Information

How well is biofeedback understood?

How well is biofeedback understood?


We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

From an answer to the question Research suggesting conscious control over brain region activation? I have learned:

"[S]ubjects become better at up-regulating or down-regulating activation in specific brain regions by attending to feedback-- even moreso than subjects who do not receive biofeedback. This is reflected both in the fMRI images and subjective reports from the subjects."

Given this as a fact: How well is it understood? Which mechanisms are believed to be at work? I assume the fMRI scans mainly indicate that a specific brain region is more or less active but not why so. "Why so" could mean:

  • By which mechanisms inside the region?
  • By which influence by other regions?
  • By which learned practice?
  • How are the immediate causes (of higher activity) related to the fact that the subject pays attention to the feedback?
  • How does consciousness come into play?

My question is: Which of these questions do already have a (partial) answer?


Career Overview

Biofeedback school is becoming increasingly popular in a number of health and medical spheres, including physical therapy, psychology, nursing and respiratory therapy. Biofeedback is used to treat a range of ailments, from high blood pressure to pelvic muscle dysfunction, without the assistance of drugs.

Practitioners of biofeedback therapy often work in hospitals, medical offices or physical therapy clinics. During a biofeedback session, which typically lasts 30 to 60 minutes, the therapist will use techniques such as temperature biofeedback and heart rate variability biofeedback to help attune patients to the body’s physiological reactions.


Hypnosis

Hypnotherapy can be effective in helping individuals to recount memories that too painful to consciously recall

Hypnosis, which some argue is just an extreme sense of relaxation has been effective in reducing pain and managing anxiety symptoms associated with medical procedures (Lang et al., 2000). Through extensive training, an individual can learn to engage in self-hypnosis or obtain recorded hypnosis monologues to assist with management of physiological symptoms outside of hypnosis sessions. While additional research is still needed within the field of hypnosis, studies have indicated that hypnosis is effective in not only treating chronic pain, but also assist with a reduction in anxiety, improved sleep, and improved overall quality of life. (Jensen et al., 2006).


Managing Anxiety with Biofeedback

Worrying is natural. In some cases, anxiety can be beneficial, such as before a big sports event or dance recital. However, some of us are overwhelmed by worry on a daily basis. The worry becomes excessive and can interfere with daily tasks. The anxiety or panic felt is gripping for those who have experienced it.

Having an anxiety disorder is difficult and frustrating. It is considered a silent killer and most people who see you upset will just say &ldquocalm down&rdquo or &ldquostop worrying so much&rdquo and not truly understand.

The feeling anxiety creates and the worried thoughts it causes do not have an immediate &ldquooff&rdquo switch.

The good news is there is a simple, non-drug treatment for the management of anxiety: biofeedback.

The most common types of anxiety disorders are:

  • generalized anxiety disorder (GAD)
  • obsessive-compulsive disorder (OCD)
  • panic disorder
  • post-traumatic stress disorder (PTSD)
  • social anxiety disorder (SAD)
  • specific phobias

Although each anxiety disorder is unique, there is a common thread. The loop of anxiety often looks like this: worried thought -> physiological response -> more worried thoughts -> heightened response.

The physiological response is due to adrenaline and other stress hormones rushing through your body, creating the fight-or-flight stance, regardless of any real threat. The threat is almost always perceived and irrational, and the individual is usually aware of this. Anxiety can cause you to feel &ldquoout of your mind,&rdquo suffocated, scared, upset, stressed, and not in control.

Anxiety is due to environmental causes, genetics, and personal experiences. A common trait among those who have anxiety disorders is the person&rsquos need for control. When the desire to control a situation feels out of reach, this can trigger anxiety.

Highly sensitive people also can experience anxiety in the presence of an overload of stimuli. For example, a person might become overwhelmed and experience panic if they are at a club with loud music, strobe lights, and crowds of people. Even something as harmless as a grocery store can trigger an anxiety attack due to the amount of choices available.

Symptoms vary for each person. They can range from wanting to throw up or wanting to escape, to feeling exhausted, to having migraines, to feeling tense and scared, to feeling like your head is way up in the clouds.

Treating Anxiety Symptoms with Biofeedback

Managing anxiety symptoms is on the path to treating it. For many who suffer from an anxiety disorder, they will usually tell you that it never goes away, but they have learned to control it so that the symptoms are less overwhelming.

Biofeedback therapy is a highly effective research-based treatment for anxiety disorders. The individual is taught how to properly respond to their anxiety and it is one of the ways he or she can learn how to manage and control it without the use of medications.

Biofeedback gives the anxious person the opportunity to view his or her physiological responses to stress. When a person becomes anxious, some of the changes that will be displayed visually and audibly with the use of noninvasive instruments are:

  • increases in heart rate
  • hands becoming cold and clammy
  • rapid or shallow breathing
  • skin temperature
  • muscle tension
  • EEG showing higher activity for hi-beta waves in the brain (these waves increase when the mind is stressed)
  • loss of metabolic activity in frontal lobe (showing higher activity in the emotional centers of the mid-brain)

Biofeedback teaches awareness, profound relaxation skills and ways to manage an anxiety attack, as well as ways to recognize, reduce, and control stress responses. It also teaches the individual how to control the brain&rsquos activity and maintain the proper brainwave levels to achieve a calm and focused state. By returning the body to a healthier physiological state, the &ldquofoggy head&rdquo that anxiety can cause, as well as the feeling of fear and panic throughout the body, are removed.


Biofeedback

• Neurofeedback: the term that typically refers to EEG feedback designed to alter a condition for which there is evidence that it has a neural basis.

• Biofeedback is the general term for any therapeutic intervention that uses medical equipment to monitor a body function that is otherwise outside of our awareness (a blood pressure cuff, a thermometer, a PET scan are all medical devices that can be used for biofeedback interventions).

• Neurofeedback specifically refers to biofeedback interventions using brain wave readings (also called an electroencephalogram).

• Neurofeedback practitioners have to be much more thoroughly trained than biofeedback practitioners, so there's a separate board certification for the specialty.

• Both related to learning theory and based partly on relaxation techniques

• Cbt handbooks do not include chapters on biofeedback, but biofeedback literature continues to recognize the role of cognitive factors in biofeedback interventions

• Behavioral techniques stage: acquiring self regulation
o Practitioner listens to pt's internal dialogue failures in self regulation process can be used as opportunity to learn about possible cognitions that can be discussed and modified

• Cognitive techniques stage: acquiring self regulation
o Cognitive techniques used to achieve relaxation for example, stress inoculation technique: subjects taught to substitute positive self statements and expectations for negative self statements about their ability to relax may teach pt about negative automatic thoughts that interfere with acquiring relaxation skills abc model (actual event, consequence, belief system)
o May also use act: one of main premises of act is the understanding that to try too hard is unproductive. Use biofeedback to convey this act principle to help pt's "let go" and "not try too hard."

• Generalization stage
o Pt should learn to implement self-regulation techniques outside of practitioner's office ex: start in reclining chair, then sitting position in office chair, and later standing up. Pt should practice in more common mental state conditions should ask pt what external and internal conditions thwart self-regulation

• Exposure & desensitization stage
o May integrate various types of exposure into biofeedback practice goal is to achieve a state of relaxation while simultaneously re-creating a real or imaginary stressful scenario in vitro re-creation is sufficient: for ex: a pt who is anxious about taking tests we can train pt's to implement and practice relaxation techniques during difficult situations whether in vivo or vitro. They can advance to the final stage only after they acquire and learn to implement control abilities in stressful situations as well


Biofeedback

1. the provision of visual or auditory evidence to a person of the status of an autonomic (involuntary, vital) body function such as heart rate, blood pressure, or respiratory rate, as a method of teaching control of certain visceral responses previously thought to be exclusively dictated by the autonomic nervous system and therefore involuntary or unconscious.

