Biofeedback

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Biofeedback ( ancient Greek βίος bios , German 'life' and English feedback 'feedback') describes an empirical, scientific method. The body's own biological processes aremade observablewith technical, often electronic , aids.

Biofeedback enables the empirical measurability of behavioral and learning theory approaches. The possible uses of the treatment technique are diverse. In addition to curative approaches, biofeedback is also used in the area of peak performance training ( mental training in top-class sport ) and coaching . It is often used for relaxation , but also for rehabilitation , for example of slack muscles. Biofeedback has nothing to do with bioresonance therapy .

theory

The body's own internal regulatory processes are often not directly accessible to consciousness . Consequently, imbalances (imbalances) cannot consciously influence the control loop . Biofeedback makes body functions (such as pulse , skin conductance or brain waves ) consciously perceptible by means of physiological measurements. This is generally done using tones ( volume , pitch or timbre ) or visualizations (e.g. pointers or bar graphs ). Based on this feedback, the user tries to improve the regulation through operant control . The patient should learn to be able to perceive these processes better and to influence them willingly, so the interoception ability should be increased.

Signal sources

A number of actual biological values ​​can be used for the consciously perceptible representation . These are measured non-invasively , converted in an analog-to-digital converter, averaged and amplified and finally processed graphically or acoustically. The following can be recorded in detail:

The technical design ranges from small portable devices, which often only record and report one parameter, to vaginal and rectal electrodes, to multi-channel devices that record several signals at high frequencies at the same time. In some cases, the transmission takes place wirelessly using Bluetooth technology, so that the test person / patient can move freely during the therapy.

For many of the applications it is true that there does not necessarily have to be an obvious connection between the “organ” of the disease and the measured value chosen for the therapy; for example, heart rate variability is often used as an actual value for biofeedback in the case of depression .

practice

A possible implementation in practice looks like this: The test person sits in front of a computer screen. A measuring sensor is attached to his finger , which measures the skin conductance and thus indirectly the degree of tension in the autonomic nervous system . A monitor shows the measured value and gives the test person feedback on his current physiological control mechanisms. At the same time, the breathing curve or the degree of muscle tension on the forehead and neck can be recorded. A pulse amplitude measuring device on the temporal artery (A. temporalis) provides further information (important for the treatment of migraine patients, see below). The screen shows the collected values ​​as a curve diagram or otherwise graphically prepared. In this way, psychophysiological relationships are made clear. For example, it is possible to track the effects of memories of beautiful or difficult situations on breathing, skin conductance and the cardiovascular system. The observable reaction pattern is individually different.

This feedback leads to the fact that the person being treated gets to know himself / herself better and learns to distinguish between relaxation and tension. Often enough, the measurements show that muscles are tense, the breath is shallow, the palms of the hands are sweaty or the heart is beating quickly, even though the person concerned is not aware of this. The biofeedback is used to raise awareness of one's own internal states. One speaks of an increase in interoception .

In a second step, the parameters should be changed using exercises. z. B. to lower the skin conductance, to throttle the muscle tension, to let the breathing pattern become even and calm. The way to achieve the goal is not predetermined. Biofeedback can easily be combined with relaxation methods such as autogenic training , yoga , mindfulness-based methods or progressive muscle relaxation . The immediate feedback on the success of the technology used increases the motivation to continue what has already been started and to perfect it. Ultimately, it is about influencing the autonomic nervous system reliably in everyday life even without auxiliary equipment in order to better master difficult situations without developing complaints.

The duration of the therapy depends on the disorder to be treated. According to one study, the therapy should be carried out until certain previously defined target criteria have been achieved.

