Abstract Title:
[Effectiveness of Biofeedback for Primary Headache - A Randomized Controlled Study].
Abstract Source:
Psychother Psychosom Med Psychol. 2020 Jan 21. Epub 2020 Jan 21. PMID: 31962346
Abstract Author(s):
Lisa Kolbe, Tanya Eberhardt, Beate Leinberger, Thilo Hinterberger
Article Affiliation:
Lisa Kolbe
Abstract:
BACKGROUND: Biofeedback-treatment for primary headache is highly recommended. Its expenses are mostly not or not completely covered by health funds, hindering the implementation in the care system. This randomized controlled study aimed at evaluating the efficacy of a biofeedback-treatment for primary headache in the outpatient care system all over Germany.
METHODS: The participants were divided into a direct treatment-group (n=41) and a waiting control-group (n=29). The treatment was carried out for 8-11 sessions with vasoconstriction-/vasodilation training for migraine, with electromyography training for headache of the tension type (diagnosis according to the criteria of the International Headache Association). Headache characteristics (frequency, duration, intensity) were collected via headache-diary before, during and after the treatment and headache specific disability using the Pain Disability Index before and after the treatment. The waiting group stated additional information of the questionnaires about 3 months before and again ultimately before the start of the treatment. Measurement of the headache specific self-efficacy (Headache Management Self-efficacy Scale) took place every second session. For the collected parameters the effect sizes for r were computed before in comparison to after the treatment and comparing the treatment-group to the waiting-group.
RESULTS: Headache characteristics decreased during the time of the study significantly linearly with medium to strong effects (frequency f=0.302, p<0.001, duration f=0.186, p<0.001, mean intensity f=0.502, p<0.001, maximal intensity f=0.546, p<0.001). Using biofeedback the self-efficacy rose significantly (p<0.001, r=0.782), even compared to the waiting time (p<0.001, r=0.604). Additionally the handling of pain, the psychological disability and the disability in everyday life improved significantly.
DISCUSSION AND CONCLUSION: Overall the effects were comparable to already existing studies. Therefore biofeedback turned out to be efficient against migraine and tension-type headache in the out-patient care setting. By that a better integration in the care system seems to be qualified.
Article Published Date : Jan 20, 2020
Abstract Title:
Biofeedback and Neurofeedback for Anxiety Disorders: A Quantitative and Qualitative Systematic Review.
Abstract Source:
Adv Exp Med Biol. 2020 ;1191:265-289. PMID: 32002934
Abstract Author(s):
David F Tolin, Carolyn D Davies, Danielle M Moskow, Stefan G Hofmann
Article Affiliation:
David F Tolin
Abstract:
Biofeedback refers to the operant training of physiological responding. Variants include electromyography (EMG), electrodermal activity (EDA), skin temperature, heart rate (HR) and heart rate variability (HRV), respiratory biofeedback of end-tidal CO(ETCO), electroencephalography (EEG) signal, and blood oxygen-level dependent signal using functional magnetic resonance imaging (fMRI). This chapter presents a qualitative and quantitative systematic review of randomized controlled trials of biofeedback for anxiety disorders as defined by the 3rd through 5th editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Meta-analytic results indicated that biofeedback (broadly defined) is superior to wait list, but has not been shown to be superior to active treatment conditions or to conditions in which patients are trained to change their physiological responding in a countertherapeutic direction. Thus, although biofeedback appears generally efficacious for anxiety disorders, the specific effects of biofeedback cannot be distinguished from nonspecific effects of treatment. Further, significant limitations were identified in the existing literature, with the majority receiving a"weak"rating according to Effective Public Health Practice Project (EPHPP) rating system guidelines. Future directions for research are discussed.
Article Published Date : Dec 31, 2019
Abstract Title:
Modified Biofeedback (Conditioned Biofeedback) Promotes Antinociception by Increasing the Nociceptive Flexion Reflex Threshold and Reducing Temporal Summation of Pain: A Controlled Trial.
Abstract Source:
J Pain. 2019 Nov 1. Epub 2019 Nov 1. PMID: 31683023
Abstract Author(s):
Jamie L Rhudy, Natalie Hellman, Cassandra A Sturycz, Tyler A Toledo, Shreela Palit
Article Affiliation:
Jamie L Rhudy
Abstract:
This study examined whether a modified version of biofeedback (ie, Conditioned Biofeedback) that incorporated placebo analgesia-like manipulations could promote antinociception in healthy, pain-free participants. During Conditioned Biofeedback (n = 28), sympathetic arousal level was displayed visually and participants were asked to reduce it while they received painful electric stimulations that were surreptitiously controlled by their arousal level. Thus, electric pain decreased as arousal decreased to associate successful arousal-reduction/relaxation with pain relief, and to promote expectations for future pain relief. A Biofeedback Only group (n = 24) controlled for the general effects of biofeedback/relaxation. A Biofeedback+Shock group (n = 21) controlled for the effects of practicing biofeedback during painful shocks. Nociceptive flexion reflex (NFR) threshold and temporal summation of pain (TS-pain) were used to assess changes in spinal nociception and pain facilitation, respectively. Results indicated all groups showed pre- to postbiofeedback increases in NFR threshold, but only the Conditioned Biofeedback group showed pre- to postbiofeedback reductions in TS-pain. Moreover, Conditioned Biofeedback resulted in a persistent (prebiofeedback) increase in NFR threshold across sessions, whereas Biofeedback Only resulted in a persistent (prebiofeedback) decrease in TS-pain. In sum, Conditioned Biofeedback maypromote antinociception in healthy participants thus reducing risk for chronic pain. The study was registered prospectively on ClinicalTrials.gov (TU1560). PERSPECTIVE: A modified version of biofeedback that employs placebo analgesia manipulations was successful in increasing descending inhibitionand reducing pain facilitation in healthy volunteers. As a result, it may be an effective means of reducing risk of future chronic pain onset by promoting an antinociceptive pain profile.
