Biofeedback Training Group Research Articles

The Effect of Heart Rate Variability Biofeedback Training on Vagal Tone in Athletically Talented Secondary School Students.

This study examines whether twelve sessions of heart rate variability biofeedback training would improve vagally mediated heart rate variability. If so, it would go some way in explaining why breathing-based interventions reduce clinical symptoms and improve non-clinical performance outcomes. Methods: Thirty participants (N = 30, Nfemale = 13) aged 14–13-year-old, all talented athletes, from a sport specialist school in SE London UK, were randomly divided into three groups, a control group, a psychology skills training combined with heart rate variability biofeedback training group, and a heart rate variability biofeedback only group. For the combined group, a variety of typical psychological skill training techniques were also used. Results: Paired participant t-test and the Wilcoxon Signed Rank test found non-significant differences between pre- and post-intervention measurements of heart rate variability. Non-significant results remained even after pooling the biofeedback training groups (n = 19). Conclusions: Our results do not indicate that beneficial effects associated with focused breathing training can be attributed to improved vagal tone. Further investigation into the underlying mechanisms of the benefits of focused breathing techniques is necessary to maximize clinical and non-clinical outcomes.

Effect of EMG, RESP, and TEMP Biofeedback Training to reduce Anxiety among Undergraduate Students

Background: It is evident that anxiety and stress are two of the main predominant issues that cause several mental health problems and disorders in university students, causing a negative impact on this population. Higher educational institutes in Pakistan have limited access and resources to face these issues. It is suggested that biofeedback-aided relaxation training has been effective in alleviating anxiety and stress symptoms among undergraduate students, especially during their examination season. Recent research has proven biofeedback to be effective training for anxious students. The current randomized control trial is planned to investigate the effectiveness of Electromyography-EMG, Respiration Rate-RESP, and Skin Temperature-TEMP biofeedback training for reducing anxiety symptoms among nursing students be receiving 8 sessions for 4 weeks.
 Methodology: This study is planned to investigate the effectiveness of EMG, RESP, and TEMP Biofeedback Training in reducing symptoms of anxiety among the nursing students from one school, and to determine whether biofeedback training is associated with relaxing the minds and bodies of the anxious nursing students to cope with the distressing situation. Study subjects meeting the eligibility criteria will be randomized into two groups using randomly generated numbers: the Biofeedback training group and the Control group. Biofeedback training will be used as an intervention vs. the control. All the study subjects who give consent to participate will be made to complete the study questionnaires (Demographic, Screening for Anxiety using the State-Trait Anxiety Inventory –STAI) at baseline and post-intervention (after 4 weeks).
 Discussion: This study might help us determine biofeedback as a possible effective and useful technique in helping nursing students manage their anxiety. Moreover, it is suggested that Individuals receiving biofeedback training tend to show significant changes for the three psychophysiological modalities, i.e., EMG, RESP, and TEMP. This study might also give us insight into the efficacy of biofeedback in the Pakistani population seeking help for stress and anxiety.

The Effects of Biofeedback Training and Smartphone-Delivered Biofeedback Training on Resilience, Occupational Stress, and Depressive Symptoms among Abused Psychiatric Nurses.

Psychiatric ward (PW) nurses are at a higher risk to encounter workplace violence than are other healthcare providers, and many interventions have been developed to improve their mental health. We compared the effectiveness of biofeedback training (BT) and smartphone-delivered BT (SDBT) interventions on occupational stress, depressive symptoms, resilience, heart rate variability, and respiration rate in a sample of abused PW nurses. This was a quasi-experimental study. Structured questionnaires were administered before and six weeks after the intervention. Data were collected from April 2017 to October 2017. A total of 159 abused PW nurses were randomly assigned to BT, SDBT, and control groups, and 135 of them completed all processes of our protocol, with the study consisting of 119 females (88.1%) and 16 males (11.9%) and their age range being from 22 to 59 with the mean age of 35.61 and a standard deviation of 8.16. Compared to the controls, both the BT and the SDBT intervention groups experienced significant improvements in depressive symptoms, resilience, and respiration rate; and the SDBT group experienced significant reductions in occupational stress. Considering the cost, accessibility, restrictions time and space, SDBT be used as an effective intervention in people with resilience or occupational stress.