Areas of application

According to the abundance of parameters that can be derived, the clinical and practical application possibilities are diverse. They include

effectiveness

A large number of studies have looked at the effectiveness of biofeedback for various disorders. In 2002, the American Association for Applied Psychophysiology and Biofeedback developed a rating scale analogous to other subject areas. Tan, Shaffer, Lyle, & Teo gave the following overview in 2016:

  1. Significant superiority compared to a control group with randomized allocation, or at least the same effect compared to a treatment method with recognized effectiveness
  2. Superiority or equivalence in at least two independent settings
  3. Inclusion criteria are reliably and operationally defined
  4. Measurements are valid and clearly specified
  5. Appropriate data analysis
  6. Diagnostics, treatment variables and procedures clearly defined, independent replication of the study possible
Indications that meet these requirements are: adult headache , anxiety and anxiety disorders , muscle-related orofacial pain, non-cardiac chest pain, postural pain problems, constipation , depressive disorders , diabetes mellitus : glycemic control, epilepsy , erectile dysfunction , fecal incontinence, high blood pressure , irritable bowel syndrome , Preeclampsia , Raynaud's disease , temporomandibular joint disease (TMJD) pain .
  • Level 5, effective and specific : Significant superiority in at least two settings compared to credible sham therapy, medicinal or bona fide treatments (expression of Anglo-Saxon literature for treatments by trained professionals, based on recognized principles and publications). Tan et al. assigned the indication ADHD to this category .

Institutionalizations

In Austria and Germany there is a qualified training and further education for biofeedback.

The Austrian Society for Biofeedback and Psychophysiology (ÖBFP) was founded in 1989 as an interdisciplinary association. According to its own information, it has more than 150 members in 2005. The Austrian training course comprises 150 hours of theory and practice. Graduates have the title “biofeedback therapist” (as a doctor or psychologist) or “trainer” (as an auxiliary medical profession). The 25th anniversary of the ÖBFP will be celebrated as part of a congress under the motto "Biofeedback interdisciplinary and multiprofessional" on January 25, 2014 in Vienna under its President Richard Crevenna . Since his presidency, biofeedback has been an integral part and examination material of the medical studies / MCWs (main lecture and elective) at the Medical University of Vienna.

In Austria and Germany, the European Biofeedback Academy (BFA) has been offering training and further education for biofeedback therapists since 1995 . This is also recognized by the German Medical Association. Since 2016, the BFA has also been offering a university course for biofeedback therapists together with Sigmund Freud University . The founding president of the German Society for Biofeedback, Rüdiger Schellenberg, also conducts certified training. In order to complete further training as a biofeedback therapist, it was previously necessary to obtain a license to practice medicine or psychology. Since the 2nd training curriculum in the 2nd half of 2017, psychologists, occupational therapists and non-medical practitioners can also complete their training with the certificate "Biofeedback Therapist". In contrast, the further training to become a "biofeedback trainer" can also be completed by other people with degrees in medical fields (e.g. physiotherapists, physiotherapists, nurses, nurses, sports scientists, speech therapists, etc.). In justified exceptional cases, people with other professional qualifications will also be admitted.

The German Society for Biofeedback (DGBfb) has existed since 2000 . The 8th annual conference was held in Neustadt / Aisch in November 2008. In February 2008 the Europe-wide biofeedback specialist congress of the “ Biofeedback Foundation of Europe ” took place in Vienna.

In the middle of 2002, the Biofeedback section was founded in the German StK, now the German Society for Pain Medicine (DGS). The immediate task of this section was to train as a biofeedback therapist or biofeedback trainer in the field of pain therapy . A first training course began in autumn 2002.

See also

literature

  • Winfried Rief, Niels Birbaumer (Ed.): Biofeedback. Basics, indications, communication, procedure . 3rd, completely revised and exp. Edition. Schattauer, Stuttgart 2011, ISBN 978-3-7945-2748-9 .
  • Timon Bruns, Nina Praun: Biofeedback. A manual for therapeutic practice . Vandenhoeck and Ruprecht, Göttingen 2002, ISBN 3-525-46160-7 .
  • Mehmet Eylem Kirlangic: EEG biofeedback and epilepsy. Concept, methodology and tools for (neuro) therapy planning and objective evaluation . Technical University of Ilmenau, Ilmenau 2005 (dissertation).
  • Gerhard H. Eggetsberger : Biofeedback - healing through body signals, help with: muscle tension, migraines, fears, sexual disorders, etc. v. a. m. Verlag Perlen Reihe, Vienna 1994, ISBN 3-85223-257-0 .
  • Richard Crevenna : Biofeedback. Basics and applications . Maudrich, Vienna 2010.
  • Alexandra Martin, Winfried Rief (Ed.): How effective is biofeedback? - A therapeutic procedure. 1st edition. Verlag Hans Huber, Bern 2008 ISBN 978-3-456-84645-3
  • Kropfreiter Dieter (Ed.): Biofeedback and Neurofeedback in Therapy and Training - A basic work for users and researchers. 1st edition. Hallein 2018 ISBN 978-3-200-05819-4
  • Association for Applied Psychophysiology and Biofeedback (Ed.): Evidence-based Practice in Biofeedback & Neurofeedback. 3. Edition. Wheat Ridge 2016, ISBN 978-0-9842979-6-2 .

