Introduction:
The healthcare field is continuously evolving, and one of the areas that has seen remarkable advancements in recent years is the integration of various technologies into therapeutic practices. Anywhere and at any time, we have access to plenty of information about how our bodies adapt to the world around us, whether it be through smartphones, the internet, apps, or our wearable devices. These advancements allow us to monitor and regulate various physiological and behavioral activation aspects of our health. Biofeedback-enhanced therapeutic exercises are at the forefront of this movement, offering an innovative approach to wellness and rehabilitation. In this article, we will explore the concept of biofeedback, its applications in therapeutic exercises, and its numerous benefits to patients and healthcare professionals.
What is Biofeedback
Biofeedback has been used in rehabilitation for over fifty years to facilitate normal movement patterns after injury (Giggins et al., 2013). According to a report published by the Mayo Clinic (2023), it is a technique that allows individuals to gain greater awareness and control over physiological functions in real-time using monitoring devices. These devices provide immediate feedback on various bodily processes, such as breathing patterns, heart rate, muscle tension, skin temperature, and brainwave activity.
In this process, electrical pads are connected to the body, which helps you get information about your internal body functions. Biofeedback helps to make slight changes in the body, such as relaxing muscles, to help relieve pain or reduce tension. One may not realize it, but the body changes in pain or under stress, resulting in a faster heartbeat, heavy breathing, and tightening muscles. The fundamental concept behind biofeedback revolves around harnessing the potential of mental awareness and gaining insights into internal bodily processes, ultimately allowing us to exercise greater control of our overall health.
The three most common types of biofeedback include-
Electromyography (EMG) biofeedback measures muscle tension as it changes over time.
Electroencephalography: measures brain wave activity over time.
Thermal or temperature biofeedback: measures body temperature changes over time.
The Integration of Biofeedback in Therapeutic Exercises
Biofeedback has found its way into therapeutic exercises as a valuable tool for optimizing rehabilitation and enhancing overall patient outcomes. Here is how it works:
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Neuromuscular Biofeedback
The neuromuscular system is the nervous and musculoskeletal system working together to create movement. Any measure of these systems can provide neuromuscular biofeedback, which is used in physical rehabilitation, including real-time ultrasound imaging (RTUS) and EMG biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be most effective in the treatment of many musculoskeletal conditions. This form of biofeedback is widely utilized during recovery from musculoskeletal injuries, post-operative recovery, and in post-cardiovascular accident (CVA) rehabilitation. Biofeedback can be used to monitor and control muscle activity (Giggins et al., 2013).
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Posture and Body Mechanics
Body mechanics is a term used to describe how we move in our daily lives. It includes how we carry our bodies when we stand, sit, lift, carry, bend, and sleep. When we do not move safely or correctly, the spine is subjected to abnormal stresses that can lead to the degeneration of spinal structures like joint discs, peripheral nerve injury, and unnecessary wear and tear. Proper posture and body mechanics are essential for preventing and managing musculoskeletal conditions (Bibbin, 2018).
Postural defects treated using biofeedback include adolescent idiopathic scoliosis, torticollis, and rounding of the back or slouching (functional thoracic kyphosis) due to poor posture. (Cheung et al., 2022)
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Pain Management
Biofeedback can be used to teach patients pain management techniques. By monitoring physiological responses to pain, such as heart rate and muscle tension, individuals can learn how to control and reduce their discomfort. This approach is particularly effective for chronic pain conditions. Biofeedback techniques are generally regarded as safe and free of side effects. For this reason, they are incorporated into treatment plans despite lacking strong evidence to support their benefits (Malik, 2023).
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Neurorehabilitation
Patients recovering from neurological injuries such as a stroke can benefit from biofeedback-assisted exercises. EEG biofeedback, for example, can help retrain brainwave patterns, promoting neural plasticity and functional recovery (Nizamis et al., 2021).
Benefits of Biofeedback-Enhanced Therapeutic Exercises:
Biofeedback-enhanced therapeutic exercises combine traditional therapeutic exercises with real-time physiological feedback. This approach offers several benefits for individuals undergoing rehabilitation, pain management, stress reduction, and performance improvement.