Train Your Brain? Can We Really Selectively Train Specific EEG Frequencies With Neurofeedback Training.

Neurofeedback (NFB) is an operant conditioning procedure whereby an individual learns to self-regulate the electrical activity of his/her brain. Initially developed as a treatment intervention for pathologies with underlying EEG dysfunctions, NFB is also used as a training tool to enhance specific cognitive states required in high-performance situations. The original idea behind the NFB training effect is that the changes should only be circumscribed to the trained EEG frequencies. The EEG frequencies which are not used as feedback frequencies should be independent and not affected by the neurofeedback training. Despite the success of sensorimotor rhythm NFB training in cognitive performance enhancement, it remains unclear whether all participants can intentionally modify the power densities of specifically selected electroencephalographic (EEG) frequencies. In the present study, participants were randomly assigned to either a control heart rate variability (HRV) biofeedback (HRV) training group or a combination of HRV biofeedback and neurofeedback (HRV/NFB) training group. This randomized mixed design experiment consisted of two introductory theoretical lessons and a training period of 6 weeks. We investigated the evolution of the different EEG frequency bands of our two experimental groups across and within session. All the participants exhibited EEG changes across and within session. However, within the HRV/NFB training group, untrained EEG frequencies have been significantly modified, unlike some of the trained frequencies. Moreover, EEG activity was modified in both the HRV group and the HRV/NFB groups. Hence, the EEG changes were not only circumscribed to the trained frequency bands or to the training modality.

Single-Session Video and Electromyography Feedback in Overhead Athletes With Scapular Dyskinesis and Impingement Syndrome.

Subacromial impingement syndrome (SIS) is associated with scapular dyskinesis, or imbalanced scapular muscle activity. Evidence has shown that feedback can improve scapular control in patients with SIS. However, it is unknown whether real-time video feedback or electromyography (EMG) biofeedback is optimal for improving scapular kinematics and muscle activity during a functional task. To compare the effects of video and EMG feedback sessions on absolute muscle activity (upper trapezius [UT], lower trapezius [LT], serratus anterior), muscle balance ratios (UT/LT, UT/serratus anterior), and scapular kinematics (anterior-posterior tilt, external-internal rotation, upward rotation) in SIS participants during arm elevation and lowering. Randomized controlled clinical trial. Research laboratory. Overhead athletes who were diagnosed with SIS and who also exhibited scapular dyskinesis (N = 41). Three-dimensional kinematics and EMG were recorded before and after feedback training. Lower trapezius muscle activity increased (4.2%-18%, P < .011) and UT/LT decreased (0.56-1.17, P < .013) in the EMG biofeedback training group as compared with those in the video feedback training group. Scapular upward rotation during arm elevation was higher in the video group than in the EMG group after feedback training (2.3°, P = .024). The EMG biofeedback improved muscle control and video feedback improved the correction of scapular upward rotation in patients with SIS. ClinicalTrials.gov: NCT03252444.

The effect of biofeedback training on intestinal function among patients with middle and low rectal cancer: a randomized controlled study

To evaluate the effect of biofeedback on intestinal function among patients with middle and low rectal cancer. Using a randomized controlled trial design, 109 patients with middle and low rectal cancer indicated to have preoperative radiochemotherapy, anterior resection of the rectum, and preventive stoma were randomly divided into three groups: the blank control group, the pelvic floor muscle exercise group, and the biofeedback training group. A 16-month intervention and longitudinal follow-up study was conducted, and a questionnaire on intestinal function by the Memorial Sloan-Kettering Cancer Center (MSKCC) was adopted into a Chinese version to evaluate patients' intestinal function situation. The intestinal function of the biofeedback training group was better than the blank control group and pelvic floor muscle exercise group. The total score of intestinal function and the scores of each dimension were statistically significant (P<0.05). Biofeedback training could significantly improve the intestinal function of patients with middle and low rectal cancer, promote its recovery, and is thus worthy of clinical application.

