An Innovative and Accessible Biofeedback Intervention for Improving Self-Regulatory Skills in Pediatric Chronic Pain: A Pilot Study.

Objectives: Although biofeedback has been considered an effective treatment component for pediatric chronic pain, little research has examined the generalizability to activities outside of the treatment setting. The current study aimed to examine the effects of a biofeedback intervention involving individual and group sessions to facilitate increased self-regulatory skills for chronic pain management and to translate these skills to meaningful activities promoting functional restoration. Methods: Participants included 104 adolescents (ages 12-18) attending an intensive interdisciplinary pain rehabilitation program for chronic pain/symptoms and completed biofeedback training as part of the program. The biofeedback protocol consisted of six sessions, including an assessment of baseline physiologic states, diaphragmatic breath training, and various biofeedback screens to reinforce self-regulatory skills within individual- and group-based formats. Results: As expected, patients showed significant reductions in respiration rates and muscle tension from admission to discharge. Ratings of perceived confidence also increased from admission to post-treatment, suggesting greater self-efficacy in patients using self-regulatory skills during their daily functional activities. Conclusions: An individual- and group-based biofeedback protocol with a focus on training skills in activities relevant to adolescents' lives has the potential to improve self-regulation skills and generalize these skills to real-world settings. Future randomized controlled trials are necessary to examine the efficacy of biofeedback interventions to improve physiologic regulation and enhance treatment outcomes for pediatric chronic pain.

Reliability of the box and block test of manual dexterity for use with patients with fibromyalgia.

OBJECTIVE: The aim of this study was to determine the reliability of the Box and Block (B&B) Test of Manual Dexterity for upper-extremity function in patients with fibromyalgia and to compare their results with those of healthy control participants. METHOD: We assessed reliability of the B&B Test within and between testers using the intraclass correlation coefficient (ICC). We compared fibromyalgia patient (n = 30) and control group (n = 30) scores using analysis of variance and population-based normative data. RESULTS: The B&B Test was reliable with ICCs of .90 to .85. Fibromyalgia patients' B&B Test scores were significantly lower (more impaired) than those of the control group and standardized norms. CONCLUSIONS: The B&B Test is a reliable measure of upper-extremity function in fibromyalgia patients and is able to reveal a reduction in upper-extremity function in these patients compared with both healthy control participants and normative scores.