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by: Nicollette Appel

BIL330 BIL330

Nicollette Appel
GPA 3.62
Dr. Brand

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Dr. Brand
Test Prep (MCAT, SAT...)
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This 9 page Test Prep (MCAT, SAT...) was uploaded by Nicollette Appel on Wednesday February 4, 2015. The Test Prep (MCAT, SAT...) belongs to BIL330 at University of Miami taught by Dr. Brand in Fall. Since its upload, it has received 54 views. For similar materials see Ecology in Biology at University of Miami.


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Date Created: 02/04/15
BIL 376 Chapter 7 Biofeedback History Emergence of biofeedback came from the demonstration of controllability of involuntary responses 0 Factors contributing to the emergence of biofeedback include o Psychophysiology Interplay between psychologic variables and physiologic response 0 Behavior therapy and behavior medicine Train patients to unlearn maladaptive behavior patterns 0 Stress research and stress management Progressive muscle relaxation to reduce tension Yoga and meditation became culturally appealing o Biomedical engineering Dependent on ability to detect and monitor physiologic processes 0 EMG advances Electromyogram to noninvasively monitor physiologic processes 0 Consciousness altered states of consciousness and EEG Exploration of altered states with EEG monitors showed support that EEG can be voluntarily controlled 0 Cybernetics Built on idea that learning is not possible without feedback Provides physiologic information to the subject to induce learning 0 Cultural factors 0 Professional development 0 Instrumental conditioning 0 Individuals can learn to modulate visceral functioning to a healthier standard 0 Motivation and expectations play a role in biofeedback effectiveness De nition of Biofeedback Feedback process in which factors that produce a result are modi ed corrected or strengthened by the result Biofeedback biologic information about the self is used to modify correct or strengthen processes within the self 0 Therapeutic technique that involves monitoring an individuals physiologic processes relaying the information to the individual so it can be modi ed 0 Help individuals alter their physiologic reactions to a healthier standard 0 Applied biofeedback includes the process and purpose of biofeedback 0 Group of therapeutic procedures 0 Use electronic or electromechanical instruments 0 Measure process and feed back to persons and their therapist accurately Information with education and reinforcing properties 0 Neuromuscular and autonomic activity both normal and abnormal 0 Form of analogue or binary auditory or visual feedback signals 0 Best achieved with a competent biofeedback professional 0 Objective to help persons develop greater awareness of con dence in and an increase in voluntary control over their physiologic processes 0 Need to control the external signal 0 With internal psychophysical cognitions stop or reduce it 0 Key procedural elements of biofeedback diversity instruments involvement 0 Key goals of biofeedback external feedback eventual internalization Clinical Practice 0 General approach for individuals with conditions of excessive arousal 0 Physiological stuck in fightor ight mode 0 Muscles tense pulse rate quicker increase sweating etc 0 Teach individual to prevent exaggerated bodily reactions 0 Therapeutic workhorses modalities to help promote general relaxation 0 Muscle tension biofeedback EMG 0 Temperature or thermal biofeedback o Sweat gland activity or skinconductance biofeedback Thought that lowering muscle tension in forehead promote overall relaxation Teach individuals to warm up hands as part of thermal biofeedback o Calms the nervous system blood vessels open increase blood ow 0 Skin conductance usually a sign of arousal monitor sweat to monitor stress 0 Biofeedback combines allied relaxationbased approaches yoga meditation Biofeedback uses instruments that record information about the body 0 Provides a way of gauging targets for treatment and evaluate progress Instrumentaided relaxation give concrete evidence bodily relaxation occurring 0 Provides a feedback loop allowing learning to take place more quickly General practice feedback clinicians use workhorse techniques 0 Treat conditions related to heightened arousal associated with anxiety 0 Help patients decrease state of heightened arousal o EMG to reduce tension states in targeted muscles 0 Temperature feedback to increase peripheral blood ow Biofeedback specialists use applications that require more advance training Specialized EMG for conditions of imbalanced between muscles Muscle tension biofeedback to enhance muscle tone and coordination Process of