Effect of biofeedback training on bowel function among patients undergoing rectal cancer anus preserving operation

Objective To evaluate the effect of biofeedback on bowel function among rectal cancer patients with chemoradiotherapy and temporary enterostomy. Methods This study was designed as a randomized controlled trial. The patients with low and middle rectal cancer in a Cancer Hospital of Guangzhou from June 2015 to December 2016 were randomly divided into pelvic floor muscle exercise group (control group, n=36) and biofeedback training group (intervention group, n=35) . The intestinal function questionnaire of the Chinese version of Memorial Sloan-Kettering Cancer Center (MSKCC) was used to longitudinally track and compare the intestinal function of the two groups for 16 months and 5 times in total. Results The total score of MSKCC, frequency and urgency of defecation and defecation sensory disturbance in intervention group were higher than those in control group at 4 days and 3 months after stoma inclusion operation, and the differences were statistically significant (P<0.05) . Conclusions Biofeedback training can improve the intestinal function of patients with middle and low rectal cancer, promote their recovery, and prevent intestinal and anal dysfunction of patients with middle and low rectal cancer. Key words: Rectal neoplasms; Biofeedback; Pelvic floor muscle exercise; Anus preserving operation; Intestinal function

Intervention effect of biofeedback combined with pelvic floor muscle exercise on low anterior resection syndrome in patients with low anus-preserving rectal cancer

Objective: To explore the effect of biofeedback training combined with pelvic floor muscle exercise on the recovery of anorectal function in patients with middle and low rectal cancer undergoing sphincter-preserving surgery, and to find the best way to prevent low anterior resection syndrome. Methods: A single-center prospective randomized controlled study was conducted. One hundred and nine patients with mid-low rectal cancer in Sun Yat-sen University Cancer Centre from June 2015 to December 2016 were enrolled in the study, who were going to undergo sphincter-preserving surgery or preventive ostomy after preoperative chemoradiotherapy. They were divided into three groups: blank control group, pelvic floor muscle exercise group and biofeedback training combined with pelvic floor muscle exercise group. Intervention and follow-up were conducted for 16 months. High-resolution anorectal manometry was used to measure the objective anorectal pressure and sensory index of patients, and the Chinese version of MSKCC Intestinal Function Questionnaire was used to evaluate the intestinal function of patients. The differences of objective anorectal manometry index and subjective intestinal function between the three groups were compared, and the occurrence of low anterior rectal resection syndrome was evaluated. Results: At the end of the intervention, the total scores of anal resting pressure, rectal resting pressure, anal maximum systolic pressure, anal maximum systolic time, initial rectal volume, rectal fecal sensory capacity, rectal maximum tolerance capacity, rectal compliance, anorectal hypertensive zone and total score of intestinal function in the biofeedback training combined with pelvic floor muscle exercise group were (44.83±9.01) mmHg, (4.31±1.75) mmHg, (130.46±10.00) mmHg, (19.94±4.30) s, (32.71±5.00) ml, (74.26±8.30) ml, (188.4±12.68) ml, (5.69±1.18) ml/kPa, (3.31±0.96) cm and (68.09±6.38) points respectively. The main effects of the changes of five indices, including anal resting pressure, rectal resting pressure, anal maximum systolic pressure, anal maximum systolic time and anal high pressure zone, were time. Significant differences were found in initial rectal capacity, sensory capacity of rectal defecation, maximum tolerance capacity of rectum, rectal compliance and total score of intestinal function in every time point of measurement in the biofeedback training group combined with pelvic floor muscle exercise group. They were significantly higher than those in the blank control group (P<0.05); the score of the biofeedback training group combined with pelvic floor muscle exercise group at one month after operation, perioperative period and 3 months after operation were significantly higher than those in pelvic floor muscle exercise group (P<0.05). Biofeedback training combined with pelvic floor muscle exercise reduced the incidence of low anterior resection syndrome of rectum (P<0.05). Conclusion: Biofeedback training combined with pelvic floor muscle exercise can significantly improve the sensory indicators of patients with mid-low rectal cancer, promote the recovery of intestinal function, and alleviate low anterior resection syndrome of rectal cancer patients, which is worthy of popularization and application.

