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Europa Medicophysica 1999 March;35(1):3-9

Copyright © 1999 EDIZIONI MINERVA MEDICA

lingua: Inglese

Biofeedback and its use in treatments for controlling spasticity

Llorca R., Rodriguez L. P., Pascual F., Ponce J.

Departamento de Medicina Física y de Rehabilitación y Servicio de Rehabilitación del Hospital Clínico de San Carlos de Madrid, Universidad Complutense de Madrid, España

BACKGROUND: Physical ther­a­py and Rehabilitation pro­grams ­designed for spas­tic ­patients are ­focused on re-edu­cat­ing the way in ­which the dam­aged ­limbs func­tion. It nor­mal­ly ­entails meth­ods involv­ing tech­niques ­where the ­patients ­learn how to ­assume cer­tain posi­tion pat­terns, where­by spe­cif­ic ­body move­ment ther­a­py is ­used as reiforce­ment, ­thus allow­ing for ­these move­ment pat­terns to be ­learned.
METHODS: Twenty-­five hem­i­pleg­ic ­patients ­were stud­ied (20 spas­tic men and 5 spas­tic wom­en; age: X=61.00). Thirteen of the 25 sub­jects ­under ­study under­went phys­i­cal ther­a­py in addi­tion to ­being treat­ed ­with Biofeedback (BFB), the remain­ing 12 sub­jects ­being treat­ed exclu­sive­ly ­with BFB. For the suit­able eval­u­a­tion of ­these stud­ies, two dif­fer­ent ­groups of sub­jects ­were select­ed as con­trol ­groups. One con­trol ­group was com­prised of 25 ­healthy sub­jects (13 men and 12 wom­en; age: X=46.5) all of ­which ­were ­found to be neu­ro­log­i­cal­ly ­healthy. The sec­ond ­group was com­prised of 10 spas­tic ­patients (6 men and 4 wom­en; age: X=62.2). An Electromyographic BFB was ­used, in addi­tion to impe­dance relax­a­tion and tem­per­a­ture, ­plus ­false feed­back anal­y­sis and func­tion­al eval­u­a­tion.
RESULTS: For the 25 sub­jects stud­ied, it can be not­ed ­that the elec­tro­myo­graph­ic fig­ures indi­cate a ­drop fol­low­ing the ses­sion, and ­that the impe­dance and tem­per­a­ture lev­els ­increase. The func­tion­al eval­u­a­tion ­reveals an ­increase in vol­un­tary move­ments fol­low­ing treat­ment and the ­results do not indi­cate any rela­tion­ship ­with the phys­i­cal ther­a­py car­ried out or ­with the ­lapse of ­time dur­ing ­which the dis­ease had ­been pro­gress­ing. The con­trol ­group com­prised of ­healthy sub­jects ­showed the ­same ­results, dif­fer­ing in ­such ­that ­their fig­ures ­fell with­in nor­mal ­bounds. No phys­i­cal ther­a­py was car­ried out, nor any func­tion­al eval­u­a­tion per­formed. The con­trol ­group com­prised of spas­tic ­patients for ­whom a ­false feed­back was ­used ­showed a neg­a­tive ­response and the elec­tro­myo­graph­ic, impe­dance and tem­per­a­ture find­ings hard­ly var­ied.
CONCLUSIONS: In our ­study con­duc­tance ­rose ­when the ­patient ­relaxed. The ­skin’s con­duc­tance is direct­ly relat­ed, in a pos­i­tive ­sense, to the lev­el at ­which the sym­pa­thet­ic ner­vous ­system is func­tion­ing. When relax­a­tion is ­achieved, con­duc­tance decreas­es con­sid­er­ably.