hypertension

Research Papers

Biofeedback in rehabilitation

Giggins, Oonagh M., Persson, Ulrik McCarthy, Caulfield, Brian (2013) · Journal of Neuroengineering and Rehabilitation

This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-time ultrasound imaging (RTUS) biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be effective in the treatment of many musculoskeletal conditions and in post cardiovascular accident (CVA) rehabilitation. RTUS biofeedback has been demonstrated effective in the treatment of low back pain (LBP) and pelvic floor muscle dysfunction. Cardiovascular biofeedback methods have been shown to be effective in the treatment of a number of health conditions such as hypertension, heart failure, asthma, fibromyalgia and even psychological disorders however a systematic review in this field has yet to be conducted. Similarly, the number of large scale studies examining the use of respiratory biofeedback in rehabilitation is limited. Measurements of movement, postural control and force output can be made using a number of different devices and used to deliver biomechanical biofeedback. Inertial based sensing biofeedback is the most widely researched biomechanical biofeedback method, with a number of studies showing it to be effective in improving measures of balance in a number of populations. Other types of biomechanical biofeedback include force plate systems, electrogoniometry, pressure biofeedback and camera based systems however the evidence for these is limited. Biofeedback is generally delivered using visual displays, acoustic or haptic signals, however more recently virtual reality (VR) or exergaming technology have been used as biofeedback signals. VR and exergaming technology have been primarily investigated in post-CVA rehabilitation, however, more recent work has shown this type of biofeedback to be effective in improving exercise technique in musculoskeletal populations. While a number of studies in this area have been conducted, further large scale studies and reviews investigating different biofeedback applications in different clinical populations are required.

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The Effects of Performance Enhancement Training on Hypertension, Human Attention, Stress, and Brain Wave Patterns: A Case Study

Norris, S. Louise, Lee, Ching-Tse, Burshteyn, Dmitry, Cea-Aravena, Juan (2000) · Journal of Neurotherapy

Background: The purpose of this study was to evaluate the effects of alpha-increase neurofeedback training (Performance Enhancement Training) on blood pressure, stress reduction, attention, and observe changes in brainwave patterns. A forty-nine-year-old male college student diagnosed with essential hypertension controlled by medication had undergone twenty-six sessions of alpha-increase biofeed-back (8-13 Hz) at PZ electrode site for a period of 15 weeks. Method: Pre- and post-blood pressure measurements were taken for every session. At the beginning of week number eight, the participant discontinued his medication as advised by his physician. Pre- and post-visual TOVA CPT test was administered to assess the changes in accuracy, reaction time (RT), and RT variability. Osterkamp and Press Self-Assessment Stress Inventory was administered before and after training to assess the level of stress. QEEG evaluation was conducted prior, as well as upon completion of the study. Results: Mean Arterial Blood Pressure (MAP) yielded statistically significant results between pre- and post-sessions within participant blood pressure measurements. The participant's systolic and diastolic blood pressures during the first thirteen sessions were not significantly different from those of the last thirteen sessions when his medication was discontinued, suggesting his ability to control his blood pressure within normal limits without the use of medication. The results of the TOVA test clearly indicate an improvement in individuals' reaction time and the reaction time variability. The results of the Osterkamp and Press Self-Assessment Stress Inventory indicated an improvement in two of the scales: Work and Social Life. Statistical analysis showed that before and after QEEG evaluations were within normal limits. Discussion: The mechanism through which Performance Enhancement Training simultaneously affects blood pressure, reaction time (RT), and variability needs further investigation. However, the positive changes in the measured variables appear to be a function of enhanced self-awareness that leads to the improved self-regulation.

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