Biofeedback

Question 1

What is biofeedback?

Answer 1

Referes to techniques that provide information to the user about their own physiological/biomechanical process as a means of improving self-awareness and control

Question 2

What kind of modalities does not transfer energy to its target tissue?

Answer 2

Biofeedback

Question 3

What is direct biofeedback?

Answer 3

Produce an accurate representation of the process being recorded

Question 4

What is an example of direct biofeedback?

Answer 4

Heart rate monitor

Question 5

What is transformed biofeedback?

Answer 5

Provided a representation (visual, auditory, etc. of the process being recorded

Question 6

What is an example of transformed biofeedback?

Answer 6

EMG

Question 7

What does EMG stand for?

Answer 7

ElectroMyoGraphic

Question 8

What is EMG?

Answer 8

Technique used to evaluate and record muscle activity produced by skeletal muscle

Question 9

What is feedback?

Answer 9

Providing information to a patient about the patient’s state/activity

Question 10

What is depolarization in terms of EMG?

Answer 10

When a muscle is detected by an electrode placed in close proximity on the surface of a patient’s skin

Question 11

What is gain (µV)?

Answer 11

Determines the sensitivity of a device or its ability to reflect various levels of electric (ions) activity

Question 12

The higher the _______ _______, the higher the _________ of an EMG device

Answer 12

Gain setting, sensitivity

Question 13

What is increased gain?

Answer 13

=Increased sensitivity = Small changes in electrical activity produce an EMG signal

Question 14

What is decreased gain?

Answer 14

Small changes will not be detected

Question 15

What is peak amplitude?

Answer 15

Highest EMG activity (µV) recorded during a muscle contraction. Max contraction force represented by myoelectrical activity

Question 16

What does peak amplitude demonstrate?

Answer 16

How strong of a contraction the patient is able to create

Question 17

What is threshold amplitude (µV)?

Answer 17

-Target or goal amplitude of volitional contraction
-Usually initially set between rest and normal

Question 18

What is the EMG amplitude for a muscle at rest?

Answer 18

2 µV

Question 19

What is the EMG amplitude for a muscle contraction?

Answer 19

20 to 30 µV

Question 20

What is contraction latency?

Answer 20

Time it takes muscle to reach peak amplitude following command to contact muscle (~5 sec)

Question 21

What is return latency?

Answer 21

Time from command to stop a muscle contraction to the point when myoelectric activity returns to baseline (~1 sec)

Question 22

What is hold capacity?

Answer 22

Time during a consistent EMG amplitude (sustained contraction of muscle) is observed

Question 23

What does hold capacity measure?

Answer 23

Fatiguability of a muscle

Question 24

What is the use of EMG biofeedback?

Answer 24

Provided information to the user of amount of volitional alteration of myoelectrical activity

Question 25

Why is the use of EMG biofeedback helpful to the patient?

Answer 25

The help the patient patient learn how to increase or decrease muscle activity

Question 26

What is the order of a closed loop?

Answer 26

Physiological signal --> patient response --> detection and feedback

Question 27

What type of loop does biofeedback utilize?

Answer 27

Closed loop

Question 28

What is the order of open loop?

Answer 28

Physiological signal --> patient response

Question 29

What are the two types of feedback?

Answer 29

Negative feedback (Inhibition) Positive feedback (Facilitation)

Question 30

What are some clinical indications for biofeedback?

Answer 30

Training the patient to develop internal cues Train the patient to regain voluntary control

Question 31

What are some training techniques that encourage biofeedback?

Answer 31

Use of mirrors Use of manual tapping cues Verbal cues/auditory cues Guided movements

Question 32

What conditions has indicated benefit for EMG?

Answer 32

Hemiplegia Quadriceps strengthening Headache Pelvic floor disorders Chronic pain conditions TMJ disorderes

Question 33

Why is biofeedback benifical for TMJ disorders?

Answer 33

Helps with decreasing myofascial or muscular pain and improving mandible opening compared to placebo or splinting

Question 34

What are the device characteristics for biofeedback?

Answer 34

Mode of feedback Threshold Gain/sensitivity

Question 35

What is low gain useful for?

Answer 35

Muscle re-education

Question 36

What is high hain useful for?

Answer 36

Relaxation training

Question 37

What are the different types of visual cues?

Answer 37

Flashing lights Meter read outs Oscilloscope Computer screens

Question 38

What are the different types of auditory cues?

Answer 38

Changing tones Clicks

Question 39

How many electrodes does biofeedback need for application?

Answer 39

3

Question 40

What is the 3rd electrode used for EMG?

Answer 40

It indicates a reference which can be placed between or adjacent to active electrodes

Question 41

What does the 3rd electrode eliminate in biofeedback?

Answer 41

Noise from other muscle groups

Question 42

What are contraindications of EMG biofeedback?

Answer 42

Dermatological conditions Allergy to electrode Impaired mentation No electrodes over eyes Acute inflammatory conditions Pregnancy Bladder or vaginal infection An MSK condition that gets worse with a muscle contraction

Question 43

What are precautions for EMG biofeedback?

Answer 43

Impaired sensation Sensitive skin Epilepsy