Auditory Biofeedback Research Articles

Biofeedback flutter device for managing the symptoms of patients with COPD.

Flutter is a device used in removing excess lung secretions. The conventional flutter lacks a biofeedback component to facilitate optimal use by the patients. The current research aims to compare the effects of biofeedback flutter devices with the conventional flutter in managing the symptoms of patients with chronic obstructive pulmonary diseases. One hundred and sixty-eight participants were randomly allocated into four groups: Group A (conventional), Group B (visual biofeedback), Group C (auditory biofeedback) and Group D (visual and auditory biofeedback). All groups were treated five days for 20 minutes. Outcome measures included wet sputum weight [during intervention (T1) and 1 hour after intervention (T2)], oxygen saturation and dyspnea score (before and after intervention) on all days. The wet sputum expectorated (T2) by Group B was significantly higher than Group A (P< 0.001), Group C (P< 0.001) and Group D (P< 0.05). The dyspnea score for Group B (P< 0.05), Group C (P< 0.05) and Group D (P< 0.05) was significantly lower than Group A. The post-intervention oxygen saturation level was higher in Group D followed by Groups B, C and A. The use of biofeedback flutter is effective in the removal of secretion, reducing dyspnea and improving oxygen saturation when compared to conventional flutter.

Changing accommodation behaviour during multifocal soft contact lens wear using auditory biofeedback training

Biofeedback training has been used to access autonomically-controlled body functions through visual or acoustic signals to manage conditions like anxiety and hyperactivity. Here we examined the use of auditory biofeedback to improve accommodative responses to near visual stimuli in patients wearing single vision (SV) and multifocal soft contact lenses (MFCL). MFCLs are one evidence-based treatment shown to be effective in slowing myopia progression in children. However, previous research found that the positive addition relaxed accommodation at near, possibly reducing the therapeutic benefit. Accommodation accuracy was examined in 18 emmetropes and 19 myopes while wearing SVCLs and MFCLs (centre-distance). Short periods of auditory biofeedback training to improve the response (reduce the lag of accommodation) was performed and accommodation re-assessed while patients wore the SVCLs and MFCLs. Significantly larger accommodative lags were measured with MFCLs compared to SV. Biofeedback training effectively reduced the lag by ≥0.3D in individuals of both groups with SVCL and MFCL wear. The training was more effective in myopes wearing their habitual SVCLs. This study shows that accommodation can be changed with short biofeedback training independent of the refractive state. With this proof-of-concept, we hypothesize that biofeedback training in myopic children wearing MFCLs might improve the treatment effectiveness.

Change-Point Detection of Peak Tibial Acceleration in Overground Running Retraining.

A method is presented for detecting changes in the axial peak tibial acceleration while adapting to self-discovered lower-impact running. Ten runners with high peak tibial acceleration were equipped with a wearable auditory biofeedback system. They ran on an athletic track without and with real-time auditory biofeedback at the instructed speed of 3.2 m·s−1. Because inter-subject variation may underline the importance of individualized retraining, a change-point analysis was used for each subject. The tuned change-point application detected major and subtle changes in the time series. No changes were found in the no-biofeedback condition. In the biofeedback condition, a first change in the axial peak tibial acceleration occurred on average after 309 running gait cycles (3′40″). The major change was a mean reduction of 2.45 g which occurred after 699 running gait cycles (8′04″) in this group. The time needed to achieve the major reduction varied considerably between subjects. Because of the individualized approach to gait retraining and its relatively quick response due to a strong sensorimotor coupling, we want to highlight the potential of a stand-alone biofeedback system that provides real-time, continuous, and auditory feedback in response to the axial peak tibial acceleration for lower-impact running.

Radiological (Magnetic Resonance Image and Ultrasound) and biochemical effects of virtual reality training on balance training in football players with chronic low back pain: A randomized controlled study.

