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International Journal of... Jan 2021Over the last years, biofeedback applications are increasingly used to enhance interoceptive awareness and self-regulation, in psychiatry and beyond. These applications... (Review)
Review
Over the last years, biofeedback applications are increasingly used to enhance interoceptive awareness and self-regulation, in psychiatry and beyond. These applications are used to strengthen emotion regulation skills by home training (ambulatory biofeedback) and real-time support in everyday life stressful situations (biocueing). Unfortunately, knowledge about the feasibility and effectivity of these applications is still scarce. Therefore, a systematic literature search was performed. In total, 30 studies (4 biocueing, 26 ambulatory biofeedback) were reviewed; 21 of these studies were conducted in non-psychiatric samples and 9 studies in psychiatric samples. Study characteristics, biofeedback characteristics, effectivity and feasibility outcomes were extracted. Despite the rapid advances in wearable technology, only a few biocueing studies were found. In the majority of the studies significant positive effects were found on self-reported (stress-related) psychological measures. Significant improvements on physiological measures were also reported, though these measures were used less frequently. Feasibility of the applications was often reported as sufficient, though not adequately assessed in most studies. Taken into account the small sample sizes and the limited quality of the majority of the studies in this recently emerging field, biocueing and ambulatory biofeedback interventions showed promising results. Future research is expected to be focusing on biocueing as a just-in-time adaptive intervention. To establish this research field, closer cooperation between research groups, use of more rigorous as well as individually tailored research designs and more valid feasibility and effectivity assessment are recommended.
Topics: Biofeedback, Psychology; Emotional Regulation; Humans; Stress, Psychological; Wearable Electronic Devices
PubMed: 33248196
DOI: 10.1016/j.ijpsycho.2020.11.009 -
Dysphagia Apr 2021Dysphagia is common after stroke, leading to adverse outcome. The Effortful Swallow (ES) is recommended to improve swallowing but it is not known if dysphagic patients...
Dysphagia is common after stroke, leading to adverse outcome. The Effortful Swallow (ES) is recommended to improve swallowing but it is not known if dysphagic patients can increase muscle activity during the exercise or if age affects performance. Providing surface electromyographic (sEMG) biofeedback during dysphagia therapy may enhance exercise completion, but this has not been investigated and the technique's acceptability to patients is not known. Aims: To determine if age or post-stroke dysphagia affect the ability to increase submental muscle activity during the ES, if sEMG biofeedback improves ES performance and if sEMG is an acceptable addition to therapy. In a Phase I study submental sEMG amplitudes were measured from 15 people with dysphagia < 3 months post-stroke and 85 healthy participants aged 18-89 years during swallowing (NS) and when they performed the ES with and without sEMG biofeedback. Participant feedback was collected via questionnaire. Measurements were compared with repeated measures ANOVA and age effects were examined with linear regression. Both groups produced significantly greater muscle activity for the ES than NS (p < 0.001) and significantly increased activity with biofeedback (p < 0.001) with no effect of age. Participant feedback about sEMG was very positive; over 98% would be happy to use it regularly. The ES is a physiologically beneficial dysphagia exercise, increasing muscle activity during swallowing. sEMG biofeedback further enhances performance and is considered an acceptable technique by patients. These findings support the potential application of sEMG biofeedback and the ES in dysphagia therapy in stroke, justifying further investigation of patient outcome.
Topics: Biofeedback, Psychology; Deglutition; Deglutition Disorders; Electromyography; Healthy Aging; Humans
PubMed: 32445060
DOI: 10.1007/s00455-020-10129-8 -
Neurogastroenterology and Motility May 2015Anorectal disorders such as dyssynergic defecation, fecal incontinence, levator ani syndrome, and solitary rectal ulcer syndrome are common, and affect both the adult...
