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Biofeedback

Biofeedback

Extract

Extract from ongoing clinical study…

Authors: 
Mgr. Jaroslava Pochmonová, Ph.D.
Bc. Anežka Tomková
Bc. Josef Srnec

Was ist Biofeedback?

Biofeedback (biological feedback) is a therapeutic process enabling individual teaching to improve health and performance. Body parameters of individual are monitored in real time and presented in appropriate form. Presentation of information, often in conjunction with changes in thinking, emotions and behavior supports desirable physiological changes over time. These changes can then endure without additives source. (Association for applied psychophysiology and biofeedback, 2017) Biofeedback is a form of external feedback, that instead of using their own sensor sources receive information about movement from external surroundings in the form of visual, sound or tactile feedback. It does not consist of instructions obtained before performing the motion. (Barbosa, Santos, Martins, 2015) 

In external form the feedback combines providing information to achieve optimal result (knowledge of results) which can be a huge motivating factor in indicated cases using information helping to obtain optimal performance process (knowledge of performance). Individual is then learning how to work with each parameter, control them by his own will and with that participating on ongoing treatment process. There is a transfer of autonomic physiological processes on a conscious level using classical conditioning (Švíglerová, 2009).

Anwendungen

Biofeedback (biological feedback) is a therapeutic process enabling individual teaching to improve health and performance. Body parameters of individual are monitored in real time and presented in appropriate form. Presentation of information, often in conjunction with changes in thinking, emotions and behavior supports desirable physiological changes over time. These changes can then endure without additives source. (Association for applied psychophysiology and biofeedback, 2017) Biofeedback is a form of external feedback, that instead of using their own sensor sources receive information about movement from external surroundings in the form of visual, sound or tactile feedback. It does not consist of instructions obtained before performing the motion. (Barbosa, Santos, Martins, 2015) 

In external form the feedback combines providing information to achieve optimal result (knowledge of results) which can be a huge motivating factor in indicated cases using information helping to obtain optimal performance process (knowledge of performance). Individual is then learning how to work with each parameter, control them by his own will and with that participating on ongoing treatment process. There is a transfer of autonomic physiological processes on a conscious level using classical conditioning (Švíglerová, 2009).

Prinzipien und Effekte

Virtual reality applies game features of biofeedback and supports maximal level of motivation and attention of neuroplastic change. In a neurophysiological point of view, using sufficient motivation helps to change teaching process using cholinergic telencephalon system. Specifically, we are talking about the influence of opioid receptors in visual, auditory and somatosensory cortex. That leads individuals to prefer new and easily interpreted subjects. It has been experimentally verified that the administration of acetylcholine agonists accelerates the learning process. Use of feedback also improves the retention of newly learned skills through the creation of new sensory memory traces. This process is made possible by Wolf (1983), thanks to the activation of unused synapses in motion control and provides the ability to perform subsequent movement without biofeedback.

According to Schuemie et al. (2001) game features immersing individual to the game and improving his presence in the game improves dramatically his motoric performance. Due to a present knowledge about neuroplasticity, using virtual reality is suitable even for a chronic stage of the disease. This statement is supported by studies in patients after stroke focused on walking and activation of the upper limb.

Neuroplaszität

Studies regarding stability and walking parameters of patients in chronic phase after stroke leads to a better result in a studied group, that in addition to convective therapy also underwent therapy using virtual reality. “Lifelong ability of nerve cells in the brain is to build, rebuild, repair and disturb their tissue.” (Benesova, Preiss, Kulišťák, 2009) Plasticity can be defined as a adaptation ability on each task in different environment. Adequate exercise can lead to a structural and functional rebuilds in brain tissue. The mechanism of neuroplasticity is a short-term strengthening of synaptic connections and long-term structural changes in the organization and the number of connections between neurons. Similar changes have been described regarding part of the brain called hippocampus, which is related to the formation and remembering of certain types of memory.

The base of induced restitution of motor functions is mainly cortical remapping and changes in balance between the two hemispheres. Some of the processes are also similar to motoric learning of healthy individuals, because it regards controlled and forced change of arousal therapy stimulating the motor areas.

In present, there exists a lot of procedures for inducing these neuroplastic changes. One of them is a therapy using virtual reality, described above. This therapy supports processes inducing neuroplastic changes by increasing motivation and attention of patient using game features. The influence of attention and motivation on learning processes has been studied for a long time.

Magazine Physical Therapy has published a study in March 2015 showing the importance of virtual reality as a way to rehabilitate upper limbs of patients after brain injury. The study has shown that traditional rehabilitation procedures have not achieved that many result as a therapy using features of virtual reality.

Burget (2015) in his review article writes about using biofeedback in verticalization of patients after stroke. He used posturographic platforms that shows both limb load. Patients could then control weight distribution and training weight transmission on paretic limb using feedback. Tate (2010) in his study writes about training patients walk after stroke and shows the improve of walking speed by 33 % and prolonging footsteps distance by 79 % of patients using biofeedback in contrary to group of patients exercising without it, whose speed increased only by 5 % and footsteps distance by 43 %.

Begrenzungen

Some studies shows that feedback should not be used for every exercise because if it is used too often, patients becomes „addicted“ and it deteriorates their capability of their own movement coordination by decreasing their internal feedback from receptors.