肌電圖生物回饋協助放鬆訓練於癌症末期疼痛控制之成效

肌電圖生物回饋協助放鬆訓練於癌症末期疼痛控制之成效

 中文摘要

 本研究探討肌電圖生物回饋協助放鬆訓練於癌症末期疼痛控制之成效。研究方法採實驗

性設計，以隨機分配方式將病人分成實驗組及對照組。樣本來自於北部某醫學中心，有 效樣本數為 24 人（流失率 37 ％），實驗組（ n = 12 ）接受為期四週計六次之肌電圖 生物回饋協助放鬆訓練；對照組（ n = 12 ）接受一般常規照護。研究主要依變項為疼 痛程度及全身肌肉張力，分別由簡明疼痛量表中文版及前額肌肌電圖測得。所有個案進 行前測疼痛程度及肌肉張力之基準值測量，四週後並行相同的後測測量。此外，實驗組 於每次訓練前皆會接受疼痛程度的評估及肌肉張力程度之測量。研究結果以描述性統計 分析敘述個案的基本資料、兩組間癌症末期疼痛程度及肌肉張力改變之比較，以 GEE

（ Generalized Estimating Equations ）統計分析，來呈現實驗組與對照組在癌症疼痛程 度變化與肌肉張力變化之差異性，以及生物回饋協助放鬆訓練介入之成效。

 本研究結果顯示肌電圖生物回饋協助放鬆訓練可降低疼痛程度（ β = 1.31 ； p < .000 1 ）及前額肌肌肉張力（ β = .46 ； p < .0010 ）、後測之前額肌肌肉張力與後測之疼痛 程度呈正相關（ r ＝ .540 ； p ＝ .006 ）、疼痛程度對肌電圖生物回饋協助放鬆訓練 之成效影響程度未達顯著水準。

 經由本研究的結果顯示，肌電圖生物回饋協助放鬆訓練能降低病人的情緒緊張度及焦慮

，並且協助病人達鬆弛狀態，進而使癌症末期病人的疼痛程度下降，因此，癌症疼痛控 制若能不只侷限藥物治療之外，佐以配合生物回饋放鬆法，將能提昇癌症末期疼痛治療 之效果。

Effects of Electromyography Biofeedback Assisted-Relaxation on Levels of Cancer- Related Pain in Advanced Cancer Patients

 英文摘要

 The purpose of this study was to evaluate the effect of electromyography (EMG) biofeedback assisted-relaxation on levels of cancer-related pain in advanced cancer patients. A convenienc e sample of 24 patients from the hospice unit in a medical center was recruited. A pre-post test experimental design was used in this study. Participants were randomly assigned to the experi mental group (n = 12) and control group (n = 12). Major outcomes included levels of pain as measured by the Chinese version of the Brief Pain Inventory and general muscle tension as det ermined by the frontalis EMG level. The experimental group received 6 EMG biofeedback-ass isted relaxation-training sessions over a 4-week period, while the control group received conv entional care. All participants were evaluated for levels of pain and muscle tension on week 1 before the training (pretest). The same evaluation was repeated after 4 weeks (posttest). In add ition, the experimental group was also evaluated for pain and muscle tension immediately befo re each training session. Descriptive analysis and GEE (Generalized Estimating Equations) we re used to analyze the data.

Results showed a significant decrease in the level of pain (β = 1.31, p < .0001) and frontalis m uscle tension (β = .46, p < .001) in participants who received the EMG biofeedback assisted-re laxation training as compared to control group. Posttest frontalis muscle tension significantly c orrelated with posttest pain levels (r = .54, p = .006).

The present study demonstrated that EMG biofeedback assisted-relaxation could effectively re duce pain level of advanced cancer patients possibly through reducing their general muscle ten sion and thus anxiety level. Thus, biofeedback-assisted relaxation can be a useful adjunct to ph armacotherapy in controlling cancer-related pain in terminal cancer patients.