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Jeffrey Ellens, Iowa State University Student Counseling Service, demonstrates the university's newest stress buster for students. Biofeedback's working principle is based on information from the body coded into an appropriate signal and provided back to the user in real time. The neurological mechanisms underlying the effectiveness of biofeedback training are still debated. The concept of task-oriented (functional) repetitive training suggests that biofeedback should be delivered during a functionally-related movement to optimize motor function (Ref: 3).
The clinician and patient decide that the main exercises should aim to ameliorate her gait, by increasing step length, and to improve balance, by correcting trunk posture, the preferred feedback is the audio one, to be modulated according to trunk position. Brain and muscle activities that are not normally controlled voluntarily may be changed according to the new available information (Ref: 1, 2). Biofeedback may enhance neural plasticity by engaging auxiliary sensory inputs, thus making it a plausible tool for neurorehabilitation and for a variety of population.
Only a few studies have evaluated different types of biofeedback in subjects with Parkinson’s disease (PD).
Her major motor symptoms include: movement start hesitation, slow gait characterized by short step, and poor balance control. She is trained for a couple of hours in the clinical center, and then she is assured with on-site technical assistance if necessary. Scientific evidence, and preliminary validation, on effects of cueing and rhythm for gait improvement with important results in patients show freezing of gait (Ref: 6, 7). Her clinician recommends her a rehabilitative program to be performed at home, by means of a new service and system based on recent technology.
With help from a biofeedback therapist, you can learn to change your heart rate or blood pressure, for example. Before each training session starts, she records a self-assigned score about her motor status.
At first you use the monitor to see your progress, but eventually you will be able to achieve success without the monitor or electrodes. Created and directed by Student Counseling Service staff psychologist Todd Pietruszka, the center is free and open to all ISU students. The clinician is so able to see if her evaluation (which can be strongly affected by mood and cognition) is in accordance to the objectivity that the system can measure. Iowa State is the first of the three Regents' universities to offer a biofeedback service to address students' emotional needs.Biofeedback uses technologies like video games and guided meditations to teach relaxation techniques, concentration skills and healthy coping responses.


The at-home rehabilitation exercise (consisting of 20 minutes walking with the audio biofeedback, and balance exercise with music on a daily base) will last for 6 weeks, after which a new medical examination will be performed in the neurological care center. For those who respond to stress with a parasympathetic response, the explanation must be couched in these terms, again, with the aim of training being the balancing of the two systems. Medical examination will be done after a wash out, and then results evaluated to possibly perform a further stage of the rehabilitation protocol.
These unconscious psychological occurrences offer insight into corresponding emotional responses. Biofeedback teaches people to become aware of their physiological responses, while providing techniques -- like deep breathing, visualization or mindfulness -- to consciously reset the body's conditioned responses. For example, when you take your temperature and find you have a fever, you might call the doctor."Quiet space away from the daily grindIowa State's Biofeedback Center is a compact room with three massage recliners, each facing its own wall-mounted computer monitor. They may also learn to respond automatically to stress by contracting, for example, in the area of the neck and shoulders. Students start with an orientation session that explains how to check out and use the equipment, and how to navigate the computer programs.
Just as we can change habitual typing errors, or learn to swim more efficiently, so can we eliminate maladaptive psychophsyiological patterns and learn more adaptive patterns.
The equipment fits into a case about the size of a portable CD player and consists of finger sensors, mouse pad and earphones. Clinical biofeedback also involves learning relaxation techniques, using the instruments to the practitioner and client toward processes that are most effective for the client. Sitting in the recliners, the students wear noise-cancelling headphones and fingertip sensors, which measure skin conductance and heart rate. As students practice the relaxation techniques presented, they can watch real-time graphs of their physiological responses. The client is responsible for between-session practice of relaxation or other homework techniques and for maintaining awareness of symptom patterns as the relate to life-style factors.
Once mastered, they can use the techniques whenever needed--before taking a test or giving a class presentation, for example. Sessions can last from 15 minutes to an hour or more,"The training module teaches how to become aware of your body, how to use breathing, how to become mindful of your thoughts," Pietruszka said.
The temperature and weight readings from these devices give “feedback” about your body to tell you whether you have a fever or have gained weight. In a similar way, biofeedback therapists use specialized equipment to train patients how to improve their health by using signals from their own bodies.


Some relaxation tools taught in the computer programs include meditation techniques, mindfulness (a calm awareness of one's physical and emotional state) deep breathing exercises, visualization and guided recitations. Two of the programs use fantasy-based game environments to present guided activities for meditation and emotional control."Once you learn the processes, you don't need to come to the center to practice them in your life," Pietruszka said.
The therapist attaches sensors or electrodes to the body and these sensors provide a variety of readings–feedback–which is displayed on the equipment for the patient to see. These are things you can do in a public crowd, no one would know you're doing them."In addition to addressing anxiety issues, biofeedback can help students who struggle with concentration, or have difficulty with negative or self-critical thoughts. With this information, patients can learn to make changes so subtle that at first they cannot be consciously perceived. The ultimate goal is emotional control," Pietruszka said."The process of quieting the mind has a lot of benefit beyond calming anxiety," he said.
People with urinary or fecal incontinence or other pelvic floor disorders can achieve improved bladder control.
What happens during a biofeedback session? In a normal biofeedback session, electrodes are attached to your skin.
They send information to a small monitoring box that translates the measurements into a tone that varies in pitch, a visual meter that varies in brightness, or a computer screen that shows lines moving across a grid. Appointments are required for the orientation session only; walk ins are welcome for subsequent sessions.
To schedule an orientation session, call (515) 294-5056.It is not necessary to be a client of the Student Counseling Service to use The Biofeedback Center. For example, it shows promise for treating urinary incontinence, which is a problems for more than 15 million Americans. Based on findings in clinical studies, the Agency for Health Care Policy and Research has recommended biofeedback therapy as a treatment for urinary incontinence. Treatment of headache, incontinence, and Raynaud's disease requires at least 10 weekly sessions and some follow-up sessions as health improves. Conditions like high blood pressure, however, usually require 20 weekly biofeedback sessions before you see improvement.



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