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Slide 2 Biofeedback student:Arman Ashrafi teacher:Dr.a.arshi Slide 3 Biofeedback is a treatment technique in which people are trained to improve their health by using signals from their own bodies. Physical therapists use biofeedback to help stroke victims regain movement in paralyzed muscles. Psychologists use it to help tense and anxious clients learn to relax. Specialists in many different fields use biofeedback to help their patients cope with pain. Slide 4 Slide 5 DEFINITION Three professional biofeedback organizations, the Association for Applied Psychophysiology and Biofeedback (AAPB), Biofeedback Certification International Alliance (BCIA), and the International Society for Neurofeedback and Research (ISNR), arrived at a consensus definition of biofeedback in 2008: is a process that enables an individual to learn how to change physiological activity for the purposes of improving health and performance. Precise instruments measure physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature. These instruments rapidly and accurately 'feed back' information to the user. The presentation of this information often in conjunction with changes in thinking, emotions, and behavior supports desired physiological changes. Over time, these changes can endure without continued use of an instrument. Slide 6 4 kind of common biofeedback modeling Slide 7 Electromyograph An electromyograph (EMG) uses surface electrodes to detect muscle action potentials from underlying skeletal muscles that initiate muscle contraction. Clinicians record the surface electromyogram (SEMG) using one or more active electrodes that are placed over a target muscle and a reference electrode that is placed within six inches of either active. The SEMG is measured in microvolts (millionths of a volt).electromyographEMG Biofeedback therapists use EMG biofeedback when treating anxiety and worry, chronic pain, computer-related disorder, essential hypertension, headache (migraine, mixed headache, andtension-type headache), low back pain, physical rehabilitation (cerebral palsy, incomplete spinal cord lesions, and stroke), temporomandibular joint disorder (TMD), torticollis, and fecal incontinence, urinary incontinence, and pelvic pain. Slide 8 Electrodermograph An electrodermograph (EDG) measures skin electrical activity directly (skin conductance and skin potential) and indirectly (skin resistance) using electrodes placed over the digits or hand and wrist. Orienting responses to unexpected stimuli, arousal and worry, and cognitive activity can increase eccrine sweat gland activity, increasing the conductivity of the skin for electrical current. Biofeedback therapists use electrodermal biofeedback when treating anxiety disorders, hyperhidrosis (excessive sweating), and stress. Electrodermal biofeedback is used as an adjunct to psychotherapy to increase client awareness of their emotions.In addition, electrodermal measures have long served as one of the central tools in polygraphy (lie detection) because they reflect changes in anxiety or emotional activation. Slide 9 Electroencephalograph An electroencephalograph (EEG) measures the electrical activation of the brain from scalp sites located over the human cortex. The EEG shows the amplitude of electrical activity at each cortical site, the amplitude and relative power of various wave forms at each site, and the degree to which each cortical site fires in conjunction with other cortical sites (coherence and symmetry).electroencephalograph Neurotherapists use EEG biofeedback when treating addiction, attention deficit hyperactivity disorder (ADHD), learning disability, anxiety disorders (including worry, obsessive-compulsive disorder and posttraumatic stress disorder), depression, migraine, and generalized seizures. Electrocardiograph The electrocardiograph (ECG) uses electrodes placed on the torso, wrists, or legs, to measure the electrical activity of the heart and measures the interbeat interval (distances between successive R- wave peaks in the QRS complex). The interbeat interval, divided into 60 seconds, determines the heart rate at that moment. The statistical variability of that interbeat interval is what we call heart rate variability.. Biofeedback therapists use HRV biofeedback when treating asthma, COPD, depression, fibromyalgia, heart disease, and unexplained abdominal pain Slide 10 . Applications Urinary incontinence Mowrer detailed the use of a bedwetting alarm that sounds when children urinate while asleep. This simple biofeedback device can quickly teach children to wake up when their bladders are full and to contract the urinary sphincter and relax the detrusor muscle, preventing further urine release. Through classical conditioning, sensory feedback from a full bladder replaces the alarm and allows children to continue sleeping without urinating. KegelKegel developed the perineometer in 1947 to treat urinary incontinence (urine leakage) in women whose pelvic floor muscles are weakened during pregnancy and childbirth. The perineometer, which is inserted into the vagina to monitor pelvic floor muscle contraction, satisfies all the requirements of a biofeedback device and enhances the effectiveness of popular Kegel exercises.Contradicting this, a 2013 randomized controlled trial found no benefit of adding biofeedback to pelvic floor muscle exercise in stress urinary incontinence. In anotherrandomized controlled trial the addition of biofeedback to the training of pelvic floor muscles for the treatment of stress urinary incontinence, improved pelvic floor muscle function, reduced urinary symptoms, and improved of the quality of life.urinary incontinencerandomized controlled trialstress urinary incontinencerandomized controlled trialtraining of pelvic floor musclesstress urinary incontinence Slide 11 moss, levaque, and hammond (2004) observed that biofeedback and neurofeedback seem to offer the kind of evidence-based practice that the health care establishment is demanding. from the beginning biofeedback developed as a research-based approach emerging directly from laboratory research on psychophysiology and behavior therapy, the ties of biofeedback/neurofeedback to the biomedical paradigm and to research are stronger than is the case for many other.behavioral interventions Clinical effectiveness Slide 12 EMG use in biofeedback