Article Published Date : Oct 31, 2019
Abstract Title:
The effect of biofeedback training on intestinal function among patients with middle and low rectal cancer: a randomized controlled study.
Abstract Source:
Ann Transl Med. 2019 Nov ;7(21):605. PMID: 32047766
Abstract Author(s):
Li Liu, Xiaodan Wu, Qianwen Liu, Caixing Tang, Baojia Luo, Yujing Fang, Zhizhong Pan, Desen Wan, Meichun Zheng
Article Affiliation:
Li Liu
Abstract:
Background: To evaluate the effect of biofeedback on intestinal function among patients with middle and low rectal cancer.
Methods: 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.
Results: 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).
Conclusions: 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.
Article Published Date : Oct 31, 2019
Abstract Title:
Rehabilitation with biofeedback training in age-related macular degeneration for improving distance vision.
Abstract Source:
Can J Ophthalmol. 2019 Jun ;54(3):328-334. Epub 2019 Apr 2. PMID: 31109472
Abstract Author(s):
Monica Daibert-Nido, Beatriz Patino, Michelle Markowitz, Samuel N Markowitz
Article Affiliation:
Monica Daibert-Nido
Abstract:
OBJECTIVES: Biofeedback training (BT) is a modern method for enhancing the use of preferred retinal loci (PRL) retraining for new retinal loci (TRL), hence improving far and near vision. This article attempts to clarify the optimal methodology for BT and the types of patients who can benefit most from BT.
METHODS: This is a retrospective review of cases who received BT with the macular integrity assessment (MAIA) microperimetre. Outcome measures selected for analysis were visual acuity, PRL location, fixation stability, fixation pattern orientation, reading acuity, critical print size, and reading speed.
RESULTS: Out of 30 cases who received BT, only those with age-related macular degeneration and visual acuity of logMAR 0.8 (20/126) or poorer showed a visual acuity gain (statistically significant of 12 letters) after BT. Those with other diagnoses and those with residual Early Treatment Diabetic Retinopathy Study best-corrected visual acuity of logMAR of 0.7 (20/100) or better showed only positive trends for visual acuity and a negative trend for fixation stability. All subjects showed a shift in PRL location toward the superior quadrant of the retina (p<0.02) in those who received BT.
CONCLUSION: BT seems to offer patients a unique and efficient modality to improve distance vision outside of using optical devices.
Article Published Date : May 31, 2019
Abstract Title:
Mind-Body Interventions for Pediatric Inflammatory Bowel Disease.
Abstract Source:
Children (Basel). 2017 Apr 3 ;4(4). Epub 2017 Apr 3. PMID: 28368365
Abstract Author(s):
Ann Ming Yeh, Anava Wren, Brenda Golianu
Article Affiliation:
Ann Ming Yeh
Abstract:
Pediatric inflammatory bowel disease is an autoimmune disease that causes chronic inflammation of the gastrointestinal mucosa. There is emerging evidence that the brain-gut connection affects inflammatory bowel disease (IBD) patients more than previously thought. This is evidenced by comorbid mood disorders, irritable bowel symptoms concurrent with quiescent IBD, and the potential of psychosocial stressors to trigger IBD flares. Mind-body interventions such as psychotherapy, relaxation, mindfulness, biofeedback, yoga, and clinical hypnosis offer an adjunct to standard medical treatment for IBD. We will review the current evidence base for these mind- body interventions in the treatment of pediatric IBD, illustrate a case study, and offer suggestions for future research for this promising field.
Article Published Date : Apr 02, 2017
Abstract Title:
Efficacy of Biofeedback in Chronic back Pain: a Meta-Analysis.
Abstract Source:
Int J Behav Med. 2017 02 ;24(1):25-41. PMID: 27307013
Abstract Author(s):
Robert Sielski, Winfried Rief, Julia Anna Glombiewski
Article Affiliation:
Robert Sielski
Abstract:
PURPOSE: The aims of the present analysis were to investigate the short- and long-term efficacy and treatment moderators of biofeedback as a psychological treatment option for chronic back pain.
METHOD: A literature search using PubMed, PsycINFO, and the Cochrane Library identified 21 eligible studies including 23 treatment conditions and 1062 patients.
RESULTS: Meta-analytic integration resulted in a significant small-to-medium effect size for pain intensity reduction (Hedges' g = 0.60; 95 % confidence interval (CI) 0.44, 0.76) that proved to be stable with a significant small-to-large effect size (Hedges' g = 0.62; 95 % CI 0.40, 0.84) over an average follow-up phase of 8 months. Biofeedback also proved to be effective in reducing depression (Hedges' g = 0.40; 95 % CI 0.27, 0.52), disability (Hedges' g = 0.49; 95 % CI 0.34, 0.74), reduction of muscle tension (EMG; Hedges' g = 0.44; 95 % CI 0.22, 0.65), and improving cognitive coping (Hedges' g = 0.41; 95 % CI 0.26, 0.57). These effects remained comparatively stable at follow-up and for controlled studies only. Moderator analyses revealed longer biofeedback treatments to be more effective for reducing disability and a greater proportion of biofeedback in the treatment to be more effective for reducing depression. Publication bias analyses demonstrated the consistency of these effects.
CONCLUSION: It is concluded that biofeedback treatment can lead to improvements on various pain-related outcomes in the short and long terms, both as a standalone and as an adjunctive intervention.
Article Published Date : Dec 31, 2016
Abstract Title:
Bowel biofeedback treatment in patients with multiple sclerosis and bowel symptoms.