Web links

Individual evidence

  1. ↑ NMDE: Biofeedback and Bioresonance. In: Biofeedback and Neurofeedback. January 9, 2020, accessed January 9, 2020 .
  2. ^ Lester M. Libo, Georgie E. Arnold: Does training to criterion influence improvement? A follow-up study of EMG and thermal biofeedback . In: Journal of Behavioral Medicine . tape 6 , no. 4 , December 1, 1983, ISSN  1573-3521 , p. 397-404 , doi : 10.1007 / BF00846326 .
  3. ↑ Evers, S., May, A., Fritsche, G., Kropp, P., Lampl, C., Limmroth, V., ... & Diener, HC (2008). Guideline of the German Migraine and Headache Society and the German Society for Neurology. Neurology , 27 , 933-949.
  4. ^ Biofeedback treatment for headache disorders: a comprehensive efficacy review. Nestoriuc et al., Appl Psychophysiol Biofeedback, September 2008; 33 (3): pp. 125-40, PMID 18726688 .
  5. ↑ Biofeedback in headache: an overview of approaches and evidence. Andrasik, Cleve Clin J Med. July 2010; 77 Suppl. 3: pp. 72-6. PMID 20622082 .
  6. ^ Robert Sielski, Winfried Rief, Julia Anna Glombiewski: Efficacy of Biofeedback in Chronic back Pain: a Meta-Analysis . In: International Journal of Behavioral Medicine . tape 24 , no. 1 , February 1, 2017, ISSN  1070-5503 , p. 25–41 , doi : 10.1007 / s12529-016-9572-9 ( springer.com [accessed May 29, 2018]).
  7. ↑ AB Crider, AG Glaros: A meta-analysis of EMG biofeedback treatment of temporomandibular disorders . In: Journal of Orofacial Pain . tape 13 , no. 1 , 1999, ISSN  1064-6655 , pp. 29-37 , PMID 10425966 .
  8. ^ The effects of biofeedback for the treatment of essential hypertension: a systematic review. Greenhalgh et al., Health Technol Assess, October 2009; 13 (46): pp. 1-104, PMID 19822104 .
  9. ↑ Maria Katsamanis Karavidas, Pei-Shan Tsai, Carolyn Yucha, Angele McGrady, Paul M. Teacher: Thermal Biofeedback for Primary Raynaud's Phenomenon: A Review of the Literature . In: Applied Psychophysiology and Biofeedback . tape 31 , no. 3 , October 3, 2006, ISSN  1090-0586 , p. 203-216 , doi : 10.1007 / s10484-006-9018-2 .
  10. ↑ A. Rosaura Polak, Anke B. Witteveen, Damiaan Denys, Miranda Olff: Breathing Biofeedback as an Adjunct to Exposure in Cognitive Behavioral Therapy Hastens the Reduction of PTSD Symptoms: A Pilot Study . In: Applied Psychophysiology and Biofeedback . tape 40 , no. 1 , March 7, 2015, p. 25-31 , doi : 10.1007 / s10484-015-9268-y , PMID 25750106 , PMC 4375291 (free full text).
  11. ↑ Preliminary results of an open label study of heart rate variability biofeedback for the treatment of major depression. Karavidas et al., Appl Psychophysiol Biofeedback, March 2007; 32 (1): pp. 19-30, PMID 17333315 .
  12. ↑ Paul Ratanasiripong, Orawan Kaewboonchoo, Nop Ratanasiripong, Suda Hanklang, Pornlert Chumchai: Biofeedback Intervention for Stress, Anxiety, and Depression among Graduate Students in Public Health Nursing . In: Nursing Research and Practice . tape 2015 , 2015, ISSN  2090-1429 , pp. 1–5 , doi : 10.1155 / 2015/160746 , PMID 25954515 , PMC 4411437 (free full text).
  13. ↑ Petra Windthorst, Ralf Veit, Paul Enck, Robert Smolka, Stephan Zipfel: Biofeedback and Neurofeedback: Possible applications in psychosomatics and psychotherapy . In: PPmP - Psychotherapy · Psychosomatics · Medical Psychology . tape 65 , no. 03/04 , 23 March 2015, ISSN  0937-2032 , p. 146–158 , doi : 10.1055 / s-0034-1387320 ( thieme-connect.de [accessed on January 9, 2020]).
