An operant conditioning computer program for biofeedback.
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Biofeedback, Psychology↗
Biomedical subjects
L P Ince
Publications and source records attributed to L P Ince.
A matching-to-sample feedback technique for training self-control of tinnitus.
Thirty individuals with subjective tinnitus aurium of a variety of types and severity were treated with a matching-to-sample feedback procedure. Following initial evaluation measures, the participants' experienced tinnitus sounds were reproduced audiometrically on all characteristics and were presented to them in the noninvolved ear or in both ears when the tinnitus was binaural. This experimental sound was then reduced in 5 decibel (dB) steps within sessions, and participants had the task of concentrating on reducing the loudness of their tinnitus until a match was achieved between it and the experimental sound at each new dB level. Results showed an overall highly significant difference in dB levels from baseline to final training session. Nearly all participants demonstrated a marked reduction in tinnitus loudness, with 84% reducing it by 10 dB to 62 dB and several eliminating it completely. Individual and pathological variables played no role in training or outcome. Our approach appears to have major advantages over other tinnitus treatment strategies in that it provides direct, significant relief and gives the patient the psychological benefit of gaining control over the problem.
Adult↗
EMG biofeedback for handwriting disabilities: a critical examination of the literature.
A critical examination of the literature on the use of electromyographic (EMG) biofeedback for problems of handwriting is presented. Examined are the procedures, results and conclusions of clinical treatments of writer's cramp and the habilitation of writing. The major flaws in each study are discussed and conclusions drawn from the review are presented, the primary one being that EMG biofeedback of the muscles of the upper extremity has yet to be demonstrated as a treatment of choice for handwriting disabilities. The lack of a sound foundation of data is seen as the main reason for the paucity of investigations in this particular area. Suggestions for further work are offered.
Arousal↗
Biofeedback treatment of upper extremity dysfunction in Guillain-Barré syndrome.
Two cases are presented of the application of electromyographic biofeedback for increasing activity of wrist and finger musculature in patients with Guillain-Barré syndrome. Patient 1, a 59-year-old woman, quadriplegic, and on a portable respirator for more than five years prior to biofeedback was given visual and auditory feedback for increased output of wrist flexor, finger flexor, and thumb opposition muscles, bilaterally. All muscles improved in activity, 9/12 significantly, although no marked improvements in activities of daily living functions were noted. Patient 2, a 51-year-old man who had experienced good motoric return following onset of the disease, was given feedback for increased activity of finger extensor, finger adductor, thumb and fifth finger opposition, wrist extensor, and finger flexor muscles, bilaterally. Of 18 muscles or muscle groups treated, 17 showed significant increases in output. This patient became ADL functional. It is believed that biofeedback can be an important modality of treatment in this disease even following termination of more traditional therapies, as was true in the present cases, and that greater attention should be paid to patients with Guillain-Barré syndrome than has been to date. It is suggested that biofeedback be initiated, along with other therapies, once the acute stage of the disease is past.
Biofeedback, Psychology↗
EMG biofeedback with upper extremity musculature for relaxation training: a critical review of the literature.
A critical review is presented of studies utilizing EMG biofeedback for relaxation of upper extremity musculature. Examined are experimental investigations with normal subjects and those with psychological problems, and clinical applications of the methodology for treatment of involuntary movements and anxiety. Articles are reviewed in terms of procedures, controls and results. It is determined that few valid conclusions can be drawn regarding the efficacy of upper extremity EMG biofeedback for relaxation and that further research is required prior to utilizing the technique clinically. Suggestions are offered for areas of investigation.
Adult↗
Reflex conditioning in a spinal man.
A man with a completely transected spinal cord and a spastic neurogenic bladder was conditioned to void upon the presentation of an external stimulus. A classical conditioning paradigm was employed in which strong abdominal shock (unconditioned stimulus) was paired with an initially neutral mild electrical stimulation of the thigh (conditioned stimulus; CS). After the pairing trials, a reliable conditioned response of urination was elicited by the CS alone. The conditioned response did not extinguish over time, and the procedure left the bladder with clinically safe residual amounts of urine. Practical implications of the conditioning technique for the treatment of spastic neurogenic bladder conditions in spinally injured patients are discussed, as is the theoretical significance of conditioning at the reflex level in the absence of cortical involvement.