Abstract Source:
Dis Colon Rectum. 2011 Sep ;54(9):1114-21. PMID: 21825891
Abstract Author(s):
Giuseppe Preziosi, Dimitri A Raptis, Julie Storrie, Amanda Raeburn, Clare J Fowler, Anton Emmanuel
Article Affiliation:
1GI Physiology Unit, University College London Hospital, London, United Kingdom 2Division of General Surgery, University College London, London, United Kingdom 3Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Abstract:
BACKGROUND: : Bowel symptoms are common in patients with multiple sclerosis, but current treatment is empirical.
OBJECTIVE: : This study aimed to identify effect of biofeedback on bowel symptoms, mood, and anorectal physiology in patients with multiple sclerosis.
DESIGN: : This was a prospective observational study: the amount of change between pre- and posttreatment values of outcome measures was compared and analyzed. Responders were considered to be patients who demonstrated an improvement greater than or equal to the 25th percentile of the change in bowel score. Comparison between responders and nonresponders was performed.
SETTINGS: : This investigation was conducted at a neurogastroenterology clinic, tertiary referrals center.
PATIENTS: : Thirty-nine patients with multiple sclerosis and constipation and/or fecal incontinence were included in the study.
INTERVENTION: : Patients were given bowel biofeedback therapy.
MAIN OUTCOME MEASURES: : The primary outcome measures were the Wexner Constipation and Wexner Incontinence scores. The secondary outcome measures were hospital anxiety and depression scores and anorectal physiology parameters.
RESULTS: : Data are reported as median and interquartile ranges. After biofeedback there was significant improvement in Wexner Constipation (12 (5-19) pretreatment vs 8 (4-14) posttreatment, P = .001), Wexner Incontinence (12 (3-15) pretreatment vs 4 (2-10) posttreatment, P<.001) and hospital depression scores (7 (3-11) pretreatment vs 5 (3-10) posttreatment, P = .015). The 5-second endurance squeeze pressure was also improved (21 (11-54) mmHg pretreatment vs 43 (26-59) mmHg posttreatment, P = .001). Posttreatment change of Wexner Constipation was -2(-5/0), and of Wexner Incontinence was -3(-9/0) ("-" indicates improvement). Therefore, those patients who had a reduction of at least 5 points in the Wexner Constipation score and/or of at least 9 points in the Wexner Incontinence score were considered responders (18 patients, 46%). They showed a greater improvement of only 5-second endurance squeeze pressure (23.5 (7.5/32.75) mmHg responders vs 4 (-6/20) mmHg nonresponders, P = .008); no difference was observed in the comparison of baseline variables with nonresponders. Significant negative relationship existed between the change in the Wexner Constipation score (-2 (-5/0)) and the pretreatment Wexner Constipation score (12 (5/19),β = -0.463, P<.001), and the change in the Wexner Incontinence score (-3 (-9/0)) with the pretreatment Wexner Incontinence score (12 (3/15),β = -0.590, P<.001). So, the higher the initial bowel symptom score, the greater the improvement.
LIMITATIONS: : This study was limited by the lack of a control group.
CONCLUSIONS: : Biofeedback improves bowel symptoms, depression, and 5-second endurance squeeze pressure in patients with multiple sclerosis.
Article Published Date : Sep 01, 2011
Abstract Title:
[Correction of posture disorders and scoliosis in schoolchildren using functional biofeedback].
Abstract Source:
Rheumatol Int. 2010 Apr 14. Epub 2010 Apr 14. PMID: 2175121
Abstract Author(s):
O V Bogdanov, N I Nikolaeva, E L Mikhaĭlenok
Abstract:
A novel technique is offered for correction of postural defects and early manifestations of scoliosis in schoolchildren using methods of functional biofeedback training. The technique allowed the patient to use the biofeedback signals informing on the degree of asymmetry in bioelectric activity of paravertebral muscles in static active straightening of the vertebral column. The data revealed a steady decrease in asymmetric activity indices in muscles erecting the column. This provided a physiological basis for a high clinical efficiency of the technique.
Article Published Date : Apr 14, 2010
Abstract Title:
Nonimmersive virtual reality mirror visual feedback therapy and its application for the treatment of complex regional pain syndrome: an open-label pilot study.
Abstract Source:
Pain Med. 2010 Apr;11(4):622-9. Epub 2010 Mar 1. PMID: 20202141
Abstract Author(s):
Kenji Sato, Satoshi Fukumori, Takashi Matsusaki, Tomoko Maruo, Shinichi Ishikawa, Hiroyuki Nishie, Ken Takata, Hiroaki Mizuhara, Satoshi Mizobuchi, Hideki Nakatsuka, Masaki Matsumi, Akio Gofuku, Masataka Yokoyama, Kiyoshi Morita
Article Affiliation:
Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama Prefecture, 700-8551, Japan. This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract:
OBJECTIVE: Chronic pain conditions such as phantom limb pain and complex regional pain syndrome are difficult to treat, and traditional pharmacological treatment and invasive neural block are not always effective. Plasticity in the central nervous system occurs in these conditions and may be associated with pain. Mirror visual feedback therapy aims to restore normal cortical organization and is applied in the treatment of chronic pain conditions. However, not all patients benefit from this treatment. Virtual reality technology is increasingly attracting attention for medical application, including as an analgesic modality. An advanced mirror visual feedback system with virtual reality technology may have increased analgesic efficacy and benefit a wider patient population. In this preliminary work, we developed a virtual reality mirror visual feedback system and applied it to the treatment of complex regional pain syndrome.
DESIGN: A small open-label case series. Five patients with complex regional pain syndrome received virtual reality mirror visual feedback therapy once a week for five to eight sessions on an outpatient basis. Patients were monitored for continued medication use and pain intensity.
RESULTS: Four of the five patients showed>50% reduction in pain intensity. Two of these patients ended their visits to our pain clinic after five sessions.
CONCLUSION: Our results indicate that virtual reality mirror visual feedback therapy is a promising alternative treatment for complex regional pain syndrome. Further studies are necessary before concluding that analgesia provided from virtual reality mirror visual feedback therapy is the result of reversing maladaptive changes in pain perception.
