Biofeedback PDF

**[Biofeedback]** **Definition:** Biofeedback is the recording, processing and feeding back reinforcing information about the physiological activities of the body via auditory or visual signals. **Principles of biofeedback:** The physiological changes within the body are measured by some instrum...

**[Biofeedback]** **Definition:** Biofeedback is the recording, processing and feeding back reinforcing information about the physiological activities of the body via auditory or visual signals. **Principles of biofeedback:** The physiological changes within the body are measured by some instruments and the output of this measurement is displayed via visual and audible indicator (feedback). Subject perceives this information and tries under conscious control to make the appropriate physiological changes to alter it. C:\\Users\\Marwa Taher\\Pictures\\Saved Pictures\\biofeedback.png **[Types of biofeedback:]** *[The most commonly used forms of biofeedback therapy are:]* 1. **Electromyography (EMG)**; measures muscle tension 2. **Electroencephalography (EEG);** measures brain waves activity 3. **Electrodermography (EDG)**; measures skin electrical activity 4. **Pneumography**; measures abdominal/ chest movement in breathing 5. **Photoplethysmograph (PPG)**; measures peripheral blood flow, heart rate.  C:\\Users\\Marwa Taher\\Pictures\\Saved Pictures\\mind-controlled.jpg  C:\\Users\\Marwa Taher\\Pictures\\Saved Pictures\\biofeedback-pnemography.jpg  C:\\Users\\Marwa Taher\\Pictures\\Saved Pictures\\photoplethysmograph.jpg **[Electromyography biofeedback (EMG):]** - EMG biofeedback is a method of retraining muscle by creating new feedback systems as a result of the conversion of myoelectrical signals in the muscle into visual and auditory signals. EMG uses surface electrodes to detect a change in skeletal muscle activity, which is then fed back to the user usually by a visual or auditory signal. EMG biofeedback has been shown to be useful in both musculoskeletal and neurological rehabilitation. - Deciding to use auditory or a visual display depends on many factors, one is the patient preference, and the other practical factors need to be considered. If a lower extremity muscle is being monitored in preparation for ambulation, training, auditory feedback may be preferred because visual feedback is not practical during ambulation. **[Uses of EMG biofeedback ]** **Spasticity control**: EMG biofeedback could be used aiming to control or reduce spasticity and facilitate more normal pattern of movement in cases of cerebrovascular stroke, head injury and cerebral palsy. EMG biofeedback can be used to either increase activity in weak or paretic muscle or it can be used to facilitate a reduction in tone in a spastic one. **Muscle re-education:** After tendon and muscle transplantation, biofeedback can be used to help the patient to learn the new muscle action in association with muscle stimulation currents. Biofeedback informs the patient if producing voluntary contraction in the appropriate muscle, thus helping the patient to making the correct response. **Peripheral nerves lesions**: EMG biofeedback can detect the activity of muscle before the patient himself, this activity indicating reinnervation. Once this activity is detected the voluntary contraction can be encouraged and the patient is asked for further effort to train the muscle **Facilitation of muscle activity:** One of the common problems for which EMG biofeedback has been shown to be effective is the facilitation of quadriceps contraction after knee surgery as following meniscectomy or ACL reconstruction. **Motor control of diatonic conditions: Dystonia is due to abnormal contraction of agonist and antagonist. EMG biofeedback works in two ways; first by making the patient aware of abnormal contractions and second by controlling excessive contraction of involved muscle group.** **Relaxation of muscle spasm: Protective muscle spasm due to pain or fear of movement is known as muscle guarding. The aim of EMG biofeedback is to induce relaxation of the muscle.**  **[Other forms of biofeedback used in physical therapy:]** **Postural control:** Monitors are worn which signal tilt away from the vertical. The inclination monitor is worn on the trunk and fitted with audio feedback. The trunk inclination monitor has been used for the treatment of LBP. **Weight bearing control**: The amount of weight taken through one foot is monitored with pressure pad in the shoe. This is connected to circuit carried in small box which is attached either to the leg or at the waist. The circuit generates an audible signal when a present pressure is reached. This could be used to encourage weight bearing as in hemiplegic patient. **Balance control**: Standing balance training using a force plate connected to a visual display is used to improve control of postural sway as in hemiplegic patients. C:\\Users\\Marwa Taher\\Pictures\\Saved Pictures\\postural biofeedback.png  C:\\Users\\Marwa Taher\\Pictures\\Saved Pictures\\posture biofeedback.jpg  [ ] **[Advantage of EMG biofeedback]** 1. It provides objective information to both therapist and patient about the muscle activity so that the individual become aware of his response and then makes voluntary effort to alter the feedback signal in order to modify muscle activity. 2. Sensitivity and accuracy: (**EMG)** biofeedback is sensitive enough to detect small changes in the level of recruitment and accurately reflects the actual level of recruitment. 3. EMG biofeedback devices can provide a variety of feedback signals that motivate the patient. 4. The motor learning process is accelerated by feeding back information; about progress made to the patient that is very helpful in rehabilitation of neurological disorders.