My name is Joanna. In this course I will introduce you to my biofeedback machines, demonstrate how they operate and then we'll conduct a mock therapy session before we go over patient homework.
I was trained in biofeedback therapy fifteen years ago through the Professional Biofeedback Certificate Program and The Biofeedback Training Institute that is offered by Stens Corporation. After my training, I invested in an M57 EMG stand alone and a thermal feedback stand-alone. For the fifteen years I've been training people in relaxation techniques, I've used these two machines without fail. We will be using these machines in our course today.
Identify EMG and thermal feedback machines
- the hardware
- set up of equipment
- Cautions and precautions of feedback machines.
- Concerns with electrical shock
We will assimilate a “general relaxation” session.
- Identify placement options for the electrodes.
- Review summarized relaxation session.
- Advantages & Disadvantages
- Real world therapy
The EMG and thermal feedback machines are referred to as "stand-alone" devices because they require nothing else to work and they are portable. No plugs, no computer, just the box with a set of "C" batteries.
To the right you will see the electrodes for the stand-alone. The electrode is cupped allowing for a conductive gel to be applied. On the opposite side of the electrode is a "button" for attaching the source input wire. The machines we will be using today have three electrode cups attached to three source wires. Then the three source wires connect to a preamplifier. This is a standard set-up. EMG
The thermal stand-alone simply consists of a single wire that plugs into the back of the stand-alone and the other end is taped to the dorsal side of the patients finger. The thermal stand-alone is capable of GSR or galvanic skin response feedback if an IG-3 cable is attached.
To help you get a better idea of how it works study the picture below. The target lets say is music notes. The electrodes pick up the notes as well as the ambient noise. Ambient noise is everything around your target. It can be helpful and sought after in certain applications, but not in biofeedback, for the most part. So the baby crying next door, someone knocking on the door, the lawn mower starting up, this is all ambient noise. The preamplifier filters out a good deal of that ambient noise so all you hear is the music notes.
With the electrodes attached to a patient the signals from a muscle may have ambient noise from your heartbeat or adjacent muscles. The electrodes are very sensitive. Placing them closer together will aid in reducing ambient noise.
Cautions and Pre-cautions
Biofeedback equipment is electrically conductive. The EMG picks up the "electrical signals" from your muscles. The gel inside the electrode aids in that pickup by creating conductivity between the skin and electrode. Just like a pail of water will conduct electricity far better than an empty pail. With all this conductivity being encouraged if any wire is frayed, stressed or broken it has the potential to electrocute the patient.
Taking care of the machines and their accessories is important in preventing electrocution. Visually checking the wires and connections as they are connected and disconnected can help catch any potential problems of stressed connectors and/or wires. Always grasp the wire at the connector and pull out gently. Pulling a wire, by the wire, only weakens the wire in the connection and reduces the life of that connection. Leading to potential electrocution.
In the event the patient feels discomfort at the site of the electrodes in any way, remove them immediately and thoroughly check your equipment.
General Relaxation Therapy Procedure
General relaxation is sometimes used to familiarize a person to biofeedback, especially if they have concerns or difficulty obtaining a state of relaxation.
Electrodes are placed on the anterior surface of each forearm (Johnson & Hockersmith, 1989). The patients heartbeat may appear as ambient noise with this set up. It can be used as a goal or eliminated with filters. The preamplifier will not filter out the heartbeat because both electrodes, set at the same point on each arm, with the reference nearby on either arm, all three will pick up the heartbeat. Source 1 will not have anything to minus from source 2 because its hearing the same beat, beat, beat. However, if so desired, the therapist may invoke the sensitivity filter to eliminate it.
I make several adjustments to demonstrate the machines options. Normally these adjustments wouldn't be set before starting the session.
Please view the companion video noting the proximity of the reference (green) electrode to the input (white) electrode. The closer the reference (green) is to the input electrode (white) the less ambient noise you will pick up.
Home care has its advantages and its disadvantages. If practicing incorrectly the results can develop unwanted responses. Yet, practicing correctly can be of the utmost benefit.
Its important for the patient to practice the techniques they have learned at home and "real-life" situations. It's equally important that they practice correctly. A thorough understanding of the techniques they have learned and mastery of the skill is very important. If the patient is not well versed in their technique, when they practice at home they may very well create undesirable responses and habits. When the patient has shown competence in their techniques then they can be provided a schedule of practice time or allowed to practice as needed at least once a day. This will greatly improve their session results and provide the ability to invoke their techniques when they really need it or when their symptoms manifest themselves in "real-life".
Home aides are available such as a feedback card. The patient sets their finger on the square to receive an instant feedback of thermal excitement. This is helpful when trying to obtain a degree of desirable relaxation in a chaotic environment. Its discreet, convenient and fairly accurate.
Have you ever experienced biofeedback therapy?
If yes, would you say it was helpful?
Biofeedback is still in its infancy. Health insurance has just recently recognized biofeedback as a form of health care. Few trials and experiments have been conducted on the subject. Electrode placement and feedback results need to be thoroughly studied. What we do know and use has produced encouraging results. The outlook for biofeedback is very promising with new therapies for various diseases being reported everyday.
Thank you for joining me in Biofeedback 101. I hope you enjoyed the course as I enjoyed creating and sharing it!