in daily life. During the SFT sessions, the therapist focused on the patient's solution image, and the patient not only described his future goals, but also performed muscle control during various daily life activities. After four sessions of SFT, the symptoms improved. It is concluded (1) that combining BF and psychotherapy may be a helpful relaxation technique to reduce muscle tension in patients with spasmodic torticollis, and (2) SFT may contribute to the spontaneous behavior of patients and to the control of symptoms in daily life. Psychotherapeutic approaches to BF might also enhance motivation.