Use Of Biofeedback Research Articles

Biofeedback-Based Connected Mental Health Interventions for Anxiety: Systematic Literature Review.

BackgroundConnected mental health, which refers to the use of technology for mental health care and technology-based therapeutic solutions, has become an established field of research. Biofeedback is one of the approaches used in connected mental health solutions, which is mainly based on the analysis of physiological indicators for the assessment and management of the psychological state. Biofeedback is recommended by many therapists and has been used for conditions including depression, insomnia, and anxiety. Anxiety is associated with several physiological symptoms, including muscle tension and breathing issues, which makes the inclusion of biofeedback useful for anxiety detection and management.ObjectiveThe aim of this study was to identify interventions using biofeedback as a part of their process for anxiety management and investigate their perceived effectiveness.MethodsA systematic literature review of publications presenting empirically evaluated biofeedback-based interventions for anxiety was conducted. The systematic literature review was based on publications retrieved from IEEE Digital Library, PubMed, ScienceDirect, and Scopus. A preliminary selection of papers was identified, examined, and filtered to include only relevant publications. Studies in the final selection were classified and analyzed to extract the modalities of use of biofeedback in the identified interventions, the types of physiological data that were collected and analyzed and the sensors used to collect them. Processes and outcomes of the empirical evaluations were also extracted.ResultsAfter final selection, 13 publications presenting different interventions were investigated. The interventions addressed either primarily anxiety disorders or anxiety associated with health issues such as migraine, Parkinson disease, and rheumatology. Solutions combined biofeedback with other techniques including virtual reality, music therapy, games, and relaxation practices and used different sensors including cardiovascular belts, wrist sensors, or stretch sensors to collect physiological data such as heart rate, respiration indicators, and movement information. The interventions targeted different cohorts including children, students, and patients. Overall, outcomes from the empirical evaluations yielded positive results and emphasized the effectiveness of connected mental health solutions using biofeedback for anxiety; however, certain unfavorable outcomes, such as interventions not having an effect on anxiety and patients’ preferring traditional therapy, were reported in studies addressing patients with specific physical health issues.ConclusionsThe use of biofeedback in connected mental health interventions for the treatment and management of anxiety allows better screening and understanding of both psychological and physiological patient information, as well as of the association between the two. The inclusion of biofeedback could improve the outcome of interventions and boost their effectiveness; however, when used with patients suffering from certain physical health issues, suitability investigations are needed.

Lower-Limb Rehabilitation at Home

Ageing causes loss of muscle strength, especially on the lower limbs, resulting in higher risk to injuries during functional activities. The path to recovery is through physiotherapy and adopt customized rehabilitation exercise to assist the patients. Hence, lowering the risk of incorrect exercise at home involves the use of biofeedback for physical rehabilitation patients and quantitative reports for clinical physiotherapy. This research topic has garnered much attention in recent years owing to the fast ageing population and the limited number of clinical experts. In this paper, the authors survey the existing works in exercise assessment and state identification. The evaluation results in the accuracy of 95.83% average classifying exercise motion state using the proposed raw signal. It confirmed that raw signals have more impact than using sensor-fused Euler and joint angles in the state identification prediction model.

Biofeedback: Its function, effects on organism and utility in sports sciences

Biofeedback trainings are frequently used both to treat some diseases and to increase the performance of healthy individuals. Great progress has been made in this regard in various fields. Biofeedback is a method used in fields such as art, surgery, and military service, as well as sports, in order to increase mental and physical performance. In addition it can be said that various researches related to this topic may be carried out in the future, and comprehensive scientific resources will thus be needed. The aim of this review is to conduct a comprehensive literature review about biofeedback practices and to present a scientific resource in Turkish that will meet the need. For this purpose, the findings obtained by examining the studies in the relevant literature were compiled and presented to the reader in a systematic way. In this context, firstly, the basic logic of biofeedback training is explained and the measurement tools along with their functions are presented. Afterwards, the contribution of biofeedback training to self-regulation skills is explained in detail and its effect on the autonomic nervous system is discussed. Then, biofeedback practices used in different fields are summarized. Finally, by referring to the use of biofeedback in the field of sports sciences, relevant researches in the field of sports in Turkey are assessed.

The use of biofeedback intervention in the improvement of depression levels: a randomised trial.

To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group. A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher's exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2. The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group. The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.