Biofeedback Detection and ampli cation of a biologic response by using certain measurement devices and electronic ampli ers Conversion of these bioelectrical signals to a form that the person can easily understand and process Immediate feedback of or information about the signal to the person Computer receiving information able to manipulate physiologic information o Displayed to patient in order to learn meaningful modulation 0 Feedback usually auditory or visual presented Binary feedback signal used when patient needs to strive for speci c target 0 Use continuous feedback to shape every increasing degree of relaxation 0 Information has reinforcing qualities when desired response produced Voluntary control developed through trial and error then by desired results Descriptions of Biofeedback Modalities ElectromyographicAssisted Relaxation EMG O O O O EMG signal when muscle contracts creating small electrochemical signal Action potentials among muscle bers detected based on ion exchange Believe reduction in forehead muscle tension generalize to others State of cultivated low arousal needs to be trained during treatment Bandpass of equipment affects measurements from different machines Measurements affected by sensor type and size placement distance Raw signal undergo processing to yield information easy to comprehend Case Illustration of EMG O O O O O Tension headaches experienced from situational stress Headache continuous and prolonged pain is bilateral generalized or bandlike exacerbation related temporally to stress absent of neurologic Look at headache sum frequency headache free days and peak sum Use EMG biofeedback sessions to lower muscles tensions Acquired moderate skills to selfregulate her EMG w or wo feedback 0 Skin TemperatureAssisted Relaxation O O O O Spontaneous end to migraine seen with ushing of hand and temperature increase on hand surface Given feedback to raise hand temperatures to regulate headache activity Autogenic feedback use autogenic training augmentation Decrease sympathetic out ow increase vasodilation and blood ow 0 Case Illustration of Temperature Relaxation O O O Biofeedback and other approaches to control blood pressure Multicomponent psychophysiologic therapy used Involve patient education thermal biofeedback for hand and foot temperature increase frontal EMG biofeedback diaphragmatic breathing exercises autogenic phrases home relaxation practice and home monitoring of hand and foot temperatures and BP Continue until complete or partial success in blood pressures o Multicomponent and individually tailored treatments preferred 0 Skin ConductanceAssisted Relaxation electrodermal response EDR 0 Sweat contains electrically conductive salts skin more conduche 0 Changes in skin conductance vary with changes in arousal increase 0 Used to promote general relaxation in two portions of the CNS 0 Eccrine sweat glands respond to psychologic stimulation 0 Conductance measures used for straightforward explanation Case Illustration of EDR 0 Panic attacks with rapid heart rate sweating trembling dizziness o Psychophysiologic stress pro le show attacks with increase sweat activity 0 Pro le made from monitoring responses during stimulated conditions 0 Worries on attack only worsened the condition 0 Eventually didn39t need external help from monitor to regulate arousal EEG heart rate variability blood volume pulse are newly emerging modalities Specialized Biofeedback Applications Electroencephalographic Feedback or Neurotherapy EEG o Sums of postsynaptic potential create an EEG 0 Many frequencies occur simultaneously correlating to a given behavior 0 First used for epilepsy now for treatment of attention disorders 0 Case Illustration of EEG 0 Children with an attention disorder show different EEG patterns 0 Neurotherapy attempts to wake up the brain make children attentive 0 Active therapeutic process to shape brainwaves to remain alert 0 EEG treatment to reduce theta to beta wave ratio massed practice 0 Became able to reduce theta and increase beta Electrocardiologic and Heart Rate Variability Biofeedback 0 Record electrical impulses associated with the heart beaUng O O O 0 Heart rate variability HRV interbeat interval taken Lack of variation shows imbalance between both ANS aspects Decreased parasympathetic tone or overstimulation reduces HRV Raise HRV to relax and become calm Blood Volume Pulse Biofeedback O 0 Assessment of blood ow possible by plethysmography Blood ow determined by amount of light detected by photocell Procedural Concern in Administering Biofeedback Therapeutic Context 0 O O Biofeedback should be administered in right therapeutic context Certain therapist behavior effect the patients performance Expectancies of the patient heavily impact condition improvements Evaluation