•A new wearable plantar-force based vibrotactile biofeedback system was introduced.•The system provided feedback regarding changes in forces at the fore- and rearfoot.•It improved initial reactions ...to translational perturbations.•Further optimizations are needed to facilitate fall prevention in real-life conditions.
Maintaining postural equilibrium requires fast reactions and constant adjustments of the center of mass (CoM) position to prevent falls, especially when there is a sudden perturbation of the support surface. During this study, a newly developed wearable feedback system provided immediate vibrotactile clues to users based on plantar force measurement, in an attempt to reduce reaction time and CoM displacement in response to a perturbation of the floor. Ten healthy young adults participated in this study. They stood on a support surface, which suddenly moved in one of four horizontal directions (forward, backward, left and right), with the biofeedback system turned on or off. The testing sequence of the four perturbation directions and the two system conditions (turned on or off) was randomized. The resulting reaction time and CoM displacement were analysed. Results showed that the vibrotactile feedback system significantly improved balance control during translational perturbations. The positive results of this preliminary study highlight the potential of a plantar force measurement based biofeedback system in improving balance under perturbations of the support surface. Future system optimizations could facilitate its application in fall prevention in real life conditions, such as standing in buses or trains that suddenly decelerate or accelerate.
Objective: The objective of this study is to investigate the results of contraction- and relaxation-based biofeedback (BF) in children with lower urinary tract dysfunction (LUTD). Materials and ...Methods: Between 2007 and 2017, we randomly directed children with the diagnosis of LUTD and refractory to standard urotherapy modifications via BF by using two different animations: animation A with relaxation nature BF (RBF) and animation B with contraction nature BF (CBF). The categories of non-response, partial response, and full response were defined as a 0-49% decrease, 50-99% decrease, and 100% decrease in the LUTD Symptom score, respectively. Results of biofeedback using RBF or CBF were compared. Results: There were 100 and 70 children in the RBF and CBF groups, respectively. Patients with an abnormal voiding pattern (abnormalVP) and a positive electromyography (EMG) activity (positive EMG) had a better resolution with RBF (p=0.001), whereas patients with abnormalVP and a negative EMG activity (negative EMG) had a better resolution with CBF (p=0.039). Despite being statistically insignificant, patients with a normal voiding pattern (normalVP) and positive EMG had a better resolution with CBF (p=0.452), whereas patients with normalVP and negative EMG had a better resolution with RBF (p=0.083). Conclusion: The EMG activity identifies the BF nature in children with LUTD and abnormalVP. Importantly, positive EMG had better results with RBF, whereas negative EMG had better results with CBF. Keywords: LUTD, Biofeedback, EMG activity, Voiding pattern, Contraction, Relaxation Amac: Alt uriner sistem disfonksiyonu (AUSS) olan cocuklarda kasilma ve gevseme bazli biofeedback (BF) sonuclarinin arastirilmasi amaclandi. Gerec ve Yontem: 2007-2017 yillari arasinda AUSS tanisi alan ve standart uroterapi tedavisine direncli olan cocuklar iki farkli animasyon kullanilarak rastgele BF'ye yonlendirildi: Animasyon A gevseme niteliginde BF (RBF) ve animasyon B kontraksiyon niteliginde BF (CBF) idi. Cevap vermeme, kismi cevap ve tam cevap, AUSS'de sirasiyla %0 ila %49 dusus, %50 ila %99 dusus ve %100 dusus olarak tanimlandi. RBF veya CBF kullanan biofeedback sonuclari karsilastirildi. Bulgular: RBF ve CBF grubunda sirasiyla 100 ve 70 cocuk vardi. Hastalarda anormal iseme akimi (abnormalVP) ve pozitif EMG aktivitesi (positive EMG) olan hastalarda RBF ile daha anlamli iyilesme (p=0,001); anormalVP ve negatif EMG aktivitesi (negative EMG) olan hastalar CBF ile daha anlamli iyilesmeye sahip oldugu tespit edildi (p=0,039); Istatistiksel olarak onemsiz olmasina ragmen, normal iseme akimi (normalVP) ve positive EMG olan hastalar CBF ile daha iyi cozunurluge sahip iken (p=0,452); normalVP ve negative EMG hastalarinda RBF ile daha anlamli iyilesme gozlendi (p=0,083). Sonuc: LUTD ve Anormal VP'li cocuklarda, EMG aktivitesi biofeedback tedavisinin tipini belirlemektedir: positive EMG, RBF ile daha iyi sonuclara sahip iken, negative EMG, CBF ile daha iyi sonuclara sahiptir. Anahtar Kelimeler: LUTD, Biofeedback, EMG aktivitesi, Iseme akimi, Kasilma, Gevseme