Virtual reality training is commonly used for balance problems in neurological conditions with the use of visual and auditory biofeedback. The knowledge about the effective implementation of this training in chronic low back pain is lacking. The objective of this study is to find the radiological and biochemical effects of virtual reality training in football players with chronic low back pain. A randomized, single-blinded controlled study was conducted on 36 participants. The first group received virtual reality training (VRT; n= 12), the second group received combined physical rehabilitation (CPR; n= 12), and the third group (control group; n= 12) received conventional training exercises for four weeks. Radiological (muscle cross-sectional area and muscle thickness) and biochemical (CRP, TNF-α, IL-2, IL-4, IL-6) values were measured at baseline and after four weeks. Four weeks following training, the VRT group showed more significant changes in the muscle cross-sectional area than the CPR and control groups (p⩽ 0.001). Biochemical measures such as CRP, TNF-α, IL-2, IL-4, and IL-6 also showed significant improvement in the VRT group compared to the other two groups (p⩽ 0.001). The results show that virtual reality training has positive effects on the radiological and biochemical aspects in university football players with chronic low back pain.

Electroskip auditory biofeedback in a patient with Parkinson disease: a case report.

The purpose of this case study was to observe the effects of a rehabilitation program with an audio-biofeedback technology device called Electroskip in a patient with Parkinson disease. The patient was a 61-year-old man with moderate Parkinson disease (Hoehn and Yahr Parkinson’s scale stage III) and dementia who had progressive episodes of freezing of gait. The patient also had a history of recent falls. The patient completed a 6-week rehabilitation program focused on functional tasks, balance and gait training while using Electroskip technology, which is a wireless, wearable device that sends a discrete real-time generative audio-biofeedback signal when the user steps on either the heel or toe force sensors positioned under the innersoles. The outcome measures included the Timed Up and Go test, the modified Gait Abnormality Rating Scale, the modified Parkinson’s Activity Scale, and the Freezing of Gait Questionnaire. The patient completed 17 of the 18 scheduled training sessions and all testing sessions; no adverse events occurred during the rehabilitation program and high satisfaction levels were reported by the patient and family after completion of the 6-week rehabilitation program. Clinically significant improvements were seen in all measures at 6 weeks. The results of this report suggest that a rehabilitation program focused on functional tasks, balance, and gait training using the Electroskip technology may be beneficial for improving gait and balance in a patient with moderate Parkinson disease. Future work is needed to determine the effectiveness of Electroskip technology by means of randomized controlled trials.

Sound design for auditory biofeedback and motor performance in participants with stroke: a pilot study

ABSTRACT Background: Although auditory biofeedback (ABF) has proved to be effective in stroke rehabilitation, there are a variety of means by which to present information through sound. Objectives: To examine if ABF sound design influences the motor performance of patients with stroke. Methods: A total of four people with chronic stroke participated . They were asked to track target signals by their paretic ankle dorsiflexion. Half of the participants were assigned to one of the two groups. Those in the Error ABF group heard ABF that alerted them to the error between the target and the joint angle. Those in the Full ABF group heard ABF that presented both the target and the angle separately by modulating the frequencies of two sounds. Therefore, when there was no error, no sound or two sounds with the identical frequency were heard in the Error and Full ABF sessions, respectively. The same visual BF (VBF) was always present regardless of the group. The accuracy of the task was quantified via an accuracy index (AI, ranging from −100 to 100). All participants were trained by repeating tracking, and the pre- and post-training AIs were obtained. Results: The AIs of all participants increased after training, but the increase was greater for the Error ABF group (mean increase = 8.9 and 14.9 for the Full and Error groups, respectively). Conclusions: The Full ABF was less effective than the Error ABF, probably because the VBF was present, and the information provided by the Full ABF was therefore redundant.

