Biofeedback-Webinar India

Translated from German to English - www.onlinedoctranslator.
com
WEBINAR
The quick introduction to biofeedback
Sensors and software operation
Copyright by Insight Instruments, Dr.

Dieter Kropfreiter.
These learning materials (slides and
videos) provided in the online seminar are
ment for personal use only. Reproduction or
use of the content for other purposes is not
permitted. By participating in the online
course, the participant agrees to these
terms of limited use in full.
© EUROPEAN BIOFEEDBACK ACADEMY, 2020 1

SEMINAR OVERVIEW
• Basics Biofeedback
• Neuromaster-System and Biolife-Software
• Parameter SKIN CONDUCTIVITY
• Parameter TEMPERATURE
• Parameter BREATHING
• Parameter PULSE
• Parameter MUSCLE TENSION
• Parameter EEG

What is biofeedback?
Biofeedback is a scientifically proven therapeutic procedure

in which physical processes, which are only perceived
imprecisely, are reported back with the help of technical
aids and thus become conscious. In a next step it is possible
to learn to influence these processes, by reinforcing changes
in the desired direction. This will increase the Self-control
and Self-efficacy of the patient.
© INSIGHT INSTRUMENTS, 2019 3

The biofeedback -principle
Visible bodily
response
= feedback
PC Sensors

Overview of parameter changes
Parameter Stress Relaxation
Skin conductance - SCL
Temperature
Pulse rate
Pulse amplitude
Respiratory rate
Breathing amplitude
Muscle tension - EMG

The biofeedback principle:
1. Diagnostics: Stress-recovery profile
OBJECTIVE MEASUREMENT
SUBJECTIVE EXPERIENCE OF STRESS

The biofeedback principle:
2. Training with feedback
• Measuring unconscious body

reactions (e.g. muscle tension)
• Feedback on the PC
• Influence towards therapy goals

Biofeedback system
Neuromaster
BioLife Software

Neuromaster
ON/OFF button
Battery compartment Connection to the

with SD-Card slot neurolink

Neuromaster light signals

Wireless mode

USB Mode

Neuromaster sensors
▪Multisensor
▪EMG sensor
▪Breathing sensor
▪ECG sensor
▪Vaso sensor
▪EEG sensor

Security and medical device
- Therapy is only permitted with medical
devices according to MPG (Medical
safety CE mark)
- Patient safety through galvanic isolation

and safety power supply
- Use only for biofeedback training
- Be sure to read the operating instructions
- Disinfection with surface disinfectant

(antivirucidal)

Demonstration biofeedback software BioLife
The main Features

Biofeedback SOFTWARE BioLife
patient invest/seek/changeEtc.

patient choose/ template choose

Session libraries
•Anxiety treatment and phobias
•Breathing school with Breath pacing
•Diagnosis
•Relaxation training
•Cardiovascular training
•Children
•Sleep disorders
•Pain management
•Muscle building
•Muscular disorders
•Addictions
•Eating disorder
•Burnout
•Neurofeedback

The session libraries
Each library contains:

•Instructions for the
therapist
•Finished session
setup

Patient screen whiletheMeasurement

Review –MenusandSetting options

Neuromaster Sensors
Multisensor
• measuresonefinger
• Skin conductance
• Pulse rate
• blood circulation
• temperature

Multisensor:
Abbreviation/parame Unit Standard values Significant change

ter
SCL -Skin conductance µS no standard values; relative change; doubling
can only be interpreted within one session (behaves proportionally; at a higher basic level
=> stronger reaction), frequent spontaneous
fluctuations
TEM - temperature °C In relaxed calm: >30 °C +/- 0.5°C

PF - pulse frequency bpm Resting heart rate 60-80 bpm Increases, but no longer decreases when relaxed
(approx. +5 bpm)
PK - pulse curve (raw % No standard values, possible display range is Clearly visible “constriction”or“widening”
signal) from -100 to +100

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SKIN CONDUCTIVITY

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Skin conductance
• Is the electrical conductance of the skin
• Dependent of the activity the sweat glands in the respective

skin region
• Sweat gland activity is influenced by symthathicusd
• Expression psychological activation
• Dependent alsofrom
− Thick ness the cornea
− habitual extent the Sweat secretion
− (Outside-)temperature
© EUROPEAN BIOFEEDBACK
26
ACADEMY, 2017
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Training Academy
(Psycho)physiology
•Frequent spontaneous Skin conductance reactions

(Spontaneous fluctuations) can stand for high excitement or
anxiety.
•Depressive and emotional inhibited persons show most of

time no or only low skin conductance activity.
•Every emotion becomes directly as skin conductance

reaction (phasic change).