  14. ^ Burgio KL, Locher JL, Goode PS, et al .: Behavioral vs drug treatment for urge urinary incontinence in older women: A randomized controlled trial . In: JAMA . tape 280 , no. 23 , December 16, 1998, pp. 1995-2000 , doi : 10.1001 / jama.280.23.1995 .
  15. ↑ M. Van Kampen, W. De Weerdt, H. Van Poppel, D. De Ridder, H. Feys: Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomized controlled trial . In: Lancet (London, England) . tape 355 , no. 9198 , January 8, 2000, p. 98-102 , doi : 10.1016 / S0140-6736 (99) 03473-X , PMID 10675166 .
  16. ^ Olafur S. Palsson, Steve Heymen, William E. Whitehead: Biofeedback treatment for functional anorectal disorders: a comprehensive efficacy review . In: Applied Psychophysiology and Biofeedback . tape 29 , no. September 3 , 2004, ISSN  1090-0586 , PMID 15497616 .
  17. ↑ Mark J. Stern, Robert AF Guiles, Richard Gevirtz: HRV Biofeedback for Pediatric Irritable Bowel Syndrome and Functional Abdominal Pain: A Clinical Replication Series . In: Applied Psychophysiology and Biofeedback . tape 39 , no. 3-4 , October 2, 2014, ISSN  1090-0586 , p. 287–291 , doi : 10.1007 / s10484-014-9261-x ( springer.com [accessed October 17, 2018]).
  18. ^ A. Dobbin, J. Dobbin, SC Ross, C. Graham, MJ Ford: Randomized controlled trial of brief intervention with biofeedback and hypnotherapy in patients with refractory irritable bowel syndrome . In: The Journal of the Royal College of Physicians of Edinburgh . tape 43 , no. 1 , 2013, ISSN  2042-8189 , p. 15-23 , doi : 10.4997 / JRCPE.2013.104 , PMID 23516685 .
  19. ↑ Martijn Arns, Sabine de Ridder, Ute Strehl, Marinus Breteler, Anton Coenen: Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis . In: Clinical EEG and neuroscience . tape 40 , no. 3 , July 1, 2009, ISSN  1550-0594 , p. 180-189 , PMID 19715181 .
  20. ↑ Yoko Nagai, Laura H. Goldstein, Peter BC Fenwick, Michael R. Trimble: Clinical efficacy of galvanic skin response biofeedback training in reducing seizures in adult epilepsy: a preliminary randomized controlled study . In: Epilepsy & Behavior: E&B . tape 5 , no. 2 , April 2004, ISSN  1525-5050 , p. 216-223 , doi : 10.1016 / j.yebeh.2003.12.003 , PMID 15123023 .
  21. ↑ James Barnes, Eimer Philbin Bowman, John Cullen: Biofeedback as an adjunct to psychotherapy in the treatment of vaginismus . In: Biofeedback and Self-regulation . tape 9 , no. 3 , September 1, 1984, ISSN  0363-3586 , p. 281–289 , doi : 10.1007 / BF00998972 ( springer.com [accessed September 18, 2017]).
  22. ↑ Amelia M. Stanton, Ryan L. Boyd, Justin J. Fogarty, Cindy M. Meston: Heart rate variability biofeedback increases sexual arousal among women with female sexual arousal disorder: Results from a randomized-controlled trial . In: Behavior Research and Therapy . tape 115 , April 2019, ISSN  1873-622X , p. 90-102 , doi : 10.1016 / j.brat.2018.10.016 , PMID 30466714 .
  23. ↑ Grace Dorey, Mark J. Speakman, Roger CL Feneley, Annette Swinkels, Christopher DR Dunn: Pelvic floor exercises for erectile dysfunction . In: BJU International . tape 96 , no. 4 , September 2005, ISSN  1464-4096 , p. 595–597 , doi : 10.1111 / j.1464-410x.2005.05690.x ( wiley.com [accessed October 17, 2018]).