Article Published Date : Apr 01, 2010
Abstract Title:
The relative efficacy of connectivity guided and symptom based EEG biofeedback for autistic disorders.
Abstract Source:
Appl Psychophysiol Biofeedback. 2010 Mar;35(1):13-23. Epub 2009 Aug 1. PMID: 19649702
Abstract Author(s):
Robert Coben, Thomas E Myers
Abstract:
Autism is a neurodevelopmental disorder characterized by deficits in communication, social interaction, and a limited range of interests with repetitive stereotypical behavior. Various abnormalities have been documented in the brains of individuals with autism, both anatomically and functionally. The connectivity theory of autism is a recently developed theory of the neurobiological cause of autisic symptoms. Different patterns of hyper- and hypo-connectivity have been identified with the use of quantitative electroencephalogray (QEEG), which may be amenable to neurofeedback. In this study, we compared the results of two published controlled studies examining the efficacy of neurofeedback in the treatment of autism. Specifically, we examined whether a symptom based approach or an assessment/connectivity guided based approach was more effective. Although both methods demonstrated significant improvement in symptoms of autism, connectivity guided neurofeedback demonstrated greater reduction on various subscales of the Autism Treatment Evaluation Checklist (ATEC). Furthermore, when individuals were matched for severity of symptoms, the amount of change per session was significantly higher in the Coben and Padolsky (J Neurother 11:5-23, 2007) study for all five measures of the ATEC. Our findings suggest that an approach guided by QEEG based connectivity assessment may be more efficacious in the treatment of autism. This permits the targeting and amelioration of abnormal connectivity patterns in the brains of people who are autistic.
Article Published Date : Mar 01, 2010
Abstract Title:
Neurofeedback outcomes in clients with Asperger's syndrome.
Abstract Source:
Appl Psychophysiol Biofeedback. 2010 Mar;35(1):63-81. PMID: 19908142
Abstract Author(s):
Lynda Thompson, Michael Thompson, Andrea Reid
Abstract:
This paper summarizes data from a review of neurofeedback (NFB) training with 150 clients with Asperger's Syndrome (AS) and 9 clients with Autistic Spectrum Disorder (ASD) seen over a 15 year period (1993-2008) in a clinical setting. The main objective was to investigate whether electroncephalographic (EEG) biofeedback, also called neurofeedback (NFB), made a significant difference in clients diagnosed with AS. An earlier paper (Thompson et al. 2009) reviews the symptoms of AS, highlights research findings and theories concerning this disorder, discusses QEEG patterns in AS (both single and 19-channel), and details a hypothesis, based on functional neuroanatomy, concerning how NFB, often paired with biofeedback (BFB), might produce a change in symptoms. A further aim of the current report is to provide practitioners with a detailed description of the method used to address some of the key symptoms of AS in order to encourage further research and clinical work to refine the use of NFB plus BFB in the treatment of AS. All charts were included for review where there was a diagnosis of AS or ASD and pre- and post-training testing results were available for one or more of the standardized tests used. Clients received 40-60 sessions of NFB, which was combined with training in metacognitive strategies and, for most older adolescent and adult clients, with BFB of respiration, electrodermal response, and, more recently, heart rate variability. For the majority of clients, feedback was contingent on decreasing slow wave activity (usually 3-7 Hz), decreasing beta spindling if it was present (usually between 23 and 35 Hz), and increasing fast wave activity termed sensorimotor rhythm (SMR) (12-15 or 13-15 Hz depending on assessment findings). The most common initial montage was referential placement at the vertex (CZ) for children and at FCz (midway between FZ and CZ) for adults, referenced to the right ear. Metacognitive strategies relevant to social understanding, spatial reasoning, reading comprehension, and math were taught when the feedback indicated that the client was relaxed, calm, and focused. Significant improvements were found on measures of attention (T.O.V.A. and IVA), core symptoms (Australian Scale for Asperger's Syndrome, Conners' Global Index, SNAP version of the DSM-IV criteria for ADHD, and the ADD-Q), achievement (Wide Range Achievement Test), and intelligence (Wechsler Intelligence Scales). The average gain for the Full Scale IQ score was 9 points. A decrease in relevant EEG ratios was also observed. The ratios measured were (4-8 Hz)(2)/(13-21 Hz)(2), (4-8 Hz)/(16-20 Hz), and (3-7 Hz)/(12-15 Hz). The positive outcomes of decreased symptoms of Asperger's and ADHD (including a decrease in difficulties with attention, anxiety, aprosodias, and social functioning) plus improved academic and intellectual functioning, provide preliminary support for the use of neurofeedback as a helpful component of effective intervention in people with AS.
Article Published Date : Mar 01, 2010
Abstract Title:
Influence of sympathetic autonomic arousal on tics: implications for a therapeutic behavioral intervention for Tourette syndrome.
Abstract Source:
J Psychosom Res. 2009 Dec;67(6):599-605. PMID: 19913664
Abstract Author(s):
Yoko Nagai, Andrea Cavanna, Hugo D Critchley
Article Affiliation:
Department of Psychology, University of Essex, Colchester, UK. This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract:
OBJECTIVES: The pharmacological treatment of Tourette syndrome (TS) has improved due to the application of new medications and combinations of medications, coupled to greater phenomenological and neurobiological understanding of the condition. Nevertheless, for many individuals with TS, potentially troublesome tics persist despite optimized drug treatment. Anecdotally, a relationship is frequently described between tic frequency and states of bodily arousal and/or focused attention. The galvanic skin response (GSR) is an accessible and sensitive index of sympathetic nervous activity, reflecting centrally induced changes in peripheral autonomic arousal. Sympathetic nervous arousal, measured using GSR, has been shown to have an inverse relationship with an electroencephalographic index of cortical excitability (slow cortical potential), and GSR arousal biofeedback shows promise as an adjunctive therapy in management of treatment-resistant epilepsy.
