What is Biofeedback q Its a Therapy i
What is Biofeedback? q It's a Therapy, i. e. type of treatment where people are trained to improve their health by using Signals from their own bodies q Provides the patient immediate Auditory and/or Visual information about Physiological Process q By watching the monitor and listening to the sound the patient gets the Feedback information and can adjust thinking and behavior. q The Goal in Lower GI is to Improve Pelvic Floor Dysfunction by teaching patients to change physiologic responses FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Biofeedback in Lower GI q Voluntary Sphincter contractions are recorded. Abdominal pressure as well Efferent Sphincter EMG q Feedback sent to patient (display and/or sound) Abdominal Pressure q Patient actions: S 2 S 3 S 4 To increase sphincter contraction Motor Internal Sphincter External Sphincter To decrease abdominal pressure FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Pelvic Floor Training EMG + Pressure Effort EMG curve area EMG Ura Vag Anal Straining = Effort Index Pabd 5" Duration Increased 7" 4" 18" FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Patient Selection Process q Evaluate patient - diagnostic tests: AFT/ others q Diagnose patient i Incontinence i Constipation i Others q Evaluate whether this patient would benefit from Biofeedback FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Pathologies Non-Neurogenic Origin Incontinence Stress Fecal Incontinence due to: q Weak external Sphincter q Dyssynergia IS/ES to Rectum q Pelvic Floor Muscles Dysfunction Constipation q Due to Anismus FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Biofeedback Process q Perform first biofeedback training in clinic q Help patient train at home q Perform biofeedback assessment in clinic to evaluate progress i Change difficulty level q More home training q Etc. . . FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Polygraf ID® Concept i Sprite moves up/ down according to patient activity i Lane moves right to left i Patient tries to follow the lane Lane Sprite FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Protocol Settings q Primary (and secondary) channel q Capture display rate i. Lane (Squeeze, Relax) Initial wait Time response Duration Target level Tolerance Number of repetitions i. Graphics for lane, above lane, Time response Amplitude Time Squeeze FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Running Biofeedback q Run non-saving mode “Monitoring/ Set-up phase” Change of protocol must be done before you enter saving mode q Run saving mode 1 or more recordings (training paradigms) FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Reviewing Biofeedback q Review i. Lane displayed i“Hidden” markers - bar i. Calculations (mouse over) q Report i. Protocol used i. Fulfillment in percent (percentage time within lane) i. Relax, squeeze, total FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
With Polygraf ID® Polygraf ID q Various background screens are available q Curves analysis to quantify training and improvement FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Pelvic Floor Training EMG + Pressure I try to Contract or relax my Sphincters and keep my Abdominal Wall Relaxed ! Anal Sphincter and Abdominal Pressure activity FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Pelvic Floor Training Two EMG Sphincter or Vaginal EMG and Suprapubic EMG FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Accessories EMG Electrodes Pressure Measurement 1. DPT Pressure Transducer 1. Disposable Surface 2. Disposable Anal and Vaginal Sponge 3. Reusable Anal Plug With extension line & flushing syringe 2. Abdominal Catheter a. Opened-end - F 8 b. Balloon With Abdominal catheter insertion lumen 2 b 9021 P 4221 2 a 3 9013 K 0782 9013 K 0792 1 9021 S 0231 9013 S 0221 2 1 9021 P 1091 9013 L 4811 9021 L 0203 FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Polygram Net Biofeedback Application Enhancement wishes with the migration: q Progress report that evaluate the patients improvements over time. q Fine tuning of the track directly from the education view - by moving the lane/track to the patients performance level q A count-down window showing performed/to go procedures (in capture) FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
Thanks! FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL
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