Design and validation of an auditory biofeedback system for modification of running parameters

Real-time auditory feedback during sports activities is becoming increasingly popular in view of opportunities for monitoring and movement (re)training in ecological environments. However, the design of an effective feedback strategy is difficult. In this paper, we present a methodical approach to the design of an auditory feedback strategy for running gait modification of recreational runners, using distortion of a musical baseline. First tests were conducted to select the best performing auditory distortion signal in terms of clarity and level perception, and to derive the relative perception curve. This was found to be pink noise with an exponential response curve. Further tests were carried out to determine the just noticeable difference of this signal in actual running conditions. Finally, validation tests were performed to examine if the real-time auditory biofeedback, combined with music, could alter the runner’s steps per minute (SPM) during treadmill-based running. The results show that our sonification strategy can alter the mean running SPM in a clear and non-disturbing way, and that our noise-based continuous feedback approach performs better than standard verbal instructions. Even though some of the participants did not respond effectively to the feedback, a large majority of the participants rated the feedback system as pleasant and indicated that they would use such system to improve their running style.

Unwind: a musical biofeedback for relaxation assistance

ABSTRACTUnwind is a musical biofeedback interface which combines nature sounds and sedative music into a form of New-Age music for relaxation exercises. The nature sounds respond to the user’s physiological data, functioning as an informative layer for biofeedback display. The sedative music aims to induce calmness and evoke positive emotions. UnWind incorporates the benefits of biofeedback and sedative music to facilitate deep breathing, moderate arousal, and promote mental relaxation. We evaluated Unwind in a 2 × 2 factorial experiment with music and biofeedback as independent factors. Forty young adults performed the relaxation exercise under one of the following conditions after experiencing a stressful task: Nature sounds only (NS), Nature sounds with music (NM), and Auditory biofeedback with nature sounds (NSBFB), and UnWind musical biofeedback (NMBFB). The results revealed a significant interaction effect between music and biofeedback on the improvement of heart rate variability. The combination of music and nature sounds also showed benefits in lowering arousal and reducing self-report anxiety. We conclude with a discussion of UnWind for biofeedback and the wider potential of blending nature sounds with music as a musical interface.

Effects of real-time gait biofeedback on paretic propulsion and gait biomechanics in individuals post-stroke

ObjectivesGait training interventions that target paretic propulsion induce improvements in walking speed and function in individuals post-stroke. Previously, we demonstrated that able-bodied individuals increase propulsion unilaterally when provided real-time biofeedback targeting anterior ground reaction forces (AGRF). The purpose of this study was to, for the first time, investigate short-term effects of real-time AGRF gait biofeedback training on post-stroke gait.MethodsNine individuals with post-stroke hemiparesis (6 females, age = 54 ± 12.4 years 39.2 ± 24.4 months post-stroke) completed three 6-minute training bouts on an instrumented treadmill. During training, visual and auditory biofeedback were provided to increase paretic AGRF during terminal stance. Gait biomechanics were evaluated before training, and during retention tests conducted 2, 15, and 30 minutes post-training. Primary dependent variables were paretic and non-paretic peak AGRF; secondary variables included paretic and non-paretic peak trailing limb angle, plantarflexor moment, and step length. In addition to evaluating the effects of biofeedback training on these dependent variables, we compared effects of a 6-minute biofeedback training bout to a non-biofeedback control condition.ResultsCompared to pre-training, significantly greater paretic peak AGRFs were generated during the 2, 15, and 30-minute retention tests conducted after the 18-minute biofeedback training session. Biofeedback training induced no significant effects on the non-paretic leg. Comparison of a 6-minute biofeedback training bout with a speed-matched control bout without biofeedback demonstrated a main effect for training type, with greater peak AGRF generation during biofeedback.DiscussionOur results suggest that AGRF biofeedback may be a feasible and promising gait training strategy to target propulsive deficits in individuals post-stroke.

