Neuroscience is a modern computer-based therapeutic technology based on the principles of adaptive feedback. The basic concept of biofeedback boils down to the fact that information about one’s own functional state, obtained through sensors in real time, allows the operator (subject, patient) to easily learn how to improve normal and correct impaired physiological function with the participation of voluntary and involuntary self-regulation mechanisms.
Biofeedback is a unique psychophysiological technology that can be considered as an effective way to solve complex problems such as the formation of the optimal functioning state.
- Computer bio-control systems allow you to determine the physiological markers of emotional stress, assess the current psychophysiological state by a number of physiological parameters: EEG rhythms, electromyogram (muscle tension), skin temperature, heart rate, respiratory rate, skin-galvanic reaction.
- with the help of biofeedback, you can learn to manage various physiological functions: optimize the respiratory rate based on the ratio of the duration of inhalation/exhalation; reduce muscle tension; normalize heart rate, peripheral temperature, skin-galvanic response; and also develop skills for rapid recovery after emotional and physical exertion.
- optimal functioning Training, which combines the use of basic biofeedback and neurofeedback technologies, teaches activation methods (readiness for action), maintaining a high level of performance over a long period of time, and skills for achieving calmness and concentration. To do this, a computer simulation of the game plot is used, which is controlled by the physiological functions of the trainee. To win in such a game is possible only by applying effective strategies of behavior, control and self-regulation of the psycho-vegetative status.
It is known that a large number of psychophysiological tests are used to assess the degree of readiness for optimal functioning in a difficult situation, among which procedures that simulate professionally significant situations have recently begun to play an important role. These include psychophysiological models of competition and behavior in situations of uncertainty, as well as performing complex motor and cognitive tasks under limited time conditions. The result of such tests is information recorded by the computer system about the body’s physiological responses to stress and the quality of subsequent recovery according to indicators of the cardiovascular, muscular and respiratory systems, and brain biorhythms.
This data together with the results of psychological testing are used to form an individual training protocol for optimal functioning.
2. Areas of application of biofeedback
2.1. Clinical practice of biofeedback
The most widespread use of biofeedback is found in the clinic of borderline, psychosomatic disorders and a large group of organic diseases of the nervous system. BOS-training is a unique method that promotes the development of visceral perception processes, fine differentiation of internal sensations and emotions. Awareness of body signals is an important predictor of success in mastering the biofeedback method. The method of bio-management can be both an independent psychotherapeutic technique and an effective tool that helps the doctor to achieve a more pronounced and lasting therapeutic effect in the psychotherapeutic context.
In the clinic of nervous diseases, bio-management methods in the electromyogram have demonstrated high effectiveness in the treatment of post-stroke hemiparesis, spinal cord injuries, cerebral palsy, spastic torticollis, and facial nerve neuropathy. EEG-BOS training is not used without success in the treatment of epilepsy. However, many authors consider the use of biofeedback training in the treatment of headaches, especially migraine headaches, to be the cornerstone of clinical biofeedback.
HeadacheThus, cooling the hands serves as a signal of stress onset, and acquiring the skill of arbitrary control over the temperature of the fingertips of the extremities is an effective way to expand the vessels of the extremities, reduce blood pressure, increase peripheral resistance, and ultimately, to prevent the development of mental and emotional stress or reduce its level.
One of the most common symptoms in neurotic, neurosis-like, and affective disorders. In the treatment of migraines, it is believed that temperature BOS training is more effective. It is known that the stress response is accompanied by the centralization of blood circulation, "pumping"; blood flow to vital organs, increased blood PRESSURE, accelerated blood flow, decreased blood flow to the extremities, and peripheral vascular spasm.
Training to increase the temperature of the hands helps to reduce sympathetic activation, causes physiological changes that can interrupt the onset of a painful attack. Analysis of the patient’s experiences and images during the training allows them to understand their role in the occurrence of pain and prevent its occurrence.
Treatment of patients with motor disorders after spinal injuryV. Brucker and N. Bulaeva investigated the effects of BOS in patients with spinal injury. The study involved 100 patients with quadriplegia. The time elapsed after the injury ranged from 1 to 29.7 goals. It has been found that BOS can significantly increase the volitional EMG response of certain muscle groups below the level of injury. It has also been shown that the effectiveness of the BOS technique in patients with spinal injury does not depend on the duration of the post-injury period, initial muscle tension, and function or initial volitional control of the EMG response. Many patients with an initial lack of EMG response were able to achieve it with the help of BOS training, the Increase in EMG response was very significant from 20% to 40%.