Examples of the kinds of biological feedback that can be provided include information about changes in skin temperature, muscle tonicity, cardiovascular activities, blood pressure, and brain wave activities. With the aid of such sensitive electronic equipment as the electrocardiograph, electromyograph, and electroencephalograph, it is possible for the person to become consciously aware of the response being measured and to learn to control it. The feedback may be presented in the form of musical tones, lights, or direct visualization of scales or meters which indicate variance in the response.

In clinical biofeedback, the patient must practice the particular desired response many times under the supervision of professional persons who are skilled in the techniques of psychophysiology. An example in which biofeedback may be used clinically is in the treatment of raynaud's disease , in which the patient learns to consciously raise skin temperature in the extremities and thus reduce vasoconstriction.


Equipment Used for Biofeedback

Biofeedback therapy may utilize a wide variety of specialized equipment depending on the physiologic functions being monitored. These biofeedback sensor modalities include:

  • Electromyographs (EMG): provides data on muscle tension
  • Feedback thermometers: offers data on skin temperature
  • Electrodermographs (EDG): measures the electrical properties of the skin, which are often linked to the activity of the sweat glands
  • Electroencephalographs (EEG): measures brainwaves and other electrical brain activities and are commonly used for neurofeedback
  • Pneumographs: measures chest expansion, chest contraction, and respiration rate
  • Photoplethysmographs (PPG): provides data on blood flow through a digit (for example, a finger), blood volume pulse, heart rate, and heart rate variability
  • Electrocardiograms (ECG): offers information about the heart&rsquos electrical activity and heart rate variability
  • Hemoencephalographs (HEG): measures the relative amounts of oxygenated and deoxygenated blood in the brain area
  • Capnometers or capnographs: provides insight into the quality of a person&rsquos breathing by measuring the partial pressure of carbon dioxide gas in exhaled air
  • Rheoencephalographs (REG): measures blood blow in the brain
  • Air pressure devices: commonly used to measure muscle performance

The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis

Some evidence suggests that heart rate variability (HRV) biofeedback might be an effective way to treat anxiety and stress symptoms. To examine the effect of HRV biofeedback on symptoms of anxiety and stress, we conducted a meta-analysis of studies extracted from PubMed, PsycINFO and the Cochrane Library.

The search identified 24 studies totaling 484 participants who received HRV biofeedback training for stress and anxiety. We conducted a random-effects meta-analysis.

The pre-post within-group effect size (Hedges' g ) was 0.81. The between-groups analysis comparing biofeedback to a control condition yielded Hedges' g = 0.83. Moderator analyses revealed that treatment efficacy was not moderated by study year, risk of study bias, percentage of females, number of sessions, or presence of an anxiety disorder.

HRV biofeedback training is associated with a large reduction in self-reported stress and anxiety. Although more well-controlled studies are needed, this intervention offers a promising approach for treating stress and anxiety with wearable devices.


Biofeedback

What Is It?
Biofeedback is a therapeutic technique that teaches you how to control physical responses such as breathing, muscle tension, hand temperature, heart rate, blood pressure and brain activity that are not normally controlled voluntarily.

Biofeedback is a therapeutic technique that teaches you how to control physical responses such as breathing, muscle tension, hand temperature, heart rate, blood pressure and brain activity that are not normally controlled voluntarily. This control is achieved by learning how to focus on and modify signals from your body. Biofeedback may be used to help people change the way their bodies respond to a variety of conditions, including chronic pain, stress and anxiety, to name a few.

The skill typically is taught by a health care professional with expertise in the techniques and uses a handful of clinical, noninvasive instruments. Once you understand how the technique is applied, and after some practice, it is usually possible to use the skill independently.

To understand biofeedback, think of a thermometer—an external device that measures a physiological change. Biofeedback uses electronic or electromechanical instruments to monitor, measure, process and feed back information about blood pressure, muscle tension, heart rate, brain waves and other physiological functions.

Audio and/or visual feedback signals, often provided through a computer, reflect this activity. This gives you greater awareness and voluntary control: First you learn to control the external signal and, eventually, you learn to recognize and use internal cues.

Biofeedback is a relatively recent approach, developed in the 1940s. The term came into use around 1969 to describe procedures that trained research subjects to alter brain activity, blood pressure, muscle tension, heart rate and other "involuntary" bodily functions. The goal is to train you, primarily by changing thought processes, to control physiologic responses.

At first, biofeedback was viewed with skepticism, but it has been increasingly accepted by mainstream health care professionals and insurers. In the last 40 years, scientists have been exploring the mind/body connection. More acceptance and widespread use of biofeedback therapy has resulted.

Studies indicate that it is an effective therapy. It is used to help treat a range of illnesses and ailments, from chronic pain to constipation to incontinence. It is usually used in addition to a primary treatment to emphasize self-control or self-regulation.

Biofeedback is most helpful for conditions involving muscle tension. It's a particularly useful therapy for reducing stress and anxiety, and the National Institutes of Health has approved its use in the treatment of chronic pain and insomnia. Biofeedback can be used as both a primary and secondary treatment. Secondary treatments are used in conjunction with traditional medicine. For example, biofeedback would be used to deal with the trauma or fear of having a disease like cancer the pain associated with the condition and the nausea from chemotherapy. Biofeedback is also a secondary treatment for diseases like multiple sclerosis, Crohn's disease and other conditions that are not considered curable by biofeedback, although some symptoms of these conditions can be alleviated with this therapy.

There are at least 150 applications for biofeedback, and the list continues to grow. Below are some of those uses:

  • addiction to alcohol, tobacco and other drugs
  • anxiety disorders
  • asthma
  • bruxism (teeth grinding)
  • cardiac arrhythmia (abnormalities in heartbeat)
  • chronic fatigue syndrome
  • chronic pain
  • circulatory problems (such as Raynaud's phenomenon)
  • complex regional pain syndrome
  • concentration improvement for education and meditation
  • control of brain waves for spiritual development and inner tranquility
  • constipation
  • diabetes
  • epilepsy
  • fecal incontinence
  • fibromyalgia
  • headaches (including migraines)
  • high blood pressure
  • insomnia
  • irritable bowel syndrome and other digestive disorders
  • jaw pain and dysfunction (including temporomandibular joint syndrome)
  • menopausal symptoms
  • menstrual cramps
  • migraine headaches
  • mild depression
  • nausea and motion sickness
  • neuromuscular re-education
  • paralysis, spinal cord injury and other movement disorders
  • premenstrual syndrome
  • stress
  • torticollis (neck muscles contract involuntarily, causing the head to turn)
  • Tourette's syndrome
  • urinary incontinence
  • vulvovaginal pain

Although biofeedback is perhaps most closely associated with stress relief, new applications are being developed regularly. Motion sickness is one of the newest applications. NASA used biofeedback to help astronauts deal with space sickness, and now the space agency's techniques are being used to help others who suffer from nausea, vomiting and motion sickness.

A particular type of biofeedback, called electroencephalographic (EEG) biofeedback, or neurofeedback, is used for a variety of conditions. Through neurofeedback, you learn to pay attention to brainwave activity and ultimately control it. It may be helpful in reducing hyperactivity and attention deficit hyperactivity disorder, though studies are continuing to determine its effectiveness.

Unlike many other approaches to health care, biofeedback puts you in charge. It requires you to learn from the signals your body sends and make changes accordingly. It even involves practice at home. And after you finish your biofeedback sessions, you need to use what you learned regularly. You will use it, of course, to affect the condition. Daily practice, even when your symptoms are responding to treatment, reinforces your skills.

Depending on the condition you're trying to change, your practice period may range from a couple of minutes intermittently during the day to half-hour sessions. You might focus on a particular muscle group, a hand-warming technique or some other technique specific to your needs.