Hypotonicity of the upper esophageal sphincter (UES) has been reported only two times previously in the literature, with no reports of treatment options for this rarity. We present a third case of ...hypotonic UES found during high‐resolution pharyngeal manometry. Although the patient had nearly absent resting pressures of the UES, pressures during and post‐swallow were normal. It was hypothesized that the patient might be able to increase pre‐swallow UES pressure using biofeedback. Using a chin up/out maneuver during manometry, the patient was able to achieve a more normal swallow pressure pattern. This case also highlights the need to complete manometry alongside other swallow imaging techniques for effective treatment planning and patient outcomes. Laryngoscope, 131:E1567–E1569, 2021
Home-based healthcare provides a viable and cost-effective method of delivery for resource- and labour-intensive therapies, such as rehabilitation therapies, including anorectal biofeedback. However, ...existing systems for home anorectal biofeedback are not able to monitor patient compliance or assess the quality of exercises performed, and as a result have yet to see wide spread clinical adoption. In this paper, we propose a new Internet of Medical Things (IoMT) system to provide home-based biofeedback therapy, facilitating remote monitoring by the physician. We discuss our user-centric design process and the proposed architecture, including a new sensing probe, mobile app, and cloud-based web application. A case study involving biofeedback training exercises was performed. Data from the IoMT was compared against the clinical standard, high-definition anorectal manometry. We demonstrated the feasibility of our proposed IoMT in providing anorectal pressure profiles equivalent to clinical manometry and its application for home-based anorectal biofeedback therapy.
Tele-rehabilitation has the potential to considerably change the way patients are monitored from their homes during the care process, by providing equitable access without the need to travel to rehab ...centers or shoulder the high cost of personal in-home services. Developing a tele-rehab platform with the capability of automating exercise guidance is likely to have a significant impact on rehabilitation outcomes. In this paper, a new vision-based biofeedback system is designed and validated to identify the quality of performed exercises. This new system will help patients to refine their movements to get the most out of their plan of care. An open dataset was used, which consisted of data from 30 participants performing nine different exercises. Each exercise was labeled as "Correctly" or "Incorrectly" executed by five clinicians. We used a pre-trained 3D Convolution Neural Network (3D-CNN) to design our biofeedback system. The proposed system achieved average accuracy values of 90.57% ± 9.17% and 83.78% ± 7.63% using 10-Fold and Leave-One-Subject-Out (LOSO) cross validation, respectively. In addition, we obtained average F1-scores of 71.78% ± 5.68% using 10-Fold and 60.64% ± 21.3% using LOSO validation. The proposed 3D-CNN was able to classify the rehabilitation videos and feedback on the quality of exercises to help users modify their movement patterns.
This article studies the suitability of smartphones with built-in inertial sensors for biofeedback applications. Biofeedback systems use various sensors to measure body functions and parameters. ...These sensor data are analyzed, and the results are communicated back to the user, who then tries to act on the feedback signals. Smartphone inertial sensors can be used to capture body movements in biomechanical biofeedback systems. These sensors exhibit various inaccuracies that induce significant angular and positional errors. We studied deterministic and random errors of smartphone accelerometers and gyroscopes, primarily focusing on their biases. Based on extensive measurements, we determined accelerometer and gyroscope noise models and bias variation ranges. Then, we compiled a table of predicted positional and angular errors under various biofeedback system operation conditions. We suggest several bias compensation options that are suitable for various examples of use in real-time biofeedback applications. Measurements within the developed experimental biofeedback application show that under certain conditions, even uncompensated sensors can be used for real-time biofeedback. For general use, especially for more demanding biofeedback applications, sensor biases should be compensated. We are convinced that real-time biofeedback systems based on smartphone inertial sensors are applicable to many similar examples in sports, healthcare, and other areas.