for Biofeedback O O O O 0 Most important component is discussion of treatment oonns History Taking Critical in determining clients readiness for change and treatment Time of onset previous treatments successfailure medical history Biofeedback involves life stresses and modifying physiologic activity Patients capable of effectively managing their environment See if more medical interventions needed for presence of organic disease Establishing Baseline Levels of Symptoms and Physiologic Responses Baselines of symptoms necessary to appropriately design and evaluate Record intensity frequency duration and impact on quality of life Should not mistake habituation effect for a training effect new place Adaptation client being comfortable and returning to normal levels Good adaptation period provide more meaning information Helpful to identify response systems most reactive to stress Biofeedback Training 0 Patient Education O O O O O 0 Know underlying factors and variables that can be controlled Explanation accompanied by live demonstration that point out different steps along with written material and diagrams can be useful Patients not psychologically inclined are more accepting of biofeedback Know it39s a multidisciplinary approach not just psychologic More client understands better client will apply the new learning Treatment Parameters Choice of approach based on pathologic mechanisms underlying disorder Type of feedback rate type and modality of biofeedback Spacing feedback trials and length and number of training sessions Choice based on needs of the client and the problems presented Generalization and Maintenance Goal to enable patient to discriminate when target response is in need of control and effect the necessary change in absence of feedback Enable selfregulation at rst perceptible sign of attack Discrimination plays role in selfregulation of physiologic response Maintenance to help make biofeedback training effects more durable Overlearning target response provide booster treatment gradually remove feedback training under stress stimulation provide portable biofeedback equipment augment biofeedback with other interventions Maintaining the Patients Involvement in Treatment Minimize frustration or negativity experienced by early failure lnform of difficulty to show failure from that not personal inadequacies Control gained by adopting a passive attitude don39t try too hard Effect of emotional processes on physiologic functioning and success Progress Review Need to practice eventually use them to manage problematic behavior Regularity of practice emphasized increase frequency review time spent Efficacy of Biofeedback Treatment 0 Develop guidelines to use when evaluating clinical efficacy of biofeedback and psychophysiologic interventions and develop objective criteria for determining levels of support for disorders treated by biofeedback 0 Look at major areas of application based on disorders treated 0 Highest level of efficacy for disorders where biofeedback better than most other behavioral treatments or medications o Pursue more focused indepth efficacy reviews of clinical disorders Expanding Boundaries of Biofeedback Use biofeedback and operant conditioning for paralyzed patients 0 Used to help them communicate by producing certain brainwaves Used in optimization of function or peak performance in athletesmusicians Physiologic selfregulation should be taught as a basic life skill in schools 0 Can enhance quality of life when living in extreme conditions Introduced into work environment to design and evaluate interventions Telehealth biofeedback system become more readily available Biofeedback Therapist Training and Credentials Clinicians in mental health centers universities medical schools hospitals etc 0 Degrees in psychology social work mental health medicine nursing etc 0 Anyone can purchase biofeedback equipment diverse appHcanns Certi cations require minimum of a bachelors degree completion of coursework in anatomy and physiology adherence to ethical code and appropriate licensing Indications o Desirable for patients who do not want to take medications Person must be actively engaged in learning process to see results 0 Must understand the biofeedback process to be motivated to learn desired Complications Medications acting on CNS or ANS complicate the biofeedback process 0 Muscle relaxants inhalers stimulants need adjustments with biofeedback Ef cacy Level 1 Autism Eating disorders Multiple sclerosis Spinal cord injury Ef cacy Level 23 Alcoholism or substance abuse Arthritis Asthma Cancer and HIV Cerebral palsy Cystic brosis EpHepsy Motion Sickness PTSD Stroke Traumatic brain injury Ef cacy level 4 Anxiety Hype engon ADHD Headaches


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