Biofeedback Training

Biofeedback training is a process wherein the patient is trained to improve his/her health by using signals from his/her own body. It helps a person control physiological processes such as blood pressure, heart rate and muscle tension. These processes actually are involuntary but can be manipulated and controlled at will. Biofeedback therapy is used to treat conditions such as migraine headache, tension headache, urinary incontinence, high blood pressure, chronic pain, etc.

The concept behind biofeedback training is very interesting. It utilizes the power of the mind to become aware of what is happening within the body. This awareness helps a person to gain more control over bodily functions, involuntary ones too. This therapy works wonders on people experiencing stress. Stress can cause fluctuations in blood pressure and biofeedback therapy aids in relaxation.

Electrodes are attached to the patient's skin, which sends information to the monitor. Based on the monitor reading, the therapist understands the mental activities of the patient. The parameters that are monitored include blood pressure, sweating, breathing rate, and muscle activity. If a patient is experiencing stress at a particular moment the above mentioned parameters may alter. Understanding this alteration can help understand which part of the body needs to relax.

Depending on the severity of the issue, the number of sessions may vary. A session may typically last from 30 minutes to one hour. Biofeedback therapy does not have any side effects or pose any risk and is a non-invasive procedure. To undertake a session in biofeedback therapy, it is advisable to work with a health care professional trained in biofeedback.

Biofeedback therapy uses

Biofeedback therapy can be used to treat:

Chronic pain: Helps in identifying tight muscles and relaxing them, relieves lower back pain, abdominal pain, etc. This therapy benefits people across all age groups.

Anxiety: Anxiety relief is one huge area wherein biofeedback therapy can be very helpful. The therapy helps understand the body's responses when a person is stressed and anxious. By understanding this, one can control body response using biofeedback therapy.

Urinary incontinence: People may have trouble in controlling the urge to urinate. This therapy, particularly in women helps in tightening the pelvic floor muscles that control the urge/feeling to urinate. It is helpful in treating kids who bed wet.

Headache: Stress and muscle tension can cause headaches like migraine and other types of headache. This therapy can help relax the muscles and reduce frequency as well as severity of the headache.

Other conditions that can be cured using biofeedback therapy include ADHD (Attention Deficit Hyperactivity Disorder), asthma, constipation, rheumatoid arthritis, COPD (Chronic Obstructive Pulmonary Disease), high blood pressure, etc. Different relaxation exercises used in biofeedback therapy:

• Deep breathing
  
  
• Guided imagery: Concentrating on a specific image and focusing on the image to make the person feel relaxed.
  
  
• Progressive muscle relaxation: Alternately tightening and relaxing various muscle groups.
  
  
• Mindfulness meditation: Focusing thoughts to let go of negative emotions.

Biofeedback therapy types

Neuro feedback: Used to measure brain wave feedback. Used to treat epilepsy and other seizure disorders.

Thermal biofeedback: Used to measure skin temperature. Used to treat headache and Raynaud's disease.

Electromyography: Used to measure muscle activity and tension. Used to treat conditions such as headaches, back pain, anxiety disorder, incontinence, muscle retraining after injury.

Electrodermal activity: Used to measure sweating and can be used in pain and anxiety.

Levator Ani Syndrome

Levator ani syndrome also known as levator ani spasm, refers to pain and discomfort in the rectum caused by spasms in the levator muscles that surround the anus. Patients with Levator ani syndrome often complain of a pain associated with rectal pressure that gets worse on sitting or lying down. The pain is almost always dull and constant with a sensation of tightness and fullness in the rectal region. In few cases, the pain may not be constant, but recurrent at frequent intervals lasting up to 20 minutes. Prevalence of Levator ani syndrome is five times higher in women than men. Proctalgia fugax refers to the 'anal pain without known cause'. Here the episodes of pain are very brief and occur rather infrequently.

Diagnosis

When the patient develops rectal pain, firstly the doctor would want to rule out any disease related to organs surrounding the anal canal and pelvic floor. Sometimes an endoscopy is done to investigate the cause of the pain. Patient with Levator Ani Syndrome experiences severe tenderness on palpation of the pubo-rectalis muscle and this forms the basis for diagnosing the levator ani syndrome. In case of Levator ani syndrome, the patient also undergoes posterior traction of the puborectalis muscle during rectal examination.

There is constant rectal, vaginal or perineum pressure. Defection becomes difficult. The symptoms are often aggravated by emotional stress. Muscular tension, injury or surgery can also lead to this condition. Childbirth injury, pelvic infection, lumbar disc surgery or sexually related injuries can lead to levator ani syndrome.

Treatment of Levator Ani Syndrome

Levator ani syndrome is usually resolved through the following steps:

1. Sitting on a doughnut shaped pillow to reduce the pressure.

2. Anti inflammatory drugs and muscle relaxants.

3. Application of perianal lidocaine jelly ointments.

4. Apart from medication and special tools, levator ani syndrome is also treated with physical therapy which includes digital massage of levator muscle, pelvic floor strengthening exercises , pelvic floor relaxation techniques.

5. Hot sitz bath also helps in alleviating the pain and anal pressure.

6. Levator ani syndrome is also treated using Electrogalvanic stimulation (EGS) and Biofeedback training. However recent studies reveal that Biofeedback is far more effective than EGS in treating Levator Ani Syndrome.