Different weight shift trainings can improve the balance performance of patients with a chronic stroke: A randomized controlled trial.

Background:Improving balance ability, increasing walking ability, and reducing the occurrence of falls are important objectives in the rehabilitation of stroke patients. Do the posture balance training and the intervention of lateral wedge insoles to improve of balance function and increase walking ability in patients with a chronic stroke?Methods:A randomized, controlled trial with concealed allocation, intention-to-treat analysis, and blinded assessors. Participants who had a chronic stroke (onset >6 months) were recruited from the rehabilitation and neurology departments of a hospital in central Taiwan. Subjects were divided into 3 groups: a visual biofeedback balance training group, a lateral wedge group, and a control group; apart from their usual rehabilitation program, and both experimental groups received a 6-week training session program. The primary outcome was the balance computerized adaptive test (balance CAT), and secondary outcome was timed up and go (TUG) test. All subjects were evaluated at the baseline, posttraining (6-week), 1st follow-up (10-week), and 2nd follow-up (18-week).Results:A total of 56 subjects were participated in this study, including 38 males and 18 females. The mean age of the subjects was 59.1 years old, and the mean time was 43.7 months after the onset of the stroke. This study found the interaction in groups and measurement time points reached statistical significance of the balance CAT and TUG test (F = 5.740, P < .001; F = 2.926, P = .011; respectively). In addition, the performance of both the visual biofeedback training and lateral wedge group was superior to that of the control group.Conclusion:Six-week visual biofeedback training and intervention of 5° lateral wedge insoles can improve the balance ability of patients with a chronic stroke.Trial registry:http://www.chictr.org.cn, ChiCTR-IPR-15007092.

Biofeedback Training in Crisis Managers: A Randomized Controlled Trial.

Working in crisis environments represents a major challenge, especially for executive personnel engaged in directing disaster operations, i.e. crisis managers. Crisis management involves operating under conditions of extreme stress resulting, for instance, from high-level decision-making, principal responsibility for personnel, multitasking or working under conditions of risk and time pressure. The present study aimed to investigate the efficacy of a newly developed biofeedback training procedure based on electrodermal activity, especially designed for the target group of crisis managers. The training comprised exercises promoting acquisition of control over sympathetic arousal under resting conditions and during exposure to visual, acoustic and cognitive stressors resembling situations related to crisis management. In a randomized controlled design, 36 crisis managers were assigned to either a biofeedback training group or waiting list control group. Subjective stress was assessed using the Perceived Stress Scale. In the training group, stress level markedly decreased; the decrease remained stable at follow-up 2 months after the training. The results indicate that biofeedback training in crisis management is an effective method for stress management that may help to reduce vulnerability to stress-related performance decline and stress-related disease.