Biofeedback and Hypnosis

Many health professionals use both hypnosis and biofeedback, often together. In fact, it is impossible to teach biofeedback without also teaching a type of self-hypnosis exercise, such as imagery relaxation, progressive relaxation or imagery change.

One benefit from using the combination of hypnotherapy and biofeedback is that the participant recognizes quickly that changing thinking changes physiologic responses. This encourages mental practice toward the goal of making a desired physiologic change permanent.

Diagnosis

Although biofeedback is harmless, your health care professional will want to do a thorough exam related to your condition. This gives a better understanding of the causes of your medical condition and guides the biofeedback therapist in developing an appropriate treatment plan. In addition, the physiological testing that is done before beginning treatment can help you measure your progress as you proceed with treatment.

Biofeedback is generally not a substitute for conventional medical treatment. Rather, it should be used with any other therapies prescribed by your health care professional.

Overall, biofeedback is safe: It is noninvasive and generally has no side effects. However, if you are deeply apprehensive, be sure to discuss your concerns with the therapist. A healthy dose of skepticism and interest in the details of your care should be welcome. If a therapist doesn't answer your questions, seek another therapist. Ultimately, you don't have to believe in biofeedback for it to work. But you will have to practice the techniques to discover whether or not they are effective for you. Biofeedback requires that you be a responsive participant in the process.

Whether biofeedback works for you depends on your particular condition and your ability to learn from the feedback you receive. The amount of time you commit to helping your body and mind make the necessary changes is crucial. Once a commitment is there, change will take place, but the extent will depend on the severity of your complaint and the ability of your body to make the necessary changes.

Getting started

To get started, you'll need a trained professional who can operate the monitoring equipment and interpret the results. Biofeedback professionals come from a number of health-related disciplines, including psychology, psychiatry, social work, medicine, dentistry and nursing.

Your health care professional may be able to make a referral. Physicians, dentists, psychologists and others use biofeedback. The psychology or psychiatry department at a nearby university also may be able to point you in the right direction. And check with your health care plan—it may cover your visits to approved biofeedback therapists.

Although the practice isn't licensed, biofeedback therapists can receive certification from the Biofeedback Certification Institute of America (BCIA). To be certified, they must meet certain education requirements, pass an exam and either be licensed in a health care field or work under the supervision of a licensed health care professional. The organization offers referrals (www.bcia.org). BCIA estimates that about 1,500 health care professionals in 25 countries are certified either in general biofeedback, EEG biofeedback or pelvic muscle dysfunction.

Treatment

Biofeedback typically involves a series of sessions over several weeks. The length and number of sessions you need will depend on your condition and how fast you can learn to control your physical responses. Some conditions require as few as three or four sessions, especially for children, while others may require 10 times that many or more.

Electroencephalographic (EEG) biofeedback—which measures, displays and teaches you to control brainwaves—can take longer. Some conditions may require 40 or 50 EEG sessions in the clinic. You and your biofeedback therapist will come up with a schedule that's right for your condition.

You can expect a session to last from 30 minutes to an hour. (Your first one may take longer as the therapist explains the process to you.)

The biofeedback therapist will first explain the process to you and show you the various pieces of equipment. You'll sit in a comfortable chair, and the therapist will apply sensors to various points on your body (most typically, the shoulders, fingers, back and/or head) depending on your complaint and the protocol developed to bring about beneficial change. This may vary among clinics. For instance, if you have headaches or insomnia, the sensors will probably be placed on your scalp.

The sensors are connected to equipment that provides instantaneous feedback on the function you are trying to control. What's this feedback like? It varies. Some machines show you the changes on a computer monitor. Others beep or buzz or blink or otherwise indicate fluctuations in the function you are targeting.

Before the training begins, the biofeedback professional will take a baseline reading to find what your "normal" state is this makes it possible to gauge changes.

Next, the therapist will guide you through various mental or physical exercises that are designed to bring about the desired biological changes—exercises that can help you control a particular function. And by paying attention to the feedback, you'll learn to associate certain thoughts and actions with the desired change in your previously involuntary responses. Sensors are attached to your body to monitor certain physical processes such as temperature, heart rate and muscle tension, for example. This information is fed back by electronic signals, which help to speed the learning process so that you know immediately if the desired effect has been achieved.

For instance, you may be connected to a device that indicates muscle tension via an electronic signal. This signal increases as you tense and decreases as you relax. This approach is particularly helpful to women with incontinence. It raises awareness of and control over pelvic floor muscles. By using electronic devices to gauge bladder and urethral muscle contractions, you can learn to control and strengthen these muscles. Sometimes the pelvic floor muscles are strong but are spastic or in spasm and need to be retrained so they relax appropriately.

Your therapist will serve as a coach who guides and encourages you in various relaxation techniques, self-regulation, self-awareness and home practices. By practicing these techniques, you gain greater control over your bodily functions. Once you gain competence practicing at the clinic, the idea is to become so good that you no longer need to be monitored by the instrumentation or a therapist.

In some clinics you are first taught to close your eyes and focus inward to listen to bodily changes. After you're familiar with the technique, you are taught to open your eyes and focus on the sounds, lights or computer display to help fine-tune skills learned with your eyes closed.

Gradually, you'll be able to do this without the audio or visual aids. Just by concentration, you can contract and/or relax certain muscles. At that point, you can use biofeedback on your own, without the equipment and guidance of a clinic session.

There are several basic methods and instruments:

  • Electromyography (EMG) measures muscle activity. This approach is used for a number of conditions, including muscle stiffness, stress incontinence, urge incontinence, overflow incontinence, urinary urgency and frequency, headaches, tooth grinding, stress and chronic pain. It's also used when muscles are healing or being reconditioned. Sensors are usually attached to the affected muscles.
  • Thermal biofeedback provides information about skin temperature, an indication of blood flow. You might take this approach if you suffer from migraines, Raynaud's phenomenon, anxiety or high blood pressure. Sensors often go on your fingers or feet.
  • Galvanic skin response training measures changes in your skin's surface—particularly perspiration rates. This is a common method for dealing with stress, phobias and stuttering.
  • Heart rate variability biofeedback. Commonly used in commercial devices, this type of biofeedback helps you control your heart rate in order to improve blood pressure and lung function and to ease stress and anxiety.
  • Respiration (rate, rhythm and type of breathing) can be monitored—often through a strain gauge wrapped around your chest or waist. This method is often used for asthma, hyperventilation, anxiety, panic and angina with chest pain.
  • Electroencephalographs (EEG) (EEG) measure brainwaves. Ideally, an EEG will help you learn how to recognize and modify your brainwave activity by identifying certain brainwave patterns. EEG biofeedback (also called neurofeedback) can help improve attention and reduce impulsivity and is used to treat attention deficit hyperactivity disorder, head injuries and mild depression. It also has been used to treat epilepsy and depression and to promote recovery from head injuries and stroke. Sensors are placed on the head in various locations dependent on the treatment.

In addition to the actual biofeedback, your therapist will probably work with you on relaxation exercises, stress-coping techniques, deep breathing and muscle relaxation.

There also are biofeedback tools available online. While it is still recommended that you start out working with a professional, some of the new tools make it easier to practice at home. HeartMath offers software compatible with the iPhone, iPad, iTouch and computers that teaches you to monitor your body signals to better manage stress. The company offers online training and works with therapists worldwide to help you get started.

Many people learn to control various functions, including heart rate, blood pressure and muscle tension. (This ability enables some people to go off certain medications, such as those for blood pressure and mild depression. But don't make this decision alone talk to the prescribing health care professional before discontinuing any drug regimen.)

Biofeedback success rates vary widely based on the individual and the condition. There have been numerous published studies on the efficacy of biofeedback, and researchers continue to do further studies. The practice is increasingly gaining mainstream acceptance with more complex conditions.