BACKGROUND
Anorectal disorders such as dyssynergic defecation, fecal incontinence, levator ani syndrome, and solitary rectal ulcer syndrome are common, and affect both the adult and pediatric populations. Although they are treated with several treatment approaches, over the last two decades, biofeedback therapy using visual and verbal feedback techniques has emerged as an useful option. Because it is safe, it is commonly recommended. However, the clinical efficacy of biofeedback therapy in adults and children is not clearly known, and there is a lack of critical appraisal of the techniques used and the outcomes of biofeedback therapy for these disorders.
PURPOSE
The American Neurogastroenterology and Motility Society and the European Society of Neurogastroenterology and Motility convened a task force to examine the indications, study performance characteristics, methodologies used, and the efficacy of biofeedback therapy, and to provide evidence-based recommendations. Based on the strength of evidence, biofeedback therapy is recommended for the short-term and long-term treatment of constipation with dyssynergic defecation (Level I, Grade A), and for the treatment of fecal incontinence (Level II, Grade B). Biofeedback therapy may be useful in the short-term treatment of Levator Ani Syndrome with dyssynergic defecation (Level II, Grade B), and solitary rectal ulcer syndrome with dyssynergic defecation (Level III, Grade C), but the evidence is fair. Evidence does not support the use of biofeedback for the treatment of childhood constipation (Level 1, Grade D).
Topics: Adult; Anus Diseases; Biofeedback, Psychology; Child; Constipation; Electromyography; Europe; Fecal Incontinence; Gastroenterology; Humans; Manometry; Pain; Rectal Diseases; Societies, Medical; Treatment Outcome; Ulcer; United States
PubMed: 25828100
DOI: 10.1111/nmo.12520 -
Neuron Oct 2020Faster, more reliable, and comfortably wearable personal devices are producing data from biosensors on an unprecedented scale. Combined with context and analytics, these... (Review)
Review
Faster, more reliable, and comfortably wearable personal devices are producing data from biosensors on an unprecedented scale. Combined with context and analytics, these signals hold great promise to advance neuroscience via real-world data. Here, we discuss wearable technology broadly and provide specific examples of activity patterns from electrodermal sensors found during sleep, stress, and seizures.
Topics: Biofeedback, Psychology; Functional Laterality; Galvanic Skin Response; Humans; Neurosciences; Seizures; Sleep; Stress, Psychological; Wearable Electronic Devices
PubMed: 33058768
DOI: 10.1016/j.neuron.2020.09.030 -
Nature Communications Sep 2022Invasive electrical stimulation (iES) is prone to cause neural stimulus-inertia owing to its excessive accumulation of exogenous charges, thereby resulting in many side...
Invasive electrical stimulation (iES) is prone to cause neural stimulus-inertia owing to its excessive accumulation of exogenous charges, thereby resulting in many side effects and even failure of nerve regeneration and functional recovery. Here, a wearable neural iES system is well designed and built for bionic and long-lasting neural modulation. It can automatically yield biomimetic pulsed electrical signals under the driven of respiratory motion. These electrical signals are full of unique physiological synchronization can give biofeedback to respiratory behaviors, self-adjusting with different physiological states of the living body, and thus realizing a dynamic and biological self-matched modulation of voltage-gated calcium channels on the cell membrane. Abundant cellular and animal experimental evidence confirm an effective elimination of neural stimulus-inertia by these bioelectrical signals. An unprecedented nerve regeneration and motor functional reconstruction are achieved in long-segmental peripheral nerve defects, which is equal to the gold standard of nerve repair -- autograft. The wearable neural iES system provides an advanced platform to overcome the common neural stimulus-inertia and gives a broad avenue for personalized iES therapy of nerve injury and neurodegenerative diseases.
Topics: Animals; Biofeedback, Psychology; Bionics; Electric Stimulation; Electric Stimulation Therapy; Nerve Regeneration
PubMed: 36085331
DOI: 10.1038/s41467-022-33089-z -
Sensors (Basel, Switzerland) May 2022Sensory feedback is critical in proprioception and balance to orchestrate muscles to perform targeted motion(s). Biofeedback plays a significant role in substituting...
