BIOFEEDBACK

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
 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
 EMG & Other Units
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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
 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
 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
Lie Detectors
 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
EMG Units
 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)
 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
 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
 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

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