Improvement of Praxis Skills in Children with Hemiplegic Cerebral Palsy by Using New Trend of Augmented Visual and Auditory Feedback Training: A Case Report

Aims: The aim of the study is to investigate if the new method of auditory and visual biofeedback as Upper Limb Exercise may improve praxis skills alone without any traditional physical therapy treatment or not and within three successive months of treatment in children with hemiplegic cerebral palsy. Methods: A 6-year-old hemiplegic cerebral palsied child was treated with Upper-Limb Exerciser as one of augmented visual and auditory feedback devices. Sensory Integration and Praxis test was used to measure a child’s ability to integrate sensory input for perception, motor planning, and spatial actions in; Space Visualization, Figure-Ground Perception, Standing and Walking Balance, Design Copying, Postural Praxis, Bilateral Motor Coordination, Constructional Praxis, Postrotary Nystagmus, Motor Accuracy, Sequencing Praxis, Oral Praxis, Manual Form Perception, Kinesthesia, Finger Identification, Graphethesia, Localization of Tactile Stimuli, and Praxis on Verbal Command. Results: The results revealed improvement of the major standard score for each of the 17 subtests of Sensory Integration and Praxis Test when compared after three successive treatment. Conclusion: The using upper limb exerciser as one method of augmented visual and auditory feedback can be used as one of the physical and occupational therapy programs aiming to improve praxis skills in hemiplegic cerebral palsied children.

Generating the Visual Biofeedback Signals Applicable to Reduction of Wrist Spasticity: A Pilot Study on Stroke Patients.

Introduction:Application of biofeedback techniques in rehabilitation has turned into an exciting research area during the recent decade. Providing an appropriate visual or auditory biofeedback signal is the most critical requirement of a biofeedback technique. In this regard, changes in Surface Electromyography (SEMG) signals during wrist movement can be used to generate an indictable visual biofeedback signal for wrist movement rehabilitation via SEMG biofeedback. This paper proposes a novel methodology for selecting the most appropriate features out of wrist muscle SEMG signals.Methods:To this end, the surface EMG signals from flexor and extensor muscle groups during wrist joint movements were recorded and analyzed. Some linear and nonlinear features in frequency, time, and time-frequency domains were extracted from the recorded surface EMG signals of the flexor and extensor muscles. Experiments and analyses were performed on ten healthy subjects and four stroke patients with wrist muscle spasticity as the movement disorder subjects. Some heuristic feature selection measures were applied. The main motivation behind choosing applied heuristic feature selection measures was meeting. In the first step, the designed visual biofeedback signal should indicate a healthy wrist motion profile as its successful tracking by the patient guarantees rehabilitation. In addition, the visual biofeedback signal should be a smooth curve thus preventing the patient from discomfort while tracking it on a monitor during the biofeedback therapy.Results:In this pilot study, after using the introduced feature selection measures, quantitative and qualitative analyses of the extracted features indicated that Shannon entropy is the most appropriate feature for generating a visual biofeedback signal as a healthy wrist motion profile to improve the ability of stroke patients in controlling wrist joint motion. In addition, it was shown that when the wrist joint moves between a flexed and rest position, the flexor muscle EMG signal should be used for generating a visual biofeedback signal. However when the wrist joint moves between a rest position and an extended position, the extensor muscle EMG signal is appropriate for providing a visual biofeedback signal. It is worth noting that the achieved pilot study results should be confirmed by the future studies with larger samples.Conclusion:According to the obtained results, it can be concluded that among the analyzed features, the Shannon entropy was the most appropriate feature. It can be employed for generating a visual biofeedback signal for reduction of spasticity in patients with stroke.

Learning effects of dynamic postural control by auditory biofeedback versus visual biofeedback training

Augmented sensory biofeedback (BF) for postural control is widely used to improve postural stability. However, the effective sensory information in BF systems of motor learning for postural control is still unknown. The purpose of this study was to investigate the learning effects of visual versus auditory BF training in dynamic postural control. Eighteen healthy young adults were randomly divided into two groups (visual BF and auditory BF). In test sessions, participants were asked to bring the real-time center of pressure (COP) in line with a hidden target by body sway in the sagittal plane. The target moved in seven cycles of sine curves at 0.23Hz in the vertical direction on a monitor. In training sessions, the visual and auditory BF groups were required to change the magnitude of a visual circle and a sound, respectively, according to the distance between the COP and target in order to reach the target. The perceptual magnitudes of visual and auditory BF were equalized according to Stevens’ power law. At the retention test, the auditory but not visual BF group demonstrated decreased postural performance errors in both the spatial and temporal parameters under the no-feedback condition. These findings suggest that visual BF increases the dependence on visual information to control postural performance, while auditory BF may enhance the integration of the proprioceptive sensory system, which contributes to motor learning without BF. These results suggest that auditory BF training improves motor learning of dynamic postural control.