Facts to Know

  1. Biofeedback isn't a treatment or a cure. It's a set of techniques or methods for helping you become aware of your body processes in order to control them. These changes, not the biofeedback equipment itself, are what improve your health.
  2. Biofeedback should never be used for treating symptoms that haven't been checked out by your primary health care professional.
  3. Biofeedback uses audio, visual and digital cues to reflect changes in your physiology.
  4. Biofeedback is frequently used to help people with stress-related disorders, insomnia and chronic pain. Currently, over 150 applications of biofeedback have been described and evaluated.
  5. The term "biofeedback" comes from "biological feedback" and came into use around 1969.
  6. Biofeedback is emerging as a therapy for vulvovaginal pain. The rationale is the same as for incontinence—biofeedback can help you train and strengthen your pelvic muscles, which in turn can help you control the muscle spasms that often accompany this condition. It is also useful in helping eliminate vaginismus, painful vaginal spasms often associated with intercourse.
  7. Although biofeedback therapy is not licensed by the state, you can find accredited practitioners through the Biofeedback Certification Institute of America (www.bcia.org).
  8. Biofeedback crosses many health care categories. It's used in several disciplines, including psychology, dentistry, physical therapy, pain management and internal medicine. (In fact, some nurses, physicians and dentists are also biofeedback therapists.)
  9. Researchers aren't exactly sure why biofeedback works, but most think that learning how to relax can help the patient learn from biofeedback. Relaxation and stress-reduction exercises are an important part of biofeedback therapy.
  10. Biofeedback is painless.

Questions to Ask

Review the following Questions to Ask about biofeedback so you're prepared to discuss this important health issue with your health care professional.

  1. What kind of training do you have? Are you certified and by whom?
  2. How long have you been doing this? What types of conditions do you most commonly address? How many times have you treated patients with my condition?
  3. Which types of biofeedback do you use?
  4. How much will this cost? Will my health care plan cover treatment?
  5. How many sessions do you think I will need?
  6. Tell me how each of these machines work.
  7. I have a pacemaker. Do you need to take special precautions?
  8. What types of exercises will I need to do at home?
  9. Will I need follow-up visits once the initial treatment and training are finished?
  10. I am pregnant. Will biofeedback affect my pregnancy? If so, how?

Key Q&A

  1. I'm currently on medication for the same condition for which I'm seeking biofeedback therapy. Will biofeedback take the place of these drugs? It might, but this can't be decided without careful evaluation of your condition and only in conjunction with your physician. Biofeedback is another tool for you to use. Some people discover that they are able to stop taking certain medications once they master biofeedback. Your medication will be continued until such time as you demonstrate you no longer need medication, or it is safe to change your dosage. When you learn to control your symptoms, only then may your physician eliminate your medication.
  2. I don't really want to try biofeedback, but my doctor says it might help. I don't believe her. Do I need to try? Trying one session might change your mind, but it doesn't commit you to further sessions. After one session you can decide whether to continue. If, after this first session, you are still reluctant, then discuss it with your therapist or referring health care professional. Biofeedback may not be for you.
  3. I called a biofeedback therapist and she said that I needed to have my regular health care professional check out my symptoms first. Why? Biofeedback is never recommended for unevaluated symptoms. For instance, if you have insomnia or chronic pain, that could be a symptom of another condition. And biofeedback, by itself, is not appropriate for many conditions. You need to know what's wrong before you seek treatment.
  4. I see at-home biofeedback equipment advertised on the Web. Should I try that? Not without running it by your biofeedback therapist or health care professional first. There are increasingly more biofeedback devices and programs that are being marketed for home use in the form of computer software and portable devices. Keep in mind that some of these products may not be reputable. For best results, work with a trained biofeedback therapist and/or check with your health care professional before using any at-home biofeedback program or device.
  5. Biofeedback is considered an alternative therapy. Does that mean it's somehow spiritual? The elements of health are considered to involve mind, body and spirit. In this instance, spirit relates to an inner sense of well-being, not to anything religious in nature. However, if you wish to investigate a deeper spiritual connection, you should find a therapist proficient in this area.

Organizations and Support

For information and support on Biofeedback, please see the recommended organizations below.


Example of BFRT Protocol

When using BFRT, it is first necessary to determine whether the client would benefit from such therapy. General relaxation may be helpful in a variety of conditions and it may also be useful as an incompatible response during such procedures as systematic desensitization. BFRT normally takes between 8 and 20 sessions, depending on the acquisition skills and the distress level of the client before and during therapy. After determination of the need for BFRT, the therapist must explain the rationale for biofeedback therapy, outline the basic aspects of the physiological processes that will be trained, and discuss the potential benefits and risks of the training. This author recommends conducting the first BFRT session with frontal EMG feedback while monitoring other modalities such as finger temperature, SCA, and/or heart rate. During the first biofeedback session, facial muscle discrimination training should be demonstrated and the client should be provided time to use his or her relaxation techniques to reduce frontal EMG levels. The therapist should monitor the other modalities during the session to observe the changes that occur as the client tries to reduce frontal EMG levels. The value of monitoring other modalities is that, for instance, by observing sweat gland activity, it can be determined whether the client is engaging in arousing internal dialogue by noting whether several short duration responses are observed. If so, the therapist could interrupt the session and suggest a change in strategy by the client. During the interruption, the therapist should ask the client what strategy he or she was using and then encourage him or her to select a different strategy, such as diaphragmatic breathing or changes in imagery. The most labile physiological process is usually selected as the target of biofeedback therapy after frontal EMG levels are acceptable.

Another example of an often-used biofeedback procedure is QEEG feedback for treatment of ADHD: First, it is helpful to explain that the QEEG is different than the traditional EEG. The QEEG is the EEG after it has been digitized through the use of an analogue-to-digital converter. This process allows the mathematical determination of the characteristics of specific frequencies. Children with ADHD have been shown to have different patterns of brain waves then non-ADHD children of the same age. The diagnosed children have more electrical activity in the slow frequency range, such as theta (4-8 Hz) and alpha (8—12 Hz), and fewer in the fast frequency range, such as sensorimotor rhythm (SMR 12-15 Hz) and beta (16-30 Hz). The biofeedback technique trains for a decrease in theta or alpha and an increase in SMR or beta. The treatment protocol requires a QEEG assessment to determine which specific frequencies will need to be trained. Several studies clearly demonstrate that the QEEG patterns change according to the direction of training for some children and that clinical improvements are observed with successful training. The number of sessions necessary is usually 40-60, depending on how quickly the QEEG changes. See Lubar (2003) and Lubar and Lubar (1999) for further information.


Effect of Heart Rate Variability Biofeedback on Sport Performance, a Systematic Review

Aim is to determine if the training with heart rate variability biofeedback allows to improve performance in athletes of different disciplines. Methods such as database search on Web of Science, SpringerLink, EBSCO Academic Search Complete, SPORTDiscus, Pubmed/Medline, and PROQUEST Academic Research Library, as well as manual reference registration. The eligibility criteria were: (a) published scientific articles (b) experimental studies, quasi-experimental, or case reports (c) use of HRV BFB as main treatment (d) sport performance as dependent variable (e) studies published until October 2016 (f) studies published in English, Spanish, French or Portuguese. The guidelines of the PRISMA statement were followed. Out of the 451 records found, seven items were included. All studies had a small sample size (range from 1 to 30 participants). In 85.71% of the studies (n = 6) the athletes enhanced psychophysiological variables that allowed them to improve their sport performance thanks to training with heart rate variability biofeedback. Despite the limited amount of experimental studies in the field to date, the findings suggest that heart rate variability biofeedback is an effective, safe, and easy-to-learn and apply method for both athletes and coaches in order to improve sport performance.

Keywords: Athletes Autonomic nervous system Biofeedback Heart rate variability Sport performance.


