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Biofeedback History and Development of EPFX
Early Research
Edmund Jacobson in 1908 developed the progressive muscle relaxation technique (1958). Although most of his research on the conditioning of muscle relaxation was conducted 50 years ago, it remains relevant. For example, most therapeutic applications of biofeedback include the use of a systematic relaxation technique. Although Jacobson's system has been modified over time, his ideas and research methods have much to offer clinicians and researchers. Based on an interview reported by Mcguigan, he may have been the first researcher to use medical instrumentation to provide feedback about physiological responses (Jacobson and McGuigan), 1978). His procedure, employing a prototype of modern biofeedback instrumentation, involved an individual observing an oscilloscope to determine the level of tension in his forearm extensor muscle. Later, Wolpe (1973) modified Jacobson's technique and popularized it as part of the systematic desensitization procedure.
In 1958, Kamiya (1969) began to study the changes in consciousness that accompanied variations in EEG alpha rhythm of human subjects. He developed a discrimination conditioning task in which a bell was rung periodically and the subject was requested to indicate if he had been generating EEG alpha just prior to the auditory stimulus. Many subjects were able to learn this task and this led to further research of alpha rhythm control. Kamiya and his associates later discovered that subjects could suppress alpha when given auditory feedback concerning its presence or absence. Although the initial claims of alpha wave trainers were found to be exaggerated, research by Kamiya and others continues and may eventually lead to the development of more effective clincial methods. Due to the unpredictability of the results so far, the clinical utility of EEG alpha rhythm training remains problematic (Miller, 1974).
Ancoli and Kamiya (1978) reviewed several areas of controversy surrounding EEG biofeedback. For example, one unresolved issue is whether or not the reported increases in EEG alpha are due to reductions in visual and oculomotor responding. Ancoli and Kamiya reviewed 45 different EEG biofeedback studies from 1968 to 1976 and concluded that a majority of the studies suffered from methodological weaknesses. They believed that many negative results occurred because training times were too short and experimental conditions were not optimum. They suggest that, in the future, researchers should employ at least 4 training sessions, used continous feedback with quantitive progress scores and use experimental trials which have a duration of at least 10 minutes.
One of the intriguing areas of investigation concerns the search for empirical validation of visceral or smooth-muscle operant conditioning. Since 1938, when Skinner could not demonstrate operant conditioning of the vasoconstrictory responses, researchers have been interested in this area of learning.
Neal Miller and his colleages most notably, (the late Leo DiCara) have been involved in research on instrumental autonomic conditioning in animals for a number of years. In 1968, DiCara and Miller observed that curarized rats could learn to avoid a shock by lowering their heart rate. Miller's attempts to replicate this finding in subsequent years, however, met with frustration. Nevertheless, during this time other investigators showed that visceral conditioning, through the use of feedback techniques, could be demonstrated in man (Miller and Dworkin, 1974).
Whether or not Miller's original findings were artifactual or due to complex interactions of variables is still undetermined. There is no doubt, however, that the publication of his early research on visceral conditioning in animals did much to stimulate others to investigate similar issues in man, and more sophisticated biofeedback techniques were developed.
Although less well known, H D Kimmel (1960) spent years investigating instrumental conditioning off the autonomic nervous system (ANS) in man. Stimulated by results of earlier experiments in conditioning of the galvanic skin response (GSR), Kimmel and his students found that subjects' GSR's could be conditioned using pleasant odors. Kimmel (1974) summarized the research up to 1967, including 16 studies of GSR, five of heart rate and three of the vasomotor response. Results of all these studies supported the contention that the ANS could be modified through operant conditioning.
These findings were criticized by Katkin and Murray (1968) who argued that such results may be due to skeletal mediators and have still obtained positive results. For example, Lang and Melamed (1969) were able to condition aversively a 9-month-old child who suffered from ruminative vomiting. In addition, Frezza and Holland 1971) demonstrated that human salivation can be instrumentally conditioned.
Subsequently biofeedback procedures were applied to clinical problems. In 1973, two innovative treatment procedures were developed which are widely used today, with certain technical refinements. Elmer and Alyce Green (1977) developed a clinical protocol for thermal feedback training. They used peripheral skin temperature as a measure of vasodilatation and combined skin temperature feedback with Schultz and Luthe's (1969) "Autogenic Training". Sargent, Green and Walters (1972) applied temperature biofeedback training to treat migraine. Patients were taught to increase the warmth in their fingers (vasodilatation) while decreasing the temperature of their foreheads (vasoconstriction). They found that almost 75 percent of the subjects were able to decrease both the duration and intensity of migraine attacks. Later studies have confirmed these results.
