Biofeedback

Question 1

Biofeedback: Description

Answer 1

Electronic instrument used to measure Motor Unit Action Potentials (MUAP) generated by active muscles.

Question 2

Biofeedback: Electrode Selection

Answer 2

• small: .02 cm for specific muscles
  
  • hand, FA, face
• Large: 1 cmfor large muscles or groups

Question 3

Biofeedback: Electrode Placement

Answer 3

• Bipolar technique
  
  • two active and one reference electrode - minimizes extraneous electrical activity
• generaly active electrodes are placed 1-5 cm apart and parallel to ms fibers. reference near treatment site
• active electrodes:
  
  • close together = small precise signals
  • far apart = large signals, >1 ms

Question 4

Biofeedback: Protocol - Increasing Ms Activity

Answer 4

• weak muscles: begin w/ electrodes widely spaced and biofeedback sensitivity set to high to increase detection
  
  • for single ms: begin w/ electrodes close together for more precise signal
• instruct patient to try and contract ms (iso 6-8 sec)
• As motor recruit improves, decrease sensitivity to increase difficulty
• use facilitation techniques
• progress from simple to more complex/funx movements as pt gains control
• tx: from 5-10 min to >30 minutes to tolerance
• clean skin at end

Question 5

Biofeedback: Protocol - Decrease Muscle Activity

Answer 5

• begin w/ electrodes closely spaced and sensitivity low to minimize cross talk
• instruct pt to relax, using deep breathing or visual imagery to decrease signal
• progress from low to high sensitivity, as pt gains ability to relax ms and perform fxn
• tx: from 5-10 min to > 30 min

Question 6

Criteria for Patient Selection for biofeedback

Answer 6

• good vision, hearing, and communication
• good comprehension of simple commands and concentration
• good motor planning skills
• no profound sensory or proprioceptive loss

Question 7

ES: EMG Feedback

Answer 7

Instrument used to measure motor unit action potentials (MUAP) generated by active muscles (measured in microvolts)

Reinforces voluntary control

Question 8

ES: EMG Feedback - Electrode Placement

Answer 8

• Small electrodes for specific muscles, large for large muscles or muscle groups
• Two active and a single reference electrode (may be placed adjacent to active electrodes to minimize cross-talk)
• Active electrodes placed near motor point ~1-5cm apart, parallel to muscle fibers
• Active electrodes placed close together minimizes cross-talk, yeilds smaller, more precise signals.
• Active electrodes placed further apart detects from more than one muscle.