Impact of adaptive biofeedback training on clinical efficacy, psychological status and quality of life in patient with outlet obstruction constipation

Objective To explore the effects of adaptive biofeedback training(ABF)on efficacy of clinical efficacy, psychological status and life quality in patients with outlet obstruction constipation (OOC). Methods From June 2011 to October 2014, a total of 206 patients with OOC were enrolled. They were divided into ABF group and fixed biofeedback training (FBF) group. The clinical symptoms integral, clinical efficacy, psychological status and quality of life were observed before and eight weeks after treatment. Chi-square test or t-test was performed for statistical analysis. Results A total of 138 cases completed biofeedback training and were divided into ABF group (n=76) and FBF group (n=62). Before treatment, the total scores of clinical constipation symptoms of ABF and FBF groups were 10.95±2.86 and 11.20±2.23, respectively, which were 2.02±1.10 and 2.98±1.19 after treatment. The total scores of both groups decreased after treatment (t=2.60, 2.45; both P 0.05). After treatment, the integral of each dimension of Chinese version of the MOS 36-item short form healtly survey (SF-36) in ABF group and FBF group were both higher than those before treatment, and the differences were statistically significant (all P 0.05). Conclusions Both ABF and FBF can effectively improve clinical symptoms, psychological health and the quality of life in patients with OOC. However, ABF seems to be more effective and superior and more advantages. Key words: Constipation, outlet obstruction; Biofeedback, psychology; Treatment outcome; Quality of life

Effects of ankle biofeedback training on strength, balance, and gait in patients with stroke.

[Purpose] This study aimed to investigate the effects of ankle biofeedback training on muscle strength of the ankle joint, balance, and gait in stroke patients. [Subjects and Methods] Twenty-seven subjects who had had a stroke were randomly allocated to either the ankle biofeedback training group (n=14) or control group (n=13). Conventional therapy, which adhered to the neurodevelopmental treatment approach, was administered to both groups for 30 minutes. Furthermore, ankle strengthening exercises were performed by the control group and ankle biofeedback training by the experimental group, each for 30 minutes, 5 days a week for 8 weeks. To test muscle strength, balance, and gait, the Biodex isokinetic dynamometer, functional reach test, and 10 m walk test, respectively, were used. [Results] After the intervention, both groups showed a significant increase in muscle strength on the affected side and improved balance and gait. Significantly greater improvements were observed in the balance and gait of the ankle biofeedback training group compared with the control group, but not in the strength of the dorsiflexor and plantar flexor muscles of the affected side. [Conclusion] This study showed that ankle biofeedback training significantly improves muscle strength of the ankle joint, balance, and gait in patients with stroke.

Biofeedback training during pregnancy decreases the risk of postpartum depression: a prospective randomized controlled trial

Objective To explore the clinical function of biofeedback training in patients with high risks of postpartum depression,and to provide a new method to decrease the risk of postpartum depression.Methods From May 1,to December 31,2010,in Bayi Children's Hospital,General Hospital of Beijing Military Area Command of Chinese PLA,60 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) evaluation score of 6 to 12 at 12～14 gestational weeks were randomly divided into the biofeedback training group (n=30) and the control group (n=30).The control group learned prenatal care knowledge in pregnant women's school.Moreover,the biofeedback training group received Self-generate Physiological Coherence System training till one week before delivery.Both groups were evaluated with the EPDS at baseline,and 3 days,6 weeks,3 months postpartum.Differences between the two groups were compared with mixed effect model.Results Totally,there were 51 pregnant women finished the study,including 25 women in the biofeedback training group and 26 in the control group.There were no statistical difference in EPDS score at 12～14 gestational weeks between the biofeedback training group and control group [8.5±2.0 vs 8.5±1.9,t=0.03,P=0.97].At 3 days,6 weeks and 3 months postpartum,the EPDS score of biofeedback training group was 4.1 ± 1.8,4.7 ± 2.0 and 4.6 ± 1.8 respectively,which was lower than those in the control group (6.5 ± 2.4,7.0 ± 2.5and 6.9±2.4) (interaction effect F=4.35,P=0.01).On each postpartum time-point,OR value and 95％CI was 0.12 (0.03-0.45),0.21 (0.06-0.68) and 0.23 (0.07-0.77),P＜0.05 respectively.Cohen's d value were 1.17,0.99 and 1.06 respectively.Compared with the baseline value,the total EPDS scores in each study stage declined with varied degrees in both groups,and the score-reducing level were obvious in the biofeedback training group than in the control group.Conclusion Biofeedback training could effectively relieve the depression symptoms in pregnant women with high risks of postpartum depression,and decrease the risk of postpartum depression. Key words: Depression, postpartum; Biofeedback (psychology) ; Pregnancy complications; Depressive disorder; Treatment outcome