How to teach safe landing after the jump? The use of biofeedback to minimize the shock forces generated in elements of modern dance

The aim of the study was to assess the possible use of biofeedback (information on the course and values of ground reaction forces (GRF) during landing following the performance of a dance evolution) for training minimising impact loads after a jump in modern dance. The tests involved the analysis of a total of 60 expressive elements of modern dance performed by 5 soloists. The tests involved the recording of the vertical component of GRF (GRFz) vector using Kistler platform in the landing phase following the performance of modern dance jumps. The dancers performed the above-named jumps three times in successive tests: a reference test (without biofeedback) and the next two tests with biofeedback, after the obtainment of information about the vertical value of GRF. After each performance, the dancers watched a course of GRF and films showing the recorded landing phase. Applying of a proposed didactic laboratory session led to: extension of contact time and of time preceding the obtainment of the maximum value of GRFz, reduction of the maximum values of the vertical components of the GRF, reduction of the loading rate of the ground reaction force, increase of an impulse of the vertical component of GRF in the entire stance phase and in the shock absorption phase. Proposed didactic laboratory session with biofeedback may result in the change of the post-jump shock absorption technique.

Обзор исследований использования БОС-терапии при реабилитации и восстановительном лечении пациентов неврологического профиля

Objective of the Review: To collect information, analyse and evaluate previous studies in the use of biofeedback in neurological patients. Key Points. Despite the wide practical application and a lot of available publications, the level of evidence of this method is low because of a small sample size and the challenges with biofeedback mechanism description. A review of various types of biocontrol, its mechanisms and developments shows that drug-free therapy using only patient’s resources (organic, psychological, emotional and volitional) can activate the mechanisms of neuroplasticity, which are poorly studied. Still, it does not prevent from using biocontrol for the therapy of patients and/or prevention of various diseases in healthy population. Conclusion. Biofeedback therapy has proven to be a safe, relatively efficient and easy-to-use method. However, organisation of a large-scale double blind randomized trial is one of the predominant directions in the future. Keywords: biofeedback, biocontrol, neurofeedback, biofeedback therapy.

Improving the physical fitness of students of educational organizations of the Ministry of Internal Affairs of Russia with the use of biofeedback

Improving the physical fitness of students of educational organizations of the Ministry of Internal Affairs of Russia with the use of biofeedback

The Effect of Biofeedback on Intimate Partner Violence: Study Protocol for a Randomized Controlled Trial

Background: Studies on cognitive behavioral therapy (CBT) for intimate partner violence (IPV) offenders show small to no effects on recidivism. IPV-offenders may not fully benefit from CBT due to insufficient transfer and generalization from therapy to real-life situations. During CBT, patients are taught to detect bodily signals indicative of arousal. A possible reason that the transfer is insufficient might be that the arousal-provoking stimuli in therapy do not match the real-world provoking stimuli, and thus patients do not learn to sufficiently detect bodily signals preceding arousal in real-life. Recent research has shown that IPV-offenders differ in their psychophysiological reactivity depending on their main diagnosis. This might also have implications for learning transfer. We presume that IPV perpetrators cannot fully profit from CBT interventions in which self-control is taught from cognitive techniques instead of increasing physical awareness through biofeedback. In the present study we first want to test the hypothesis that biofeedback will increase awareness of bodily signals indicative of arousal. Second, we expect that the use of biofeedback will have beneficial effects on transfer to real-life situations resulting in a decrease of IPV. For this purpose, we developed a smartphone application, Good Reaction Is Prevention (GRIP), that when used in conjunction with a heart rate monitor measures heart rate variability and notifies users when a personal stress threshold is surpassed. Methods/design: The study takes place in an outpatient forensic treatment center. In a randomized controlled trial (N = 40) we compare a 9-week CBT-based program aimed at developing motivation and self-control where IPV offenders will be treated either with or without biofeedback. The primary outcome is change in frequency of IPV from pretest to posttest. Secondary outcomes are weekly self-report questionnaires on bodily sensations of anger and change in resting HRV-values between pre and post intervention. Discussion: To our knowledge, this is the first study to test the effects of a biofeedback application on IPV. This study will test a new intervention strategy which is expected to increase treatment effects by focusing on bodily awareness instead of cognitive processes.