Yucha et al. (2008) explored the evidence-based use of biofeedback and neurofeedback techniques in various healthcare settings. Biofeedback emphasizes training individuals to self-regulate, gain awareness, increase control over their bodies, brains, and nervous systems, and improve flexibility in physiologic responses. The positive effects of feedback training enhance health, learning, and performance. Here are some of the key advantages:
Enhanced Awareness
Biofeedback provides individuals with immediate information about their physiological responses, such as muscle tension, heart rate, or skin temperature. This heightened awareness can help patients better understand their body’s responses to exercises and stressors, facilitating self-regulation and self-awareness.
Personalized Treatment
Biofeedback allows therapists to tailor exercises and treatment plans to each individual’s needs. By monitoring real-time physiological data, therapists can adjust exercise intensity, duration, or technique to optimize the therapeutic benefits.
Performance Enhancement & Tracking
Athletes and individuals looking to optimize their physical performance can benefit from biofeedback-enhanced exercises. Real-time feedback can help them refine their technique, maintain proper form, and maximize their training efforts. Healthcare professionals can objectively track a patient’s progress over time, making it easier to adjust treatment plans.
Biofeedback can motivate patients to adhere to their exercise programs. Seeing their physiological progress in real-time can be highly motivating, as it provides tangible evidence of improvement. This can lead to better compliance with prescribed exercises and treatment regimens. Biofeedback can be used in various devices and applications, including stress management, relaxation, muscle training, grip training, and many more. Many biofeedback devices also track and store data over time which can help users monitor their progress, set goals, and adjust their training or therapy.
One of the portable grip strengthener devices that incorporates biofeedback technology is Squegg, which helps users improve their hand and grip strength. Here is how the Squegg utilizes biofeedback:
Real-Time Data Monitoring
The Squegg has sensors that measure the user’s grip strength as they squeeze the device. This measurement is provided in real time, allowing users to see how much force they exert at any moment.
Visual Feedback
The biofeedback aspect of the Squegg typically includes a visual element. Users may see their grip strength displayed on a screen, often as a graph or numerical value. This visual feedback provides immediate information about their performance.
Progress Tracking
Besides real-time feedback, the Squegg often has features for tracking grip strength progress over time. Users can review historical data to see improvements or changes in their hand strength and track their fitness or rehabilitation progress.
Goal Setting
Squegg allows users to set grip strength goals. Biofeedback in this context helps users work toward these goals by providing feedback on whether they are meeting or exceeding their target grip strength levels.
Motivation
Real-time visual feedback can be highly motivating. Users can see how their efforts directly impact their grip strength and can strive to improve their performance during each session.
Data Analysis
Users, therapists, or healthcare professionals can analyze the data collected by the Squegg over time to assess trends, identify areas for improvement, and adjust exercise routines accordingly.
Conclusion
Incorporating biofeedback into grip strength training with a device like the Squegg can have several benefits, including improved engagement, better adherence to exercise routines, and the ability to tailor workouts to individual needs. It is especially valuable for rehabilitation after hand injuries or surgeries, as it allows for precise monitoring and adjustment of exercises to aid recovery. As technology advances, biofeedback will likely become an increasingly integral part of the therapeutic landscape, offering hope and healing to countless individuals on their path to recovery and well-being.
References:
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Bibbin, B. (2018). Nursing students knowledge and practice regarding body mechanics in caring helpless patient. International Journal of Nursing Education and Research. https://doi.org/10.5958/2454-2660.2018.00054.6.
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Mayo Clinic. (2023, March 18). Biofeedback. https://www.mayoclinic.org/tests-procedures/biofeedback/about/pac-20384664.
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Cheung, M., Yip, J., & Lai, J. S. K. (2022). Biofeedback posture training for adolescents with mild scoliosis. BioMed Research International, 2022, 1–8. https://doi.org/10.1155/2022/5918698.
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Giggins, O. M., Persson, U. M. C., & Caulfield, B. (2013). Biofeedback in rehabilitation. Journal of Neuroengineering and Rehabilitation, 10(1), 60. https://doi.org/10.1186/1743-0003-10-60.
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Malik, K. (2023, March 2). Biofeedback. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK553075/.
- Nizamis, K., Athanasiou, A., Almpani, S., Dimitrousis, C., & Astaras, A. (2021). Converging robotic technologies in targeted neural rehabilitation: A review of emerging solutions and challenges. Sensors, 21(6), 2084. https://doi.org/10.3390/s21062084.
- Yucha, C., & Gilbert, C. (2004). Evidence-based practice in biofeedback and neurofeedback. Association for Applied Psychophysiology & Biofeed.