Diabetes Care, Vol 15, Issue 7 853-858, Copyright © 1992 by American Diabetes Association
Effect of thermal biofeedback-assisted relaxation training on blood circulation in the lower extremities of a population with diabetes
BI Rice and JV Schindler
Department of Health Education, University of Wisconsin-La Crosse.
OBJECTIVE--Investigate the effect of relaxation training/thermal
biofeedback on blood circulation in the lower extremities of diabetic
subjects. RESEARCH DESIGN AND 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.