Biofeedback

What Is It?
Biofeedback is a therapeutic technique that teaches you how to control physical responses such as breathing, muscle tension, hand temperature, heart rate, blood pressure and brain activity that are not normally controlled voluntarily.

Biofeedback is a therapeutic technique that teaches you how to control physical responses such as breathing, muscle tension, hand temperature, heart rate, blood pressure and brain activity that are not normally controlled voluntarily. This control is achieved by learning how to focus on and modify signals from your body. Biofeedback may be used to help people change the way their bodies respond to a variety of conditions, including chronic pain, stress and anxiety, to name a few.

The skill typically is taught by a health care professional with expertise in the techniques and uses a handful of clinical, noninvasive instruments. Once you understand how the technique is applied, and after some practice, it is usually possible to use the skill independently.

To understand biofeedback, think of a thermometer—an external device that measures a physiological change. Biofeedback uses electronic or electromechanical instruments to monitor, measure, process and feed back information about blood pressure, muscle tension, heart rate, brain waves and other physiological functions.

Audio and/or visual feedback signals, often provided through a computer, reflect this activity. This gives you greater awareness and voluntary control: First you learn to control the external signal and, eventually, you learn to recognize and use internal cues.

Biofeedback is a relatively recent approach, developed in the 1940s. The term came into use around 1969 to describe procedures that trained research subjects to alter brain activity, blood pressure, muscle tension, heart rate and other "involuntary" bodily functions. The goal is to train you, primarily by changing thought processes, to control physiologic responses.

At first, biofeedback was viewed with skepticism, but it has been increasingly accepted by mainstream health care professionals and insurers. In the last 40 years, scientists have been exploring the mind/body connection. More acceptance and widespread use of biofeedback therapy has resulted.

Studies indicate that it is an effective therapy. It is used to help treat a range of illnesses and ailments, from chronic pain to constipation to incontinence. It is usually used in addition to a primary treatment to emphasize self-control or self-regulation.

Biofeedback is most helpful for conditions involving muscle tension. It's a particularly useful therapy for reducing stress and anxiety, and the National Institutes of Health has approved its use in the treatment of chronic pain and insomnia. Biofeedback can be used as both a primary and secondary treatment. Secondary treatments are used in conjunction with traditional medicine. For example, biofeedback would be used to deal with the trauma or fear of having a disease like cancer the pain associated with the condition and the nausea from chemotherapy. Biofeedback is also a secondary treatment for diseases like multiple sclerosis, Crohn's disease and other conditions that are not considered curable by biofeedback, although some symptoms of these conditions can be alleviated with this therapy.

There are at least 150 applications for biofeedback, and the list continues to grow. Below are some of those uses:

  • addiction to alcohol, tobacco and other drugs
  • anxiety disorders
  • asthma
  • bruxism (teeth grinding)
  • cardiac arrhythmia (abnormalities in heartbeat)
  • chronic fatigue syndrome
  • chronic pain
  • circulatory problems (such as Raynaud's phenomenon)
  • complex regional pain syndrome
  • concentration improvement for education and meditation
  • control of brain waves for spiritual development and inner tranquility
  • constipation
  • diabetes
  • epilepsy
  • fecal incontinence
  • fibromyalgia
  • headaches (including migraines)
  • high blood pressure
  • insomnia
  • irritable bowel syndrome and other digestive disorders
  • jaw pain and dysfunction (including temporomandibular joint syndrome)
  • menopausal symptoms
  • menstrual cramps
  • migraine headaches
  • mild depression
  • nausea and motion sickness
  • neuromuscular re-education
  • paralysis, spinal cord injury and other movement disorders
  • premenstrual syndrome
  • stress
  • torticollis (neck muscles contract involuntarily, causing the head to turn)
  • Tourette's syndrome
  • urinary incontinence
  • vulvovaginal pain

Although biofeedback is perhaps most closely associated with stress relief, new applications are being developed regularly. Motion sickness is one of the newest applications. NASA used biofeedback to help astronauts deal with space sickness, and now the space agency's techniques are being used to help others who suffer from nausea, vomiting and motion sickness.

A particular type of biofeedback, called electroencephalographic (EEG) biofeedback, or neurofeedback, is used for a variety of conditions. Through neurofeedback, you learn to pay attention to brainwave activity and ultimately control it. It may be helpful in reducing hyperactivity and attention deficit hyperactivity disorder, though studies are continuing to determine its effectiveness.

Unlike many other approaches to health care, biofeedback puts you in charge. It requires you to learn from the signals your body sends and make changes accordingly. It even involves practice at home. And after you finish your biofeedback sessions, you need to use what you learned regularly. You will use it, of course, to affect the condition. Daily practice, even when your symptoms are responding to treatment, reinforces your skills.

Depending on the condition you're trying to change, your practice period may range from a couple of minutes intermittently during the day to half-hour sessions. You might focus on a particular muscle group, a hand-warming technique or some other technique specific to your needs.

Biofeedback and Hypnosis

Many health professionals use both hypnosis and biofeedback, often together. In fact, it is impossible to teach biofeedback without also teaching a type of self-hypnosis exercise, such as imagery relaxation, progressive relaxation or imagery change.

One benefit from using the combination of hypnotherapy and biofeedback is that the participant recognizes quickly that changing thinking changes physiologic responses. This encourages mental practice toward the goal of making a desired physiologic change permanent.

Diagnosis

Although biofeedback is harmless, your health care professional will want to do a thorough exam related to your condition. This gives a better understanding of the causes of your medical condition and guides the biofeedback therapist in developing an appropriate treatment plan. In addition, the physiological testing that is done before beginning treatment can help you measure your progress as you proceed with treatment.

Biofeedback is generally not a substitute for conventional medical treatment. Rather, it should be used with any other therapies prescribed by your health care professional.

Overall, biofeedback is safe: It is noninvasive and generally has no side effects. However, if you are deeply apprehensive, be sure to discuss your concerns with the therapist. A healthy dose of skepticism and interest in the details of your care should be welcome. If a therapist doesn't answer your questions, seek another therapist. Ultimately, you don't have to believe in biofeedback for it to work. But you will have to practice the techniques to discover whether or not they are effective for you. Biofeedback requires that you be a responsive participant in the process.

Whether biofeedback works for you depends on your particular condition and your ability to learn from the feedback you receive. The amount of time you commit to helping your body and mind make the necessary changes is crucial. Once a commitment is there, change will take place, but the extent will depend on the severity of your complaint and the ability of your body to make the necessary changes.

Getting started

To get started, you'll need a trained professional who can operate the monitoring equipment and interpret the results. Biofeedback professionals come from a number of health-related disciplines, including psychology, psychiatry, social work, medicine, dentistry and nursing.

Your health care professional may be able to make a referral. Physicians, dentists, psychologists and others use biofeedback. The psychology or psychiatry department at a nearby university also may be able to point you in the right direction. And check with your health care plan—it may cover your visits to approved biofeedback therapists.

Although the practice isn't licensed, biofeedback therapists can receive certification from the Biofeedback Certification Institute of America (BCIA). To be certified, they must meet certain education requirements, pass an exam and either be licensed in a health care field or work under the supervision of a licensed health care professional. The organization offers referrals (www.bcia.org). BCIA estimates that about 1,500 health care professionals in 25 countries are certified either in general biofeedback, EEG biofeedback or pelvic muscle dysfunction.

Treatment

Biofeedback typically involves a series of sessions over several weeks. The length and number of sessions you need will depend on your condition and how fast you can learn to control your physical responses. Some conditions require as few as three or four sessions, especially for children, while others may require 10 times that many or more.

Electroencephalographic (EEG) biofeedback—which measures, displays and teaches you to control brainwaves—can take longer. Some conditions may require 40 or 50 EEG sessions in the clinic. You and your biofeedback therapist will come up with a schedule that's right for your condition.

