What is biofeedback?
Biofeedback is a type of therapy aimed at helping people control specific bodily functions, like muscle contractions, body temperature, and heart rate. During biofeedback sessions, a healthcare professional, like a nurse, doctor, physical therapist, or occupational therapist, will connect electrodes (sensors) to your body. These electrodes pick up information about the way your body is functioning and report that information to the biofeedback processor that analyzes the data the electrodes collect. The processor then sends signals to you and/or your healthcare professional in the form of audiovisual cues. You then use those cues to learn to control the measured bodily functions and, ultimately, to improve your health or physical performance.
Physical therapists and occupational therapists often use biofeedback as part of their treatment programs. It’s a great compliment to other types of therapy as it’s safe and (mostly) non-invasive, and it has no negative side effects. Therapists often recommend it in conjunction with other treatments so their patients get more out of therapy. Because it’s so safe, biofeedback is an attractive treatment option for people who wish to avoid medication or surgery.
Physical therapists, occupational therapists, and doctors use several types of biofeedback to measure different physiologic functions, including:
- Heart rate: Biofeedback to control your heart rate can be done with an electrocardiograph (ECG) that measures your heart rate, a photolethysmograph (a machine that uses sensors to detect changes in blood volume), or a combination of the two.
- Muscle contraction: To measure the electrical activity that causes your muscles to contract, therapists place sensors on your skin over specific skeletal muscles that are connected to an electromyograph (EMG). This is one type of biofeedback therapists use to treat several urologic conditions.
- Brain waves: During brainwave biofeedback, a therapist connects sensors to your scalp to measure the electrical activity in your brain (brain waves). These sensors are also connected to a machine called an electroencephalograph (EEG).
- Breathing: To measure your breathing rate and patterns, your therapist will put special bands around your chest and abdomen.
- Body temperature: Temperature biofeedback measures blood flow to your skin via sensors on your fingers or feet.
- Sweat gland activity: This type of biofeedback uses sensors on your fingers, palm, or wrist to measure electrical activity of your sweat glands and how much sweat is on your skin.
Doctors and physical/occupational therapists use biofeedback to treat several conditions, including:
- Headaches
- Anxiety
- Chronic pain
- TMJ
- Fibromyalgia
- Muscle spasms
- Back pain
- High blood pressure
- Post-traumatic stress disorder (PTSD)
- Raynaud’s disease
- ADHD
- Urologic disorders
Biofeedback is a common therapy used by physical therapists or doctors in urology practices to strengthen the muscles in the pelvic floor to treat urologic conditions, such as urinary and fecal incontinence, urinary frequency, and nighttime incontinence.
Biofeedback to treat urological disorders in men, women, and children
Urologic disorders, such as urinary incontinence (the inability to control the flow of urine) and nocturnal enuresis (bedwetting), are common conditions in men, women, and children, and they can cause significant distress. Many of these urologic conditions are due to weakness and dysfunction of the muscles in the pelvic floor. Biofeedback, when used in conjunction with a pelvic floor therapy program, can successfully treat some urologic conditions, including:
- Urge incontinence – A strong and uncontrollable urge to urinate
- Stress incontinence – Losing bladder control during physical activity or when laughing or sneezing
- Urinary frequency – Needing to urinate more often than normal
- Nocturnal enuresis – Wetting the bed
- Nocturia – Waking frequently throughout the night to urinate
- Erectile dysfunction – The inability to obtain or keep an erection
- Fecal incontinence – The inability to control the bowels
Biofeedback and pelvic floor therapy can also help people who have had surgeries that led to urinary problems. These surgeries include hysterectomy, bladder surgery, prostate removal, and colon surgery. Women who are pregnant or have been pregnant can also benefit from biofeedback and pelvic floor physical therapy.
The goal of biofeedback during pelvic floor therapy is to strengthen and retrain your pelvic floor muscles in order to improve your condition. For example, biofeedback can help improve bladder function and decrease pelvic floor pain.
What happens during a biofeedback session for urologic conditions?
If your doctor or physical therapist recommends biofeedback to treat a urologic condition, you will have your sessions in either the doctor’s or therapist’s office. The doctor/therapist will place two electrodes on your body – one on your abdomen and another just inside your vagina or anus. These electrodes measure the electrical activity in the pelvic floor muscles that control your bladder and bowels and then send data to a biofeedback machine called an electromyograph.
During the session, you will be asked to squeeze and relax the muscles in your pelvic floor without using your abdominal muscles. If you have difficulty isolating and contracting those muscles, your doctor or therapist may use electrical impulses to stimulate the right muscles to contract.
The goal of this type of biofeedback is to help you learn how to isolate your pelvic floor muscles so you can contract them properly in order to strengthen them and learn to control them better. The purposeful contraction and relaxation of pelvic floor muscles is called Kegel exercises (or Kegels). Kegels can improve the function of your urethra and rectal sphincter muscles, which can improve your bladder and bowel control. But to get the most benefit, you must do Kegels correctly. This is where biofeedback can help. It teaches you how to use the right muscles during your exercises.
What to expect from biofeedback sessions
Biofeedback visits will typically last between half an hour and an hour. Your doctor or therapist will recommend the number of visits based on factors such as the severity of your condition, how quickly you learn to exercise your pelvic floor muscles, and how effective the treatments are. Many people experience significant improvement in their symptoms within two or three months of treatment (eight to ten sessions).
While you should start biofeedback and pelvic floor therapy in your doctor or therapist’s office, you will also need to practice your Kegel exercises at home regularly. The more you practice, the stronger and more effective your muscles will be. If you’re interested in continuing with biofeedback at home, ask your doctor whether he or she recommends any specific biofeedback machines for home use.
Biofeedback is not for everyone. For example, it may not work as intended for people with some health conditions. Talk to your therapist or doctor about whether it could work for you. And don’t stop any medications unless your doctor instructs you to do so. Biofeedback can help you improve your health and can reduce the need for medication and other treatment, but that doesn’t mean you won’t still need to take your prescribed medications.
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