METHOD: We examined how changes in sympathetic arousal, induced using GSR biofeedback, impact on tic frequency in individuals with TS. Two different physiological states (sympathetic arousal and relaxation) were induced using GSR biofeedback in 15 individuals with a diagnosis of TS. During both biofeedback sessions, participants were videotaped to monitor the occurrence of tics.
RESULTS: We observed significantly lower tics during relaxation biofeedback compared to arousal biofeedback, with tic frequency positively correlating with sympathetic arousal during the arousal session.
CONCLUSION: These findings indicate that the conjunction of focused attention to task and reduced peripheral sympathetic tone inhibits tic expression and suggests a potential therapeutic role of biofeedback relaxation training for tic management in patients with TS.
Article Published Date : Dec 01, 2009
Abstract Title:
The effects of biofeedback training of pelvic floor muscles on fecal incontinence.
Abstract Source:
J Pediatr Surg. 2009 Dec;44(12):2384-7. PMID: 20006032
Abstract Author(s):
Xiao-bing Sun, Li Zhang, Yan-hua Li, Jin-liang Li, Yu-li Chen
Abstract:
OBJECTIVE: The purpose of this study is to discuss the effect of pelvic floor muscle training on fecal incontinence.
METHODS: A retrospective study was performed on patients who received pelvic floor muscle training from March 2002 to April 2007. There were 55 patients with fecal incontinence (male, 32 cases; female, 23 cases; mean age, 9.4 years old from 6 to 14), including 39 cases of anorectal malformation and 16 cases of Hirschsprung's disease. Pelvic floor muscle training was performed using biofeedback for 2 weeks in hospital, 2 times each day, and 30 minutes each time. The patients were then instructed to carry out self-training at home without the biofeedback device daily and received training evaluations in the hospital outpatient department monthly. All patients completed the training regimen and were followed up for 1 year. Anal manometry and clinical score were evaluated before and after training.
RESULTS: Anal continence of 30 patients had satisfactory improvement, but not for the other 25 cases after training. The mean anal squeeze pressures of the group that had good results and the group that had poor results were 98.4 +/- 7.3 and 47.4 +/- 13.6 mm Hg, respectively, before training. There were 31 patients whose anal squeeze pressures were above 80 mm Hg, and 26 of these had satisfactory anal continence improvement, including all patients with Hirschsprung's disease. On the contrary, only 4 of 24 cases whose anal squeeze pressure was below 80 mm Hg acquired satisfactory anal continence improvement.
CONCLUSIONS: Pelvic floor muscle training could achieve good results in some patients with fecal incontinence. Baseline measurements during anorectal manometry appear to provide good prediction of prognosis and effective management.
Article Published Date : Dec 01, 2009
Abstract Title:
Chronic prostatitis presenting with dysfunctional voiding and effects of pelvic floor biofeedback treatment.
Abstract Source:
BJU Int. 2009 Sep 14. PMID: 19751259
Abstract Author(s):
Wei He, Minfeng Chen, Xiongbing Zu, Yuan Li, Keping Ning, Lin Qi
Abstract:
OBJECTIVE To investigate the features of chronic prostatitis presenting with dysfunctional voiding (DV) and the effects of pelvic floor biofeedback (PFB). PATIENTS AND METHODS The study included 21 patients, diagnosed by having symptoms for >/=3 months, including urinary frequency and urgency, voiding difficulty, upper abdominal or perineal discomfort, and with a score of >/=1 on the first and second part of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Patients with bacterial prostatitis, urethritis, interstitial cystitis, urethral stricture and neurogenic bladder were excluded. All patients had a urodynamic examination, to assess the uroflow curve, maximum urinary flow rate (Q(max)), maximum detrusor pressure during the storage phase (P(det.max)), maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) were recorded. PFB was carried out in patients with non-neurogenic detrusor sphincter dyssynergia, and the effects evaluated after 10 weeks.
RESULTS Before and after PFB treatment the mean (sd) Q(max), P(det.max), MUP, MUCP were 8.2 (4.1) vs 15.1 (7.3) mL/s, 125.1 (75.3) vs 86.3 (54.2) cmH(2)O, 124.3 (23.3) vs 65.4 (23.0) cmH(2)O and 101.5 (43.6) vs 43.5 (16.7) cmH(2)O, all significantly different (P < 0.05). The respective differences in the pain, urination and life impact subdomain scores, and total scores, of the NIH-CPSI were 4.0 (2.0) vs 2.2 (1.7), 7.9 (2.1) vs 2.2 (1.9), 9.6 (2.7) vs 2.9 (2.6) and 21.7 (4.8) vs 8.4 (4.6), and all differences were significant (P < 0.05).
CONCLUSIONS There might be DV in patients with chronic prostatitis and lower urinary tract symptoms. Urodynamics showed a low Q(max) and increasing intravesical pressure and, in some patients, increasing urethral pressure. Urodynamics could be used to help in the diagnosis, and to select the most appropriate treatment. PFB had satisfactory short-term effects on these patients.
Article Published Date : Sep 14, 2009
Abstract Title:
Biofeedback for pain management in traumatised refugees.
