ERIC R. FOGEL
This chapter focuses on selected biofeedback techniques for specific applications in physical therapy and muscle reeducation. I discuss the rationale and limitations of specific clinical biofeedback techniques that can help patients become more aware of how to use their bodies and aid their learning.
The therapy techniques of physical rehabilitation differ in many ways from other biofeedback interventions. The differences include the patient's neurological status, structural deformities, and levels of awareness. The feedback process is "assistive," because the feedback information acts as an adjunct to the therapist's knowledge and skills in assisting the therapy.
Using biofeedback instrumentation expands the patient's natural and internal biofeedback by making the patient more aware of self-induced changes. Physical and occupational therapies always try to help patients increase their physiological self-regulation within their natural environments. External biofeedback offers unique chances for such help to be more direct and effective. The major advantages are the increased speed of the information and the therapist's more accurate observation of the physiological activity and changes. Therapists help patients change their awareness and reactions, and help them incorporate new physical activities into new routines and habits.
To work more effectively with biofeedback, all therapists from all disciplines should understand learning theories, including operant conditioning. Therapists set up goals and help patients develop new skills, feelings, routines, and functions that improve patients' lives. There is a constant need for reassessment and changing of therapy programs. Therapy is an interaction between the therapist and the patient, with the biofeedback instrument functioning as an observer and partner. There are conditions when patients need feedback time alone to practice newly developed skills and further advance these skills toward becoming habits. I do not advise leaving rehabilitation patients alone with augmented biofeedback when they are first trying to change physiological activity.