Nystagmus

'Dancing eyes' or Nystagmus means uncontrolled movements of the eyes, from side to side, up and down or rotary. Thus Nystagmus could be horizontal, vertical or torsional. Sometimes, however the eyes can jerk sideways or up or down. These dance movements in the eyes could be in both or in just one eye. Interestingly, people with nystagmus are usually not aware of their eye movements.

Causes of Nystagmus

Abnormal function in the areas of the brain that control eye movements is usually the cause for the involuntary eye movements. It is that part of the inner ear that senses movement and position. Nystagmus syndrome can be present at birth or develop later in life because of a disease or injury. Nystagmus is usually infantile and is present from a very early age. Studies reveal that about one child out of every several thousand has nystagmus.

While the nystagmus that is present at birth is not severe, acquired nystagmus is caused by certain drugs or medicine. Such drugs include phenytoin or dilatin, an anti- seizure medicine, excessive alcohol or any other sedating medicine that can impair the labyrinth function. Acquired nystagmus may also be caused by any disease of the brain such as multiple sclerosis or brain tumor, when the areas controlling eye movements are damaged. Nystagmus may also be caused by congenital disease of the eye. This is rare and an ophthalmologist should evaluate a child with nystagmus to check any eye disease. Hyperventilation or flashing light in front of one eye, nicotine and vibrations are also known to cause nystagmus, but these are rare. Other causes of nystagmus include:

• Head injury from road accidents, mostly on motor bikes.
  
• Disorders of the inner ear such as labyrinthitis or Meniere's disease
  
• Stroke
  
• Thiamine or vitamin B12 deficiency.
  

Clinical manifestations

Nystagmus is a gradually developing condition leading to adverse effects. The severity of this condition is sometimes linked to congenital visual impairment. One of the important conditions associated with nystagmus is the lack of focus at a certain point. This happens because of the dispositional movement of the eye balls when the person turns the head from side to side. The classification of nystagmus gives a better understanding of the disease and its respective prophylaxis.

Different kinds of nystagmus

Manifest nystagmus which is present at all times, whereas latent nystagmus occurs only in one eye.

Manifest-latent nystagmus is continually present, but worsens when one eye is covered.

Congenital nystagmus is present at birth. The eyes swing like a pendulum in this condition. Strabismus is another term for this as the eyes do not necessarily work together all the time. It is associated with the oscillations that are horizontal in origin in the vestibular region. The occurrence of infantile nystagmus requires immediate attention as it may eventually lead to oculomotor disturbances causing permanent loss of vision.

Acquired nystagmus can be caused by diseases such as multiple sclerosis, brain tumor, diabetic neuropathy, accident and resulting head injury, neurological problem which could be side effect of a medication. This form of the disease is also referred as the see-saw nystagmus. It involves the impairment of the central or peripheral vestibular region. In this condition there a periodical oscillation of the eye which occurs in a rhythmic manner. There are many predisposing factors that contribute to the occurrence of this condition which include multiple sclerosis and any form of trauma affecting the head and neck.

There are two basic types of nystagmus. While the one is eye related 'optokinetic', the other is inner ear related 'vestibular'. Those with inner ear problems develop 'jerk nystagmus' where the eyes drift slowly in one direction and jerk back in the other direction. Chances are people with this condition can develop nausea and vertigo. However, this type of nystagmus is quite temporary. It can also occur in persons with Meniere's disease or when water settles into one ear. A decongestant can be taken to clear up nystagmus of this type.

Diagnosis of nystagmus

The following tests are done for diagnosis of nystagmus:

• CT scan of the head
  
• Electro oculography, which is an electrical method of measuring eye movements using tiny electrodes.
  
• MRI of the head
  
• Vestibular testing by recording the movements of the eyes.
  

History of the patient is taken and recorded, and a thorough physical examination is performed. The doctor would focus on the nervous system and inner ear. The doctor may ask the patient to wear a pair of goggles so that eyes could be magnified for the examination. Spin the patient for about 30 seconds, and stop and make her/him stare at an object. The patients' eye will first move slowly in one and then suddenly in the opposite direction. The eye movements of those suffering from nystagmus due to a medical condition will depend on the cause.

Treatment of nystagmus

The distressing fact is that there is no treatment for most cases of congenital nystagmus. Treatment for acquired nystagmus depends upon its cause. There are some instances when nystagmus. However, visual function of the patient with nystagmus can improve by some treatment. Prisms, surgeries such as tenotomy and drug therapies are used for infantile nystagmus. There are surgical treatments for people with nystagmus, and surgery usually reduces the null positions. Thus the head tilt is lessened and cosmetic appearance improves. Drug therapies include drugs such as botox or baclofen which reduce some nystagmic movements. But these results are usually temporary. Some with nystagmus benefit from biofeedback training. In some cases, wearing eyeglasses and contact lenses can help people with nystagmus see better. Contact lenses are a superior option to the glasses as the lens move with the eyes.

Some changes at home to help combat dizziness, visual problems or nervous system disorders can also be done to help the patients. And those children with nystagmus need special help in learning to adapt to school work and social conditions.