Abstract Source:
Cogn Behav Ther. 2009 Sep;38(3):184-90. PMID: 19675955
Abstract Author(s):
Julia Muller, Anke Karl, Claudia Denke, Fabienne Mathier, Jennifer Dittmann, Nicolas Rohleder, Christine Knaevelsrud
Article Affiliation:
Department of Psychiatry, University Hospital Zurich, Switzerland. This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract:
Chronic pain (CP) and posttraumatic stress disorder (PTSD) are both frequent and often comorbid in refugees. To date, few controlled trials have studied the efficacy of treatments targeting this comorbidity; no treatment guidelines yet exist. The authors examined the feasibility and efficacy of short-term cognitive behavioural biofeedback (BF) addressing CP in traumatised refugees. The sample comprised 11 severely traumatised refugees with CP and PTSD (mean age = 36 years, SD = 6), who underwent assessment with the Mini International Neuropsychiatric Interview, Posttraumatic Diagnostic Scale, Pain Disability Index, and Visual Rating Scale. Additionally, coping with pain and psychotherapy tolerance were assessed. Acceptance of BF was high. Pre-post effects were small to medium for increased pain management and associated heart rate reactivity but large for coping with pain. The results encourage further research to confirm whether BF is indicated as a treatment component, but not a stand-alone treatment, for traumatised refugees with comorbid CP and PTSD.
Article Published Date : Sep 01, 2009
Abstract Title:
Training with virtual visual feedback to alleviate phantom limb pain.
Abstract Source:
Neurorehabil Neural Repair. 2009 Jul-Aug;23(6):587-94. Epub 2009 Jan 26. PMID: 19171946
Abstract Author(s):
Catherine Mercier, Angela Sirigu
Article Affiliation:
Center for Cognitive Neuroscience, Bron, France. This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract:
BACKGROUND: Performing phantom movements with visual virtual feedback, or mirror therapy, is a promising treatment avenue to alleviate phantom limb pain. However the effectiveness of this approach appears to vary from one patient to another.
OBJECTIVE: To assess the individual response to training with visual virtual feedback and to explore factors influencing the response to that approach.
METHODS: Eight male participants with phantom limb pain (PLP) resulting from either a traumatic upper limb amputation or a brachial plexus avulsion participated in this single case multiple baseline study. Training was performed 2 times per week for 8 weeks where a virtual image of a missing limb performing different movements was presented and the participant was asked to follow the movements with his phantom limb.
RESULTS: Patients reported an average 38% decrease in background pain on a visual analog scale (VAS), with 5 patients out of 8 reporting a reduction greater than 30%. This decrease in pain was maintained at 4 weeks postintervention in 4 of the 5 participants. No significant relationship was found between the long-term pain relief and the duration of the deafferentation or with the immediate pain relief during exposure to the feedback.
CONCLUSIONS: These results support the use of training with virtual feedback to alleviate phantom limb pain. Our observations suggest that between-participant differences in the effectiveness of the treatment might be related more to a difference in the susceptibility to the virtual visual feedback, than to factors related to the lesion, such as the duration of the deafferentation.
Article Published Date : Jul 01, 2009
Abstract Title:
The effect of biofeedback on function in patients with heart failure.
Abstract Source:
Appl Psychophysiol Biofeedback. 2009 Jun;34(2):71-91. Epub 2009 Feb 10. PMID: 19205870
Abstract Author(s):
Kimberly S Swanson, Richard N Gevirtz, Milton Brown, James Spira, Ermina Guarneri, Liset Stoletniy
Abstract:
Decreased HRV has been consistently associated with increased cardiac mortality and morbidity in HF patients. The aim of this study is to determine if a 6-week course of heart rate variability (HRV) biofeedback and breathing retraining could increase exercise tolerance, HRV, and quality of life in patients with New York Heart Association Class I-III heart failure (HF). Participants (N = 29) were randomly assigned to either the treatment group consisting of six sessions of breathing retraining, HRV biofeedback and daily practice, or the comparison group consisting of six sessions of quasi-false alpha-theta biofeedback and daily practice. Exercise tolerance, measured by the 6-min walk test (6MWT), HRV, measured by the standard deviation of normal of normal beats (SDNN), and quality of life, measured by the Minnesota Living with Congestive Heart Failure Questionnaire, were measured baseline (week 0), post (week 6), and follow-up (week 18). Cardiorespiratory biofeedback significantly increased exercise tolerance (p = .05) for the treatment group in the high (>or=31%) left ventricular ejection fraction (LVEF) category between baseline and follow-up. Neither a significant difference in SDNN (p = .09) nor quality of life (p = .08), was found between baseline and follow-up. A combination of HRV biofeedback and breathing retraining may improve exercise tolerance in patients with HF with an LVEF of 31% or higher. Because exercise tolerance is considered a strong prognostic indicator, cardiorespiratory biofeedback has the potential to improve cardiac mortality and morbidity in HF patients.
Article Published Date : Jun 01, 2009
Abstract Title:
Long-term results of biofeedback treatment for faecal incontinence: a comparative study with untreated controls.
Abstract Source:
Colorectal Dis. 2009 Apr 10. PMID: 19486084
Abstract Author(s):
G Lacima, M Pera, A Amador, G Escaramís, J M Piqué
Abstract:
ABSTRACT Aim: Long-term results of biofeedback for faecal incontinence are controversial. Moreover, its value compared to standard care has been recently questioned. The study aimed to analyse the long-term efficacy of biofeedback therapy for faecal incontinence to formed stool and to compare it with no treatment. Method: Seventy-nine patients with faecal incontinence to solid stool were evaluated at baseline and 1, 6, 36, and 60 months after treatment. Comparing the long-term results with no treatment, 40 patients initially evaluated but not referred for therapy were used as controls. Results: More than 80% of patients recovered continence or had a reduction in the number of episodes of incontinence greater than 75% at 1, 6, 36, and 60 months indicating that the success rate of biofeedback was maintained over time. At 60 months, 86% of patients treated with biofeedback were fully continent or had a >75% reduction in the number of incontinent episodes compared with 26% of the untreated patients (p < 0.001). Conclusions: Biofeedback therapy is effective in patients with faecal incontinence to formed stool compared with no treatment. Overall, clinical improvement is maintained in the long-term.
Article Published Date : Apr 10, 2009
Abstract Title:
Results of biofeedback treatment on reflux resolution rates in children with dysfunctional voiding and vesicoureteral reflux.