The use of biofeedback for children with fecal incontinence secondary to retentive constipation: Experience of a French Pediatric Center

Fecal incontinence (FI) secondary to chronic retentive constipation is a frequent demand in pediatric gastroenterology clinics. The management of constipation in children includes laxatives (polyethylene glycol, PEG), enhanced toilet training, and dietary advice. Biofeedback is a possible treatment for children above the age of 7 years with resistant FI. To analyze any changes in volume to trigger defecation (VTD) and envy score over the course of biofeedback sessions according to clinical response. In this retrospective study, we reviewed the medical records of 23 children diagnosed with FI according to the Rome IV criteria and treated with biofeedback. For each biofeedback session, a mean VTD by subject was measured. At the end, therapy was considered a success if soiling disappeared and a failure if any persisted. The need to defecate expressed by the child was described as an envy score. A 0-10 visual analog scale was used to express the intensity of this sensation. Follow-up involved calling the parents 12 months after the biofeedback sessions had ended to assess symptoms remotely. The study included 19 boys and 4 girls with a median age of 10 years. Patients' ages ranged between 7 and 17 years. None of them had any associated neurological disorders. All children had FI for >1 year. The median number of soiling episodes per week was 7. The average number of biofeedback sessions was 3 (range 1-5). At the end of the rehabilitation sessions, 12 children (52%) were in the "success" group. In the latter, median VTD decreased from 97 ml to 70 ml between the first and last session. In the "failure" group, VTD decreased from 120 ml to 100 ml. The between-group difference in the median VTD at the first session was not statistically significant. The last observation carried forward (LOCF) VTD was significantly lower in the "success" group compared to the "failure" group (70 ml versus 100 ml, p = 0.03). Median envy scores decreased during the biofeedback sessions with no statistical difference between the groups at the last session. Follow-up of children in the "success" group one year after the last biofeedback session revealed that 10 patients had no relapse (83%) and 2 were lost to follow-up. Biofeedback might be an effective tool for the management of FI resistant to medical treatment in children.

Exploring public attitude toward biofeedback technologies: Knowledge, preferences and personality tendencies.

Background: Biofeedback is increasingly used in the clinical area and in daily health monitoring through wearable devices (e.g. smart watches). Nevertheless, it remains rather unknown. This study aimed to assess, in a sample of Italian citizens, the level of knowledge, attitudes, perceived efficacy and personality tendencies which could affect the uptake of biofeedback technologies.Design and Methods: Participants were recruited by advertising the survey on the social networks, from March to May 2019. 160 subjects filled in an ad hoc online questionnaire assessing socio-demographic variables, clinical status, physical activity, knowledge and attitude towards biofeedback, psychological tendencies toward health.Results: Data showed a good level of interest in biofeedback training in spite of poor knowledge about such technologies. Sport and chronic diseases were not correlated to a greater use of biofeedback. People informed about biofeedback technologies were more interested in undergoing biofeedback training and had higher scores in the Health Locus of Control. Finally, people who showed a positive perception of their own health (Health Esteem) did not rely on these technologies.Discussion: Despite the huge spread of biofeedback technologies, our results disconfirmed the expectation that people having an active lifestyle or a disease were more familiar with biofeedback systems. The attitude toward such technologies seems to depend on individual tendencies.Conclusions: This study suggests the importance to improve general public literacy on biofeedback technologies, tailor tools on their needs and characteristics, empower people’s sense of internal health control for promoting a valid use and a proper knowledge of biofeedback.Significance for public healthDespite the huge application of biofeedback technologies in different areas, the technological progress and availability of biofeedback tools does not go hand-in-hand with the general public’s knowledge and attitude for such tools. This contribution focuses on the importance to improve general public literacy on these technologies, for disseminating correct messages on their usefulness for well-being, and highlight the importance to tailor technologies on people’s real needs.

Využitie biofeedbacku pri liečbe ADHD detí

Porucha pozornosti s hyperaktivitou (ADHD) je v súčasnosti často vyskytujúca sa neurovývinová porucha u detí. Biofeedback tréningy znižujú stres, úzkosť, navodzujú relaxáciu a pozitívne emócie, zlepšujú pozornosť, učenie a akademický výkon (McCraty, 2003). Príspevok sleduje základné psychofyziologické modality u detí s ADHD a ich zmeny v procese biofeedback tréningu. Výskumná vzorka je tvorená 26 deťmi s diagnostikovanou poruchou ADHD bez komorbidnej poruchy, vo veku od 7 do 10 rokov. Respondenti sa zúčastnili biofeedback tréningu každý týždeň 45 minút, po dobu 15 týždňov.