Sensory feedback is critical in proprioception and balance to orchestrate muscles to perform targeted motion(s). Biofeedback plays a significant role in substituting such sensory data when sensory functions of an individual are reduced or lost such as neurological disorders including stroke causing loss of sensory and motor functions requires compensation of both motor and sensory functions. Biofeedback substitution can be in the form of several means: mechanical, electrical, chemical and/or combination. This study proposes a soft monolithic haptic biofeedback device prototyped and pilot tests were conducted with healthy participants that balance and proprioception of the wearer were improved with applied mechanical stimuli on the lower limb(s). The soft monolithic haptic biofeedback device has been developed and manufactured using fused deposition modelling (FDM) that employs soft and flexible materials with low elastic moduli. Experimental results of the pilot tests show that the soft haptic device can effectively improve the balance of the wearer as much as can provide substitute proprioceptive feedback which are critical elements in robotic rehabilitation.
Topics: Biofeedback, Psychology; Haptic Technology; Humans; Pilot Projects; Postural Balance; Proprioception
PubMed: 35632192
DOI: 10.3390/s22103779 -
Journal of General Internal Medicine Dec 2019Biofeedback is increasingly used to treat clinical conditions in a wide range of settings; however, evidence supporting its use remains unclear. The purpose of this... (Review)
Review
BACKGROUND
Biofeedback is increasingly used to treat clinical conditions in a wide range of settings; however, evidence supporting its use remains unclear. The purpose of this evidence map is to illustrate the conditions supported by controlled trials, those that are not, and those in need of more research.
METHODS
We searched multiple data sources (MEDLINE, PsycINFO, CINAHL, Epistemonikos, and EBM Reviews through September 2018) for good-quality systematic reviews examining biofeedback for clinical conditions. We included the highest quality, most recent review representing each condition and included only controlled trials from those reviews. We relied on quality ratings reported in included reviews. Outcomes of interest were condition-specific, secondary, and global health outcomes, and harms. For each review, we computed confidence ratings and categorized reported findings as no effect, unclear, or insufficient; evidence of a potential positive effect; or evidence of a positive effect. We present our findings in the form of evidence maps.
RESULTS
We included 16 good-quality systematic reviews examining biofeedback alone or as an adjunctive intervention. We found clear, consistent evidence across a large number of trials that biofeedback can reduce headache pain and can provide benefit as adjunctive therapy to men experiencing urinary incontinence after a prostatectomy. Consistent evidence across fewer trials suggests biofeedback may improve fecal incontinence and stroke recovery. There is insufficient evidence to draw conclusions about effects for most conditions including bruxism, labor pain, and Raynaud's. Biofeedback was not beneficial for urinary incontinence in women, nor for hypertension management, but these conclusions are limited by small sample sizes and methodologic limitations of these studies.
DISCUSSION
Available evidence suggests that biofeedback is effective for improving urinary incontinence after prostatectomy and headache, and may provide benefit for fecal incontinence and balance and stroke recovery. Further controlled trials across a wide range of conditions are indicated.
Topics: Humans; Biofeedback, Psychology; Combined Modality Therapy; Evidence-Based Medicine; Exercise Therapy; Systematic Reviews as Topic; Treatment Outcome
PubMed: 31414354
DOI: 10.1007/s11606-019-05215-z -
Applied Psychophysiology and Biofeedback Dec 2021This article provides an overview of the history of the Japanese Society of Biofeedback Research (JSBR) and presents some of its recent advances. Most of the research... (Review)
Review
This article provides an overview of the history of the Japanese Society of Biofeedback Research (JSBR) and presents some of its recent advances. Most of the research papers published in the JSBR journal (Biofeedback Kenkyu) have been written in Japanese, and therefore have had very few opportunities to reach global readers. We would like to present some of important findings previously published there. First, we present the history of the JSBR. Secondly, we will focus on paced breathing, which is instrumental in achieving relaxation in heart rate variability biofeedback (HRV-BF). We will look back on the origin of slow-paced breathing in Japan, that could be attributed to the concept of Tanden breathing (abdominal paced breathing) practiced in Zen meditation. Thirdly, we will introduce some of the current research progresses of JSBR, especially focusing on the development of a non-contact sensing technology and relaxation device. Finally, we will explain about a very recent trial, the "Suu-Haa" Relaxation Technique, which we hope may be useful for helping people cope with the SARS-CoV-2 (COVID-19) crisis.