Abstract Source:
Urology. 2007 Sep;70(3):563-6; discussion 566-7. PMID: 17905115
Abstract Author(s):
Yusuf Kibar, Onder Ors, Erkan Demir, Suleyman Kalman, Onur Sakallioglu, Murat Dayanc
Abstract:
OBJECTIVES: It is well known that a relationship exists between vesicoureteral reflux (VUR) and dysfunctional voiding, and the spontaneous resolution rate in older children is lower than the rate in younger children. In this study, we analyzed our experience with biofeedback treatment in older children with confirmed voiding dysfunction and VUR and investigated the effect of this treatment on the reflux resolution rates in these children.
METHODS: A total of 78 children, 5 to 14 years old (mean age 9), with voiding dysfunction and VUR detected by voiding cystourethrography were treated with biofeedback therapy. Voiding cystourethrography was performed 6 months after completion of the biofeedback program to determine the reflux status. The treatment results were also documented as subjective and objective improvements.
RESULTS: The reflux in 98 units (20 bilateral) was grade 1 in 26, grade 2 in 32, grade 3 in 28, and grade 4 in 12. At 6 months of follow-up, VUR had resolved on voiding cystourethrography in 62 units (63%), the grade had improved in 28 units (29%), and the reflux had remained unchanged in 8 units (8%). Among the older children treated with biofeedback, we also observed improvements in nocturnal enuresis (82%), daytime wetting (70%), constipation (78%), frequency (76%), infrequency (64%), urgency (71%), staccato voiding (81%), flattened voiding (81%), bladder overactivity (82%), detrusor sphincter dyssynergia (77%), spinning top urethra (67%), and urinary tract infection (80%).
CONCLUSIONS: Biofeedback therapy is applicable in older children with dysfunctional voiding and VUR and yields greater resolution rates than the historical resolution rates.
Article Published Date : Sep 01, 2007
Abstract Title:
High-intensity, short-term biofeedback in children with Hinman's syndrome (non-neuropathic voiding dyssynergia).
Abstract Source:
J Pediatr Urol. 2006 Aug;2(4):344-50. Epub 2006 May 19. PMID: 18947634
Abstract Author(s):
L M Costa Monteiro, D Carlson, A B Belman, H G Rushton
Abstract:
OBJECTIVE: To evaluate the long-term response to high-intensity, short-term biofeedback in children with severe voiding dysfunction.
PATIENTS AND METHODS: We retrospectively reviewed patients who underwent short-term, high-intensity biofeedback therapy from 1996 to 2004. Improvement was classified based on clinical and radiographic findings. Patients were categorized as having Hinman's syndrome when, in addition to urinary incontinence, at least four of the following categories were present: sphincter dyssynergia, bladder trabeculation, large post-void residual (PVR), hydronephrosis, vesicoureteral reflux (VUR) and urinary tract infections. There were 14 patients (eight males and six females), 13 of whom had Hinman's syndrome. Age when biofeedback was initiated varied from 5.6 to 12.9 years (mu=8.9+/-2.2). Before biofeedback, all had large PVRs, bladder trabeculation and sphincter dyssynergia. Nine had hydronephrosis and five had VUR. One patient had renal failure.
RESULTS: Before biofeedback, the mean PVR was 109 ml (25-270 ml); after biofeedback, this decreased to 21 ml (0-150 ml), including two patients who eventually failed treatment. All 14 patients were able to relax their external sphincter and reduce the PVR during biofeedback and on short-term follow up. Long-term follow up (mu=59.4 months) in 12 patients established that seven had a durable response with remission of symptoms, reduced PVR and radiographic improvement. In three, symptoms partially recurred over time and two failed treatment completely.
CONCLUSION: Short-term, high-intensity biofeedback achieves a durable response in the majority of children with Hinman's syndrome. Long-term follow up is needed to assure compliance.
Article Published Date : Aug 01, 2006
Abstract Title:
Successful treatment for giggle incontinence with biofeedback.
Abstract Source:
J Nutr. 2005 Jun;135(6):1503-9. PMID: 19695635
Abstract Author(s):
Ingride Richardson, Lane S Palmer
Abstract:
PURPOSE: Giggle incontinence is the involuntary and often unpredictable loss of urine during giggling or laughter in the absence of other stress incontinence. The pathophysiology is unclear, urodynamics are seldom helpful, and the efficacy of timed voiding and pharmacotherapy is limited. We postulated that improving sphincter tone and muscle recruitment using biofeedback techniques might be helpful in children with giggle incontinence.
MATERIALS AND METHODS: The charts of 12 patients with giggle incontinence were reviewed. Giggle incontinence severity, voiding patterns, associated symptoms and medical history including prior treatment were reviewed. Children were evaluated with uroflowmetry-electromyography and ultrasound measurement of post-void residual urine. They were assessed by the ability to isolate, contract and relax perineal muscles. They were taught Kegel exercises and instructed to perform them at home between weekly-biweekly sessions. Clinical success was characterized as a full or partial response, or nonresponse as defined by the International Children's Continence Society.
RESULTS: The 10 females and 2 males were 6 to 15 years old. Only 1 child had a partial response to first line therapy with timed voiding and bowel management. Seven children were treated with anticholinergic agents and/or pseudoephedrine with a partial response in 3. The 9 children with refractory giggle incontinence underwent biofeedback with a median of 4.5 sessions per child (range 2 to 8). The 6 patients who underwent 4 or more sessions had a full response that endured for at least 6 months and the 3 with fewer than 4 sessions had a partial response.
CONCLUSIONS: Patients with giggle incontinence can heighten external urinary sphincter awareness and muscle recruitment using biofeedback techniques. Treatment with education and pharmacotherapy only led to a partial response in some cases. Biofeedback supplemented this treatment or avoided pharmacotherapy when at least 4 sessions were performed. Biofeedback therapy should be incorporated in the treatment algorithm for giggle incontinence in children and it should be considered before pharmacotherapy.
