Biofeedback is a non-invasive technique designed to improve health and performance by teaching individuals how to alter and enhance their physiological activity, and ultimately behavior.
Highly sophisticated electronic equipment continuously measures a variety of physiological activities, including heart rate, blood pressure, respiratory rate, muscle activity, skin temperature, and brain waves. The data is then instantly provided to the individual by amplifying and converting the electronic and electromechanical activity into auditory and/or visual “feedback”. The feedback illustrates in real time an individual’s physiological activity, which enables the individual to learn and change behavior.
Biofeedback is based on the theory of operant conditioning, which states that changes in behavior occur in response to environmental stimuli, or events. Moreover, when responses to events produce positive consequences, such as rewards, behaviors are reinforced, and when responses to events produce a negative consequence, such as punishments, behaviors are reduced.
Biofeedback enables individuals to increase awareness and accuracy of their perceptions of physiological activities, thereby increasing their ability to self-regulate physiological states.
Below you will find some of our frequently asked questions about biofeedback. If your question is not answered, please feel free to contact us!
Biofeedback is a non-invasive and safe therapy.
There are no known significant or lasting side effects. However, short-term fatigue, dizziness, and nausea have been reported.
The effects of biofeedback vary depending on the severity of the problem and duration of symptoms. Likewise, changes in cognitive, emotional, or physical functioning will vary with the individual. Some people may notice effects after only a few sessions, while others take longer. Nonetheless, the effects of biofeedback are cumulative, and therefore, the more training one receives, the greater and longer lasting the benefits will be.
Because each individual is different, the number of sessions is also dependent on the individual, the severity and duration of the problem, and age of the individual. For example, younger brains learn much faster than older brains. Nonetheless, while some individuals may see lasting changes earlier, research suggest that and average of 20 sessions are required to experience permanent changes in brain functioning. However, disorders, such as epilepsy, ADHD, and schizophrenia may require significantly more training.
Early biofeedback research using electromyography (EMG) demonstrated that electrical responses in muscles offered accurate real-time data on functional muscular activity, and this data was initially used to diagnose neuromuscular disorders. However, the technology was soon used for rehabilitation purposes among stroke patients. The use of biofeedback to facilitate motor learning in rehabilitation settings, now referred to as kinetic biofeedback, has since grown. For example, it has been used to help to enhance gait patterns among children with cerebral palsy, and balance among children with autistic spectrum disorder.
Early biofeedback research using electromyography (EMG) demonstrated that electrical responses in muscles offered accurate real-time data on functional muscular activity, and this data was initially used to diagnose neuromuscular disorders. However, the technology was soon used for rehabilitation purposes among stroke patients. The use of biofeedback to facilitate motor learning in rehabilitation settings, now referred to as kinetic biofeedback, has since grown. For example, it has been used to help to enhance gait patterns among children with cerebral palsy, and balance among children with autistic spectrum disorder.
Among all vertebrates, the heart beat naturally synchronizes with the respiratory rhythm, known as respiratory sinus arrhythmia (RSA), whereby the heart rate increases during inhalation and decreases during exhalation. Breathing frequency and rate vary during different times, subsequently affecting heart rate variability (HRV). For example, during a state of relaxation when breathing is slow, there are greater variations between heart beats, whereas during periods of stress, variations between heart beats decreases. RSA and HRV are used as indicators of cardiac vagal function, respiratory-circulatory interaction and cardiac-parasympathetic regulation, as well as emotional and cognitive processing and regulation. High resting RSA amplitude and HRV are associated with increased flexibility and resilience, indicating greater physical and emotional health, whereas low resting RSA and HRV are associated with increased disorder, disease, and mortality.
HRVB is a form of biofeedback that uses breath pacing technology to teach slow breathing techniques, which relay information back to the individual related to each heartbeat. The feedback is designed to help patients increase and match their RSA to a sine-wave-like curve that reflects heart rate increases and decreases during inhalation and exhalation. Similar to mindfulness meditation techniques, HRVB requires close attention to subtle variations in the breath.
One advantage of HRVB is that patients can learn breathing techniques that allow them to self-regulate breathing and RSA at anytime, anywhere, without the use of mechanical or electrical devices.