You can expect a session to last from 30 minutes to an hour. (Your first one may take longer as the therapist explains the process to you.)

The biofeedback therapist will first explain the process to you and show you the various pieces of equipment. You'll sit in a comfortable chair, and the therapist will apply sensors to various points on your body (most typically, the shoulders, fingers, back and/or head) depending on your complaint and the protocol developed to bring about beneficial change. This may vary among clinics. For instance, if you have headaches or insomnia, the sensors will probably be placed on your scalp.

The sensors are connected to equipment that provides instantaneous feedback on the function you are trying to control. What's this feedback like? It varies. Some machines show you the changes on a computer monitor. Others beep or buzz or blink or otherwise indicate fluctuations in the function you are targeting.

Before the training begins, the biofeedback professional will take a baseline reading to find what your "normal" state is this makes it possible to gauge changes.

Next, the therapist will guide you through various mental or physical exercises that are designed to bring about the desired biological changes—exercises that can help you control a particular function. And by paying attention to the feedback, you'll learn to associate certain thoughts and actions with the desired change in your previously involuntary responses. Sensors are attached to your body to monitor certain physical processes such as temperature, heart rate and muscle tension, for example. This information is fed back by electronic signals, which help to speed the learning process so that you know immediately if the desired effect has been achieved.

For instance, you may be connected to a device that indicates muscle tension via an electronic signal. This signal increases as you tense and decreases as you relax. This approach is particularly helpful to women with incontinence. It raises awareness of and control over pelvic floor muscles. By using electronic devices to gauge bladder and urethral muscle contractions, you can learn to control and strengthen these muscles. Sometimes the pelvic floor muscles are strong but are spastic or in spasm and need to be retrained so they relax appropriately.

Your therapist will serve as a coach who guides and encourages you in various relaxation techniques, self-regulation, self-awareness and home practices. By practicing these techniques, you gain greater control over your bodily functions. Once you gain competence practicing at the clinic, the idea is to become so good that you no longer need to be monitored by the instrumentation or a therapist.

In some clinics you are first taught to close your eyes and focus inward to listen to bodily changes. After you're familiar with the technique, you are taught to open your eyes and focus on the sounds, lights or computer display to help fine-tune skills learned with your eyes closed.

Gradually, you'll be able to do this without the audio or visual aids. Just by concentration, you can contract and/or relax certain muscles. At that point, you can use biofeedback on your own, without the equipment and guidance of a clinic session.

There are several basic methods and instruments:

  • Electromyography (EMG) measures muscle activity. This approach is used for a number of conditions, including muscle stiffness, stress incontinence, urge incontinence, overflow incontinence, urinary urgency and frequency, headaches, tooth grinding, stress and chronic pain. It's also used when muscles are healing or being reconditioned. Sensors are usually attached to the affected muscles.
  • Thermal biofeedback provides information about skin temperature, an indication of blood flow. You might take this approach if you suffer from migraines, Raynaud's phenomenon, anxiety or high blood pressure. Sensors often go on your fingers or feet.
  • Galvanic skin response training measures changes in your skin's surface—particularly perspiration rates. This is a common method for dealing with stress, phobias and stuttering.
  • Heart rate variability biofeedback. Commonly used in commercial devices, this type of biofeedback helps you control your heart rate in order to improve blood pressure and lung function and to ease stress and anxiety.
  • Respiration (rate, rhythm and type of breathing) can be monitored—often through a strain gauge wrapped around your chest or waist. This method is often used for asthma, hyperventilation, anxiety, panic and angina with chest pain.
  • Electroencephalographs (EEG) (EEG) measure brainwaves. Ideally, an EEG will help you learn how to recognize and modify your brainwave activity by identifying certain brainwave patterns. EEG biofeedback (also called neurofeedback) can help improve attention and reduce impulsivity and is used to treat attention deficit hyperactivity disorder, head injuries and mild depression. It also has been used to treat epilepsy and depression and to promote recovery from head injuries and stroke. Sensors are placed on the head in various locations dependent on the treatment.

In addition to the actual biofeedback, your therapist will probably work with you on relaxation exercises, stress-coping techniques, deep breathing and muscle relaxation.

There also are biofeedback tools available online. While it is still recommended that you start out working with a professional, some of the new tools make it easier to practice at home. HeartMath offers software compatible with the iPhone, iPad, iTouch and computers that teaches you to monitor your body signals to better manage stress. The company offers online training and works with therapists worldwide to help you get started.

Many people learn to control various functions, including heart rate, blood pressure and muscle tension. (This ability enables some people to go off certain medications, such as those for blood pressure and mild depression. But don't make this decision alone talk to the prescribing health care professional before discontinuing any drug regimen.)

Biofeedback success rates vary widely based on the individual and the condition. There have been numerous published studies on the efficacy of biofeedback, and researchers continue to do further studies. The practice is increasingly gaining mainstream acceptance with more complex conditions.

Facts to Know

  1. Biofeedback isn't a treatment or a cure. It's a set of techniques or methods for helping you become aware of your body processes in order to control them. These changes, not the biofeedback equipment itself, are what improve your health.
  2. Biofeedback should never be used for treating symptoms that haven't been checked out by your primary health care professional.
  3. Biofeedback uses audio, visual and digital cues to reflect changes in your physiology.
  4. Biofeedback is frequently used to help people with stress-related disorders, insomnia and chronic pain. Currently, over 150 applications of biofeedback have been described and evaluated.
  5. The term "biofeedback" comes from "biological feedback" and came into use around 1969.
  6. Biofeedback is emerging as a therapy for vulvovaginal pain. The rationale is the same as for incontinence—biofeedback can help you train and strengthen your pelvic muscles, which in turn can help you control the muscle spasms that often accompany this condition. It is also useful in helping eliminate vaginismus, painful vaginal spasms often associated with intercourse.
  7. Although biofeedback therapy is not licensed by the state, you can find accredited practitioners through the Biofeedback Certification Institute of America (www.bcia.org).
  8. Biofeedback crosses many health care categories. It's used in several disciplines, including psychology, dentistry, physical therapy, pain management and internal medicine. (In fact, some nurses, physicians and dentists are also biofeedback therapists.)
  9. Researchers aren't exactly sure why biofeedback works, but most think that learning how to relax can help the patient learn from biofeedback. Relaxation and stress-reduction exercises are an important part of biofeedback therapy.
  10. Biofeedback is painless.

Questions to Ask

Review the following Questions to Ask about biofeedback so you're prepared to discuss this important health issue with your health care professional.

  1. What kind of training do you have? Are you certified and by whom?
  2. How long have you been doing this? What types of conditions do you most commonly address? How many times have you treated patients with my condition?
  3. Which types of biofeedback do you use?
  4. How much will this cost? Will my health care plan cover treatment?
  5. How many sessions do you think I will need?
  6. Tell me how each of these machines work.
  7. I have a pacemaker. Do you need to take special precautions?
  8. What types of exercises will I need to do at home?
  9. Will I need follow-up visits once the initial treatment and training are finished?
  10. I am pregnant. Will biofeedback affect my pregnancy? If so, how?