Traditionally, spinal cord injuries are considered as disorders with a pessimistic prognosis, which becomes more and more disappointing as time passes. The first data on the successful application of biofeedback methods in spinal injury date back to the 70s, when 6 cases of achieving a good clinical effect in patients with damage to the cervical spine and spinal cord were described.
Thus, EMG-BOS training can take a worthy place in the rehabilitation system of patients with the consequences of spinal injury.
Biofeedback training for patients with strokeIn the treatment of motor disorders, the most actively used biofeedback by electromyogram. The aim of training in electromyogram of patients with post-stroke hemiparesis is to increase voluntary muscle activity in paretic muscle groups, as well as to improve voluntary control of pathological friendly movements (coordination synkinesias). At according to the L. A. Chernikova and E. M. Sashina in the result of learning from the vast number of patients can increase the average volume of active movements and a marked reduction of the degree of paresis, and also increase the amplitude of electroactivity arbitrary cuts in paretic muscles.
One of the most promising areas is the use of the BOS training method in the rehabilitation program for people who have suffered a stroke. An important role in the clinical picture of post-stroke motor disorders belongs to disorders of psychophysiological mechanisms of movement control.
The high efficiency of the method has been demonstrated in the treatment of hyperkinetic syndrome. It is known that in patients with post-stroke hemiparesis, there is an asymmetry of the vertical posture with a mixture of the center of gravity of the body and the side of the healthy leg. In order to correct this disadvantage, which increases the risk of falling, an original development of balance-Biot training is proposed, which is based on the use of a stabilographic complex that registers the current coordinates of the projection of the center of the body by the reactions of 3 supports and displays stabilograms on the monitor screen. Studies conducted on a large number of patients have shown the effectiveness of balance therapy in training the balance function in patients with post-stroke hemiparesis.
Biofeedback therapy in psychiatric and psychotherapy practiceIdentifying the active onset of biofeedback and the so-called placebo effects when evaluating the effectiveness of biofeedback therapy in these cases creates serious problems. A successful attempt to analyze the role of the placebo effect and the identification of the active start of biofeedback was made by A. B. Skok in the study of the effectiveness of alpha-0 training for the treatment of patients with alcohol and drug addiction.
The possibilities of bio-management in the field of psychiatry and psychotherapy are much less studied than in other areas of medicine (therapy, neurology, psychosomatic medicine). There are few publications on this topic, although the number has increased somewhat in recent years. In psychotherapeutic practice, the method of bio-management has become widespread in the treatment of neurotic (phobic disorders, obsessions), anxiety, and additive disorders. In child psychiatric practice, the effectiveness of BOS training is noted in the treatment of disorders associated with attention deficit and hyperactivity disorder (EEG-BOS). The effectiveness of the biofeedback method in psychotherapy depends on many non-specific factors.; factors such as personal characteristics and competence of the psychotherapist, the presence of a psychotherapeutic doctor-patient Alliance, additional methods that combine BOS training.
Biofeedback via EEG
Of particular interest is the use of BOS for electroencephalogram. The discussion about the nature and effects of EEG-BOS has been going on for 30 years. The clinical application of EEG-BOS methods is developing in 4 directions:
- By slow cortical potentials for treating epilepsy and improving operational intelligence functions
Slow cortical potentials (MCP)these are EEG waves of very low frequency (less than 1 Hz). Negative episodes on an electroencephalogram lasting more than 300 MS cause arousal or activation (depolarization) of apical dendrites. The most important thing is to demonstrate the correlation between negative EEG shifts and shortening the response time to the signal, as well as improving short-term memory. Volitional control of the MCP allows you to reduce the frequency of seizures and reduce their intensity
- SMR-training for the treatment of epilepsy. SMK training is used in combination with beta-stimulating training
The phenomenon of SMR activity was first described in 1967. it was found that experimental animals quickly learn to change their bioelectric activity in this range and that changes in activity in this range are accompanied by an increase in tolerance to chemical agents that cause seizures
- Alpha and theta training in drug treatment practice
alpha;- theta;-Training refers to the number of methods that cause the greatest number of questions throughout the entire existence of EEG-BOS methods. Estimates of the method’s effectiveness range from extremely low to completely optimistic. Interest in alpha;- theta;-training arose after the publication devoted to the use of this method for the treatment of alcoholism patients. The lack of a common terminology and problems with reproducing research protocols allowed a number of authors to be very skeptical about the possibility of volitional control of EEG patterns, including in the treatment of addictive disorders. The situation around "alpha" training as the most "scandalous" method from the "EEG-BOS" group remained almost unchanged until the appearance of works on separate stimulation "alpha".;- activity in the left and right hemispheres. The result of separate alpha training is not a change in the current emotional state, but a change in the ability to respond to positive and negative emotional stimuli