The effectiveness of EMG biofeedback with neurorehabilitation robotic platforms has not been previously addressed. The present work evaluates the influence of an EMG-based visual biofeedback on the ...user performance when performing EMG-driven bilateral exercises with a robotic hand exoskeleton. Eighteen healthy subjects were asked to perform 1-min randomly generated sequences of hand gestures (rest, open and close) in four different conditions resulting from the combination of using or not (1) EMG-based visual biofeedback and (2) kinesthetic feedback from the exoskeleton movement. The user performance in each test was measured by computing similarity between the target gestures and the recognized user gestures using the L2 distance. Statistically significant differences in the subject performance were found in the type of provided feedback (
-value 0.0124). Pairwise comparisons showed that the L2 distance was statistically significantly lower when only EMG-based visual feedback was present (2.89 ± 0.71) than with the presence of the kinesthetic feedback alone (3.43 ± 0.75,
-value = 0.0412) or the combination of both (3.39 ± 0.70,
-value = 0.0497). Hence, EMG-based visual feedback enables subjects to increase their control over the movement of the robotic platform by assessing their muscle activation in real time. This type of feedback could benefit patients in learning more quickly how to activate robot functions, increasing their motivation towards rehabilitation.
Musical performance is a skilled activity performed under intense pressure, thus is often a profound source of anxiety. In other contexts, anxiety and its concomitant symptoms of sympathetic nervous ...system arousal have been successfully ameliorated with HRV biofeedback (HRV BF), a technique involving slow breathing which augments autonomic and emotional regulatory capacity.
This randomised-controlled study explored the impact of a single 30-minute session of HRV BF on anxiety in response to a highly stressful music performance.
A total of 46 trained musicians participated in this study and were randomly allocated to a slow breathing with or without biofeedback or no-treatment control group. A 3 Group×2 Time mixed experimental design was employed to compare the effect of group before and after intervention on performance anxiety (STAI-S) and frequency domain measures of HRV.
Slow breathing groups (n=30) showed significantly greater improvements in high frequency (HF) and LF/HF ratio measures of HRV relative to control (n=15) during 5 minute recordings of performance anticipation following the intervention (effect size: η(2) =0.122 and η(2) =0.116, respectively). The addition of biofeedback to a slow breathing protocol did not produce differential results. While intervention groups did not exhibit an overall reduction in self-reported anxiety, participants with high baseline anxiety who received the intervention (n=15) displayed greater reductions in self-reported state anxiety relative to those in the control condition (n=7) (r=0.379).
These findings indicate that a single session of slow breathing, regardless of biofeedback, is sufficient for controlling physiological arousal in anticipation of psychosocial stress associated with music performance and that slow breathing is particularly helpful for musicians with high levels of anxiety. Future research is needed to further examine the effects of HRV BF as a low-cost, non-pharmacological treatment for music performance anxiety.
Purpose
Hematologic patients have a poorer health-related quality of life due to the disease and its treatments. Non-pharmacological interventions represent an opportunity in tertiary cancer ...prevention to manage persistent symptoms and support patients in their return to active daily living. This interventional study aimed to evaluate the feasibility of a program combining physical exercise (PE) and heart rate variability biofeedback (HRVB) in hematologic patients.
Method
Hematologic patients in remission within 6 months participated in a 12-week rehabilitation program including 24 supervised sessions of PE associated with 10 supervised sessions of HRVB and daily home-based practice of paced breathing. We assessed patient adherence, fatigue, physical function, and heart rate variability.
Results
Twenty patients were included, 17 completed the protocol and 3 dropped out due to disease progression or time constraints; no adverse events or incidents were reported. Participation rates were 85% for PE and 98% for HRVB-supervised sessions. Significant improvements of physical capacity (6-min walk test,
p
< 0.001; 50-foot walk test,
p
< 0.001), muscle strength (grip force test,
p
< 0.01), and flexibility (toe-touch test,
p
< 0.001; back scratch test,
p
< 0.05) were measured. Coherence ratio (
p
< 0.001) and low-frequency spectral density of HRV signal (
p
< 0.003) increased significantly, suggesting improved autonomic function. Fatigue, static balance, and other time and frequency indicators of HRV were not improved (all
p
> 0.05).
Conclusion
A rehabilitation program combining PE and HRVB is feasible in hematologic patients and effective on physical function. Further research with a larger sample size is needed to investigate effectiveness on patients’ autonomic functions and their impacts on symptomatology.
PDF
