BIOFEEDBACK

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BIOFEEDBACK
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What is Biofeedback?

• A clinical technique that involves recording
  electrical activity generated in a muscle for
  diagnostic purposes
• Utilizes an instrument that measures, processes
  provides feedback reinforcing information via
  visual or auditory signals
• Does not monitor actual response (strength of
  contraction) but rather the conditions associated
  with the response
• Not used as a modality like heat or cold, but can
  be used for rehabilitation research purposes
• Can be used to help regain function of a muscle
  that may have been lost

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Biofeedback Units

• 4 types of Units
• Peripheral temperature,
• Finger Phototransmission,
• Electrical resistance units/ Skin Conductance
  Activity
• Electromyography (EMG),
• EMG - most typically used form of biofeedback
• Scale on unit can be both visual and audio
• Measured in microvolts, 0-10 scale, or some form
  of pitch

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EMG Other Units

• http//www.dynatronics.com/catalog/dsp_product.cfm
  ?ccats_idD832477C-F4D0-11D5-AB25-0050DAB32CA6
• http//www.bio-medical.com/results_igeneric.cfm?in
  ventory__igenericemg

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Biofeedback Units

• Peripheral temperature units
• Indirect measure of the diameter of peripheral
  blood vessels
• Easily seen in toes fingers
• Variations in body reactions change temperature
• ? temperature indicates relaxed state
• ? temperature indicates stress, fear, anxiety
• Measured in degrees Fahrenheit

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Biofeedback Units

• Finger Phototransmission
• Measured indirectly using a Photoplethysmograph
• Monitors amount of light reflected by
  subcutaneous tissues based on amount of blood
  flow
• As blood volume increases the amount of light
  detected decreases
• Monitor finger pulse

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Biofeedback Units

• Electrical resistance units/ Skin Conductance
  Activity
• Measures amount of perspiration on the skin
• Sweat contains salt which increases electrical
  conductivity
• Passes a small current through the fingers (volar
  surface) and/or palm
• Measures impedance of electrical current
• Lie detector testing

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Lie Detectors
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Biofeedback Units

• Electromyographic (EMG)
• Measures electrical activity in skeletal muscle
• May be very simple to very complex
• Take-home models
• Electrodes you will mostly see surface
  electrodes
• Active electrodes
• Detects electrical activity from muscle
  contraction converts into visual or auditory
  signals
• Reference electrode (ground electrode)
• Filters noise or unwanted electrical activity
  in the environment (other electromagnetic
  energy)
• Point of reference to compare the electrical
  activity recorded by the active electrodes

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EMG Units
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Indications for EMG Use

• Facilitation for muscle reeducation
• Restoration of neuromuscular function
• Increase muscular strength
• Promotion of relaxation of spasm
• Reduction of muscle guarding
• Assistance with pain control
• Neurological Conditions (following stroke, spinal
  cord injury, cerebral palsy, incontinence)

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Advantages for using EMG

• Provides feedback with a chance to make
  appropriate small changes in performance that are
  immediately noted rewarded
• Patient learns early in rehab to do something for
  him/herself instead of relying on the athletic
  trainer
• Proven to reduce myofascial pain, migraine
  tension headache pain and stress reduction
• With neuromuscular effects, biofeedback helps
  with input that is lost from receptor

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Contraindications

• If movement of a joint or isometric contractions
  are contraindicated
• Conditions in which muscle contractions might
  exacerbate the condition
• Unhealed tendon grafts, avulsed tendons, 3rd
  degree tears of muscle fibers
• Unstable fractures, injury to joint structure,
  ligaments, capsule or articulating surfaces

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Patient Set-up Application

• Shave area if applicable
• Clean skin to remove all dirt, oil, lotion, etc.
• Area may have to be mildly abraded if unit is
  sensitive
• Secure electrodes OVER the muscle belly. The
  active electrodes MUST be on target area.
  Reference electrode may be secured anywhere on
  the body, but is usually in between the two
  active electrodes
• Distance between active electrodes is usually
  close

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Patient Set-up Application

• Plug electrode lead(s) into unit
• Turn unit on
• Adjust output to desired mode
• THE PATIENT SHOULD NOT BE DISTRACTED BY OUTSIDE
  NOISES DURING SESSION.
• Various protocols