Abdominal Muscles↗
Conditioned responding of the neurogenic bladder.
Classical conditioning techniques were employed to condition responding of the spastic neurogenic bladder in a man with quadriparesis and urinary incontinence secondary to spinal cord injury at the cervical level. A neutral stimulus of mild electrical stimulation to the thigh was paired temporally with an unconditioned stimulus (UCS) of stronger electrical stimulation of the lower abdomen, and then was presented alone as a conditioned stimulus (CS) to elicit the conditioned response (CR) of voiding. The previously neutral CS reliably elicited large amounts of urine and left little residual urine in the subject's bladder. Following the experimental sessions, the subject self-applied the CS on a predetermined schedule during his daily routine outside of the laboratory. The CS initially was successful, but after several days the CR exhibited extinction. Additional CS-UCS pairing sessions did not reinstate the responses satisfactorily. Aspects of the experimental procedure and the results are discussed as well as the feasibility of conditioning the human spinal cord in the absence of an intact central nervous system
Abdomen↗
Biofeedback as an experimental treatment for postural hypotension in a patient with a spinal cord lesion.
A man having severe postural hypotension resulting from a spinal cord lesion at level T3, was trained to raise and lower his blood pressure with the use of biofeedback. The procedure consisted of 11 learning sessions during which the subject's task was to effect specific changes of his blood pressure without skeletal muscle or respiratory involvement. Blood pressure was continuously monitored and reported to the subject, and positive verbal reinforcement for correct changes was also supplied. Analysis of the results revealed that the subject had learned to produce large voluntary changes in pressure. This learned ability was then applied in a standing position resulting in counteracting the postural hypotension. Suggestions for further research and implications for clinical applications are discussed.
Adult↗
Conditioning bladder responses in patients with spinal cord lesions.
Two patients with spinal cord lesions and spastic neurogenic bladders were treated with classical conditioning techniques to reinstate independent bladder function utilizing electrical stimulation of the abdomen as the unconditioned stimulus and mild electrical stimulation of the thigh as the conditioned stimulus. Successful conditioning was achieved in both cases. Urination was brought under the control of a previously neutral stimulus with a high rate of responding.
Adult↗
Behavior modification of sexual disorders.
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Adult↗
Modification of articulation in dysarthria.
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Cerebrovascular Disorders↗
Biofeedback as a treatment for postural hypotension.
Two patients with cervical spinal cord lesions were treated for postural hypotension using auditory and visual feedback for voluntary increases in blood pressure. Following initial measures of blood pressure, feedback was delivered for systolic increases above baseline. Within several weeks, both patients learned to increase their pressure markedly from the start of training sessions to their conclusion. The patients' legs were progressively lowered during and at the end of training sessions without significant blood pressure decreases. Long-term follow-up indicated that they were able to maintain the learned increases in blood pressure despite adverse medical conditions. It is suggested that central nervous system damage disrupts homeostatic regulation, permitting greater voluntary control through biofeedback as a new feedback loop. Motivation is also considered an important variable for success.
Adult↗
A cross-modality approach for treatment of chronic pain: a preliminary report.
Three subjects, presenting a variety of chronic pain problems, were treated with a cross-modality feedback technique. Their presenting pain intensity was matched to a pure tone auditory stimulus decibel level and in each session this stimulus was progressively reduced in loudness, with the subjects having the task of reducing their pain to match each new, lower decibel levels. Audiometric measures, responses to pain assessment scales, self-reports, reports from hospital staff, and reductions in pain medications all demonstrated marked pain reduction in all cases. Follow-up assessments revealed that the improvements were maintained long after treatment had been discontinued.
Arthritis, Rheumatoid↗