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. 2022 Sep 26;17(9):e0268491.
doi: 10.1371/journal.pone.0268491. eCollection 2022.

Development and validation of audio-based guided imagery and progressive muscle relaxation tools for functional bloating

Vincent Tee  1 , Garry Kuan  2   3 , Yee Cheng Kueh  4 , Nurzulaikha Abdullah  4 , Kamal Sabran  5 , Nashrulhaq Tagiling  6 , Nur-Fazimah Sahran  1 , Tengku Ahmad Iskandar Tengku Alang  1 , Yeong Yeh Lee  1   7
Affiliations

Development and validation of audio-based guided imagery and progressive muscle relaxation tools for functional bloating

Vincent Tee et al. PLoS One. .

Abstract

Mind-body techniques, including Guided Imagery (GI) or Progressive Muscle Relaxation (PMR), may effectively manage bloating. The current study aimed to develop and validate (psychometric and psychological responses) audio-based GI and PMR techniques for bloating. Audio scripts were first developed from literature reviews and in-depth interviews of participants with bloating diagnosed based on the Rome IV criteria. Scripts were validated using psychometric (content & face validity index) and physiological approaches (brain event-related potentials & heart rate variability). 45/63 participants completed the in-depth interview, and 'balloon' emerged as the synonymous imagery description for bloating, of which inflation correlated with a painful sensation. The final tools consisted of narrated audio scripts in the background of a validated choice of music. Overall, the content and face validity index for PMR and GI ranged from 0.92 to 1.00. For ERP and HRV, 17/20 participants were analyzed. For ERP, there was a significant difference between GI and PMR for alpha waves (p = 0.029), delta waves (p = 0.029), and between PMR and control for delta waves (p = 0.014). For HRV, GI and PMR exhibited similar autonomic responses over controls (overall p<0.05). The newly developed GI and PMR audio-based tools have been validated using psychometric and physiological approaches.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The affect grid for the ratings of the 13 selected musical background.
Raters were instructed to rate how they are feeling right now and place one checkmark in the grid. The score is calculated according to the number of the squares. The horizontal dimension is used to score the pleasure-displeasure score, counting 1 to 9 starting at the left. The vertical dimension is used to score the arousal-sleepiness score, counting 1 to 9 starting at the bottom.
Fig 2
Fig 2. Reported values, pairwise comparison, and RM-ANOVA analysis of ERP parameters between guided imagery, progressive muscle relaxation and controls.
GI: Guided imagery, PMR: Progressive muscle relaxation, ERP: Brain event-related potentials. *Significant mean difference based on pairwise comparison in alpha waves between GI and PMR (p = 0.029), delta waves between GI and PMR (p = 0.029) and between PMR and control (p = 0.014).
See this image and copyright information in PMC

References

    1. Schmulson M, Chang L. Review article: the treatment of functional abdominal bloating and distension. Aliment Pharmacol Ther. 2011;33(10):1071–86. doi: 10.1111/j.1365-2036.2011.04637.x - DOI - PubMed
    1. Ryu MS, Jung H-K, Ryu J-I, Kim J-S, Kong KA. Clinical Dimensions of Bloating in Functional Gastrointestinal Disorders. J Neurogastroenterol Motil. 2016;22(3):509–16. doi: 10.5056/jnm15167 . - DOI - PMC - PubMed
    1. Houghton LA, Whorwell PJ. Towards a better understanding of abdominal bloating and distension in functional gastrointestinal disorders. J Neurogastroenterol Motil. 2005;17(4):500–11. doi: 10.1111/j.1365-2982.2005.00666.x - DOI - PubMed
    1. Black CJ, Yiannakou Y, Guthrie EA, West R, Houghton LA, Ford AC. A Novel Method to Classify and Subgroup Patients With IBS Based on Gastrointestinal Symptoms and Psychological Profiles. Am J Gastroenterol. 2021;116(2):372–81. doi: 10.14309/ajg.0000000000000975 . - DOI - PubMed
    1. Polster AV, Palsson OS, Törnblom H, Öhman L, Sperber AD, Whitehead WE, et al.. Subgroups of IBS patients are characterized by specific, reproducible profiles of GI and non-GI symptoms and report differences in healthcare utilization: A population-based study. J Neurogastroenterol Motil. 2019;31(1):e13483. doi: 10.1111/nmo.13483 - DOI - PubMed

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