The effect of sEMG biofeedback combined with swallowing training in treatment of dysphagic patients with cerebral infarction at recovery stage

Objective To observe the effect of surface electromyographic biofeedback (sEMG-BFB) combined with routine swallow training on dysphagic patients with cerebral infarction at recovery stage.Methods Fiftyone dysphagic patients with cerebral infarction were randomly divided into two groups:control group (26 cases) and biofeedback training group (25 cases).The control group was given routine training including orofacial function training,balloon dilatation and behavioral swallowing training,while the biofeedback training group was given behavioral swallowing training was conducted with the guidance of sEMG-BFB in addition to the routine training.Before and after the treatment,videofluoroscopy swallowing study (VFSS) was performed to observe the opening of upper esophageal sphincter (UES).Functional oral intake scale (FOIS) was used to evaluate swallow function.Results Before treatment,there were no significant difference between the two groups in terms of FOIS score and UES opening (P ＞0.05).The FOIS score increased in both groups after treatment (P ＜ 0.05),and the FOIS score was higher in the biofeedback training group than that of the control group (P ＜ 0.05).After treatment,the number of UES complete opening and incomplete opening was 18 and 8,respectively,in the control group,versus 20 and 5,respectively,in the biofeedback training group.UES opening improved in both groups after treatment (P ＜ 0.05).Conclusion Routine swallowing training combined with sEMG-BFB can benefit the dysphagic patients with cerebral infarction for their UES opening and swallowing ability at recovery stage. Key words: Dysphagia; Surface electromyographic biofeedback; Rehabilitation; Cerebral infarction

일부 여대생의 세 가지 균형조절 훈련 효과 비교

이 연구는 20대 여대생들을 대상으로 세 가지 균형조절 훈련(Aqua, Bio-feedback, Trampolin)이 정적 균형 능력과 시각, 전정각, 고유수용감각 등의 감각요소에 미치는 효과를 비교하기 위해 아쿠아 훈련군(10명), 바이오피드백 훈련군(10명), 트램폴린 훈련군(9명)으로 무작위 할당한 후 각 군별로 주 3회, 회당 30분간의 운동 프로그램을 6주간 진행하면서 3주후, 6주후에 Tetrax portable multiple system을 이용하여 안정성지수를 측정하고, 근전도 중앙주파수값을 이용하여 산출한 근전도 균형점수를 반복측정된 자료의 분산분석 및 Wilcoxon의 부호순위 검정 등을 이용하여 비교 분석한 결과를 종합해 볼 때, 바이오피드백 훈련은 세 가지 감각기능을 고루 향상시키며 아울러 감각기능 간의 협응성 또한 향상시키는 것으로 판단되며, 아쿠아 훈련은 전정기능을 집중적으로 강화시키는 것으로 보인다. This study was conducted to compare the effect improving balance abilities of 3 balance training programs by randomized intervention trial. Study subjects were 29 female students recruited from a university in Gwanju, who allocated randomly to 3 intervention groups, aqua group(modified Halliwick 10 point program, N=10), visual bio-feedback balance training group(N=10), and balance-pad plus trampolin group(N=9). As the results of repeated musure ANOVA, Wilcoxon signed rank test, major research findings were as follows; 1. Regarding SI or BIEMG measured at upright posture on hard platform, bio-feedback group under the condition with opening both eye and aqua group under the condition with closing both eye showed signigicant improvement in balance ability, respectively. 2. Regarding SI or BIEMG measured at upright posture on soft platform, bio-feedback group under the condition with opening both eye and aqua group under the condition with closing both eye showed signigicant improvement in balance ability, respectively. 3. Regarding all 3 sensory ratios, bio-feedback group showed significantly higher increasement in them than other 2 groups. The results suggested that visual bio-feedback training program improve the all 3 sensory functions required for balancing, and aqua training modified from Halliwick 10 point program contribute to improve vestibular function principally.

