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FUNCTIONAL DIAGNOSTICS

Biofeedback. FUNCTIONAL DIAGNOSTICS. Copyright MFD 2001 - Any kind of reproduction is prohibited. Biofeedback . It's a Therapy , i.e. type of treatment where people are trained to improve their health by using Signals from their own bodies.

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FUNCTIONAL DIAGNOSTICS

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  1. Biofeedback FUNCTIONAL DIAGNOSTICS Copyright MFD 2001 - Any kind of reproduction is prohibited

  2. Biofeedback • It's a Therapy, i.e. type of treatment where people are trained to improve their health by using Signals from their own bodies • Provides the patient immediate Auditory and/or Visual information about Physiological Process • By watching the monitor and listening to the sound the patient gets the Feedback informationand can adjust thinking and behavior. • The Goal in Lower GI is to Improve Pelvic FloorDysfunctionby teaching patients to change physiologic responses

  3. Biofeedback • It's a Therapy, i.e. type of treatment where people are trained to improve their health by using Signals from their own bodies. • Provides the patient immediate Visual information about Physiological Process. • By watching the monitor the patient gets the Feedback • informationand he can adjust his thinking and behavior. • The Goal is to Improve Pelvic Floor Functionby teaching patients to change physiologic responses Descending Anal kanal S2 S3 S4 Motor

  4. The biofeedback process • Perform first biofeedback training in clinic • Help patient train at home • Perform biofeedback assessment in clinic to evaluate progress • Change difficulty level • More home training • Biofeedback assessment to evaluate progress • Change difficulty level

  5. The Patient Selection Process • Evaluate patient - diagnostic tests: AFT/others • Diagnose patient • Incontinence • Constipation • Others • Evaluate whether this patient would benefit from Biofeedback (patient must be capable to cooperate)

  6. Pathologies Non-Neurogenic Origin Incontinence • Stress Fecal Incontinence • Weak external Sphincter • Dyssynergia IS/ES to Rectum • Pelvic Floor Muscles Dysfunction • Constipation • Due to Anismus

  7. Polygraf ID With Polygraf ID® • Various background screens are available • Curves analysis to quantify training and improvement

  8. Biofeedback • Marketing package; • Product flyer • Summaries of reference articles • Sample reports • Example Data Export files • Training program

  9. Biofeedback Protocol Settings • Primary (and secondary) channel • Capture display rate • Track (Squeeze, Relax) 1) Initial wait 2) Response time 3) Duration 4) Target level 5) Tolerance 6) Number of repetitions • Graphics for lane, above lane, below lane and sprite (BMP files) • Sound (wave file) 5 4 1 2 3

  10. Running Biofeedback • Run non-saving mode • Important: Change of protocol must be done before you enter saving mode • Run saving mode • 1 or more recordings (training paradigms) • Review • Lane displayed • “Hidden” markers - bar • Calculations (mouse over) • Report • Protocol used • Fulfillment in percent (percentage time within lane) • Relax, squeeze, total

  11. I try to Contract or relax my Sphincters and keep my AbdominalWallRelaxed ! SPHINCTER ABDOMINAL Sphincter and Abdominal Muscle activity Pelvic Floor Training constipation

  12. EMG measurements in general • What is measured? • Muscle electrical activity over a bundle of muscle fibers

  13. EMG measurements in general • How is it measured? • Absolute: • Pre-calibrated with a known amplifier and sensor sensitivity. • Measured in mV • Relative • Patient relaxation and maximum squeeze is the calibration points. • Measured in percent

  14. EMG measurements in general • How does the EMG filter in Polygram 98 work? • Rectifies incoming signals • Signal smoothing: • High pass filter • 0.2 second time constant

  15. Review • Lane displayed • “Hidden” markers - bar • Calculations (mouse over) • Report • Protocol used • Fulfillment in percent (percentage time within lane) • Relax, squeeze, total Reviewing Biofeedback

  16. EMG Electrodes Pressure Catheters 1. Disposable Surface 2. Disposable Anal and Vaginal Anorectal 3. Reusable Anal Sphincter With Abdominal catheter insertion lumen 1 3 2 Accessories

  17. FUNCTIONAL DIAGNOSTICS Thanks !

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