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Applied Psychophysiology and Biofeedback, 1981
Biofeedback, a field still in its infancy, has developed treatments that have been used with clinical success in the treatment of a number of disorders. Many have expressed their public concern that biofeedback has not lived up to its early promise and that it has not developed treatments that are, in fact, efficacious. A number of factors, which are inherent in biofeedback research, confound the results of clinical efficacy studies of biofeedback treatments. Researchers interested in the efficacy of biofeedback must address several issues: (1) Rejecting the null hypothesis is not equal to proving the null hypothesis (without the use of power analysis); (2) control for nonspecific effects is not equal to a double-blind experimental design; (3) ignorance of a mechanism of action is not equal to a lack of clinical efficacy; (4) the administration of training is not equal to the subject's learning to criterion; (5) untrained therapists are not equal to trained therapists; (6) statistical significance is not equal to clinical significance; and (7) the laboratory setting is not equal to the clinical setting.
An alternative perspective on biofeedback efficacy studies: A reply to Steiner and Dince
Biofeedback and Self-Regulation, 1983
Clinical appfications of biofeedback have proliferated and considerable lore surrounding the application of these techniques has evolved. Many assertions about the effectiveness of biofeedback training are based on findings of the least well-controlled studies, while many of the better controlled studies have failed to show that biofeedback directly mediates target symptoms or is superior to other treatments. suggest that the failure of these controlled studies is primarily attributable to methodological deficiencies. We believe that the question of whether or not there is a specific effect of biofeedback training is still frequently confused with the question of whether or not the treatment package as a whole has therapeutic value. Biofeedback is often therapeutic; however, evidence is often lacking that its effectiveness is due to biofeedbacktrained changes in a target physiological process.
The Foundations Supporting Biofeedback and Neurofeedback: II. FERB Supports Research in Biofeedback
Biofeedback, 2014
Research in the field of biofeedback has suffered both for lack of adequate methodological rigor and lack of adequate funding. The ISNR Research Foundation and the AAPB Foundation for Education and Research in Biofeedback are nonprofit foundations developed to promote and support a broad program of research in biofeedback and neurofeedback. A previous article featured an interview with the director of the ISNR Research Foundation, David Trudeau. The present article provides an interview with Paul Lehrer, Chair of the AAPB Foundation for Education and Research in Biofeedback. This interview series provides insight into the two foundations and invites professionals in the broad field of self-regulation therapies to support both.
viXra, 2016
Biofeedback is a longstanding technique whereby voluntary control may be asserted over many seemingly unconscious physiologic and autonomic processes. Neurofeedback is a particular branch of biofeedback using real time information derived through the active monitoring of brain states to allow development of therapeutically efficacious informationally rich results. Our facility and staff are expert in the use of biofeedback as both a direct therapeutic aid, and assessment tool. This document will briefly detail the historical development and underlying principles of bio-and neuro-feedback techniques and their substantial theoretical and experimental basis. Biofeedback/Neurofeedback is now well defined by the scientific community. The Association for Applied Psychophysiology and Biofeedback (AAPB), Biofeedback Certification International Alliance (BCIA), and the International Society for Neurofeedback and Research (ISNR), formulated this definition of biofeedback in 2008: Biofeedback is a process that enables an individual to learn how to change physiological activity for the purposes of improving health and performance. Precise instruments measure physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature. These instruments rapidly and accurately 'feed back' information to the user. The presentation of this information-often in conjunction with changes in thinking, emotions, and behavior-supports desired physiological changes. Over time, these changes can endure without continued use of an instrument. History, current use, evaluation and empirical substantiation: Biofeedback has been a mainstay within many cultures and cultural practices for thousands of years, and is still used today in traditional forms such as Yoga and Pranayama. In western science, the progression of biofeedback can be roughly traced as follows: Claude Bernard in 1865 derived the concept of homeostasis [1]. In 1885, J. R. Tarchanoff demonstrated control of heart rate could be direct (cortical-autonomic) [2]. In 1901, J. H. Bair showed that skeletal muscles are self-regulated [3]. Alexander Graham Bell attempted to teach the deaf to speak using two devices-the phonautograph, and a manometric flame. The former translated sound vibrations to show their acoustic waveforms, while the latter allowed sound to be displayed as patterned light [4]. Mathematician Norbert Wiener developed cybernetic theory, that proposed that systems are controlled by monitoring their results [5]. The participants at a 1969 conference coined the term biofeedback from Wiener's ideas. The conference marked the founding of the Bio-Feedback Research Society [6]. In the first experimental demonstration of biofeedback, Shearn used these procedures with heart rate. Effects of the perception of autonomic nervous system activity were initially explored by George Mandler's group in 1958. In 1965, Maia Lisina trained subjects to change blood vessel diameter, eliciting and displaying reflexive blood flow changes [7]. In 1974, H.D. Kimmel trained subjects to sweat using the galvanic skin response.