Which combination is most effective in women with idiopathic overactive bladder, including bladder training, biofeedback, and electrical stimulation? A prospective randomized controlled trial.

To evaluate the efficacy of single and combined use of biofeedback (BF) and electrical stimulation (ES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). Seventy women were randomized into four groups as follows: Group 1 received BT alone (n = 18), Group 2 received BT+BF (n = 17), Group 3 received BT+ES (n = 18), and Group 4 received BT + BF + ES (n = 17). BF and ES were performed 3 days a week, 20 mina day, a total of 24 sessions for 8 weeks. All women were evaluated in terms of incontinence severity (pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes, and number of pads), QoL (incontinence impact questionnaire), treatment success (positive response rate), cure/improvement rate, treatment satisfaction (Likert scale), and discomfort level (visual analog scale). At the end of the treatment, severity of incontinence, frequency of voiding, incontinence episodes, and treatment satisfaction significantly improved in Group 3 and Group 4 compared with the other two groups. In Group 3 and Group 4, high statistically significant values were found in cure/improvement and positive response rates as opposed to Group 1 and Group 2. In Group 2 and Group 3, statistically significant improvements were seen in nocturia and QoL compared withGroup 1. Moreover, statistically significant improvements in nocturia and QoL were found in Group 4 compared with the other three groups. There was no difference in the discomfort level of application between the groups. We conclude that in the first-line conservative treatment of women with idiopathic OAB:(i) adding BF and/or ES to BT increases treatment effectiveness, (ii) clinical efficiency is greater when the combination includes ES, (iii) BT + BF + ES (triple combination) is the most effective treatment option in reducing nocturia and improving QoL.

Biofeedback for Pelvic Floor Disorders.

Defecatory disorders can include structural, neurological, and functional disorders in addition to concomitant symptoms of fecal incontinence, functional anorectal pain, and pelvic floor dyssynergia. These disorders greatly affect quality of life and healthcare costs. Treatment for pelvic floor disorders can include medications, botulinum toxin, surgery, physical therapy, and biofeedback. Pelvic floor muscle training for pelvic floor disorders aims to enhance strength, speed, and/or endurance or coordination of voluntary anal sphincter and pelvic floor muscle contractions. Biofeedback therapy builds on physical therapy by incorporating the use of equipment to record or amplify activities of the body and feed the information back to the patients. Biofeedback has demonstrated efficacy in the treatment of chronic constipation with dyssynergic defecation, fecal incontinence, and low anterior resection syndrome. Evidence for the use of biofeedback in levator ani syndrome is conflicting. In comparing biofeedback to pelvic floor muscle training alone, studies suggest that biofeedback is superior therapy.

Sport Biofeedback: Exploring Implications and Limitations of Its Use

Biofeedback is among the various self-regulation techniques that mental performance consultants can utilize in their practice with athletes. Biofeedback produces psychophysiological assessments in real time to enhance awareness of thoughts and emotions. Quantitatively, research shows that biofeedback can facilitate self-regulation, allowing an athlete to gain control over psychophysiological responses that could be detrimental to performance. With technology becoming a widespread tool in monitoring psychophysiological states, an exploration of consultants’ use of biofeedback, their perceptions of effectiveness, and limitations of their use was warranted to qualitatively evaluate efficiency of the tool. A qualitative descriptive approach was taken through semistructured interviews with 10 mental performance consultants. Inductive reasoning uncovered three themes: positive implications, practical limitations, and equipment options. With biofeedback, athletes have the ability to develop a deeper level of self-awareness and thereby facilitate the use of self-regulation strategies intended for optimal performance states and outcomes.

An Impact of Biofeedback Training on the Effectiveness of Cognitive Training in Stroke Patients