  24. ↑ neurofeedback for Treating tinnitus. Dohrmann et al., Prog Brain Res, 2007; 166: pp. 473-85, PMID 17956812 .
  25. ↑ Cornelia Weise, Kristin Heinecke, Winfried Rief: Biofeedback for chronic tinnitus - treatment guidelines and preliminary results on effectiveness and acceptance . In: behavior therapy . tape 17 , no. 4 , 2007, p. 220-230 , doi : 10.1159 / 000111462 .
  26. ↑ Rosalyn Stanton, Louise Ada, Catherine M. Dean, Elisabeth Preston: Biofeedback improves activities of the lower limb after stroke: a systematic review . In: Journal of Physiotherapy . tape 57 , no. 3 , 2011, ISSN  1836-9553 , p. 145-155 , doi : 10.1016 / S1836-9553 (11) 70035-2 , PMID 21843829 .
  27. ↑ Lucas C. Aragão Albuquerque, Leandro Pernambuco, Camila M. da Silva, Marina Moura Chateaubriand, Hilton Justino da Silva: Effects of electromyographic biofeedback as an adjunctive therapy in the treatment of swallowing disorders: a systematic review of the literature . In: European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery . tape 276 , no. 4 , April 2019, ISSN  1434-4726 , p. 927-938 , doi : 10.1007 / s00405-019-05336-5 , PMID 30771061 .
  28. ↑ Marianna Munafò, Elisabetta Patron, Daniela Palomba: Improving Managers' Psychophysical Well-Being: Effectiveness of Respiratory Sinus Arrhythmia Biofeedback . In: Applied Psychophysiology and Biofeedback . tape 41 , no. 2 , June 1, 2016, ISSN  1090-0586 , p. 129–139 , doi : 10.1007 / s10484-015-9320-y ( springer.com [accessed September 18, 2017]).
  29. ↑ Auditya Purwandini Sutarto, Muhammad Nubli Abdul Wahab, Nora Mat Zin: Resonant breathing biofeedback training for stress reduction among manufacturing operators . In: International journal of occupational safety and ergonomics: JOSE . tape 18 , no. 4 , 2012, ISSN  1080-3548 , p. 549-561 , doi : 10.1080 / 10803548.2012.11076959 , PMID 23294659 .
  30. ↑ Sergio Jiménez Morgan, José Arturo Molina Mora: Effect of Heart Rate Variability Biofeedback on Sport Performance, a Systematic Review . In: Applied Psychophysiology and Biofeedback . tape 42 , no. 3 , September 1, 2017, ISSN  1090-0586 , p. 235–245 , doi : 10.1007 / s10484-017-9364-2 ( springer.com [accessed September 18, 2017]).
  31. ↑ T. Djajadiningrat, L. Geurts, PR Munniksma, G. Christiaansen, & J. de Bont (2009): Rationalizer: An emotion mirror for online traders. In: Proceedings of the 5th International Workshop on Design and Semantics of Form and Movement. Taipei, Taiwan, pp. 39-48.
  32. ↑ Eficacy. How we rate the efficacy of our treatments or how to know if our treatments actually work. Association for Applied Psychophysiology and Biofeedback website, 2011. (Accessed May 6, 2016)
  33. ^ G. Tan, F. Shaffer, R. Lyle, & I. Teo (Eds.). (2016): Evidence-based practice in biofeedback and neurofeedback. ISBN 978-0-9842979-6-2 . Quoted from: Effectiveness of biofeedback- INSIGHT INSTRUMENTS. In: biofeedback.co.at. Retrieved February 21, 2017 .
  34. ↑ eduniwien.ac.at
  35. ↑ News: Cooperation between the European Biofeedback Academy and the Sigmund-Freud University. In: BFA. Retrieved April 21, 2016 .
  36. ↑ [1]