Key Q&A

  1. I'm currently on medication for the same condition for which I'm seeking biofeedback therapy. Will biofeedback take the place of these drugs? It might, but this can't be decided without careful evaluation of your condition and only in conjunction with your physician. Biofeedback is another tool for you to use. Some people discover that they are able to stop taking certain medications once they master biofeedback. Your medication will be continued until such time as you demonstrate you no longer need medication, or it is safe to change your dosage. When you learn to control your symptoms, only then may your physician eliminate your medication.
  2. I don't really want to try biofeedback, but my doctor says it might help. I don't believe her. Do I need to try? Trying one session might change your mind, but it doesn't commit you to further sessions. After one session you can decide whether to continue. If, after this first session, you are still reluctant, then discuss it with your therapist or referring health care professional. Biofeedback may not be for you.
  3. I called a biofeedback therapist and she said that I needed to have my regular health care professional check out my symptoms first. Why? Biofeedback is never recommended for unevaluated symptoms. For instance, if you have insomnia or chronic pain, that could be a symptom of another condition. And biofeedback, by itself, is not appropriate for many conditions. You need to know what's wrong before you seek treatment.
  4. I see at-home biofeedback equipment advertised on the Web. Should I try that? Not without running it by your biofeedback therapist or health care professional first. There are increasingly more biofeedback devices and programs that are being marketed for home use in the form of computer software and portable devices. Keep in mind that some of these products may not be reputable. For best results, work with a trained biofeedback therapist and/or check with your health care professional before using any at-home biofeedback program or device.
  5. Biofeedback is considered an alternative therapy. Does that mean it's somehow spiritual? The elements of health are considered to involve mind, body and spirit. In this instance, spirit relates to an inner sense of well-being, not to anything religious in nature. However, if you wish to investigate a deeper spiritual connection, you should find a therapist proficient in this area.

Organizations and Support

For information and support on Biofeedback, please see the recommended organizations below.


Equipment Used for Biofeedback

Biofeedback therapy may utilize a wide variety of specialized equipment depending on the physiologic functions being monitored. These biofeedback sensor modalities include:

  • Electromyographs (EMG): provides data on muscle tension
  • Feedback thermometers: offers data on skin temperature
  • Electrodermographs (EDG): measures the electrical properties of the skin, which are often linked to the activity of the sweat glands
  • Electroencephalographs (EEG): measures brainwaves and other electrical brain activities and are commonly used for neurofeedback
  • Pneumographs: measures chest expansion, chest contraction, and respiration rate
  • Photoplethysmographs (PPG): provides data on blood flow through a digit (for example, a finger), blood volume pulse, heart rate, and heart rate variability
  • Electrocardiograms (ECG): offers information about the heart&rsquos electrical activity and heart rate variability
  • Hemoencephalographs (HEG): measures the relative amounts of oxygenated and deoxygenated blood in the brain area
  • Capnometers or capnographs: provides insight into the quality of a person&rsquos breathing by measuring the partial pressure of carbon dioxide gas in exhaled air
  • Rheoencephalographs (REG): measures blood blow in the brain
  • Air pressure devices: commonly used to measure muscle performance

Managing Anxiety with Biofeedback

Worrying is natural. In some cases, anxiety can be beneficial, such as before a big sports event or dance recital. However, some of us are overwhelmed by worry on a daily basis. The worry becomes excessive and can interfere with daily tasks. The anxiety or panic felt is gripping for those who have experienced it.

Having an anxiety disorder is difficult and frustrating. It is considered a silent killer and most people who see you upset will just say &ldquocalm down&rdquo or &ldquostop worrying so much&rdquo and not truly understand.

The feeling anxiety creates and the worried thoughts it causes do not have an immediate &ldquooff&rdquo switch.

The good news is there is a simple, non-drug treatment for the management of anxiety: biofeedback.

The most common types of anxiety disorders are:

  • generalized anxiety disorder (GAD)
  • obsessive-compulsive disorder (OCD)
  • panic disorder
  • post-traumatic stress disorder (PTSD)
  • social anxiety disorder (SAD)
  • specific phobias

Although each anxiety disorder is unique, there is a common thread. The loop of anxiety often looks like this: worried thought -> physiological response -> more worried thoughts -> heightened response.

The physiological response is due to adrenaline and other stress hormones rushing through your body, creating the fight-or-flight stance, regardless of any real threat. The threat is almost always perceived and irrational, and the individual is usually aware of this. Anxiety can cause you to feel &ldquoout of your mind,&rdquo suffocated, scared, upset, stressed, and not in control.

Anxiety is due to environmental causes, genetics, and personal experiences. A common trait among those who have anxiety disorders is the person&rsquos need for control. When the desire to control a situation feels out of reach, this can trigger anxiety.

Highly sensitive people also can experience anxiety in the presence of an overload of stimuli. For example, a person might become overwhelmed and experience panic if they are at a club with loud music, strobe lights, and crowds of people. Even something as harmless as a grocery store can trigger an anxiety attack due to the amount of choices available.

Symptoms vary for each person. They can range from wanting to throw up or wanting to escape, to feeling exhausted, to having migraines, to feeling tense and scared, to feeling like your head is way up in the clouds.

Treating Anxiety Symptoms with Biofeedback

Managing anxiety symptoms is on the path to treating it. For many who suffer from an anxiety disorder, they will usually tell you that it never goes away, but they have learned to control it so that the symptoms are less overwhelming.

Biofeedback therapy is a highly effective research-based treatment for anxiety disorders. The individual is taught how to properly respond to their anxiety and it is one of the ways he or she can learn how to manage and control it without the use of medications.

Biofeedback gives the anxious person the opportunity to view his or her physiological responses to stress. When a person becomes anxious, some of the changes that will be displayed visually and audibly with the use of noninvasive instruments are:

  • increases in heart rate
  • hands becoming cold and clammy
  • rapid or shallow breathing
  • skin temperature
  • muscle tension
  • EEG showing higher activity for hi-beta waves in the brain (these waves increase when the mind is stressed)
  • loss of metabolic activity in frontal lobe (showing higher activity in the emotional centers of the mid-brain)

Biofeedback teaches awareness, profound relaxation skills and ways to manage an anxiety attack, as well as ways to recognize, reduce, and control stress responses. It also teaches the individual how to control the brain&rsquos activity and maintain the proper brainwave levels to achieve a calm and focused state. By returning the body to a healthier physiological state, the &ldquofoggy head&rdquo that anxiety can cause, as well as the feeling of fear and panic throughout the body, are removed.


Biofeedback

• Neurofeedback: the term that typically refers to EEG feedback designed to alter a condition for which there is evidence that it has a neural basis.

• Biofeedback is the general term for any therapeutic intervention that uses medical equipment to monitor a body function that is otherwise outside of our awareness (a blood pressure cuff, a thermometer, a PET scan are all medical devices that can be used for biofeedback interventions).

• Neurofeedback specifically refers to biofeedback interventions using brain wave readings (also called an electroencephalogram).

• Neurofeedback practitioners have to be much more thoroughly trained than biofeedback practitioners, so there's a separate board certification for the specialty.

• Both related to learning theory and based partly on relaxation techniques

• Cbt handbooks do not include chapters on biofeedback, but biofeedback literature continues to recognize the role of cognitive factors in biofeedback interventions

• Behavioral techniques stage: acquiring self regulation
o Practitioner listens to pt's internal dialogue failures in self regulation process can be used as opportunity to learn about possible cognitions that can be discussed and modified

• Cognitive techniques stage: acquiring self regulation
o Cognitive techniques used to achieve relaxation for example, stress inoculation technique: subjects taught to substitute positive self statements and expectations for negative self statements about their ability to relax may teach pt about negative automatic thoughts that interfere with acquiring relaxation skills abc model (actual event, consequence, belief system)
o May also use act: one of main premises of act is the understanding that to try too hard is unproductive. Use biofeedback to convey this act principle to help pt's "let go" and "not try too hard."

