What is biofeedback?

Biofeedback is a technique in which people are trained to improve their health by learning to control certain internal bodily processes that normally occur involuntarily, such as heart rate blood pressure, muscle tension, and skin temperature. These activities can be measured with electrodes and displayed on a monitor that both the participant and his or her practitioner can see. The monitor provides feedback to the participant about the internal workings of his or her body. This person can then be taught to use this information to gain control over these "involuntary" activities. Biofeedback is an effective therapy for many conditions, but it is primarily used to treat high blood pressure, tension headache, migraine headache, chronic pain, and urinary incontinence.

Are there different types of biofeedback?

The three most commonly used forms of biofeedback therapy are:

• Electromyography (EMG), which measures muscle tension 
• Thermal biofeedback, which measures skin temperature
• Neurofeedback or electroencephalography (EEG), which measures brain wave activity 

How does biofeedback work?

Scientists are not able to explain exactly how or why biofeedback works. However, there does seem to be at least one common thread: most people who benefit from biofeedback have conditions that are brought on or made worse by stress. For this reason, many scientists believe that relaxation is key to successful biofeedback therapy. When a body is repeatedly stressed, internal processes like blood pressure become overactive. Guided by a biofeedback therapist, a person can learn to lower his or her blood pressure through relaxation techniques and mental exercises. When a person successfully relaxes and lowers his or her blood pressure, the feedback signals reflect this accomplishment. This acts as affirmation and encouragement for the person's continued efforts.

What happens during a biofeedback session?

In a normal biofeedback session, electrodes are attached to the skin. These electrodes then feed information to a small monitoring box that translates the physiologic responses into a tone that varies in pitch, a visual meter that varies in brightness, or a computer screen that varies the lines moving across a grid. The biofeedback therapist then leads the person in mental exercises. Through trial and error, people can soon learn to identify and control the mental activities that will bring about the desired physical changes.

What is biofeedback good for?

Various forms of biofeedback appear to be effective for a range of health problems. For example, biofeedback shows considerable promise for the treatment of urinary incontinence, which affects over 15 million Americans. Many people prefer biofeedback over medicine because of the lack of side effects. One early study found that biofeedback improves bladder function and reduces symptoms of urinary incontinence by up to 94 percent. Based on these and other findings, the Agency for Health Care Policy and Research has recommended biofeedback therapy as a treatment for urinary incontinence. Biofeedback also appears to be helpful for people with fecal incontinence.

Research also suggests that thermal biofeedback may soothe the symptoms of Raynaud's disease (a condition that causes diminished blood flow to fingers, toes, nose or ears) while EMG biofeedback has been shown to reduce pain, morning stiffness, and the number of tender points in people with fibromyalgia. In addition, a review of scientific studies found that biofeedback may help people with insomnia fall asleep.

In addition, one preliminary study found that the combination of temperature biofeedback and EEG neurofeedback helped alcoholics feel less depressed and more likely to abstain from drinking alcohol.

Biofeedback can also be used effectively for certain ailments in children. For example, EEG neurofeedback (especially when combined with cognitive therapy) has been shown to improve behavior and intelligence scores in children with attention deficit/hyperactivity disorder (ADHD). Biofeedback combined with fiber may also help relieve abdominal pain in children. Thermal biofeedback helps well alleviate migraine and chronic tension headaches among children and adolescents as well.

Biofeedback may also be useful for the following health problems:

• anorexia nervosa
• anxiety
• asthma
• autism
• back pain
• bed wetting
• chronic pain
• constipation
• depression
• diabetes
• fecal incontinence
• epilepsy and related seizure disorders
• head injuries
• high blood pressure
• learning disabilities
• motion sickness
• muscle spasms
• sexual disorders, including pain with intercourse
• spinal cord injuries

How many sessions will I need?

Each session generally lasts less than one hour. The number of sessions required depends on the condition being treated. Many people begin to see results within 8 to 10 sessions. Treatment of headache, incontinence, and Raynaud's disease (as mentioned a condition that causes diminished blood flow to the fingers, toes, nose, or ears) requires at least 10 weekly sessions and then less frequent sessions as health improves. Conditions like high blood pressure, however, usually require 20 weekly biofeedback sessions before improvement can be seen. In addition to these sessions, you will also be taught mental exercises and relaxation techniques that can be done at home and must be practiced at least 5 to 10 minutes every day.

Are there any risks associated with biofeedback?

Biofeedback is considered a safe procedure. No negative side effects have been reported.

How can I find a qualified practitioner?

Specialists who provide biofeedback training range from psychiatrists and psychologists to nurses, dentists, and physicians. The Association for Applied Psychology and Biofeedback (www.aapb.org) is the national membership association for professionals using biofeedback and is a good resource for finding qualified biofeedback practitioners in your area. To receive a directory of trained biofeedback specialists in your area, write to the AAPB at 10200 W. 44^th Avenue, Suite 304, Wheat Ridge, CO 80033-2840 or call them at 800-477-8892.

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