The lecture describes basics of Biofeedback and Role in Physiotherapy

2. Dr. Deepak Anap
Associate Professor
COPT,PDVVPF,COPT,Ahmednagar

3. What is Biofeedback ?
 Procedure by which information about ‘ Physiological function ‘ is
fed back to the individual by means of an auditory or visual signal.
 When presented with this visual or auditory feedback the patient
can attempt to modify the activity.

4. BIOPHYSICAL PRINCIPLES
Biofeedback units operate on one (or more) of four
principles
EMG
Measure electrical activity
Implanted or surface electrodes
Galvanic Skin Response
Measures production of sweat

5. Peripheral Temperature
Measure changes in temperature of the distal
extremities
Increased temp = systemic relaxation
Photoplethysmography
Measures the amount of light reflected by
subcutaneous tissues Ex. Pulse oximeter

6. EMG Biofeedback
Measure electromyographic activity (EMG) indicating
amount of electrical activity during muscle contraction
Most common type of biofeedback used in athletic
training and physiotherapy Rehabilitation

7. EMG Biofeedback
• Nerve fiber conducts an impulse to the neuromuscular junction
where acetylcholine binds to receptor sites on the sarcolemma
inducing a depolarization of the muscle fiber
• Changes in electrochemical potential difference associated with
depolarization can be detected by an electrode placed in close
proximity

8. s
Measuring Electrical Activity
• EMG does not measure muscle contraction directly
• EMG biofeedback unit receives small amounts of
electrical energy generated during muscle
contraction (via the electrodes)
• Separates or filters electrical energy from other
extraneous electrical activity (non meaningful)on
skin
• Amplifies the EMG electrical energy and converts it
to some type of information which has meaning to
the patient
- Meter, auditory signal, light display

10. EMG Biofeedback

11. Electrodes
Basic units have one channel composed of three
surface electrodes on a self-adhesive electrode
“Active” Electrodes
Detect electrical signal
“Reference” Electrode
Filters nonmeaningful information

12. © 2004
The Process
Identify Signal
Get the eletromyographic signal from the
body
Amplify Signal
Filter out background noise
Similar to a volume control on a radio,
enhance the strength of the signal to
meaningful levels
Rectify Signal
Make all values “positive”
Integrate Signal
Group the data into meaningful
clusters

14. • The Stabilizer monitors the position of the low back or cervical spine
during muscle testing to determine if the patient is able to selectively
isolate their cervical or lumbopelvic core stabilization muscles.
• When used during exercise, the Stabilizer provides a patient feedback
as to when they have isolated and are maintaining a contraction of
either the cervical or lumbopelvic core stability muscles.
Pressure Biofeedback

16. Clinical Applications
Muscle re-education
 Isometric contractions sustained for 6-10
sec
 Tx time = 5-10 min
Relaxation of muscle guarding/Pain control
 Concentrate on muscle relaxation

17. Indications:
• Muscle re-education
• Regaining neuromuscular control
• Increasing isometric/isotonic strength
• Relaxation of muscle spasm/guarding
• Pain reduction

18. Contraindications
• Any musculoskeletal condition in which a muscle
contraction may exacerbate the condition
• Unhealed tendon grafts
• Avulsed tendons
• Third degree tears of muscle fibers
• Unstable fracture
• Injury to joint structure, ligaments, capsule, or
articulating surface