Topics: Biofeedback, Psychology; COVID-19; Heart Rate; Humans; Japan; Respiratory Rate; SARS-CoV-2
PubMed: 34146187
DOI: 10.1007/s10484-021-09516-0 -
Sensors (Basel, Switzerland) Sep 2022This review aims to recommend directions for future research on robotic biofeedback towards prompt post-stroke gait rehabilitation by investigating the technical and... (Review)
Review
This review aims to recommend directions for future research on robotic biofeedback towards prompt post-stroke gait rehabilitation by investigating the technical and clinical specifications of biofeedback systems (BSs), including the complementary use with assistive devices and/or physiotherapist-oriented cues. A literature search was conducted from January 2019 to September 2022 on Cochrane, Embase, PubMed, PEDro, Scopus, and Web of Science databases. Data regarding technical (sensors, biofeedback parameters, actuators, control strategies, assistive devices, physiotherapist-oriented cues) and clinical (participants' characteristics, protocols, outcome measures, BSs' effects) specifications of BSs were extracted from the relevant studies. A total of 31 studies were reviewed, which included 660 stroke survivors. Most studies reported visual biofeedback driven according to the comparison between real-time kinetic or spatiotemporal data from wearable sensors and a threshold. Most studies achieved statistically significant improvements on sensor-based and clinical outcomes between at least two evaluation time points. Future research should study the effectiveness of using multiple wearable sensors and actuators to provide personalized biofeedback to users with multiple sensorimotor deficits. There is space to explore BSs complementing different assistive devices and physiotherapist-oriented cues according to their needs. There is a lack of randomized-controlled studies to explore post-stroke stage, mental and sensory effects of BSs.
Topics: Biofeedback, Psychology; Gait; Humans; Robotic Surgical Procedures; Robotics; Stroke; Stroke Rehabilitation
PubMed: 36236303
DOI: 10.3390/s22197197 -
Clinical Biomechanics (Bristol, Avon) Nov 2018Biofeedback seems to be a promising tool to improve gait outcomes for both healthy individuals and patient groups. However, due to differences in study designs and... (Review)
Review
BACKGROUND
Biofeedback seems to be a promising tool to improve gait outcomes for both healthy individuals and patient groups. However, due to differences in study designs and outcome measurements, it remains uncertain how different forms of feedback affect gait outcomes. Therefore, the aim of this study is to review primary biomechanical literature which has used biofeedback to alter gait-related outcomes in human participants.
METHODS
Medline, Cinahl, Cochrane, SPORTDiscus and Pubmed were searched from inception to December 2017 using various keywords and the following MeSHterms: biofeedback, feedback, gait, walking and running. From the included studies, sixteen different study characteristics were extracted.
FINDINGS
In this mapping review 173 studies were included. The most common feedback mode used was visual feedback (42%, n = 73) and the majority fed-back kinematic parameters (36%, n = 62). The design of the studies was poor: only 8% (n = 13) of the studies had both a control group and a retention test; 69% (n = 120) of the studies had neither. A retention test after 6 months was performed in 3% (n = 5) of the studies, feedback was faded in 9% (n = 15) and feedback was given in the field rather than the laboratory in 4% (n = 8) of the studies.
INTERPRETATION
Further work on biofeedback and gait should focus on the direct comparison between different modes of feedback or feedback parameters, along with better designed and field based studies.
Topics: Biofeedback, Psychology; Biomechanical Phenomena; Feedback, Sensory; Gait; Gait Disorders, Neurologic; Humans; Research Design
PubMed: 30253260
DOI: 10.1016/j.clinbiomech.2018.09.020