Efficacy of electromyographic biofeedback and electrical stimulation following arthroscopic partial meniscectomy: a randomized controlled trial

Objective: To compare the effectiveness of electromyographic biofeedback training and electrical stimulation therapy for rehabilitation following arthroscopic partial meniscectomy. Design: Randomized, prospective, controlled single-blind trial. Setting: Department of physical medicine and rehabilitation, university hospital. Subjects: Forty-five patients who had undergone surgery for arthroscopic partial meniscectomy were randomly divided into three groups with 15 patients in each group. Interventions: The control group had home exercise, the second and third groups received electromyographic biofeedback training or electrical stimulation therapy to quadriceps muscle in addition to home exercise. Main measures: The patients were evaluated for: visual analogue scale, gait velocity (m/s), time using a walking aid after surgery, Lysholm Knee Scoring Scale score, knee flexion–extension angle, maximum and average contraction powers of vastus medialis obliquus and vastus lateralis muscles on the day before the operation and two and six weeks after. Results: The time using a walking aid was 8.3 ± 8.0, 1.5 ± 2.5 and 4.5 ± 5.5 days, respectively, for the home exercise, electromyographic biofeedback training and electrical stimulation groups, and significantly shorter in the electromyographic biofeedback training than in the home exercise group (P < 0.017). While significant progress was detected in Lysholm Knee Scoring Scale score in the second and sixth postoperative weeks compared to the preoperative within-group evaluation for each of the three groups (P < 0.017), there was significant difference in Lysholm Knee Scoring Scale in the second postoperative week in favour of electromyographic biofeedback training compared to home exercise (P < 0.017). There were significant differences in vastus medialis obliquus average and vastus lateralis maximum and average contractions in favour of electromyographic biofeedback compared to home exercise and electrical stimulation in the second postoperative week (P < 0.017). Conclusions: The addition of electromyographic biofeedback training to a conventional exercise programme following arthroscopic partial meniscectomy helps to speed up the rehabilitation process.

Long-term outcomes of individualized biofeedback training based on the underlying dysfunction for patients with imperforate anus

Although better anorectal function was achieved due to the advanced operation procedures, the fecal incontinence and constipation still remain as major postoperative complications. The aim of this study was to design a individualized biofeedback program based on the underlying dysfunctions and to assess the short-term and long-term clinical and quality of life outcomes for patients with imperforate anus. Thirty-one patients were treated using individualized biofeedback program according to their different dysfunctions after completed assessment of anorectal function. The many of special biofeedback training methods that consisted of the strengthening perianal muscles biofeedback, sensory discrimination biofeedback, synchronizing external sphincter contraction biofeedback and improving defecation dynamic biofeedback were selected to make up the individualized biofeedback training program. The clinical scores and quality of life scores were assessed at short-term and long-term follow-up. The clinical scores and quality of life scores in patients at before training group, after biofeedback training group, short-term follow-up group and long-term follow-up group were 3.2 +/- 1.1 and 8.7 +/- 1.1, 5.2 +/- 0.6 and 11.0 +/- 0.8, 5.0 +/- 0.6 and 10.8 +/- 0.9, and 4.6 +/- 0.7 and 10.0 +/- 0.7 respectively. After biofeedback training, the first leak volume and all parameters that evaluated the function of the perianal muscles were increased significantly, the abnormal rectal threshold sensations and defecation dynamics were reverted to normal, and 82% patients who have not external anal sphincter reflex acquired the new reflex. The latencies of pudendo-anal reflex have significant difference in patients with poor response compared with those patients with good response before and after the biofeedback training. At short-term follow-up 12 patients (57%) maintained the clinical outcome and only 9 patients (43%) have regressions slightly. At long-term follow-up 7 patients (33%) maintained the clinical outcome very well and 14 patients (67%) have regressions. Although the clinical and quality of life scores have decreased slightly at follow-up, they were still increased significantly compared with before biofeedback training group. The causes of postoperative fecal dysfunction in patients with imperforate anus are multifactorial, and the individualized biofeedback is more suitable for improvement of the clinical outcome and the quality of life, and it maintain good clinical outcome and quality of life at short-term and long-term follow-up.

