Biofeedback in physiotherapy practice

Biofeedback in physiotherapy practice is perhaps not as widely used as it could be. Physiotherapists working with clients in physical rehabilitation or sport can make great use of biofeedback approaches.  The essence of this is that Biofeedback enables a client to learn to self-regulate signals representing body functions and in this way to gain more control.

 EMG biofeedback can quantify and reduce muscle tension

EMG biofeedback can quantify and reduce muscle tension

For example, many stress related and attention related disorders can be treated successfully by applying biofeedback training. Biofeedback offers a non-invasive and effective tool to determine the psychophysiological (mind-body) condition in terms of physiological parameters like breathing, heart rate, muscle tension, temperature, sweating and more. Clients gain more insight in the body-mind connections. Typical applications are with situations of burn-out, anxiety, PTSD, chronic pain, headache, insomnia and many stress related disorders which are so often overlaying many physical rehabilitation challenges.

By means of EMG biofeedback, the person learns to strengthen or to relax certain muscles in e.g. rehab or temporomandibular disorders.  Muscle feedback or myofeedback provides insights in movement and posture. Are exercises done as they are intended and does the muscle tension really increase? With myofeedback, the electromyography (EMG) or electrical conduction of muscle fibres is measured because this has a direct relationship to muscle tension. EMG training is often applied in rehabilitation of muscles that are too relaxed or too tense. 

Biofeedback for pelvic floor muscle retraining is a treatment to help clients learn to strengthen or relax their pelvic floor muscles in order to improve bowel or bladder function and decrease some types of pelvic floor pain. For this training, the person learns to strengthen the rectal sphincter or vaginal muscles. Ideally, this is combined with a measurement of the activation of the abdominal muscles. The method is based on the same principle as measuring surface EMG. Biofeedback has had a great impact upon incontinence, due to its ease of use and very high success rate. Although treatment time varies, in most people, continence can generally be restored in 4-8 weeks for both fecal and urinary incontinence by using the techniques described in this protocol, which combine clinical assessment and training with EMG biofeedback.

Physiotherapist's typically choose a NeXus 4 or a NeXus 10 system combined with a numbe rof suitable sensors. A NeXus 4 system starts at around £2,400 and a NeXus 10 unit around £4,200. In addition, a number of sensors can be chosen to suite the desired applications.

Conclusion

Biofeedback can add greatly to the effectiveness of physiotherapy by:-

  • Measuring and retraining muscle tension in movement, gait or posture
  • Showing dysfunctional patterns, aiding in creating functional movement patterns
  • Facilitating psychophysiological stress profiling showing stress responses and identifying triggers
  • Providing an assessment and training tool in stress, pain and anxiety
  • Allowing the training of several muscles combined with other parameters at the same time
  • Motivating clients to take a more active role in their personal health care or rehabilitation
  • Visualising physiological activity and processes of the mind-body interface