Biofeedback in Physical Therapy

The English word feedback is translated into our language as feedback or feedback. It provides the correction of the information error in the output by giving the information at the output of a system back to the input. The term biofeedback, on the other hand, means that certain functions that occur in the human body, generally without the awareness of the person, are detected by electronic receivers and given real-time audio-visual-tactile feedback. In recent years, methods that give feedback with virtual reality technology have also been developed.

What is Biofeedback?

Biofeedback is a technique that helps control some functions of the body. Functions such as heart rate, skin temperature, blood pressure are automatically controlled by the nervous system. Activities such as exercise, psychological factors such as excitement or nervousness affect the autonomic functions we mentioned. Biofeedback method can be used to increase control over these functions, which normally do not have voluntary control. It has been found to be effective in curing problems such as muscle weakness, spasticity and balance disorder in neurological problems such as stroke, brain damage and MS. Biofeedback can be useful in the treatment of problems such as chronic pain, migraine-type headaches, urinary incontinence, high blood pressure, and stroke due to brain damage.

Some electrical sensors are often used to measure the state of the body during biofeedback. Thus, small changes that are normally difficult to notice, such as contraction or relaxation of certain muscles, can be detected. With biofeedback, people can learn to control a muscle unit (motor unit) connected to a single nerve cell. Ultimately, goals such as increasing physical performance or improving health can be achieved.

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Types of Biofeedback

Many measurable variables in the body can be used for biofeedback purposes. Finger or wrist-worn sensors can record parameters such as heart rate and skin changes. Head-mounted tape or head-shaped sensors can measure brain waves. Wearable sensors can record variables such as balance, posture, range of motion.

  • Electromyography (EMG): Measures muscle tension and contraction.
  • Thermal biofeedback: Measures skin temperature.
  • Neurofeedback/electroencephalography (EEG): Records brain wave activity.
  • Electrodermography (EDG): The electrical activity of the skin is measured.
  • Heat flow: It measures the heat distribution in the body.
  • Pneumography: Measures abdominal and thoracic movements during breathing.
  • Capnometer: It measures the level of CO2 in the exhaled breath.
  • Hemoencephalography: It measures the relative oxygenation rate in the cerebral circulation based on the difference in the color of the light reflected from the scalp.
  • Photoplethysmograph (PPG): Measures peripheral blood flow, heart rate, and heart rate variability.

The fact that many different measurements can be used for biofeedback opens the door to different application areas. EMG-biofeedback is most commonly used in physical therapy. It is not used alone, but in combination with other therapy methods within the framework of rehabilitation goals, to strengthen their effect. With biofeedback, it may be advantageous for the patient to focus on their own performance, apart from the physiotherapist’s guidance. Thus, the patient can take some control over his own healing process. When the voluntary control of the targeted functions with biofeedback is achieved, the dependency on the device is also eliminated. Other advantages are that it is a non-invasive method, no medication, and no side effects.

Main Uses

  • Stress incontinence (incontinence in cases such as coughing, sneezing) treatment
  • Migraine and tension-type headaches
  • stroke rehabilitation
  • Peripheral nerve injuries
  • spinal cord injuries
  • Cerebral palsy
  • Spazmodik tortikollis
  • Facial paralysis
  • Multiple skleroz
  • orthopedic rehabilitation
  • Fibromyalgia
  • chronic pain
  • Neck pain
  • Backache
  • post traumatic stress syndrome
  • Anxiety
  • Irritable Bowel Syndrome
  • temporomandibular joint disorder
  • Hypertension
  • balance disorder
  • attention deficit and hyperactivity disorder
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How Is Biofeedback Done?

In accordance with the technique used, sensors are placed on the body. These are usually pads that are attached to the skin, but they can be of different types. Thus, the body’s response is precisely measured. Measurements are given by visual, auditory or tactile feedback. For example, when the right muscle is contracted during exercise, a sound alert comes. Or someone with a tension headache learns to relax their tense muscles with this method. A person learns to control his body’s response by changing his feelings, thoughts or behaviors. A typical session takes between 30-60 minutes. The duration of treatment varies according to the disease and the current condition of the person.

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