• Generalization stage
o Pt should learn to implement self-regulation techniques outside of practitioner's office ex: start in reclining chair, then sitting position in office chair, and later standing up. Pt should practice in more common mental state conditions should ask pt what external and internal conditions thwart self-regulation

• Exposure & desensitization stage
o May integrate various types of exposure into biofeedback practice goal is to achieve a state of relaxation while simultaneously re-creating a real or imaginary stressful scenario in vitro re-creation is sufficient: for ex: a pt who is anxious about taking tests we can train pt's to implement and practice relaxation techniques during difficult situations whether in vivo or vitro. They can advance to the final stage only after they acquire and learn to implement control abilities in stressful situations as well


Hypnosis

Hypnotherapy can be effective in helping individuals to recount memories that too painful to consciously recall

Hypnosis, which some argue is just an extreme sense of relaxation has been effective in reducing pain and managing anxiety symptoms associated with medical procedures (Lang et al., 2000). Through extensive training, an individual can learn to engage in self-hypnosis or obtain recorded hypnosis monologues to assist with management of physiological symptoms outside of hypnosis sessions. While additional research is still needed within the field of hypnosis, studies have indicated that hypnosis is effective in not only treating chronic pain, but also assist with a reduction in anxiety, improved sleep, and improved overall quality of life. (Jensen et al., 2006).


Biofeedback

1. the provision of visual or auditory evidence to a person of the status of an autonomic (involuntary, vital) body function such as heart rate, blood pressure, or respiratory rate, as a method of teaching control of certain visceral responses previously thought to be exclusively dictated by the autonomic nervous system and therefore involuntary or unconscious.

Examples of the kinds of biological feedback that can be provided include information about changes in skin temperature, muscle tonicity, cardiovascular activities, blood pressure, and brain wave activities. With the aid of such sensitive electronic equipment as the electrocardiograph, electromyograph, and electroencephalograph, it is possible for the person to become consciously aware of the response being measured and to learn to control it. The feedback may be presented in the form of musical tones, lights, or direct visualization of scales or meters which indicate variance in the response.

In clinical biofeedback, the patient must practice the particular desired response many times under the supervision of professional persons who are skilled in the techniques of psychophysiology. An example in which biofeedback may be used clinically is in the treatment of raynaud's disease , in which the patient learns to consciously raise skin temperature in the extremities and thus reduce vasoconstriction.


Effect of Heart Rate Variability Biofeedback on Sport Performance, a Systematic Review

Aim is to determine if the training with heart rate variability biofeedback allows to improve performance in athletes of different disciplines. Methods such as database search on Web of Science, SpringerLink, EBSCO Academic Search Complete, SPORTDiscus, Pubmed/Medline, and PROQUEST Academic Research Library, as well as manual reference registration. The eligibility criteria were: (a) published scientific articles (b) experimental studies, quasi-experimental, or case reports (c) use of HRV BFB as main treatment (d) sport performance as dependent variable (e) studies published until October 2016 (f) studies published in English, Spanish, French or Portuguese. The guidelines of the PRISMA statement were followed. Out of the 451 records found, seven items were included. All studies had a small sample size (range from 1 to 30 participants). In 85.71% of the studies (n = 6) the athletes enhanced psychophysiological variables that allowed them to improve their sport performance thanks to training with heart rate variability biofeedback. Despite the limited amount of experimental studies in the field to date, the findings suggest that heart rate variability biofeedback is an effective, safe, and easy-to-learn and apply method for both athletes and coaches in order to improve sport performance.

Keywords: Athletes Autonomic nervous system Biofeedback Heart rate variability Sport performance.


The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis

Some evidence suggests that heart rate variability (HRV) biofeedback might be an effective way to treat anxiety and stress symptoms. To examine the effect of HRV biofeedback on symptoms of anxiety and stress, we conducted a meta-analysis of studies extracted from PubMed, PsycINFO and the Cochrane Library.

The search identified 24 studies totaling 484 participants who received HRV biofeedback training for stress and anxiety. We conducted a random-effects meta-analysis.

The pre-post within-group effect size (Hedges' g ) was 0.81. The between-groups analysis comparing biofeedback to a control condition yielded Hedges' g = 0.83. Moderator analyses revealed that treatment efficacy was not moderated by study year, risk of study bias, percentage of females, number of sessions, or presence of an anxiety disorder.

HRV biofeedback training is associated with a large reduction in self-reported stress and anxiety. Although more well-controlled studies are needed, this intervention offers a promising approach for treating stress and anxiety with wearable devices.


Career Overview

Biofeedback school is becoming increasingly popular in a number of health and medical spheres, including physical therapy, psychology, nursing and respiratory therapy. Biofeedback is used to treat a range of ailments, from high blood pressure to pelvic muscle dysfunction, without the assistance of drugs.

Practitioners of biofeedback therapy often work in hospitals, medical offices or physical therapy clinics. During a biofeedback session, which typically lasts 30 to 60 minutes, the therapist will use techniques such as temperature biofeedback and heart rate variability biofeedback to help attune patients to the body’s physiological reactions.


Example of BFRT Protocol

When using BFRT, it is first necessary to determine whether the client would benefit from such therapy. General relaxation may be helpful in a variety of conditions and it may also be useful as an incompatible response during such procedures as systematic desensitization. BFRT normally takes between 8 and 20 sessions, depending on the acquisition skills and the distress level of the client before and during therapy. After determination of the need for BFRT, the therapist must explain the rationale for biofeedback therapy, outline the basic aspects of the physiological processes that will be trained, and discuss the potential benefits and risks of the training. This author recommends conducting the first BFRT session with frontal EMG feedback while monitoring other modalities such as finger temperature, SCA, and/or heart rate. During the first biofeedback session, facial muscle discrimination training should be demonstrated and the client should be provided time to use his or her relaxation techniques to reduce frontal EMG levels. The therapist should monitor the other modalities during the session to observe the changes that occur as the client tries to reduce frontal EMG levels. The value of monitoring other modalities is that, for instance, by observing sweat gland activity, it can be determined whether the client is engaging in arousing internal dialogue by noting whether several short duration responses are observed. If so, the therapist could interrupt the session and suggest a change in strategy by the client. During the interruption, the therapist should ask the client what strategy he or she was using and then encourage him or her to select a different strategy, such as diaphragmatic breathing or changes in imagery. The most labile physiological process is usually selected as the target of biofeedback therapy after frontal EMG levels are acceptable.

Another example of an often-used biofeedback procedure is QEEG feedback for treatment of ADHD: First, it is helpful to explain that the QEEG is different than the traditional EEG. The QEEG is the EEG after it has been digitized through the use of an analogue-to-digital converter. This process allows the mathematical determination of the characteristics of specific frequencies. Children with ADHD have been shown to have different patterns of brain waves then non-ADHD children of the same age. The diagnosed children have more electrical activity in the slow frequency range, such as theta (4-8 Hz) and alpha (8—12 Hz), and fewer in the fast frequency range, such as sensorimotor rhythm (SMR 12-15 Hz) and beta (16-30 Hz). The biofeedback technique trains for a decrease in theta or alpha and an increase in SMR or beta. The treatment protocol requires a QEEG assessment to determine which specific frequencies will need to be trained. Several studies clearly demonstrate that the QEEG patterns change according to the direction of training for some children and that clinical improvements are observed with successful training. The number of sessions necessary is usually 40-60, depending on how quickly the QEEG changes. See Lubar (2003) and Lubar and Lubar (1999) for further information.


Watch the video: BIOFEEDBACK VERIM, ΒΙΟΑΝΑΔΡΑΣΗ-ΧΑΛΑΡΩΣΗ ΗΛΕΚΤΡΟΔΕΡΜΙΚΗ (June 2022).


Comments:

  1. Macauliffe

    Faced with the problem of choice (whether we are making a large purchase or buying a nice trinket), it is important for us to know about the qualities of the product. Expert advice, which can be found in each article posted on this site, will help you to understand the whole variety of goods or services.

  2. Iomar

    I have a similar situation. Let's discuss.

  3. Zululmaran

    Problem is, a quick answer :)

  4. Rexford

    It makes no sense.

  5. Mikara

    I mean, you allow the mistake. I can prove it. Write to me in PM, we will handle it.

  6. Fuller

    I doubt that.

  7. Peer

    This is the sentence simply incomparable)



Write a message