Effects of unilateral real-time biofeedback on propulsive forces during gait

BackgroundIn individuals with post-stroke hemiparesis, reduced push-off force generation in the paretic leg negatively impacts walking function. Gait training interventions that increase paretic push-off can improve walking function in individuals with neurologic impairment. During normal locomotion, push-off forces are modulated with variations in gait speed and slope. However, it is unknown whether able-bodied individuals can selectively modulate push-off forces from one leg in response to biofeedback. Here, in a group of young, neurologically-unimpaired individuals, we determined the effects of a real-time visual and auditory biofeedback gait training paradigm aimed at unilaterally increasing anteriorly-directed ground reaction force (AGRF) in the targeted leg.MethodsGround reaction force data during were collected from 7 able-bodied individuals as they walked at a self-selected pace on a dual-belt treadmill instrumented with force platforms. During 11-min of gait training, study participants were provided real-time AGRF biofeedback encouraging a 20–30% increase in peak AGRF generated by their right (targeted) leg compared to their baseline (pre-training) AGRF. AGRF data were collected before, during, and after the biofeedback training period, as well as during two retention tests performed without biofeedback and after standing breaks.ResultsCompared to AGRFs generated during the pre-training gait trials, participants demonstrated a significantly greater AGRF in the targeted leg during and immediately after training, indicating that biofeedback training was successful at inducing increased AGRF production in the targeted leg. Additionally, participants continued to demonstrate greater AGRF production in the targeted leg after two standing breaks, showing short-term recall of the gait pattern learned during the biofeedback training. No significant effects of training were observed on the AGRF in the non-targeted limb, showing the specificity of the effects of biofeedback toward the targeted limb.ConclusionsThese results demonstrate the short-term effects of using unilateral AGRF biofeedback to target propulsion in a specific leg, which may have utility as a training tool for individuals with gait deficits such as post-stroke hemiparesis. Future studies are needed to investigate the effects of real-time AGRF biofeedback as a gait training tool in neurologically-impaired individuals.

Assessment and rehabilitation of central sensory impairments for balance in mTBI using auditory biofeedback: a randomized clinical trial

BackgroundComplaints of imbalance are common non-resolving signs in individuals with post-concussive syndrome. Yet, there is no consensus rehabilitation for non-resolving balance complaints following mild traumatic brain injury (mTBI). The heterogeneity of balance deficits and varied rates of recovery suggest varied etiologies and a need for interventions that address the underlying causes of poor balance function. Our central hypothesis is that most chronic balance deficits after mTBI result from impairments in central sensorimotor integration that may be helped by rehabilitation. Two studies are described to 1) characterize balance deficits in people with mTBI who have chronic, non-resolving balance deficits compared to healthy control subjects, and 2) determine the efficacy of an augmented vestibular rehabilitation program using auditory biofeedback to improve central sensorimotor integration, static and dynamic balance, and functional activity in patients with chronic mTBI.MethodsTwo studies are described. Study 1 is a cross-sectional study to take place jointly at Oregon Health and Science University and the VA Portland Health Care System. The study participants will be individuals with non-resolving complaints of balance following mTBI and age- and gender-matched controls who meet all inclusion criteria. The primary outcome will be measures of central sensorimotor integration derived from a novel central sensorimotor integration test. Study 2 is a randomized controlled intervention to take place at Oregon Health & Science University. In this study, participants from Study 1 with mTBI and abnormal central sensorimotor integration will be randomized into two rehabilitation interventions. The interventions will be 6 weeks of vestibular rehabilitation 1) with or 2) without the use of an auditory biofeedback device. The primary outcome measure is the daily activity of the participants measured using an inertial sensor.DiscussionThe results of these two studies will improve our understanding of the nature of balance deficits in people with mTBI by providing quantitative metrics of central sensorimotor integration, balance, and vestibular and ocular motor function. Study 2 will examine the potential for augmented rehabilitation interventions to improve central sensorimotor integration.Trial registrationThis trial is registered at clinicaltrials.gov (NCT02748109)