Article Published Date : Jun 01, 2005
Abstract Title:
Comparative analysis of biofeedback and physical therapy for treatment of urinary stress incontinence in women.
Abstract Source:
Am J Phys Med Rehabil. 2001 Jul;80(7):494-502. PMID: 11421517
Abstract Author(s):
I H Pages, S Jahr, M K Schaufele, E Conradi
Article Affiliation:
Outpatient Clinic, Department of Physical Medicine and Rehabilitation, University Hospital Charité, Humboldt University, Berlin, Germany.
Abstract:
OBJECTIVE: To compare the effectiveness of an intensive group physical therapy program with individual biofeedback training for female patients with urinary stress incontinence.
DESIGN: Randomized study of two therapeutic interventions consisting of a specific physical therapy program (PT) or biofeedback training (BF) daily for 4 wk, followed by a 2-mo, unsupervised home exercise program in both groups in an outpatient clinic of a large university hospital. Forty women, referred by gynecologists for nonoperative treatment of genuine stress incontinence of mild-to-moderate severity, were included. Measurements of daytime/nocturnal urinary frequency and subjective improvement of incontinence were the main outcome measures at initial presentation, after completion of the therapy program, and at follow-up after 3 mo. Standardized examinations of digital contraction strength, speculum tests, and manometric measurements were documented as secondary outcome measures.
RESULTS: In the PT group, the daytime urination frequency decreased 22% after 4 wk of therapy and 19% after 3 mo (P<0.05) from baseline. The nocturnal urination frequency was reduced by 66% after 4 wk of therapy and 62% after 3 mo (P<0.001). In the BF group, the daily urination frequency decreased 10% after 4 wk of therapy and 5% after 3 mo (P>0.05). The nocturnal urination frequency declined 36% after 4 wk of therapy and 66% after 3 months (P<0.05). Subjective assessment after 3 mo showed that in the PT group, 28% of patients were free of incontinence episodes, 68% reported improved symptoms (incontinence episodes improved by>50%), and 4% were unchanged. In the BF group, 62% were free of incontinence episodes, and 38% were improved. Results of the digital contraction strength assessments, speculum tests, and manometric measurements showed statistically significant improvement in all variables in both groups after 3 months.
CONCLUSION: Four weeks of both intensive group physical therapy or individual biofeedback training followed by an unsupervised home exercise program for 2 mo are effective therapies for female urinary stress incontinence and result in a significantly reduced nocturnal urinary frequency and improved subjective outcome. Only group physical therapy resulted in reduced daytime urinary frequency. BF therapy resulted in a better subjective outcome and higher contraction pressures of the pelvic floor muscles.
Article Published Date : Jul 01, 2001
Abstract Title:
Effectiveness of audio-biofeedback in postural training for adolescent idiopathic scoliosis patients.
Abstract Source:
Prosthet Orthot Int. 2001 Apr;25(1):60-70. PMID: 11411007
Abstract Author(s):
M S Wong, A F Mak, K D Luk, J H Evans, B Brown
Article Affiliation:
Hong Kong Polytechnic University, Rehabilitation Engineering Centre, Hong Kong, China. This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract:
The possibility of using learned physiological responses in control of progressive adolescent idiopathic scoliosis (AIS) was investigated. Sixteen (16) AIS patients with progressing or high-risk curves (Cobb's angle between 25 degrees and 35 degrees at start and reducible by lateral bending) were fitted with a device with tone alarm for poor posture. In the first 18 months of application, 3 patients defaulted and 4 showed curve progression>10 degrees (2 changed to rigid spinal orthoses and 2 underwent surgery). The curves for the other 9 patients were kept under control (within +/- 5 degrees of Cobb's angle) and 5 of them have reached skeletal maturity and terminated the application. The remaining 4 patients were still using the devices until skeletal maturity or curve progression. The curve control rate was 69%. A long-lasting active spinal control could be achieved through the patient's own spinal muscles. Nevertheless, before the postural training device could become a treatment modality, a long-term study for more AIS patients was necessary. This project is ongoing in the Duchess of Kent Children's Hospital, Sandy Bay, Hong Kong.
Article Published Date : Apr 01, 2001
Abstract Title:
Biofeedback for the treatment of stress and urge incontinence.
Abstract Source:
J Urol. 1995 Mar;153(3 Pt 1):641-3. PMID: 7861503
Abstract Author(s):
M Stein, W Discippio, M Davia, H Taub
Abstract:
Biofeedback and pelvic floor electrical stimulation are new modalities that have been advocated for the treatment of urinary incontinence. To evaluate the long-term effectiveness of biofeedback and identify factors predictive of a positive outcome, we prospectively studied 28 patients with stress and urge incontinence. All patients were evaluated with a complete history, physical examination, urinalysis and culture. Of 28 patients 21 were also studied with video urodynamics. Biofeedback was performed with the InCare PRS 8900* machine with each patient undergoing at least 6 office sessions. Quantifiable symptoms, such as frequency, nocturia and urgency, were evaluated before and periodically after treatment. Patients also graded the overall treatment response on a scale of 0 to 3. Biofeedback successfully treated 5 of 14 patients (36%) with stress incontinence and 9 of 21 (43%) with urgency incontinence. Treatment response was durable throughout followup in all responding patients. Additionally, there was a statistically significant decrease in daytime frequency and nocturia following biofeedback (p = 0.038 and p = 0.044, respectively). No pretreatment factors predictive of a positive outcome could be identified. Improvement in perineal muscle tone with time approached statistical significance. We conclude that biofeedback is a moderately effective treatment for stress and urge incontinence, and should be offered to patients as a treatment option. Few patients, however, choose biofeedback as a primary mode of therapy and, due to the availability of other highly successful treatments for stress urinary incontinence, it is unlikely to become a popular treatment option.
Article Published Date : Mar 01, 1995
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