Abstract
This study examined the efficacy of a cardiorespiratory biofeedback intervention compared to bed rest in the treatment of 47 women diagnosed with pregnancy-induced hypertension (PIH). The investigation consisted of a historical control group with 31 PIH subjects receiving treatment as usual (TAU), bed rest and antihypertensive medications, and an experimental group with 16 PIH subjects receiving TAU and instruction on using a portable respiratory sinus arrhythmia (RSA) biofeedback device once daily until delivery. Results indicated that systolic and diastolic blood pressure levels were unchanged for either group. Failing to find the intended main effects, a series of exploratory analyses were performed. Findings of associated hypotheses revealed that the RSA BF group had a 35 % higher birth weight than the TAU group. The gestational age at delivery was 10 % greater in the RSA BF group than in the TAU group. A significant relationship was found between the StressEraser Total and the 1-min Apgar score. Eighty-one percent of the subjects stated that the device was relaxing. Fifty percent of the subjects believed that the device helped them fall asleep. Overall, these results suggest that portable RSA biofeedback may be effective in reducing stress during pregnancy and improving perinatal outcomes.
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Atallah, A. N., Hofmeyr, G. J., & Duley, L. (2002). Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews, 1(CD001059).
Bae, J. H., Kim, J. H., Choe, K. H., Hong, S. P., Kim, K. S., Kim, C. H., et al. (2006). Blood pressure change following 8-week, 15-minute daily treatment with paced breathing guided by a device: A Korean multi-center study. Journal of Clinical Hypertension, 8(5), A43.
Beddoe, A. E., & Lee, K. A. (2008). Mind-body interventions during pregnancy. Journal of Obstetrics, Gynecologic, & Neonatal Nursing, 37(2), 165–175.
Bucher, H. C., Guyatt, G. H., Cook, R. J., Hatala, R., Cook, D., Lang, J. D., et al. (1996). Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia. Journal of American Medical Association, 275(14), 1113–1117.
Chappell, L. C., Seed, P. T., Briley, A. L., Kelly, F. J., Lee, R., Hunt, B. J., et al. (1999). Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: A randomised trial. The Lancet, 354, 810–815.
Contreras, F., Fouillioux, C., Bolivar, A., Betancourt, M. C., Colmenares, Y., Rivero, M., et al. (2003). Endothelium and hypertensive disorders in pregnancy. American Journal of Therapeutics, 10(6), 415–422.
Ebben, M. R., Kurbatov, V., & Pollak, C. P. (2009). Moderating laboratory adaptation with the use of heart-rate variability biofeedback device (StressEraser). Applied Psychophysiology and Biofeedback, 34(4), 245–249.
Elliot, W., & Izzo, J. (2006). Device-guided breathing to lower blood pressure: Case report and clinical overview. Medscape General Medicine, 8(3), 23.
Grossman, E., Grossman, A., Schein, M. H., Zimlichman, R., & Gavish, B. (2001). Breathing-control lowers blood pressure. Journal of Human Hypertension, 15(4), 263–269.
Heilman, K. J., Handelman, M., Lewis, G., & Porges, S. W. (2008). Accuracy of the StressEraser in the detection of cardiac rhythms. Applied Psychophysiology and Biofeedback, 33(2), 83–89.
Keppel, G. (1991). Design and analysis: A researcher’s handbook (3rd ed.). Upper Saddle River, NJ: Prentice-Hall Inc.
Lain, K. Y., & Roberts, J. M. (2002). Contemporary concepts of the pathogenesis and management of preeclampsia. The Journal of the American Medical Association, 287(24), 3183–3186.
Lehrer, P. M., Vaschillo, E., & Vaschillo, B. (2000). Resonant frequency biofeedback training to increase cardiac variability: Rationale and manual for training. Applied Psychophysiology and Biofeedback, 25(3), 177–191.
Linden, W., & Moseley, J. V. (2006). The efficacy of behavioral treatments for hypertension. Applied Psychophysiology and Biofeedback, 31(1), 51–63.
Little, B. C., Hayworth, J., Benson, P., Hall, F., Beard, R. W., Dewhurst, J., et al. (1984). Treatment of hypertension in pregnancy by relaxation and biofeedback. The Lancet, 1(8382), 865–867.
Maloni, J. A., Cohen, A. W., & Kane, J. H. (1998). Prescription of activity restriction to treat high-risk pregnancies. Journal of Women’s Health, 7(3), 351–358.
Muench, F. (2008). The portable StressEraser heart rate variability biofeedback device: Background and research. Biofeedback, 36(1), 35–39.
Reineke, A. (2007). The effects of heart rate variability biofeedback in reducing blood pressure for the treatment of essential hypertension. San Diego: Alliant International University.
Roberts, J. M., & Redman, C. W. G. (1993). Pre-eclampsia: More than pregnancy-induced hypertension. The Lancet, 341(8858), 1447.
Rosenthal, T., Alter, A., Peleg, E., & Gavish, B. (2001). Device-guided breathing exercises reduce blood pressure: Ambulatory and home measurements. American Journal of Hypertension, 14(1), 74–76.
Schein, M. H., Gavish, B., Herz, M., Rosner-Kahana, D., Naveh, P., Knishkowy, B., et al. (2001). Treating hypertension with a device that slows and regularizes breathing: A randomised, double-blind controlled study. Journal of Human Hypertension, 15(4), 271–278.
Sherlin, L., Gevirtz, R., & Muench, F. (2009). The effects of brief respiratory sinus arrhythmia training on anxiety and heart rate. International Journal of Stress Management, 16(3), 233–248.
Sibai, B. M. (2003). Diagnosis and management of gestational hypertension and preeclampsia. Obstetrics and Gynecology, 102(1), 181–192.
Somers, P. J., Gevirtz, R. N., Jasin, S. E., & Chin, H. G. (1989). The efficacy of biobehavioral and compliance interventions in the adjunctive treatment of mild pregnancy-induced hypertension. Biofeedback and Self-Regulation, 14(4), 309–318.
StressEraser. (2010). Retrieved July 20, 2010.
Walling, A. D. (2004). Management of gestational hypertension-preeclampsia. American Family Physician, 69(4), 979–980.
Zamorski, M. A., & Green, L. A. (2001). NHBPEP report on high blood pressure in pregnancy: A summary for family physicians. American Family Physician, 64(2), 263–270, 216.
Zucker, T. L., Samuelson, K. W., Muench, F., Greenberg, M. A., & Gevirtz, R. N. (2009). The effects of respiratory Sinua arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study. Applied Psychophysiology and Biofeedback, 34(2), 135–143.
Acknowledgments
This research was supported through the generosity of a grant from Helicor, Inc., the makers of the StressEraser portable biofeedback device used in this study, and a scholarship from the Ferne Miller Memorial Research Fund. Frederick Muench is the former Director of Clinical Research at Helicor. Investigators have no other financial conflicts of interest with the sponsor. The authors would like to thank Marna Morimoto for her assistance with subject recruitment and follow up interviews.
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Cullins, S.W., Gevirtz, R.N., Poeltler, D.M. et al. An Exploratory Analysis of the Utility of Adding Cardiorespiratory Biofeedback in the Standard Care of Pregnancy-Induced Hypertension. Appl Psychophysiol Biofeedback 38, 161–170 (2013). https://doi.org/10.1007/s10484-013-9219-4
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DOI: https://doi.org/10.1007/s10484-013-9219-4