Biofeedback

What is biofeedback?

techniques that provide information to the user about their own physiological or biomechanical processes

a device that uses EMG to detect when muscle contractions occur and the strength of the contraction. the patient receives cues from the device visually and through sound (beeping).

What are the purposes of biofeedback?

improve self-awareness

gain control of a specific motion or muscle

What is EMG?

refers to the measurement of electrical activity occurring in muscle tissue

electrodes that are placed on the skin detect the intrinsic electrical activity of the underlying muscles

the electrical activity is converted into an auditory, visual or tactile signal

What are the physiological effects of EMG biofeedback?

neuromuscular facilitation (up training)

neuromuscular inhibition (down training)

neuromuscular coordination

What is neuromuscular facilitation (up training)?

commonly used after surgery to help resolve the motor function impairment due to the presence of swelling and pain (arhtrogenic muscle inhibition)

EMG biofeedback uses attentional strategies to reduce inhibition of muscle activity

• enhance muscle contraction timing or increased motor-unit recruitment

  • increase excitability of the motor cortex

What is neuromuscular inhibition (down training)?

signals the user to decrease the motor input to the muscle. teaches the patient what is feels like to have the muscle relaxed.

increase afferent inhibition of unnecessary efferent signals (reduce excitability of the motor cortex)

What is neuromuscular facilitation?

used to improve the timing and recruitment of muscle activity to improve functional activities such as gait or higher level activities

What are indications of biofeedback?

hemiplegia, quadriceps strengthening, headache, pelvic floor disorders, chronic pain conditions, tempromandibular disorders

What are contraindications and precautions of biofeedback?

acute inflammatory conditions

pregnancy (intravaginal)

bladder or vaginal infection (intravaginal)

What are additional considerations of biofeedback?

Be cautious when using on patients who have an allergy to the electrode. Biofeedback may need to be discontinued if reaction is more than minor skin irritation.

Patients with impaired mentation are unlikely to be appropriate candidates as the patient may not be able to follow directions.

What are adverse effects of biofeedback?

cardiac complications due to muscle contraction or activity

• ex: dyspnea, fatigue, angina

increased pain

delayed onset muscle soreness