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Biofeedback Approach to Differential Diagnosis
BIOFEEDBACK APPROACH TO DIFFERENTIAL DIAGNOSIS
But what is Biofeedback?
Biofeedback is a major part of the holistic approach to medicine, psychology and education that emphasises an integration of mind-body process.
Biofeedback is the use of instrumentation to mirror psycho-physiological processes of which the individual is not normally aware and which are brought under voluntary control.
This means giving a person immediate information about his or her own biological conditions, such as:
This feedback enables the individual to become an active participant in the process of health maintenance.
Biofeedback involves the use of specialised instrumentation. This instrumentation may be as simple as a hospital thermometer or as sophisticated as an electro-encephalogram, an electronic device which measures brain wave patterns.
The most important feature about the instrumentation, no matter how simple or complex, is that it tells the individual about the measurement which it just made. It is this important feature of measurement and immediate feedback which distinguishes biofeedack from other techniques which teach 'relaxation' or 'alpha-control', but which do not involve feedback of actual physiological changes.
Biofeedback is not 20th century with man controlled by machine, but just the opposite. It represents man controlling machine in an effort to control himself.
Biofeedback instrumentation gives some information about the body. There are many ways to 'mirror' this information so the individual understands what changes occurred or what condition exists. The information may be conveyed by use of a meter or light which the person watches, or by a sound which is heard, or even by the movement of a toy train! Whatever means are used, the critical point is that the person gets immediate information about his or her own body. With appropriate instrumentation anything which can be measured can also be fed back to the individual in some way.
At any instant, there are innumerable minute changes occurring in our bodies. For example, there are fluctuations in muscle activity, brain wave patterns, heart rate, blood flow, hormonal and gastric acidity.
Many of these changes are related to psychological factors, such as: stress, arousal, fear, sexual excitement, anxiety and relaxation.
The term "psychophysiological processes" covers physiological conditions which are related to pychological factors. It is this interaction of the body-mind which underlies much of biofeedback training.
Currently there are four major psychophysiological processes which are measured and 'fed back' to the individual. The brief descriptions cover only the major conditions and thus are not inclusive of all psychophysiological changes which can be measured by biofeedback instrumentation.
1 Muscle tension and relaxation
Muscles tension and relaxation can be measured and fed back by the electromyograph.
Sensors placed on the skin over a muscle will detect electrical activity of the muscle. More electrical fireings indicate greater tension (activity). Subjectively, people often are not aware of areas which are tense until it becomes painful.
Before biofeedback training, people usually cannot feel the process fo increasing muscle tension or small changes towared relaxation. After training, one can learn to recognise when tension BEGINS to increand and WHEN and HOW to relax.
There are many sites whree muscle activity is measured and the tension-relaxation changes fed back. Tje selection of the site of electromyograph training will depend on the type of symptom which is being treated. The use of electromyograph biofeedback is extensively applied in:
General Relaxation Training
Temporomandibular Joint Pain
Bruxism and other syndromes
2 Arousal changes
Arousal changes due primarily to sympathetic nervous system changes, are measured by the Galvanic Skin Response. We measure changes in sweat responses on the surface of the skin, and the individual can get feedback on his or her own arousal system. We successfully use this in:
The two steps in the Biofeedback learning process are awareness of body states and voluntary control over these states. A third step involves using these new skills in everyday life.
3 Brain Wave Patterns
This can be measured and analysed by an EEG. The EEG measures small microvoltages of electrical activiity of the brain cortex by use of sensors places on the scalp. The measurement is converted and analysed into particular brain wave frequencies and amplitudes.
The frequences are categorised into four major groups:
Beta Alpha Theta Delta
There are different subjective experiences which are associated with these major groups ranging from attentiveness or anxiousness (Beta), to more meditative and 'daydreaming' associations (Alpha), to passive problem solving and creativity (Theta), and finally sleep (Delta).
We are never in any one 'state' rather, there may be a predominance of one frequency and associated subjective experiences. EEG biofeedback is useful in treating certain kinds of disorders including:
4 Peripheral Blood Flow
We measure peripheral blood flow by measuring the temperature of the surface of the skin by use of Temp. Changes in the dilation or constriction of the peripheral vessls lead to changes in blood flow.
For example, in a constant environment, skin surface temperature of the hands can fluctuate between 60-95 degrees. Minute changes in the skin temperatures are measured by a themistor placed on the surface of the skin and fed back to the individual. We employ temp. feedback suddessfully in treatment of such conditions as:
We apply biofeedback technique in other areas of concern succesfully covering problems like:
Like Biochemistry and Physiology, Biofeedback is both diagnostic and therapeutic.
The underlying philosophy of biofeedback is basically a return of responsibility for one's health to the individual. It is a self-control model and, thus is different from the traditional medical model where responsibility is given to the doctor to take care of the illness with drugs, surgery or other 'external'controls. For example:
Biofeedback can reduce or elininate the need for drugs for a particular condition or elininate the need for more dreastic measures (such as surgery) as the person learns to gain control over certain conditions (e.g. hypertension). It allows self-control through increased awareness of stress responses and the ability to voluntarily control responses.
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