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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autogenic Training / methods
  • Flatulence
  • Gastrointestinal Diseases*
  • Humans
  • Imagery, Psychotherapy / methods
  • Muscle Relaxation
  • Music Therapy*
  • Music*
  • Relaxation Therapy / methods

Grants and funding

V.T. is funded by the Malaysian Society of Gastroenterology & Hepatology (MSGH) Research Award 2021. Y.C.K is funded by the Research University Individual Grant from Universiti Sains Malaysia (1001.PPSP.8012250). Y.Y.L. is funded by the Morinaga-USM Gut Health & Microbiota Project Grant, 304/PPSP/6150155/M145. URL of MSGH: https://www.msgh.org.my/. URL of Universiti Sains Malaysia https://www.usm.my/index.php/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.