2.5 - biofeedback

external

biofeedback provides information about ourselves typically through the use of _________ instruments

treatment (dec pain, inc balance); training (learn to recognize physiologic processes and alter them)

biofeedback can be thought of as both ________ and ______

• visual - main one

• audio

• vibration

• electrical

what are the 4 types of biofeedback?

what is the main one?

Electromyography (EMG)

________________ biofeedback in a PT clinic can be used to monitor muscle activity by looking at the electrical signal produced during a voluntary contraction.

motor unit action potential

the EMG signal consists of the summation of all the ___________ within the recording location

location; size

electrode _________ and __________ matters when you are observing total motor unit signals for that certain muscle

• stationary

• portable

what are the 2 basic EM G biofeedback systems

stationary 

the ____________ EMG biofeedback system is typically computer-based with subject tethered 

portable

the ____________ EMG biofeedback system is self contained and can be telemeterized data logger, or just feedback

• surface 

• fine wire

• needle 

what are the 3 EMG recording electrode types 

3 (+, - , ground)

how many electrodes are used for bipolar EMG systems

difference; common

the bipolar EMG system records the ___________ of the 2 electrodes in the electrical pattern from 2 detection sites. This technique allows _________ signals to be removed

noise 

common signals are also referred to as… 

• isolation and pre-amplification (protect subject and amplify signal as much as possible)

• amplification (contd amplification)

• filter (remove unwanted signal)

• rectification (convert neg signal to pos) 

• integration (area under the curve)

what are the 5 data processing and analysis techniques that need to occur in order for the EMG signal to be useful clinically

filter

________ is a data processing/analysis technique used with EMG data collection that selectively removes unwanted signal

high pass; low pass; notch 

a combination of _________, _________, and _________ filters are used to filter the EMG data 

rectification 

________ is a data processing/analysis technique used with EMG data collection that converts all negative signal components to positive values 

integration

________ is a data processing/analysis technique used with EMG data collection that is the summation of data over time

under

integration is the area (under or above) the curve of a graph

visual; audible; more

The integrated signal can be used to drive ________ or ________ feedback. The larger the signal, the (less or more) lights and/or sound provided to the subject.

T

T/F: Results do not support the use of EMG biofeedback to improve gait in the acute phase after stroke

trapezius

a study was done to treat asthma with EMG and they decreased pulmonary impedance by increasing the relaxation of the __________ muscle

F (there are proven positive results) 

T/F:  the results of treating fibromyalgia with pain management via EMG is inconclusive 

decreased

in a study looking at cervical traction with a group receiving biofeedback vs conventional traction, the biofeedback group (decreased or increased) time to raise traction force from start to optimum

auditory

biofeedback was used to help hemiplegic cerebral palsied children gait train and facilitated symmetric pattern via insole pressure switch and _________ feedback

postural 

auditory feedback is linked to _________ movement which is measured via force platforms 

insomnia

EEG can be applied via “brain music” to treat ___________

functional sensory substitution 

_____________ is another term for biofeedback related to conditions where sensory loss has occurred 

• narrow band noise

• biological noise

• cross talk

• artifacts

what are the 4 sources of noise

narrow band

____________ noise is a result of AC lines/60Hz

biological 

___________ noise is subject/lead movement, EKG, respiration, etc. 

cross talk

___________ noise is a signal from adjacent muscles or between instrumentation channels

artifacts

____________ noise is from electrodes of muscle length changes

artificial balance 

_______________ is non-EMG but it is FES

ex. braced body above shanks, ankle position and moment used to drive PF stimulator in “closed-loop” control system

spectral

using ____________ analysis (FFT, PSD), changes in EMG that relate to muscle fatigue may soon be available in a feedback format.

• UE neuroprosthesis

• LE neuroprosthesis

• exercise

• mobility

what are the 4 applications of functional electrical stimulation

parastep 

the ___________ stimulation generates sequences of electrical pulses. These pulses are passed to target peripheral nerves through surface applied skin electrodes, placed over selected muscles and sensory nerves of the lower extremities.

• sufficient muscular force with FNS at the hip and knee required for function

• adequate cardiopulmonary reserve

• the ability to transfer independently and safely lower him/her self to the ground without the system operating

• adequate standing tolerance

• balance and trunk control

• hand/finger dexterity to manipulate system controls

what are the 6 inclusion criteria for the parastep simulator

• cardiac demand pacemaker

• cancer in the area of electrode placement

• severe scoliosis

• severe osteoporosis

• skin disease at stimulation sites or over swollen, infected, or inflamed areas or skin eruptions

• irreversible contracture

• autonomic dysreflexia

what are the 7 exclusion criteria for the parastep simulator

• fatigue

• control (switches vs muscle)

• usability/compliance (home vs clinic)

what are the 3 problems to using functional electrical stimulation

• Preservation of muscle bulk

• Improved muscle appearance

• Improved heart rate, blood circulation and kidney function

• Prevention of contracture, bone demineralization and pressure sores

• Reduced spasticity

• Preservation of moral

what are the 6 health benefits to using functional electrical stimulation