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  • Writer's pictureRobin R Varghese, PT.

Biofeedback in Physical Therapy


  • Biofeedback is used to control automatic body functions such as heart rate, muscle tension, breathing, perspiration, skin temperature, blood pressure and even brain waves.

  • It is an evidence-based approach to improve the ability to modify involuntary processes consciously.

  • It enables the individual to increase awareness of the process and gain conscious control.

  • Thus, helps to improve your medical condition, relieve chronic pain, reduce stress, or improve your physical or mental performance.

What is the mechanism behind it?

  • There are two major components of the autonomic nervous system, the sympathetic and the parasympathetic systems. The parasympathetic works in particular at rest and recuperation while the sympathetic works at efforts. Due to chronic stress the autonomic nervous system can function worse, consequently the regulation of the body may get disrupted and an imbalance between the two systems may arise.

  • While under stress, heart rate speeds up, muscles tighten, blood pressure rises, sweat excessively, and breathing hastens. The stress responses shown up on the monitor, and then get immediate feedback as per modifications made to stop them.

  • As patient slows the heart rate, lower blood pressure, and ease muscle tension, they get instant feedback on the screen. Eventually, they learn how to control these functions on their own, first without the biofeedback equipment and later without it.

  • The idea behind biofeedback is that, by harnessing the power of mind and becoming aware of what's going on inside the body, one can gain more control over one’s health.

How does it work as a mode of treatment?

  • emphasize that the technology is an aid to the outcome, not a magical solution.

  • biofeedback is not at its most effective when used as a treatment in its own right, but should be integrated with other therapeutic interventions.

  • It acts as an enhancer of the therapy, enabling the patient (and the therapist) to make more effective and rapid progress towards the rehabilitation goal.

  • Furthermore, it is useful in that it helps the patient to reduce their reliance on the therapist and become more reliant on their own performance.

  • It can be used effectively to enable the patient to take some control or ownership over their rehabilitation .

  • The key to success of biofeedback in rehabilitation is to use the device as an adjunct to therapy, to enable the patient to gain control without reliance on the therapist, and once gained, to maintain control without either the therapist or the machine.

Why do Physical Therapists use biofeedback?

  • Physical therapists use biofeedback to help refine a movement sequence or activation pattern to assist patients to achieve a goal.

  • visual, physical and/or auditory feedback may be used to guide the patient to give their optimal performance

Strategies used:

  • Direct feedback where a numerical value is displayed on a wearable device, such as a watch.

  • Transformed feedback the measurements are used to control an adaptive auditory signal, visual display or tactile feedback method.

Categories of Biofeedback are:

  • Physiological based

The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system.

  • Biomechanical based

Biomechanical biofeedback involves measurements of movement, postural control and force.



Anxiety, Depression

Fecal incontinence

Raynaud phenomenon

Urinary incontinence


Chronic pain

Neck pain

Chronic insomnia

​Post traumatic stress syndrome

Chronic fatigue


Migraine headaches

Balance disorder




​Motion sickness

Many different forms of biofeedback are currently used in the clinical setting including:

  • Electromyography (EMG) - measures muscle tension

  • Thermal biofeedback - measures skin temperature

  • Neurofeedback/ electroencephalography (EEG) - measures brain wave activity

  • Electrodermography (EDG) - measures skin electrical activity

  • Heat Flux - measures the rate at which heat is being dissipated from body

  • Pneumography - measures abdominal/chest movement when breathing

  • Capnometry - measures end-tidal carbon dioxide

  • Hemoencephalography - measures the differences in the color of light reflected back through the scalp based on the relative amount of oxygenated and unoxygenated blood in the brain

  • Photoplethysmography (PPG) - measures peripheral blood flow, heart rate, and heart rate variability

Can there be any complications?

  • Biofeedback is a very safe and well-tolerated procedure that has minimal complications.

  • During training, it is beneficial to practice the same techniques without the biofeedback equipment as part of the overall treatment for sustained improvement.

  • Over dependence on the machine may lead to drop in the performance following its discontinuation and the treatment can have less than intended results over time and may require retraining.

At Valley Healing hands, Brownsville, Texas, we provide best physical therapy for CVA, fibromyalgia, Migraine, and many more conditions, integrated with biofeedback mechanism to achieve the best results. Our therapists are highly skilled and well trained with the biofeedback equipment and will be your right guide and trainer. Our patients are completely satisfied with our services. You may learn about it here and get connected to us here. Our patients love us and you too will.


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