Therapeutic Goals of Skin conductance
feedback
• Demonstration of psychophysiological Connections
• Diagnosis & evaluation of immediate sympathetic arousal

levels
• To learn to control the own sympathetic arousal

(vegetative relaxation by means of different cognitive
relaxation techniques, monitoring/control during
Relaxation exercises e.g. AutogenicTraining)

Example of training session
Instruction: Just Instruction: Relax with

sit and do the visualisation of a
nothing relaxing image

Demonstration of skin conductance

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Temperature-
Feedback

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(Psycho)pphysiology
• The peripheral temperature is influenced by the blood
circulation in the finger.
• temperature increases when person is relaxed and feels

safe – influenced by sympathicus (as skin conductance)

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Therapeutic Goals of temperature-

feedbacks
• increase the peripheral temperatureon above 30°C

by relaxing the autonomic nervous system
• Maintain the temperature constant.

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INDICATION AREAS
• Circulatory disorders (Raynaud's disease)

• General Relaxation training
• Treatment of migraine

Example: Hand warming training session
Temperature

Demonstration temperature

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PPG: Pulse pethysmography

Neuromaster Sensors
Vaso-Sensor for migraine therapy

measures blood flow
the temporal artery

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Characteristics at the Pulse- Feedback
Pulse rate Heart rate (bpm)
Raw signal “pulse Relative measure of blood

curve”.“ circulation in the tissue
Or Pulse amplitude under the sensor

The goal is to reduce the Example
pulse-amplitude because this
reduces the pain episodes in Vasoconstriction-
length and intensity. training for
migraine

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ECG- electrocardiography

Neuromaster
Sensors
Sensor for ECG (heart rate)
highly accurate HRV measurement

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measuring technology
• ECG is measured with the Help of electrodes

which register the electrical activity of heart.
• The Heart frequency is calculated

automatically from ECG in the software.

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(psycho)physiological Basics
• Heart rate Variability: Breathing is influencing the heart rate
= Respiratory Sinus Arrhythmia- RSA: When Vagus
(Parasympathicus) is active the RSA increases. Vagus is
responsible for recreation, relaxation. => HRV is a “window”
into the Vagus.
• Stressors or psychological activity (pain) increase the heart

rate and lower the pulse-amplitude in the periphery, and
the heart rate variability
• Cognitive factors are influencing theheart rate (acceptance

of Information is lowering HR, expectation of an activity
increases HR).
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Therapeutic Goals of Heart rate/Pulse

rate-Feedbacks
• Reduction the Resting heart rate
(Guideline60 - 80 bpm inQuiet)
• Stabilization the Resting heart rate
• Expansion the respiratory Sinus arrhythmia(RSA) or

Heart rate variability(HRV)

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INDICATION AREAS
• Treatment of Panic attacks (Heart Rate with ECG

Sensor)
• Treatment of high blood pressure (HRV with ECG
Sensor)
• Support cardiovascular Relaxation (with ECG Sensor
or Multisensor)
• Treatment of migraine (Pulse amplitude with Vaso
Sensor)

disinfectionECG
sensor,Vasosensor
1. Surface disinfection with virucidal disinfectant
2. Wipe the active surfaces, the housing and the cables
several times with a cloth dipped in disinfectant or with
alcohol-based wipese.g.DecoceptPureWipesRTU
(www.schuhmacher-online.com)
3. Changing or disinfecting the Velcro fastening tape
(Vasosensor) after each patient (e.g.dby washing at 70
degrees)