Biofeedback, 2011
The mission of the Biofeedback Certification International Alliance (BCIA) is to certify individuals who meet education and training standards in biofeedback and progressively recertify those who advance their knowledge through continuing education. In strategic recognition of the growing international interest in biofeedback research and practice, BCIA has launched a number of programs in support of worldwide biofeedback certification and global standards for training and education. This article discusses BCIA's international efforts in support of its mission.
Evidence-based practice in biofeedback and neurofeedback
is a mind-body therapy using electronic instruments to help individuals gain awareness and control over psychophysiological processes (Gilbert & Moss, 2003; Moss, 2001; Schwartz & Andrasik, 2003). Biofeedback instruments measure muscle activity, skin temperature, electrodermal activity, respiration, heart rate, heart rate variability, blood pressure, brain electrical activity, and brain blood flow. Research shows that biofeedback, alone and in combination with other behavioral therapies, is effective for treating a variety of medical and psychological disorders, ranging from headache to hypertension to temporo-mandibular to attentional disorders. The present publication surveys these applications, and reviews relevant outcome research. Biofeedback is used by physicians, nurses, psychologists, counselors, physical therapists, occupational therapists, and others. Biofeedback therapies guide the individual to facilitate the learning of voluntary control over body and mind, and take a more active role in maintaining personal health and higher level mind-body wellness. Neurofeedback is a specialty field within biofeedback, which devotes itself to training control over electro-chemical processes in the human brain (LaVaque, 2003; Evans & Abarbanel, 1999). Neurofeedback uses a feedback electroencephalogram (EEG) to show the trainee current electrical patterns in his or her cortex. Many neurological and medical disorders are accompanied by abnormal patterns of cortical activity. Neurofeedback assessment uses a baseline EEG, and sometimes a multi-site quantitative EEG (QEEG), to identify abnormal patterns (LaVaque, 2003). Clinical training with feedback EEG then enables the individual to modify those patterns, normalizing or optimizing brain activity. Neurofeedback practice is growing rapidly, with the widest acceptance for applications to attention deficit hyperactivity disorder (ADHD), learning disabilities, seizures, depression, acquired brain injuries, substance abuse, and anxiety (Clinical EEG, 2000). Complementary and Alternative Therapies Biofeedback and neurofeedback are ideal approaches for those individuals seeking comple mentary and alternative medicine (CAM) therapies (Lake & Moss, in press). The public appears to seek out therapies which: 1) give the individual a more active role in his or her own health care, 2) involve a holistic emphasis on body, mind, and spirit, 3) are non-invasive, and 4) elicit the body's own healing response (Jonas & Levin, 1999; Moss, 2003a). James Gordon, the first chairman of the federal Advisory Council of the NIH Office of Alternative Medicine, emphasizes that educating individuals in self-care must be at the center of the new medicine, in order to deal with the changing picture of health problems today, especially the increasing incidence of chronic conditions (Gordon, 1996). Both biofeedback and neurofeedback are holistic therapies, based on the recognition that changes in the mind and emotions affect the body, and changes in the body also influence the mind and emotions. Biofeedback and neurofeedback emphasize training individuals to self-regulate, gain awareness, increase control over the ir bodies, brains, and nervous systems, and improve flexibility in physiologic responding. The positive effects of feedback training enhance health, learning and performance. There are biofeedback protocols to address many of the disorders, including anxiety, depression,
A reply on the nature of biofeedback efficacy studies
Applied Psychophysiology and Biofeedback, 1983
Kewman and Roberts, in their reply to our commentary of 1981, make a number of points that we believe require clarification. In that commentary we questioned the design and quality of biofeedback efficacy studies while stressing the importance of utilizing appropriate clinical practices in the pursuit of such studies. We stated that researchers interested in the efficacy of biofeedback must address several issues: (a) Rejecting the null hypothesis is not equal to proving the null hypothesis (without the use of power analysis); (b) control of nonspecific effects is not equal to a double-blind experimental design; (c) ignorance of a mechanism of action is not equal to a lack of clinical efficacy; (d) the administration of training to a subject is not equal to the subject's learning to criterion; (e) untrained therapists are not equal to trained therapists; (f) statistical significance of an effect is not equal to clinical significance; and (g) the laboratory setting is not equal to the clinical setting (Steiner & Dince,
Current applications of biofeedback to physical medicine and rehabilitation
Clinical biofeedback has a 35 year history of developing applications to disorders in physical medicine and rehabilitation. The authors summarize the paradigm of biofeedback, discuss its mechanisms, and review current protocols for the treatment of asthma, epilepsy, fibromyalgia, headache, myofascial pain disorders, repetitive strain disorders, and urinary incontinence. Biofeedback interventions are compatible with and often augment the therapeutic effects of conventional medical, pharmacologic and manual interventions. Biofeedback offers evidence-based alternative therapies for a variety of common disorders in rehabilitation.