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
Effects of Electromyography Biofeedback Assisted-Relaxation on
Levels of Cancer-Related Pain in Advanced Cancer Patients
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 < .0001）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。 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 convenience 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 experimental 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 determined by the frontalis EMG level. The experimental group received 6 EMG biofeedback-assisted relaxation-training sessions over a 4-week period, while the control group received conventional 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 addition, the experimental group was also evaluated for pain and muscle tension immediately before each training session. Descriptive analysis and GEE (Generalized Estimating Equations) were used to analyze the data. Results showed a significant decrease in the level of pain (β = 1.31, p < .0001) and frontalis muscle tension (β = .46, p < .001) in participants who received the EMG biofeedback assisted-relaxation training as compared to control group. Posttest frontalis muscle tension significantly correlated with posttest pain levels (r = .54, p = .006).
The present study demonstrated that EMG biofeedback assisted-relaxation could effectively reduce pain level of advanced cancer patients possibly through reducing their general muscle tension and thus anxiety level. Thus, biofeedback-assisted relaxation can be a useful adjunct to pharmacotherapy in controlling cancer-related pain in terminal cancer patients.
