BIOFEEDBACK

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Definition
..a method of controlling a system by reinserting into it the results of its past performance. 1.information is detected, 2.provided in an understandable way to the patient who can then, at their own initiation, 3.use the information to achieve a measure of control over the same process.
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Every day forms of biofeedback

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You have to have accurate feedback, of course!

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 A simple device to provide feedback to ensure quality, and precision in exercise performance and testing. Monitors position of the low back and provides feedback when the abdominal muscles are not actively or effectively protecting the spine.
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BF as a component of treatment
should be integrated with other therapeutic interventions an enhancer of the therapy reduce their reliance on the therapist gain control without reliance on the therapist, and once gained, to maintain control without either the therapist or the machine.
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Working

A biofeedback loop. Here the forearm muscles are monitored to provide a visual readout to the user. The feedback loop is completed when the user alters her muscle tension to adjust Sreeraj S R the readout.

Equipment

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Visual cues 1.Meter read outs 2.Flashing lights 3.Oscilloscope 4.Computer screens Auditory cues 1.Changing tones 2.Clicks
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Electrode Placement
Silver/Silver Chloride construction judicious electrode placement electrode spacing Noise/ movement artefact active electrodes should be placed in parallel with the dominant muscle fibres

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Features of the BF Devices

Gain settings, low & high Sound Threshold Peak Hold facility

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Uses
Facilitate muscle contractions Promote increased motor recruitment Regain neuromuscular control Decrease muscle spasm Promote relaxation

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Indications
Stroke Spinal cord injury Recovering and improving muscle action Chronic musculoskeletal injury Pain Posture control Balance and mobility Trunk muscle re education Respiratory muscle controle Stress related conditions Hypertension Idiopathic Raynauds disease
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Contraindications
If the patient is prohibited from moving the joint or isometric contractions, then BF should NOT be used Unhealed tendon grafts Avulsed tendons Third degree tears of muscle fibers Unstable fracture Injury to joint structure, ligaments, capsule, or articulating surface
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Technique for Motor Recruitment

Position pt. Explain to pt. Work in quiet area. Apply sensors to an area to demonstrate the desired A-V signal and activity. Adjust to the most sensitive level that picks up any MUAP that pt. Can produce Instruct pt. To try to produce an A-V signal As voluntary m activity improves, the A-V signal will increase. Adjust the gain to decrease the sensitivity, so pt. Has to work harder to recruit more mu. As pt. Masters in one position, change positions Document all parameters. Tx duration 30-60 min Clean up

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Inhibition of Spasticity
Goal: decrease undesirable m activity that may be interfering with functional movement. Eval spasticity, Explain to pt. Apply sensors and demonstrate desired activity. Find the least sensitive setting that produces minimal A-V feedback Have pt relax, use techniques and have pt. lower the A-V signal. As the signal decreases, lower the shaping controls(gain), to a more sensitive level. As pt. relaxes better, continue to increase sensitivity Change positions
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