Introduction. The clinical significance of cognitive impairments remaining in patients with acute cerebrovascular accidents (stroke) in the second rehabilitation period actualizes the need for their correction. The technique of cognitive training shows a high degree of cognitive function recovery, but negative emotional states that may occur in patients during rehabilitation may reduce its positive effect. In this regard, the use of biofeedback (BFB) training to stabilize the patients’ psycho-emotional state before cognitive training can increase its effectiveness.Purpose. To evaluate the impact of BFB-training on the effectiveness of cognitive training in patients with acute cerebrovascular disorders in the second rehabilitation period.Design. 41 post-stroke patients (ischemic stroke) in their late recovery period with varying degrees of cognitive impairments, not reaching the level of dementia, completed a course of standard rehabilitation and psychological treatment, including cognitive training sessions. Of these, 20 patients (the experimental group), before cognitive training, additionally underwent a BFB-training based on the skin conductance parameter. Psychodiagnostic evaluation conducted before and after the rehabilitation course included a study of visual and auditory-speech memory, volume, distribution, and attention switching, the level of depression, as well as unconscious and conscious anxiety.Results. After the course of rehabilitation and psychological treatment, the experimental group showed a statistically significant improvement in all cognitive functions and indicators of psycho-emotional state. Positive dynamics in the control group is observed only in the cognitive sphere. The level of cognitive functions in the experimental group after the rehabilitation course was significantly higher than in the control one.Conclusions. An additional inclusion of BFB-training in the course of rehabilitation and psychological treatment helps to increase the effectiveness of cognitive training by stabilizing the psycho-emotional state, as well as by providing a positive impact of biofeedback methods on cognitive functions.

EEG Markers in Emotionally Unstable Personality Disorder-A Possible Outcome Measure for Neurofeedback: A Narrative Review.

Objectives. There is growing evidence for the use of biofeedback (BF) in affective disorders, dissocial personality disorder, and in children with histories of abuse. Electroencephalogram (EEG) markers could be used as neurofeedback in emotionally unstable personality disorder (EUPD) management especially for those at high risk of suicide when emotionally aroused. This narrative review investigates the evidence for EEG markers in EUPD. Methods. PRISMA guidelines were used to conduct a narrative review. A structured search method was developed and implemented in collaboration with an information specialist. Studies were identified via 3 electronic database searches of MEDLINE, Embase, and PsycINFO. A predesigned inclusion/exclusion criterion was applied to selected papers. A thematic analysis approach with 5 criteria was used. Results. From an initial long list of 5250 papers, 229 studies were identified and screened, of which 44 met at least 3 of the predesigned inclusion criteria. No research to date investigates EEG-based neurofeedback in EUPD. A number of different EEG biomarkers are identified but there is poor consistency between studies. Conclusions. The findings heterogeneity may be due to the disorder complexity and the variable EEG related parameters studied. An alternative explanation may be that there are a number of different neuromarkers, which could be clustered together with clinical symptomatology, to give new subdomains. Quantitative EEGs in particular may be helpful to identify more specific abnormalities. EEG standardization of neurofeedback protocols based on specific EEG abnormalities detected may facilitate targeted use of neurofeedback as an intervention in EUPD.

How Do Different Forms Of Feedback Effect Maximal Voluntary Force In The Forearm Flexors?

Biofeedback provides a unique stimulus enhancement to the maximal voluntary isometric contraction (MVIC) ability in several muscle groups. However, limited research has investigated the use of biofeedback in the upper extremities specifically, the forearm flexors (FF). PURPOSE: The purpose of this study was to examine whether different methods of biofeedback affect the maximal force achieved during the FF MVIC test. METHODS: Twenty subjects (10 Male) consented to participate in this randomized counter-balanced experiment. In a single visit, subjects were exposed to the following conditions whilst performing the FF MVIC test. These included, 1) Visual and verbal feedback (VIVE); 2) Verbal feedback only (VE); 3) Visual feedback only (VI); and 4) no feedback at all (NOVIVE). Real-time force output was displayed on a monitor for VIVE and VI, and loud standardized verbal encouragement of ‘pull, pull, pull’ was utilized for VIVE and VE. For each condition, a total of three, 5-second MVIC trials were completed with a two-minute rest between each trial. In addition, a 5-minute rest was provided between consecutive conditions. A 4 x 2 repeated measures ANOVA was performed using the peak MVIC (in Newton) with a significance level set at 0.05. Condition (VIVE vs. VE vs. VI vs. NOVIVE) was a within subject factor and sex (Male vs. Female) was a between subject factor. RESULTS: A significant main effect for condition (p<.001) but no interaction was revealed, with follow-up Bonferroni-adjusted pairwise comparisons demonstrating significantly greater force production in the VIVE compared to VE (mean + standard error (SE): 330.80 + 16.09 vs. 310.62 + 15.51, p=.006), and NOVIVE (mean + SE: 330.80 + 16.09 vs. 304.42 + 15.88, p=.001) conditions; as well as, significantly greater force production in the VI compared to VE (mean + SE: 327.24 + 15.84 vs. 310.62 + 15.51, p<.001), and NOVIVE (mean + SE: 327.24 + 15.84 vs. 304.42 + 15.88, p=.004) conditions. CONCLUSIONS: The main finding is that both VIVE and VI biofeedback provide the most effective form of encouragement during FF MVIC tests by demonstrating the greatest force output. Many studies commonly include VE feedback only, however, here we demonstrate the importance of providing VI biofeedback. Therefore, it is suggested that future studies include VIVE feedback during MVIC trials in the FF.