Demonstration pulse

Translated from German to English - www.onlinedoctranslator.com
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EMG
muscle tension-Feedback

Neuromaster
Sensors
EMG sensor
• measures muscle tension

EMG=Electromyography
• Recording of the electrical activity of the muscle
fibers(=Muscle sum potentials)
• Electrode types:
• surface electrodes
(for relaxation training/reeducation)
• Vaginal- or Rectal electrodes
(for Pelvic floor training/Incontinence therapy)

EMG sensor
Abbreviation/parameter Unit Standard values Significant change

EMG - muscle tension µV Normative values at rest from Cram, At rest outside the normal
1990: range
Frontalis muscle: Increases with stress, but

approx. 1.9 µV or 5 µV no longer decreases with
relaxation
Trapezius muscle:
approx. 2.2 µV or 5.1µV
Masseter muscle:
approx. 1.7 µV or 3.1 µV

Electrode placement
Bipolar derivation
the voltage difference between two electrodes (active Electrodes)
determined in relation to a reference electrode
The Reference electrode should placed on a largely neutral/muscle-free

Zone (e.g.Foot-/wrist, whirl) or between the active electrodes
Pretreatment the skin locations for electrodes

• Degrease (alcohol), let dry
• If possible no Hair (otherwise Hair remove)
• Stick on the pre-gelled Electrodes

Therapeutic Goals of EMG training
1.Relaxation for pain treatment (headache)

→maximum Muscle relaxation
→Raise awareness of the influence of mental or emotional states on
the activity of muscle (Tension perception)
→posture+muscle tension/ Posture modification
2.Reeducation after stroke, injuries etc.

→Muscle finding
→Muscle training

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EMG -Indication areas
• TreatmentfromTension headache
• Treatmentfrom chronic Back pain
• Muscle building(Incontinence,paralysis)
• general Relaxation induction
• Treatmentfrom Bruxism
• TreatmentfromTorticollis
• TreatmentfromIncontinence
• Treatmentfromparalysis
• Treatmentfromasthma
• Workplace ergonomics
Sample course “Diagnostics”
EMG: Typical curve shape
Baseline Stressor Relaxatio

n

Example course: EMG relaxation training

Disinfection EMG sensor


Demonstration of muscle tension

BREATHING feedback

Neuromaster
Sensors
Two types of sensors available:
• Contactless sensor (Infrared technology)
• Breathing Belt
Contactless sensor

Breathing sensor
Abbreviation/parameter Unit Standard values Significant change
AF - respiratory rate breaths per minute Sitting position: 6 – 14 Increases, but no longer decreases
Relaxation: 6 – 8 when relaxed
AA - breathing amplitude % No standard values – relative Decreases, but no longer

change, increases when relaxed
possible display range is from 0 to
200
AK – breathing curve (raw % No standard values – relative Clearly noticeable change in shape
signal) change, (e.g. Serrations become smaller,
possible display area goes denser or higher and wider)
from -100 to +100

Breathing(belt)
Measures the strain of

chest or
abdominal

Contactless breathing
sensor
measures respiration
contactless with infrared
technology

(psycho)physiology of the breathing
• Chest breathing as expression of fear and defense

(also physical burden!)
• Abdominal breathing as expression psychological

relaxation

Physiological Basics
• Inspirational extension the • Expiration (exhalation) is

bronchial muscles is controlled by
controled by sympathicus parasympatheticus → heart
→ heart rate increases rate decreases
(=RSA)

Indication areas
• to induce general Deep relaxation

• Improvement of breathing behavior
• Treatment of Hyperventilation
• Treatment of Panic attacks

Example Baseline Stressor Relaxation
diagnostics for
breathing

Breathing training
Be aware of Change to slow

breathing – dont abdomnal
influence it breathing

Breathing demonstration

EEG
Neurofeedback

Neuromaster
Sensors
Sensor for EEG frequency band training
• Theta, delta
• alpha
• Beta, high beta, SMR

Measurement technology,
psychophysiology
→Feedback of brain wave activity by recording voltage fluctuations
using electroencephalography (EEG)
→Decomposition into frequency bands

