Abstract：
OBJECTIVE: Abdominal distention results from abdominophrenic dyssynergia (ie, diaphragmatic contraction and abdominal wall relaxation) in patients with disorders of gut-brain interaction. This study aimed to validate a simple biofeedback procedure, guided by abdominothoracic wall motion, for treating abdominal distension.
METHODS: In this randomized, parallel, placebo-controlled trial, 42 consecutive patients (36 women and 6 men; ages 17-64 years) with meal-triggered visible abdominal distension were recruited. Recordings of abdominal and thoracic wall motion were obtained using inductance plethysmography via adaptable belts. The signal was shown to patients in the biofeedback group, who were taught to mobilize the diaphragm. In contrast, the signal was not shown to the patients in the placebo group, who were given a placebo capsule. Three sessions were performed over a 4-week intervention period, with instructions to perform exercises (biofeedback group) or to take placebo 3 times per day (control group) at home. Outcomes were assessed through response to an offending meal (changes in abdominothoracic electromyographic activity and girth) and clinical symptoms measured using daily scales for 7 days.
RESULTS: Patients in the biofeedback group (n = 19) learned to correct abdominophrenic dyssynergia triggered by the offending meal (intercostal activity decreased by a mean ± SE of 82% ± 10%, anterior wall activity increased by a mean ± SE of 97% ± 6%, and increase in girth was a mean ± SE of 108% ± 4% smaller) and experienced improved clinical symptoms (abdominal distension scores decreased by a mean ± SE of 66% ± 5%). These effects were not observed in the placebo group (all, P < .002).
CONCLUSIONS: Abdominothoracic wall movements serve as an effective biofeedback signal for correcting abdominophrenic dyssynergia and abdominal distention in patients with disorders of gut-brain interaction. ClincialTrials.gov, Number: NCT04043208.
METHODS: In this randomized, parallel, placebo-controlled trial, 42 consecutive patients (36 women and 6 men; ages 17-64 years) with meal-triggered visible abdominal distension were recruited. Recordings of abdominal and thoracic wall motion were obtained using inductance plethysmography via adaptable belts. The signal was shown to patients in the biofeedback group, who were taught to mobilize the diaphragm. In contrast, the signal was not shown to the patients in the placebo group, who were given a placebo capsule. Three sessions were performed over a 4-week intervention period, with instructions to perform exercises (biofeedback group) or to take placebo 3 times per day (control group) at home. Outcomes were assessed through response to an offending meal (changes in abdominothoracic electromyographic activity and girth) and clinical symptoms measured using daily scales for 7 days.
RESULTS: Patients in the biofeedback group (n = 19) learned to correct abdominophrenic dyssynergia triggered by the offending meal (intercostal activity decreased by a mean ± SE of 82% ± 10%, anterior wall activity increased by a mean ± SE of 97% ± 6%, and increase in girth was a mean ± SE of 108% ± 4% smaller) and experienced improved clinical symptoms (abdominal distension scores decreased by a mean ± SE of 66% ± 5%). These effects were not observed in the placebo group (all, P < .002).
CONCLUSIONS: Abdominothoracic wall movements serve as an effective biofeedback signal for correcting abdominophrenic dyssynergia and abdominal distention in patients with disorders of gut-brain interaction. ClincialTrials.gov, Number: NCT04043208.
摘要：
目的：腹胀导致腹肌协同失调（即，the肌收缩和腹壁松弛）患有肠-脑相互作用障碍的患者。本研究旨在验证一个简单的生物反馈程序，由腹胸壁运动引导，用于治疗腹胀.
方法：在本随机分组中，平行,安慰剂对照试验,招募了42名连续患者（36名女性和6名男性；年龄17-64岁），这些患者均患有膳食引发的明显腹胀。通过自适应带使用电感体积描记术获得腹部和胸壁运动的记录。该信号显示给生物反馈组的患者，他们被教导动员隔膜。相比之下,安慰剂组的患者没有得到信号，给他们服用了安慰剂胶囊。在为期4周的干预期内进行了三次会议，指示进行锻炼（生物反馈组）或每天服用安慰剂3次（对照组）在家。通过对不良膳食的反应（腹胸电活动和周长的变化）和使用每日量表测量的临床症状持续7天，来评估结果。
结果：生物反馈组（n=19）的患者学会了纠正由进餐引起的腹肌协同失调（肋间活动平均降低了82％±10％，前壁活动增加了97%±6%的平均±SE，周长的增加平均±SE减少了108％±4％），并且临床症状得到改善（腹胀评分降低了66％±5％的平均±SE）。在安慰剂组中未观察到这些效果（所有，P<.002)。
结论：腹胸壁运动可作为一种有效的生物反馈信号，用于纠正肠-脑相互作用障碍患者的腹肌协同失调和腹胀。ClincialTrials.gov,编号：NCT04043208。
方法：在本随机分组中，平行,安慰剂对照试验,招募了42名连续患者（36名女性和6名男性；年龄17-64岁），这些患者均患有膳食引发的明显腹胀。通过自适应带使用电感体积描记术获得腹部和胸壁运动的记录。该信号显示给生物反馈组的患者，他们被教导动员隔膜。相比之下,安慰剂组的患者没有得到信号，给他们服用了安慰剂胶囊。在为期4周的干预期内进行了三次会议，指示进行锻炼（生物反馈组）或每天服用安慰剂3次（对照组）在家。通过对不良膳食的反应（腹胸电活动和周长的变化）和使用每日量表测量的临床症状持续7天，来评估结果。
结果：生物反馈组（n=19）的患者学会了纠正由进餐引起的腹肌协同失调（肋间活动平均降低了82％±10％，前壁活动增加了97%±6%的平均±SE，周长的增加平均±SE减少了108％±4％），并且临床症状得到改善（腹胀评分降低了66％±5％的平均±SE）。在安慰剂组中未观察到这些效果（所有，P<.002)。
结论：腹胸壁运动可作为一种有效的生物反馈信号，用于纠正肠-脑相互作用障碍患者的腹肌协同失调和腹胀。ClincialTrials.gov,编号：NCT04043208。