Outcomes of Paradoxical Vocal Cord Motion Diagnosed in Childhood.

To explore long-term patient reported outcome (PRO) measures of pediatric paradoxical vocal cord motion (PVCM) including ease of diagnosis, management, symptom duration and effect on quality of life. All children >8 years of age diagnosed with PVCM at a tertiary pediatric hospital between 2006 and 2017 were invited to complete a survey addressing study objectives. 21/47 eligible participants could be contacted and 18/21 (86%) participated. 78% were female with a mean age at diagnosis of 11.6 and 15.0 years at survey completion. Common PVCM symptoms reported were dyspnea (89%), globus sensation (56%), and stridor (50%). The median time to diagnosis was 3 months (IQR 2-5 months). Nearly all reported being misdiagnosed with another condition, usually asthma, until being correctly diagnosed usually by an otolaryngologist. Participants reported undergoing 3.7 diagnostic studies (range 0-8); pulmonary function testing was most common. Of numerous treatments acknowledged, breathing exercises were common (89%) but only reported helpful by 56%. Use of biofeedback was recalled in 1/3 of subjects but reported helpful in only 14% of them. Anti-reflux, allergy, anticholinergics, inhalers and steroids were each used in >50%, but rarely reported effective. PVCM was reportedly a significant stressor when initially diagnosed but despite 2/3 of participants still reporting ongoing PVCM symptoms, the perceived stress significantly decreased over time (Z = 3.26, P = 0.001). This first PVCM PRO study endorses that diagnosis is often delayed and prescribed treatments often viewed as ineffective. While biofeedback and breathing exercises may be critical for short-term control of PVCM episodes, lifestyle changes and stress reduction are likely necessary for long-term management. Increased awareness and improvements in management are needed for this condition.

Learning to stand tall: Idiopathic scoliosis, behavioral electronics, and technologically-assisted patient participation in treatment, c. 1969-1992.

Drawing on the archives of American learning psychologist Neal E. Miller, this article investigates the role of instrumentation in the expansion and diversification of the behavior therapy domain from the late 1960s to the early 1990s. Through the case of Miller's research on the use of biofeedback to treat idiopathic scoliosis, it argues that the post-World War II adoption of electronic technology by behavioral psychologists contributed to extending their subject matter to include physiological processes and somatic conditions. It also enabled a technologically-instrumented move outside the laboratory through the development of portable ambulatory treatment devices. Using the example of the Posture-Training Device that Miller and his collaborators invented for the behavioral treatment of idiopathic scoliosis, this paper considers how electromechanical psychological instrumentation illustrated a larger and ambiguous strategic shift in behavior therapy from an orientation toward external control to one of self-control.

The Role of Biofeedback in the Treatment of Sexual Dysfunction

Biofeedback-based or biofeedback-augmented interventions have the potential to serve as first-line treatments for sexual dysfunction concerns, especially among women, for whom current psychosocial treatments are lacking. This brief review summarizes the literature on biofeedback treatments for sexual concerns and highlights recent findings. Biofeedback has been employed in the treatment of various domains of sexual dysfunction, including sexual pain and arousal in women and erectile function in men. Specifically, electromyographic (EMG) biofeedback is widely considered an effective tool to ameliorate sexual pain in women. Though EMG biofeedback has shown efficacy in several studies, it has not been proven to be superior to other (e.g., psychological, surgical) treatments. The results of studies assessing the effects of EMG biofeedback on erectile function are mixed, though men recovering from prostatectomy may benefit from the combination of biofeedback and pelvic floor physiotherapy. Heart rate variability (HRV) biofeedback may improve sexual arousal function in women, though more research is needed in this area. Evidence for the use of biofeedback to treat other sexual problems is lacking. Biofeedback is well-accepted as a primary or adjunctive treatment for specific sexual concerns in women and may be useful for improving erectile function in post-operative men. However, biofeedback would likely be best utilized as part of a multidimensional treatment model, including psychological, pharmacological, and surgical steps. Future research may better determine the precise role of biofeedback in multicomponent treatment protocols.