Biofeedback

Question 1

overview –> why is biofeedback used

Answer 1

enable pt to gain some element of voluntary over mm

Question 2

overview

Answer 2

produces auditory or visual stimuli

pt receives no electricity –> instead physiologic process is recorded

pt has to be able to actively participate

Question 3

indications

Answer 3

improve mm activation for orthopedic or neurologic dysfunction

retraining of mm activation

coordination of mm activation

relaxation mm training

muscle re-education

maintenance of mm contractions

Question 4

contraindications

Answer 4

NONE

Question 5

precautions

Answer 5

skin irritation from gel or tape from prolonged use

deep relaxation for diabetes can adversely affect metabolic levels –> just use with caution

Question 6

what happens during biofeedback

Answer 6

unit process an EMG signal and produce either visual or auditory feedback which is proportional to the input signal

electrodes record summated info from mm sensors

Question 7

visual cues

Answer 7

meter readouts

flashing lights

computer screens

Question 8

auditory cues

Answer 8

clicks

changing tones

Question 9

instructions

Answer 9

explain to pts

select muscle to be activated

make sure everything is clean and free or residue

prep skin w/ alc

secure sensor to pt –> generally 1-5 cm apart

Question 10

EMG electrodes

Answer 10

skin surface electrodes

some electrodes permanently attach to cable wires while others may snap onto the wire

some units include a set of 3 electrodes pre-placed on a velcro band which attaches to the skin

increasing size of electrodes does not increase amplitude of the signal

electrodes may be disposable or non-disposable

require some type of conducting gel

Question 11

size of electrodes

Answer 11

varies

4 mm diameter for small muscle activity

12.5 mm diameter for large muscles

Question 12

separation and amplification of EMG activity

Answer 12

2 active electrodes

1 reference electrode

active electrodes pick up electrical activity from motor units firing in the muscles beneath the electrodes

Question 13

gain

Answer 13

the relationship b/w the input signal and output amplitude of the amplifier

factor by which the input signal is multiplied to obtain output

Question 14

gain –> signal in controlled by

Answer 14

changing the gain or sensitivity

Question 15

gain –> biofeedback units range in sensitivity from

Answer 15

0-1

0-10

0-100

0-1000 uv

Question 16

gain pt 2

Answer 16

asses the pts ability to control the targeted muscle in order to properly adjust the sensitivity of the biofeedback unit

Question 17

gain example

Answer 17

if pt is just learning to recruit a muscle and the muscle is producing only 5 uv of the activity

the appropriate range would be 0-10 uv

Question 18

gain –> if goal is to relax

Answer 18

choose to have the auditory or visual cue turned on when the EMG activity exceeds the set threshold

have cues turned off w/ relaxation

signal is set to a point below the threshold