Reducing the lag of accommodation by auditory biofeedback: A pilot study

The purpose of this study was to investigate whether a reduction of the accommodative lag is possible by training the accuracy of accommodation using auditory biofeedback. Accommodation responses were measured in thirty-one young adults with myopia for dioptric target distances of 2.0, 2.5, and 3.0D using an eccentric infrared photorefractor. For the biofeedback training, subjects were randomly assigned to an experimental (n=15) or a control group (n=16). Subjects of the experimental group were provided with two tones while fixating a target, one tone was related to their accommodative response and the second to the target distance. Their task was to match these tones. The control group did not receive any auditory biofeedback. Two different training methods were applied, a continuous training of 200s, and ten consecutive sessions of 20s each. The training effects on the lag of accommodation (change Δ) were highly variable. Regarding the entire study group, the observed change in the accommodative lag was greater at closer distances, while no difference between the two training methods was revealed. Nevertheless, seven experimental subjects reduced their lag by ⩾0.3D (3.0D target distance: Δlong=−0.29±0.20D, Δshort=−0.24±0.21D). This reduction was also seen in two control subjects. Remeasurement revealed that the average training effect cannot be preserved over a period of 5–7days. The current investigation has shown that the accuracy of accommodation can be trained in some subjects using auditory biofeedback for target distances of 2.5D or closer.

The sound of smile: Auditory biofeedback of facial EMG activity

In this paper, a real-time interactive system for smile detection and sonification using surface Electromyography (sEMG) signals is proposed. When a user smiles, a sound is played. The surface EMG signal is mapped to pitch using a conventional scale. The timbre of the sound is a synthetic sound that mimics bubbles.In a user testing of smiling tasks, 14 participants underwent the system and are required to produce smiles under three conditions, i.e., auditory feedback with sonification, visual feedback with mirror, and no feedback. The impression of the system is evaluated through questionnaires and interviews with the participants. In addition, we analyzed the total amount of muscular activity and temporal envelope patterns of the sEMG during smiling.The questionnaire and interview showed that users felt that (1) the sonification system well reflects their facial expressions, and (2) the sonification system was enjoyable. The users also expressed that the auditory feedback condition is easier to smile with, as compared to the visual feedback or no feedback conditions. However, the analysis of sEMG did not provide a quantitative difference among the three conditions, which is most likely due to the experiment design, which lacks socially engaging settings.

バットスイングにおける運動連鎖を支援する音声リズムBFデバイスの開発

バットスイングにおける運動連鎖を支援する音声リズムBFデバイスの開発

Comparison of Visual and Auditory Biofeedback during Sit-to-stand Training for Performance and Balance in Chronic Stroke Patients

PURPOSE: The purpose of this study was to determine the comparison of visual and auditory biofeedback during sit-to-stand training in patients with stroke. METHODS: Thirty-five subjects with chronic stroke were divided into three groups: a visual feedback group (12 subjects), an auditory feedback group (12 subjects) and a control group (11 subjects). All Groups received neurodevelopmental treatment, and sit-to-stand training for 30minutes three times a week for four weeks. During the sit to stand training, the experimental groups received visual feedback and auditory feedback, whereas the control group performed sit-to-stand training without feedback. Five times sit-to-stand test (FTSST), motion analysis and postural sway during sit-to-stand were used to evaluate sit to stand performance ability. In addition, Berg balance scale (BBS) was performed for evaluation of balance function in participants. RESULTS: All groups showed significant increase on FTSST and BBS between pre- and post-intervention. The BBS scores in visual feedback group was significant increase than control group. The motion analysis and postural sway, more improvement was observed in the visual and auditory feedback groups compared with the control group. The only visual feedback group was a better performance of midline excursion during sit-to-stand than control group. CONCLUSION: These findings suggest that sit-to-stand training using a biofeedback may help to improve sit to stand performance and balance ability of stroke patients.