- Beta training in pediatric practice
One of the most fully studied areas of application of EEG-BOS is beta-stimulating BOS. β — Stimulating training has found application in the treatment of widespread childhood pathology attention deficit hyperactivity disorder. The use of BOS for the beta rhythm is based on the neurobiological features of this condition. Slow EEG patterns found in the Central and frontal cortex are a reflection of impaired metabolism, reduced cerebral blood flow, and reduced oxygen utilization. Altered EEG activity may indirectly indicate a change in the function of neurotransmitters in these areas. It can be thought that BOS, by changing the electroencephalogram, affects the functions of neurotransmission and cerebral metabolism
- By slow cortical potentials for treating epilepsy and improving operational intelligence functions
2.2. Neuromyopathies in sports
Leading position in sports practice among methods based on biofeedback, neurobioadministration took over. A significant number of papers have been devoted to the study of the possibility of using neurobioadministration in the training of athletes [1-8]. However, the aftereffect of the neurobioadministration course is currently insufficiently studied, which causes some coaches to doubt its safety and effectiveness, and leads to limited use of this technology in sports. In connection with this, the aim of the work was to study the dynamics of the psychophysiological state in athletes aged 18-23 years who completed a course of neurobiological management aimed at increasing the power of the alpha rhythm of the brain during the year.
The study made it possible to draw the following conclusions: the dynamic rearrangements of the bioelectric activity of the brain in athletes who have completed the course of neurobioadministration depend on the initial power of the alpha rhythm of the brain.
alpha-stimulating training has a positive effect on the psychofunctional state of athletes. Depending on the initial power of the alpha rhythm of the brain and the success of the course of neurofeedback, athletes experience urgent and delayed effects of training. The extinction of the achieved effects of the training is gradual and heterochronic. No negative effects of the course of neurobiological management were revealed.
2.3. Bio-management in musical activity optimization
Arbitrary control of reducing the integral power of the EMG and, conversely, increasing the power of the alpha and SMR ranges of the EEG. Was able to determine the optimality of a musician contractor: to improve intonationally musical perception, the ability of self-control logomasini coordination, rational organization of traffic, which was also reflected in the predominance of alpha rhythm and SMR EEG rhythms, decrease the integral power of the muscles not directly involved in game movement.
Psychomotor dysfunction of performing activities associated with a violation of optimal functioning can be corrected with the help of biofeedback technology.
2.4. Stress correction adaptation for medical students
Course training with biofeedback increases the integral health index, reduces personal anxiety and reactive anxiety, and improves academic performance. The effectiveness of BOS training was highest in the group of students with a low value of the integral health index.
After the BOS-training procedure, students noted feelings in the form of pleasant fatigue, drowsiness, and a decrease in the state of anxiety. A negative point in the BOS training is a certain monotony, which is noted by students who have completed a full course of correction.
2.5. Game bio-management — help in adaptation to school stress
The plot of the games is controlled by the heart rate using a special heart rate sensor that registers the signal and transmits it to the computer. Virtual competition, in which the player’s speed is inversely proportional to the heart rate, is a psychophysiological model of a stressful situation, performed in the form of a game.
All students who completed the course of game computer bio-management demonstrated the ability to effectively master the methods of self-regulation and control their emotional state in a situation that simulates stress.
Psychophysiological and General therapeutic direction, such as bio-management, is on the rise. Prospects for its development are provided by the features of multiparametric monitoring, which is the basis of bio-management, the availability of flexible mathematical models and developing algorithms for data evaluation. In recent years, the technology has become extremely diverse, and new "growth points" are being outlined; (BOS in hyperventilation syndrome by the concentration of carbon dioxide in the exhaled air, game versions of BOS training).
Long-forgotten modifications of biofeedback (EEG biofeedback training in combination with multi-channel mapping) are getting an unexpected development. There are good reasons to believe that practical health care and medical science have acquired a new effective non-drug method of treatment and prevention. As a result of this approach, the possibility of developing a person’s potential increases due to the study and correction of stressful States and activation of his resource state in conditions of high information density.
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