While the Green's were developing their treatment technique for migraine, Thomas Budzynski (1973) and his associates at the University of Colorado developed a feedback technique to treat muscle contraction (tension) headaches. They used EMG training to teach patients to reduce the tension in their frontalis (forehead) muscles. Their results showed that average muscle tension levels dropped from 10 to 3.5 (microvolts) and headaches intensity was reduced over the 16-week training period. Two control groups of headache patients were employed in the experimental design; one group received "false" or pseudofeedback and the other group received no feedback at all. Neither of these groups improved as much as the EMG treatment group. Since then, the results have been somewhat mixed regarding the effectiveness of EMG biofeedback compared with simple relaxation methods.
The clinical research which has been reviewed thus far has involved procedures where feedback is used to reduce muscle and blood vessel contraction ("physiological arousal"); however, a technique to increase muscle contraction (a form of EMG biofeedback training) has existed for almost 25 years. John Basmajian's (1979) early research, first published in 1963, indicated that patients can increase the functioning of single motor units through the use of EMG biofeedback. Even earlier, Marinacci and Horande (1960) demonstrated that EMG feedback could be applied to improve neuromuscular functioning in several disorders. Basmajian and his colleages have designed speciallly constructed biofeedback instruments for use in rehabilitation, e.g., a miniatue EMG feedback device. They have applied such instrumentation to various disorders including paralytic foot-drop. There is significant difference between the EMG units used in rehabilitation and those adapted for use with psychophysiological disorders. The biofeedback units employed in rehabilitation are designed to transmit information about single motor units or the functioning of a specific muscle. Most of the EMG units used to enhance relaxation, however, summate the bioelectrical information of a particular muscle group. The resulting feedback is somewhat less specific.
Prior to 1970, relatively few studies were conducted using biofeedback techniques. Since then, however, hundreds of investigations have been done and the accumulation of data has been impressive. For this reason, BSA task forces were developed to survey the current literature and summarize the current status of biofeedback as a therapeutic technique in a number of areas including: psychophysiological disorders (Fotopoulos and Sunderland, 1978), gastrointestinal disease (Whitehead, 1978), vasoconstrictive disorders (Taub and Stroebel, 1978), muscle tension headache (Budzynski, 1978) and others.
In 1989 Nelson proposed and proved that biofeedback need not be just a conscious or verbal process. The EPFX was designed to do feedback to the patient’s unconscious.
In summary, individuals in certain circumstances can learn to control various physiologic processes as a result of biofeedback training. There is still considerable confusion and controversy regarding how this learning takes place, however. Biofeedback can be viewed as developing from earlier forms of learning therapy. However whether or not biofeedback involves a form of conditioning is still undetermined.
Neuroanatomical and Physiological Basis of Biofeedback
Neurophysiologists and clinical neurologists are aware of the fact that the brain acts as a whole unit and that the functioning of each and every part of it affects the performance of most of the other parts. Clearly, however, certain areas are more closely allied than others by anatomical or physiological links. Also, there is a localization of function such that the different regions of the brain are specialized for certain activities and although their role can be substituted to a certain extent, they operate most effectively only when carrying out their particular function. Broadly speaking, the tasks of the brain can be divided into three great categories: (1) the reception of stimuli (this is the sensory system); (2) the association of stimuli and the analysis of perception of incoming stimuli; (3) the motor response to those stimuli.
Disclaimer
EPFX
Electro-physiological Feedback Xrroid
Ambulant Cardiotocographic
(with passive sensor)
Universal Electrophysiological System
This system is to be used as a Biofeedback multimedia system. It is designed for stress detection and stress reduction.
The device does not diagnose any disease other than stress. Stress can come from many sources, this system uses many multimedia treatments to treat stress. This device also measures patients electrophysiological reactivity, which is another way to represent stress, only a licensed practitioner can diagnose a patient.
This system is calibrated to measure the very fine and subtle electrical and subspace reactions to a group of biological and medical substance. The sensitivity is set so fine so as to pick up the earliest sign of distress. Thus the results might be below the client recognition. The readings should be evaluated by trained staff. Always use additional tests or referrals. No claims other that Biofeedback Stress detection and stress, pain, relaxation and peak performance management modalities are made of the system or results. Note that no device by itself can diagnose, and only a licenced health care practitioner can make a diagnosis of any disease condition or treatment regime.
Reprinted from www.epfx-scio.com
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