Effects of an auditory biofeedback device on plantar pressure in patients with chronic ankle instability

Chronic ankle instability (CAI) patients have been shown to have increased lateral column plantar pressure throughout the stance phase of gait. To date, traditional CAI rehabilitation programs have been unable to alter gait. We developed an auditory biofeedback device that can be worn in shoes that elicits an audible cue when an excessive amount of pressure is applied to a sensor. This study determined whether using this device can decrease lateral plantar pressure in participants with CAI and alter surface electromyography (sEMG) amplitudes (anterior tibialis, peroneus longus, medial gastrocnemius, and gluteus medius). Ten CAI patients completed baseline treadmill walking while in-shoe plantar pressures and sEMG were measured (baseline condition). Next, the device was placed into the shoe and set to a threshold that would elicit an audible cue during each step of the participant's normal gait. Then, participants were instructed to walk in a manner that would not trigger the audible cue, while plantar pressure and sEMG measures were recorded (auditory feedback (AUD FB) condition). Compared to baseline, there was a statistically significant reduction in peak pressure in the lateral midfoot–forefoot and central forefoot during the AUD FB condition. In addition, there were increases in peroneus longus and medial gastrocnemius sEMG amplitudes 200ms post-initial contact during the AUD FB condition. The use of this auditory biofeedback device resulted in decreased plantar pressure in the lateral column of the foot during treadmill walking in CAI patients and may have been caused by the increase in sEMG activation of the peroneus longus.

Analysis of Mp‐1 audio‐biofeedback impact on fixation in low vision patient with maculopathy

PurposeTo study the impact of a low vision rehabilitation strategy based on Nidek MP‐1 auditory biofeedback (BFB).MethodsRetrospective study of 39 eyes/26 consecutive patients referred for low vision rehabilitation. Patients received 8 monocular training sessions of BFB, each of 10 minutes duration, 7–14 days apart. Microperimetry, ETDRS VA and Pelli‐Robson was performed at the beginning and at the end of the sequence. BFB employs a sound to train the patient to keep a specific gaze position.ResultsAge median was 70. Pre‐BFB logMAR VA was 1, logCS 0.60. Post‐BFB logMAR VA was 1, logCS 0.75. Dense central scotomas and eccentric fixation locations were detected in 35 eyes/24 patients, and relative scotomas with central fixations in 4 eyes/2 patients. Mean sensitivity was 7.60 dB pre‐BFB, and 8 db post‐BFB. Pre‐BFB fixation stability was 24% within 2°, and 67% within 4°; post‐BFB, it was 25% within 2°, and 64% within 4°. BCEA analysis showed pre‐BFB values for 68.2% BCEA to be 3.6, and 4.46 post‐BFB. After BFB, no significant difference was found for any of the above‐mentioned parameters in the sample as a whole. Nevertheless, grouping cases by change in pre‐vs post‐BFB BCEA (group A: decrease in BCEA, n = 21; group B: increase in BCEA, n = 18) showed a significant difference in terms of BCEA itself, and in the related fixation stability (p &lt; 0.05).ConclusionsAlthough no significant difference in VA, CS, mean sensitivity, fixation stability at 2° and 4°, and BCEA was found after BFB in the sample as a whole, still there was an improvement in 21 eyes (53.8%) in terms of BCEA and fixation stability. Grouping analysis demonstrated that, while other tested outcome measures were not affected, some cases did respond significantly to BFB improving their fixation stability.