Biofeedback Notes

Question 1

What is biofeedback?

Answer 1

The use of electronic instruments to provide objective info to an individual about a physiologic function or response so they can become aware of their response

Question 2

How does biofeedback help patients following an injury or dysfunction?

Answer 2

Helps them develop greater voluntary control through neuromuscular relaxation or muscle re-education

Question 3

Clinicians are instruments of biofeedback (T/F)

Answer 3

True

Question 4

Feedback includes what 2 types of information

Answer 4

1. Sensations associated with movement

2. Result of action relative to some goal or objective

Question 5

When does feedback occur?

Answer 5

Before, during, and after a motor movement, it is ongoing

Question 6

What are the types of Intrinsic Feedback?

Answer 6

Kinesthetic
Visual
Cutaneous
Vestibular
Auditory

Question 7

What are the types of Extrinsic Feedback?

Answer 7

Knowledge of results
Verbally
Mechanically
Electronically

Question 8

What is an advantage to biofeedback?

Answer 8

Patient can make small changes in performance that are immediately noted and rewarded

Question 9

What is the ultimate goal in using biofeedback?

Answer 9

To teach the patient to perceive the changes without the use of the instrument

Question 10

What 4 words are used to describe EMG biofeedback?

Answer 10

Sensitive
Objective
Accurate
Quantitative

Question 11

What does peripheral skin temperature measure?

Answer 11

Vasoconstrict/dilation

Question 12

What does finger phototransmission measure?

Answer 12

Vascoconstrict/dilation

Question 13

What does skin conductance activity measure?

Answer 13

sweat gland activity

Question 14

What does electoencephalograph (EEG) measure?

Answer 14

brain’s spontaneous electrical activity over a period of time

Question 15

What does electromyographic activity measure?

Answer 15

electrical activity during muscle contraction

Question 16

What comprises a motor unit?

Answer 16

Individual muscle fibers and the nerve the innervates it

Question 17

The amount of tension developed in a muscle is proportional to _______.

Answer 17

The number of active MUs

Question 18

What does the MU recruitment pattern depend upon?

Answer 18

• Inherent properties of specific motor neurons
• Force required during the activity
• Speed of the contraction

Question 19

Which MU’s are recruited first?

Answer 19

smaller

Question 20

Which MU’s produce greatest tension?

Answer 20

larger

Question 21

Which MU’s do fast contractions excite?

Answer 21

Larger, depress smaller

Question 22

What does biofeedback actually measure?

Answer 22

electrical activity associated with muscle contraction, not the contraction itself

Question 23

All biofeedback readings can be compared (T/F)

Answer 23

False, only when same equipment is used for all readings

Question 24

What is the first step once the electrical activity has been detected by the electrodes?

Answer 24

the extraneous electrical activity, aka noise, needs to be removed

Question 25

What does the differential amplifier do?

Answer 25

Takes two signals and subtracts the signal of one active electrode from the other, cancels anything that they have in common, amplifying the difference

Question 26

What is the Common Mode Rejection Ratio (CMRR)?

Answer 26

The ability of the differential amplifier to eliminate the noise between the active electrodes

Question 27

What type of voltage is the raw EMG?

Answer 27

alternating

Question 28

What does rectification do?

Answer 28

Flips the negative pole to create a pulsed direct current

Question 29

What does smoothing do?

Answer 29

Eliminates the high-frequency fluctuations that are produced

Question 30

What does integration do?

Answer 30

Measures the area under the curve for a specific period of time, forms quantification

Question 31

What 3 questions must be asked to know if a patient is appropriate for biofeedback?

Answer 31

1. Do they have a motor impairment that would suggest the info provided would be of benefit? 2. Do they have voluntary control? 3. Are they motivated and cognitively aware?

Question 32

Conditions that could benefit from Biofeedback

Answer 32

``` Anxiety or stress Asthma Chemotherapy side effects Chronic pain Constipation High blood pressure Incontinence Irritable bowel syndrome Raynaud's disease ```

Question 33

Indications

Answer 33

``` Muscle re-ed Regaining n/m control Increasing isometric/tonic strength Decrease mm guarding Pain reduction Relaxation of mm spasm Psychological relaxation ```

Question 34

Contraindications

Answer 34

Any m/s condition that a muscular contraction might exacerbate

Question 35

What are the appeals for biofeedback?

Answer 35

``` Non-invase May reduce/eliminate need for meds Treatment alternative to meds Option if meds don't work well Alternative to meds during pregnancy Helps people take charge of their health ```

Question 36

What type of electrodes are used?

Answer 36

surface, 4mm - 12.5 mm

Question 37

What type of feedback does biofeedback provide?

Answer 37

Visual and auditory

Question 38

What are the ranges for signal sensitivity?

Answer 38

1 - 100 microvolts

Question 39

Which sensitivity is best for muscle relaxation? Re-ed?

Answer 39

Muscle relax = high | Muscle re-ed = low

Question 40

What are the training strategies that should be used with biofeedback?

Answer 40

- consider all factors related to learning theory - positive reinforcement - obtainable short and long term goals - appropriate sequencing and progression

Question 41

What are some unique uses for biofeedback?

Answer 41

- pelvic floor dysfunction - stress urinary incon - fecal incon - ED