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neurofeedback -Indication areas
• ADHD(Theta, Beta, SMR,HiBeta)

• autism-Spectrum-Disturbances(Theta, Beta, SMR,HiBeta)
• depression(alpha, beta)
• sleep disorders(SMR)
• burnout(alpha, beta,HiBeta)
• Post-traumatic Stress disorders (Alpha-Theta)
• Addictions(Alpha-Theta, SMR)
• epilepsy(SMR)
• Tic disorders, Tourette(SMR)

Alpha reactivity/alpha blockade
Eyes open eyes Eyes open

closed
(C) EUROPEAN BIOFEEDBACK ACADEMY

E.gReview: Alpha Training

Demonstration of neurofeedback

Apply EEG sensor & electrodes

Derivations/Assemblies/
Electrode placements
Example)
Monopolar/referential
derivation:
⚫ 1 electrode – 2 references
⚫ positionCzech Republic

EEG: Monopolar derivationCzech Republic
1 Reference (position A1): GREEN
1 active electrode (positionCzech Republic): YELLOW
1 Ground (position A2): BLACK

Apply electrodes
1) Measure electrode position CZ

2) Prepare skin
a) Push hair away
b) Clean skin with alcohol
c) Massage in EEG paste with a cotton swab
d) Fill EEG electrodes (bowl) with electrode gel

3) Fix electrodes
ATTACHING THE HEADBAND (USED TO
ATTACH THE NEUROMODULE TO THE
SECURE AND RELIEVE STRAIN ON THE EEG
HEADBAND USING VELCRO
NEUROMODULE)

3) Fix electrodes
CUP ELECTRODE WITH CONDUCTIVE GEL ON
ATTACH EAR CLIPS TO BOTH EARLOBES THE CLEANED SKIN AREA AT POSITION CZ -
(POSITIONS A1 AND A2). PRESS UNTIL SLIGHTLY CONDUCTIVE GEL OOZES
OUT OF THE OPENING

DisinfectionEEG sensor


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Translated from German to English - www.onlinedoctranslator.

Copyright by Insight Instruments, Dr.

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 1

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 2

Biofeedback is a scientifically proven therapeutic procedure

© INSIGHT INSTRUMENTS, 2019 3

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 4

Parameter Stress Relaxation

Skin conductance - SCL

Muscle tension - EMG

© EUROPEAN BIOFEEDBACK ACADEMY, 2015 5

© INSIGHT INSTRUMENTS, 2019 6

• Measuring unconscious body

• Influence towards therapy goals

© INSIGHT INSTRUMENTS, 2019 7

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 8

Battery compartment Connection to the

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 9

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 10

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 11

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 12

© EUROPEAN BIOFEEDBACK ACADEMY, 2015 13

- Patient safety through galvanic isolation

- Use only for biofeedback training

- Be sure to read the operating instructions

- Disinfection with surface disinfectant

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 14

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 15

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 16

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 17

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 19

Each library contains:

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 20

© EUROPEAN BIOFEEDBACK ACADEMY, 2015 21

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 22

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 23

Abbreviation/parame Unit Standard values Significant change

TEM - temperature °C In relaxed calm: >30 °C +/- 0.5°C

© INSIGHT INSTRUMENTS, 2019 24

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 25

• Dependent of the activity the sweat glands in the respective

• Sweat gland activity is influenced by symthathicusd

• Expression psychological activation

•Frequent spontaneous Skin conductance reactions

•Depressive and emotional inhibited persons show most of

•Every emotion becomes directly as skin conductance

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 27

• Diagnosis & evaluation of immediate sympathetic arousal

• To learn to control the own sympathetic arousal

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 28

Instruction: Just Instruction: Relax with

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 29

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 30

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 31

• temperature increases when person is relaxed and feels

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 32

Therapeutic Goals of temperature-

• increase the peripheral temperatureon above 30°C

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 33

• Circulatory disorders (Raynaud's disease)

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 34

© INSIGHT INSTRUMENTS, 2020 35

© EUROPEAN BIOFEEDBACK ACADEMY, 2020 36

AA - breathing amplitude % No standard values – relative Decreases, but no longer