The effect of home biofeedback training on stress incontinence

Background. To compare the effectiveness of pelvic floor training (PFT) with the aid of a home biofeedback device to PFT alone for urodynamic stress urinary incontinence (SUI) in women after a 1-year follow-up. Methods. A randomized study comparing two conservative interventions was conducted in an outpatient clinic of a university hospital. Thirty-five consecutive women were randomized to either the PFT with home biofeedback group or the PFT alone group. The intensive training period lasted 12 weeks. After 1 year, 33 women could be evaluated according to the protocol. At the 1-year visit pelvic floor muscle activity was measured and the need for surgical intervention was evaluated. Logistic multivariate analysis was used to predict response to the PFT. Results. In the home biofeedback training group 11/16 (68.8%) avoided surgery vs. 10/19 (52.6%) in the PFT alone group. The difference was not statistically significant. In the nonoperated home biofeedback group the increase in pelvic floor muscle activity (p = 0.005 in supine, p = 0.005 in standing) and the decrease in leakage index (p = 0.05) was significant after 12 weeks and pelvic floor activity remained constant. By contrast, in the nonoperated PFT group the increase in pelvic floor muscle activity after 12 weeks predicted a good result for conservative treatment. Conclusions. This randomized controlled trial suggests that the home biofeedback method in PFT has a good success rate of 68.8%. The change achieved in leakage index after 12 weeks of training predicted an effective outcome for conservative treatment.

Sex of Subject and Absorption Capacity as Correlates of Biofeedback Response

The present study investigated the role of sex of subject and absorption capacity in mediating response to electromyographic (EMG) biofeedback training. Subjects were 25 high-absorption and 22 low-absorption males and females, who were assigned to either a biofeedback training group or a no-biofeedback control group. Changes in muscle tension levels and anxiety levels were monitored over the course of two training sessions. The results indicated that absorption capacity was not significantly related to ability to use biofeedback for muscle tension reduction. Significant sex differences in response to biofeedback, however, were apparent: Females were significantly aided in muscle tension by biofeedback, whereas males reduced muscle tension equally with or without biofeedback. Females also reported less cognitive anxiety in response to biofeedback.

Effects of cognitive-behavioral therapy on pain behavior of rheumatoid arthritis (RA) patients: Preliminary outcomes

Abstract Thirty-three patients diagnosed as suffering from definite or classic rheumatoid arthritis (RA) received conventional medical therapies and were randomly assigned to one of three adjunct treatment conditions. These were (a) thermal biofeedback training and cognitive-behavioral group therapy; (b) structured social support group therapy; and (c) no adjunct treatment. Subjects in both the cognitive-behavioral and the social support treatment conditions reported significant descreases in trait anxiety and depression from the pre-treatment to posttreatment assessment. Only the cognitive-behavioral subjects showed significant decreases across assessment periods in pain behavior, self-reports of pain intensity, and rheumatoid factor titer. Subjects' perceptions of control over their RA symptoms were not associated with their outcomes. The results suggest that the cognitive-behavioral treatment produced positive effects upon pain behavior and immune system activity. The stability of these results will be...