There is a substantial amount of research indicating that higher and more complex heart rate variability (HRV) helps to regulate and fine tune the body to internal and environmental requirements, significantly enhancing physical and emotional resilience and decreasing inflammatory conditions. Additionally, there is some speculation that voluntary control of breathing patterns may increase blood flow to areas of the brain associated with attention and alertness, while reducing blood flow to areas of the brain associated with anxiety and depression.
The exact mechanisms underlying the efficacy of HRVB are still being studied. However, HRVB has been shown to be effective in treating:
- Asthma
- Chronic obstructive pulmonary disease
- Emphysema
- Irritable bowel syndrome
- Cyclic vomiting
- Recurrent abdominal pain
- Fibromyalgia
- Cardiac rehabilitation
- Hypertension
- Chronic muscle pain
- Fatigue
- Stress
- Depression
- Anxiety
- Post-traumatic stress disorder
- Insomnia
- Enhanced athletic performance.
Research with electroencephalography (EEG) examine the functional relationships between the brain and behavior by monitoring the electrical activity of neurons in the form of brain waves and inducing changes in those waves. EEG monitors delta, theta, alpha, sensorimotor, low beta, and high beta waves. Delta waves represent sleep states, and theta waves are associated with cognitive and emotional reactivity, as well as emotional healing. Alpha waves are typically associated with deep relaxation, and sensorimotor waves represent local and inhibitory/excitatory sensorimotor neuron activity, whereas beta waves represent high arousal, concentration and focused attention. Beta waves are also associated with the stress response.
Early studies in this area demonstrated that synchronized EEG activity over the motor cortex could be regulated by operant conditioning, inhibiting epileptic seizures, and that sensory motor rhythm training could successfully treat children with hyperkinetic disorder. These discoveries led to the use of EEG neurofeedback in the treatment and enhancement of neuroregulation and metabolic function in epilepsy, attention deficit hyperactivity disorder (ADHD), and autistic spectrum disorders.
In linear neurofeedback therapy, sensors are placed on the scalp and ears to measure brain wave amplitude, frequency and/or coherency. A practitioner reads the brain activity and alters brain wave patterns by either increasing and/or decreasing wave amplitudes of particular frequencies according to specific protocols. Alternatively, second generation dynamic neurofeedback systems, such as NeurOptimal, monitor brain wave patterns and relay feedback back to the brain, allowing the brain to self-correct. The concept behind self-correction relies on the assumption that the body and brain have a number of redundant systems designed to encourage optimal functioning, and that given the information, the brain will automatically initiate optimal functioning.
Additionally, Real-Time Functional Magnetic Resonance Imaging Neurofeedback (rtfMRI-nf) uses rtfMRI to help patients learn to voluntarily regulate activity of specific brain areas in order to enhance health and functioning. The assumption with rtfMRI-nf is that brain activity is shaped by experience, and that connectivity between brain regions is increased or decreased when they are simultaneously activated or deactivated.
Early studies using linear neurofeedback systems demonstrated increased relaxation by increasing alpha waves. Later studies showed that alpha training between the motor cortex and the rest of brain can enhance motor performance after stroke. The combination of Alpha/theta (A/T) training enhanced creativity, technique and presentation among instrumental artists. Additionally, studies using dynamic systems found that neurofeedback training may be effective in reducing fatigue, cognitive impairment, sleep problems, stress, anxiety, depression and pain. Similarly, initial studies with rtfMRI-nf indicate that neurofeedback may be effective in treating depression, ADHD, schizophrenia, and cravings, and increasing emotional regulation, cognitive performance, and physical functioning.
Moreover, recent studies suggest that neurofeedback training can trigger changes in functional connectivity, and that the reorganization of functional brain networks generates enhanced cognitive and behavioral performance.
While research in the area of neurofeedback is preliminary, results are promising, as studies have found support that neurofeedback can be effective in treating:
- Schizophrenia
- ADHD
- Depression
- Anxiety and stress
- PTSD
- Fatigue
- Sleep disorders
- Alzheimer’s and vascular dementia
- Chronic pain
- Traumatic brain injury (TBI)
- Cravings
Research also suggests that neurofeedback training can enhance:
- Cognitive functioning
- Physical functioning
- Emotional regulation
- Self-regulation
- Attention
- Memory
- Sport performance
- Artistic performance
